For Division use only: Date request received: ______________________ ___________Received by:
Date request completed: ____________________ Completed by: ___________
STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY - REAL ESTATE DIVISION
OFFICE OF THE OMBUDSMAN FOR COMMON-INTEREST COMMUNITIES AND
CONDOMINIUM HOTELS
3300 West Sahara Avenue, Suite 350 Las Vegas, NV 89102
(702) 486-4480 * Toll free: (877) 829-9907 * Fax: (702) 486-4520
E-mail: CICOmbudsman@red.nv.gov http://www.red.nv.gov
REQUEST FOR RECORD OF COMPLAINTS:
COMMUNITY MANAGER / RESERVE STUDY SPECIALIST
Requestor Information:
Name: _______________________________________________________________________________
Address: _____________________________________________________________________________
Phone No. _______________________________ E-Mail: _____________________________________
Fax No. _________________________________ Other: ______________________________________
Reason for request: ___________________________________________________________________
Requestor License No. (If applicable): ____________________________________________________
Subject of Request - Community Manager/Reserve Study Specialist Information
(Please submit one form per licensee.)
Name: ____________________________________________ License No. ________________________
Name of Company: ____________________________________________________________________
The information provided will not go beyond the scope of NRS 116A.260. If you require information
beyond that scope (see NAC 116.500 & NAC 116A.510), you will be required to obtain a court order.
The Division may take up to five working days to complete this request. If you have not received a
response within five days, please contact the Ombudsman’s office at 702-486-4480.
(5)
I have read and understand the foregoing information regarding my request.
____________________________________________ ___________________________
Signature of Requestor Date
Revised 08/2019 780
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