Nevada Code § 122.0665

Affidavit of removal of authority to solemnize marriages: Form of affidavit; filing by church or religious organization that authorized official to solemnize marriages
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1. If a minister or other church or
religious official authorized to solemnize a marriage is no longer authorized
to solemnize a marriage by the church or religious organization that authorized
the minister or other church or religious official to solemnize marriages when
he or she applied for a certificate of permission to perform marriages pursuant
to NRS 122.064 , the church or religious
organization shall, within 5 days after the authorization is terminated, file
an affidavit of removal of authority to solemnize marriages with the county
clerk of the county where the original affidavit of authority to solemnize
marriages was filed.
2. The affidavit of removal of authority
to solemnize marriages must be in substantially the following form:
AFFIDAVIT
OF REMOVAL OF AUTHORITY TO SOLEMNIZE MARRIAGES FOR CHURCHES OR RELIGIOUS
ORGANIZATIONS
State of Nevada }
}ss.
County of ............... }
The........................................
(name of church or religious organization) is organized and carries on its work
in the State of Nevada. Its active meetings are located
at........................................ (street address, city or town).
The........................................ (name of church or religious
organization) hereby removes the authority
of........................................ (name of minister or other church or
religious official authorized to solemnize marriages), filed in the County
of........................................, on the.......... day of the month
of...................., of the year.........., to solemnize marriages.
I am duly authorized
by........................................ (name of church or religious
organization) to complete and submit this affidavit.
..........................................
Signature of Official
..........................................
Name of Official
(type or print name)
..........................................
Title of Official
..........................................
Address
..........................................
City, State and Zip Code
..........................................
Telephone Number
Signed and sworn to (or
affirmed) before me this.......... day of the month of.................... of
the year...........
..........................................
Notary Public for
..............................
County, Nevada.
My appointment
expires..............................

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