Quarterly report concerning authorized delegates: Submission; contents

1. Each licensee shall submit to the Commissioner a report concerning each authorized delegate of the licensee within 45 days after the end of the calendar quarter. The report must include, without limitation, the following information for each authorized delegate: (a) The legal name of the company; (b) Taxpayer employer identification number; (c) Principal provider identifier; (d) Physical address; (e) Mailing address; (f) Any business conducted in other states; (g) Any fictitious or trade name; (h) The name, telephone number and electronic mail address for the contact person of the authorized delegate; (i) The date upon which the authorized delegate was designated as an authorized delegate of the licensee; (j) The date upon which the authorized delegate ceased being an authorized delegate for the licensee, if applicable; (k) Any court order concerning the licensee pursuant to NRS 671.225; and (l) Any other information the Commissioner may reasonably require with respect to the authorized delegate. 2. The Commissioner may use the Registry for the submission of the report required by this section provided that such functionality is consistent with the requirements of this section.