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Nevada Pharmacy Licensing Form Guide
The current Nevada State Board of Pharmacy application includes an Affidavit for Pharmacy License for pharmacies that are not currently performing sterile compounding. An out-of-Nevada pharmacy using that section must have an authorized person certify the pharmacy's statements concerning sterile compounding and shipments into Nevada.
The affidavit contains subscribed and sworn wording, so the notarial act is a jurat. The authorized signer must personally appear before the notary, take an oath or affirmation, and sign the affidavit in the notary's presence. A previously signed affidavit should not be presented as though it were an acknowledgment.
Lake Mead Mobile Notary can perform the jurat when the authorized signer is available in Nevada with the completed application and acceptable identification. We do not determine whether the pharmacy qualifies for licensure, whether the sterile-compounding affidavit applies, who has corporate authority, or whether the Board will approve the application.
Official Application
The Nevada State Board of Pharmacy now uses a combined Pharmacy Application for Nevada and out-of-Nevada facilities. The current application is revised June 11, 2024, and places the notarized affidavit in Section 10.
The application includes a facility-location selection for an out-of-Nevada pharmacy and requests the pharmacy, ownership, service, pharmacist, and supporting-document information relevant to Board review.
The section is titled “Affidavit for Pharmacy License” and is marked for pharmacies not currently performing sterile compounding.
It should be treated as one section of the pharmacy licensing packet rather than as proof that every out-of-state pharmacy has the same operational facts or filing requirements.
Application versions, supporting records, meeting appearances, sterile-compounding materials, and other requirements may change. Confirm current instructions with the Board when the pharmacy's circumstances are not straightforward.
Review the Nevada State Board of Pharmacy business applications page for the current pharmacy application and related business forms.
Sworn Statements
The authorized signer is making specific sworn statements about sterile compounding and the pharmacy's obligations before shipping sterile compounds into Nevada.
The signer states a title and certifies that the signer is authorized to speak on behalf of the named pharmacy.
The affidavit is designated for a pharmacy that is not currently performing sterile compounding and certifies that, upon licensure, the pharmacy will not perform sterile compounding or ship sterile compounds into Nevada.
The signer acknowledges that the pharmacy must first notify the Board in writing and obtain written approval before performing sterile compounding or shipping sterile compounds into Nevada.
The affidavit states that an authorized pharmacy representative may be required to appear before the Board if approval for sterile compounding or shipment of sterile compounds is later requested.
The signer acknowledges that the pharmacy and staff may be subject to Board discipline for performing or shipping sterile compounded products without prior written authorization.
The signer swears or affirms that the affidavit's assertions are true and correct to the best of the signer's knowledge and belief.
Notarial Act
“Subscribed and sworn to” wording requires the signer to take an oath or affirmation and sign while personally appearing before the notary.
The authorized signer must personally appear before the notary. A coworker, corporate contact, courier, or application preparer cannot present the affidavit for notarization on the signer's behalf.
The notary asks the signer to swear or affirm that the statements in the affidavit are true. The signer must respond directly.
Do not sign the affidavit section before the appointment. A jurat differs from an acknowledgment because the notary must witness the affiant sign.
Lake Mead Mobile Notary requires acceptable original, current physical identification for an in-person appointment. A photograph, screenshot, scan, or photocopy of identification is not accepted.
Authorized Affiant
The affidavit does not provide a universal list of acceptable job titles. It requires the signer to state a title and certify that the signer is authorized to speak on the pharmacy's behalf.
The applicant must identify the person who has organizational authority and sufficient knowledge to make the sworn statements. The notary cannot appoint or approve that person.
Complete the signer's name, title, and pharmacy name exactly as directed by the application and the pharmacy's authorized licensing contact.
The signer must be willing and able to swear or affirm to the affidavit. Questions about the statements or their regulatory consequences should be resolved with the Board or pharmacy counsel before the notary appointment.
Identification of the signer does not prove that the person is an officer, pharmacist, owner, manager, employee, or authorized representative of the pharmacy.
Appointment Preparation
Use the current Board application and bring the complete Section 10 affidavit. Do not rely on an older saved out-of-state application without confirming that the Board still accepts it.
Complete the signer's name, title, pharmacy name, and applicable non-signature fields, but leave the affidavit signature blank for the jurat.
The signer must personally appear with an original, current physical government-issued identification document acceptable to the notary.
The pharmacy should decide who will execute the affidavit and confirm the person's title and authority before the appointment.
Obtain written or direct Board guidance when sterile compounding, a service modification, a change of ownership or location, or another nonstandard licensing issue affects the application.
For an in-person Lake Mead Mobile Notary appointment, the signer must be physically present at the agreed Nevada location. Call before booking when the signer is outside Nevada.
Booking Guidance
Book after the current form, signer, authority, and sterile- compounding status have been confirmed.
Select this when Section 10 is the only document requiring notarization and one authorized signer will personally appear in Nevada with acceptable identification.
Select this when two to four separate prepared licensing, corporate, or regulatory documents require notarization during the same appointment.
Call or text (702) 748-7444 before booking when several representatives, several pharmacy applications, or more than four notarized documents are involved.
Contact us before scheduling. The signer’s location, the form of notarization, and the Board’s acceptance requirements must be confirmed before an appointment type is selected.
Do not schedule yet when the pharmacy is unsure whether Section 10 applies, who is authorized to sign, whether sterile compounding will occur, or which application version and supporting documents the Board requires.
Regulatory Review
A completed jurat is only one part of the application. The Board evaluates the pharmacy, application, ownership, pharmacists, services, inspections, supporting records, and any required appearance.
The notarial certificate confirms the jurat for the identified signer. It does not authorize the pharmacy to operate or ship pharmaceutical products into Nevada.
The current application identifies supporting records for out-of-Nevada pharmacies and states that a Board appearance may be required depending on the application.
A lawful jurat does not guarantee that the application is complete, current, timely, internally consistent, or acceptable to the Board.
Questions about sterile compounding, pharmacist registration, inspections, ownership, service changes, controlled substances, internet services, or pharmacy operations are outside the notary's role.
Common Questions
Do not assume so. The current application labels Section 10 for pharmacies not currently performing sterile compounding. A pharmacy that performs sterile compounding or has a different licensing situation should confirm the required materials with the Nevada State Board of Pharmacy.
The current Board Pharmacy Application revised June 11, 2024 includes the affidavit as Section 10. Use the current application available through the Board's business applications page.
The non-signature fields may be completed in advance, but the signer should not sign the affidavit beforehand. The printed jurat requires the notary to administer an oath or affirmation and witness the signature.
The form requires a person who is authorized to speak on the pharmacy's behalf. The pharmacy, the Board, or legal counsel must determine the proper representative. The notary verifies identity but does not establish corporate authority.
No. The affiant must personally appear, take the oath or affirmation, and sign in the notary's presence. A courier or coworker cannot complete the jurat for an absent signer.
No. Lake Mead Mobile Notary requires acceptable original, current physical identification for an in-person appointment. Photos, screenshots, scans, and photocopies are not accepted.
No. The notary does not inspect the pharmacy, investigate licensing, review sterile-compounding operations, verify the affidavit's factual statements, or provide regulatory advice.
No. The Board independently reviews the full application, supporting records, pharmacy qualifications, services, and any required appearance. A correct jurat does not guarantee completeness, acceptance, or licensure.
Choose Mobile Notary – 1 Document when one completed but unsigned Section 10 affidavit is the only document requiring notarization and the authorized signer will appear in Nevada with acceptable identification.
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