Nevada Form 609 – Fill Out and Use This PDF

STATE OF NEVADA

DEPARTMENT OF BUSINESS AND INDUSTRY - REAL ESTATE DIVISION

OFFICE OF THE OMBUDSMAN FOR COMMON-INTEREST COMMUNITIES AND CONDOMINIUM HOTELS

1179 Fairview Drive, Suite E * Carson City, NV 89701-5453 * (775) 687-4280

2501 East Sahara Avenue, Suite 202 * Las Vegas, NV 89104-4137 (702) 486-4480 * Toll free: (877) 829-9907 * Fax: (702) 486-4520

E-mail: CICOmbudsman@red.state.nv.us

http://www.red.state.nv.us

RESERVE STUDY SUMMARY FORM (NRS 116.31152)

All information must be provided

As of October 1, 2000, each association is required to have a reserve study conducted.

The Executive Board, at least once every 5 years, shall cause to be conducted a reserve study with a site inspection of the reserves required to repair, replace or restore the major components of the common elements and any other portion of the common- interest community that the association is obligated to maintain, repair, replace or restore. A summary of the reserve study must be submitted to the Nevada Real Estate Division no later than 45 days after the date the Executive Board adopts the results of each study.

Limited or no site inspection does not meet 5 year requirement per NRS 116.31152

IF A LIMITED OR NO SITE INSPECTION WAS PERFORMED DO NOT SUBMIT THIS FORM

PLEASE CONFIRM THE FOLLOWING:

Full Study: Physical inspection of common elements with representative sampling: (Required every 5 years)

Association’s Nevada Secretary of State (SOS) File number: _______________ SOS Original Filing Date (Mo./day/yr.): ___/___/___

(For SOS filing information, log onto http://nvsos.gov/sosentitysearch/CorpSearch.aspx)

Association’s legal name (Articles of Incorporation): ___________________________________________________________________

If association belongs to a master planned community, please provide master’s name: ______________________________________

Current billing information:

Mailing/billing address: ________________________________________________________________________________________

City: ___________________ State: ______ Zip: _____________ County the association is located in: _________________________

Management company name: (if applicable):_______________________________________________________________________

Address of Management Company: same as above _____________________________________________________________

City: ___________________ State: ______ Zip: _____________ Name of Community Manager: _____________________________

Email address for Community Manager: __________________________________ Custodian of Records: ______________________

DESCRIPTION OF ASSOCIATION PROPERTY
• Is the association a (check one)?		• If a planned community, what type(s) of units are included:
□ Condominium	□ Cooperative	□ Single Family Dwelling	□ Condominium
□ Condominium Hotel	□ Planned Community	□ Duplex □ Townhouse	□ Manufactured Housing
Approximate age of development: _______		Number of annexed units with a Certificate of Occupancy: ________

Max. (total) # of units declarant has right to annex into assn. per the Covenant, Conditions & Restrictions (CC&Rs)? __________

RESERVE STUDY INFORMATION

Date of previous reserve study with site inspection: (Mo./day/yr.): ___/___/___

Date of most current reserve study with site inspection: (Mo./day/yr.):___/___/___

Adoption date of most recent full reserve study with site inspection: (Mo./day/yr.):___/___/___

Name of Reserve Specialist (person) who conducted study: __________________________________________ Registration #: ________

Reserve Study Specialist’s name and registration # can be located at www.red.state.nv.us, Quick Links, License Lookup

If the common-interest community contains 20 or fewer units AND is located in a county whose population is 55,000 or less, the study of the reserves required by NRS 116.31152 may be conducted by any person whom the executive board deems qualified to conduct the study. [NRS 116.31152(2)] If BOTH requirements listed above have been met provide:

Name of the individual conducting the reserve study: _______________________________________ Title (if applicable):________

For office use only

Date Received:

Date Processed:

Processed By:

Revised 11/1/12

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Form 609

ADDITIONAL INFORMATION
Are there major components in this reserve study that with site inspection that was not previously identified? Yes	No
If yes, explain and attach supporting documents, if appropriate.

_______________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________

FINANCIAL/FUNDING INFORMATION	Accounting fiscal year end (Mo./day): ____/____
Reconciliation of Reserve Fund Account: (NRS 116.31151)
Reserve account balance at beginning of current fiscal year:		$_____________________
Plus: Current year budgeted reserve transfer:	+	$_____________________
Plus: Current year projected investment income:	+	$_____________________
Plus: Anticipated reserve assessment, if any (**provide info below):	+	$_____________________
Less: Current year projected major repairs and replacements:	-	$_____________________
Other reconciling items: (indicate + or – dollar amounts)	+/- $_____________________
Projected reserve account balance at the end of current fiscal year end:	=	$_____________________
Required reserve account balance at end of current fiscal year based upon this full study:		$_____________________

Is there a difference between the projected and required balances? If so, list the reason(s) for the difference:

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

How does the executive board propose resolving the difference?

___________________________________________________________________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

**Provide detailed information pertaining to any anticipated reserve assessments: ________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

Are the reserve funds held in separate accounts? Yes No

If no, explain why not?

__________________________________________________________________________________________________________

RESERVE STUDY INFORMATION:
Total estimated current replacement costs of the major component inventory:			$_____________________
Funding plan selected: Full funding	Threshold funding	Baseline funding	Other (explain):

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

“I declare under penalty of perjury under the law of the State of Nevada that the foregoing, to the best of my knowledge and belief, is true and correct.”

Name of person completing this form (print) ___________________________________________ Title (if applicable): _____________

Person authorized to sign form: □ Board Member (title: ___________) □ Community Manager (License #___________) □ Declarant

Print name: ________________________________ Signature: __________________________________ Date signed: ____/____/____

Revised 11/1/12

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Form 609