Fillable REAL ESTATE DIVISION OWNER-DEVELOPER APPLICATION (Nevada Real Estate Division)

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REAL ESTATE DIVISION OWNER-DEVELOPER APPLICATION (Nevada Real Estate Division)

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STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY
REAL ESTATE DIVISION
3300 W. Sahara Ave., Suite 350, Las Vegas, Nevada 89102 * (702) 486-4033
e-mail: realest@red.nv.gov * http://red.nv.gov/
06/05/17 Page 1 of 10 565
OWNER-DEVELOPER APPLICATION
General Information
"Owner-Developer" means a person, natural or artificial, who owns five or more lots within a recorded subdivision
or shown on an approved parcel map, on each of which there is a single family residence not previously sold. For
the purposes of this definition, the single family residence includes a condominium or townhouse unit.
"Sales Manager" means the duly authorized person filing the application form who will be responsible for sales
management.
If, for any reason, the Division denies an application, the applicant may appeal the decision. The Division shall have
broad discretion in granting or denying an application in view of the difficulty in securing evidence of bad reputation
or of specific instances of fraudulent or unethical conduct.
Licensed real estate salesmen employed by a registered owner-developer may not be associated with a real estate
broker during the same time period.
Instructions to Applicants for Owner-Developer Registration
The owner-developer registration will not be issued if an exemption from NRS 119 for the property described in the
application has not been issued by the Real Estate Division. If the exemption has not been secured, the requirements
are attached to the back of this application.
1. Application Form: This form must be filled out completely. The affidavits that are to be notarized appear on the
last page of the form. Answer each question carefully. An original application must be completed for each
recorded subdivision which an owner-developer intends to register.
2. Financial Statement: Attach the latest financial statement (not more than one year old) for the owner-developer.
If more than one application for registration is being submitted at the same time, duplicate financial forms will
not be required. Attached is a suggested financial form. You may use this form or any other form comprising
the same information which has already been prepared by your accountants.
3. Form of Business: Attach a copy of the contractor's license, city or county business license and if the business is
a corporation submit the Articles of Incorporation and current list of officers as filed with the Secretary of State.
If the business is a L.L.C. submit the Articles of Organization and current list of members. If the business is a
partnership, attach documentation of partnership. Attach a copy of the recorded fictitious name if different from
the owner-developer name.
4. Sales Agreement: Attach a copy of the sales agreement which agreement shall obligate the owner-developer to
construct a single-family residence.
5. Statutes: Copies of Nevada Revised Statutes, Chapter 645 and Chapter 119 and their respective administrative
code are available at either division office. The fee is $8 each, including postage and handling, payable in
advance. The owner-developer must comply with statute and administrative code regarding his operation and
the supervision and regulation of licensed salesmen and broker-salesmen.
6. Fee Schedule: Each Original Registration of an Owner-Developer $500, plus $125 per map
Each annual renewal of a registration $500, plus $125 per map
Each Enlargement of the area of a registration $500, plus $50 per map
Each change of name or address (Form 649
) $25
No part of any fee is refundable. Make checks payable to the Real Estate Division
STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY
REAL ESTATE DIVISION
3300 W. Sahara Ave., Suite 350, Las Vegas, Nevada 89102 * (702) 486-4033
e-mail: realest@red.nv.gov * http://red.nv.gov/
06/05/17 Page 2 of 10 565
IMPORTANT: Each detail of this application must be completed. Applications will not be considered unless
all information and companion forms called for are furnished.
This application is submitted for registration as an Owner-Developer under NRS 645.283 and the Nevada
Administrative Code.
PLEASE PRINT OR TYPE
1.
Owner-Developer's Name
First
Middle
Last
2.
Firm Name
3.
Owner of Record
(Vested Owner on Preliminary Title Report)
4.
Form of Business
Corporation Partnership Individual L.L.C.
5.
Social Security Number or Federal Tax Identification Number for the Company
6.
Address of Owner-Developer's principal place of business
7.
Name of duly authorized person who will be responsible for sales management and to whom all division
correspondence will be addressed
Name/Position
Telephone Number
8.
Address of person responsible for sales management if different from Owner-Developer
9.
Recorded name and location of subdivision:
Promotional name of subdivision:
10.
Address of sales location(s)
11.
Nevada contractor license number of Owner-Developer
12.
Has any license issued to the Owner-Developer by any public authority been suspended or revoked?
Yes No
13.
Has any license for which the Owner-Developer has applied been denied by any public authority?
Yes No
06/05/17 Page 3 of 10 565
14.
Has a surety company declined to be surety on any bond written on the Owner-Developer within 2 years
prior to the date of this application: Yes No
15.
Has any governmental agency ever instituted proceedings against the Owner-Developer?
Yes No
16.
Has any proceeding ever been instituted by or against the Owner-Developer under the Bankruptcy Act, or
has he ever made an assignment for the benefit of creditors? Yes No
17.
a.
Has the Owner-Developer or Sales Manager ever been charged with, arrested for, or convicted of a
felony? Yes No
b.
Has the Owner-Developer or Sales Manager ever been charged with, arrested for, or convicted of a
gross misdemeanor? Yes No
c.
Has the Owner-Developer or Sales Manager ever been permitted to change a plea of guilty after
conviction of a crime or had a judgement or verdict vacated? Yes No
d.
Has the Owner-Developer or Sales Manager ever entered a plea of nolo contendere to a criminal
action? Yes No
IF ANY OF QUESTIONS 12-17 WERE ANSWERED YES, GIVE FULL DETAILS, INCLUDING
THE COURT, TITLE OF PROCEEDINGS, DISPOSITION, AND ANY OTHER PERTINENT
INFORMATION ON AN ATTACHED SHEET.
18.
How long has the Owner-Developer been in business?
19.
Names of previous subdivisions built/sold
20.
Has the Owner-Developer previously filed for an exemption under the provisions of Chapter 119 of NRS
for this subdivision? Yes No
An owner-developer registration will not be issued for any subdivision which falls under the purview of
Chapter 119 of Nevada Revised Statutes until compliance has been accomplished, either previously or
with this application.
21.
The owner-developer registration precludes the sale of vacant property. Does your project include lots
offered with a residential building? Yes No
22.
Is the property description on the attached preliminary title report correct? What portion of the property
described is to be developed for the purpose of this registration? All Part Describe if other
than all.
23.
Attach a copy of the following documents:
a.
Sales agreement to be used.
b.
Business license and Contractors license.
c.
Articles of Incorporation and current list of officers or Articles of Organization and current list of
members or documentation of partnership.
d.
Corporate minutes or partnership agreement showing authority of sales manager to manage sales
personnel.
e.
Fictitious firm name filing, if applicable.
f.
Current preliminary title report with legal description in lots and blocks.
g.
Vital statistics sheet for sales manager (form attached).
h.
Financial statement of the Owner-Developer (not more than one (1) year old).
24.
The attached affidavits must be signed by the sales manager and the owner-developer. Each signature
must be notarized.
06/05/17 Page 4 of 10 565
VITAL STATISTICS FORM
The following is to be completed by the person to be responsible for sales management.
Name:
Residence:
Date of Birth:
Place of Birth:
Height:
Weight:
Eyes:
Hair:
Signature:
Date:
06/05/17 Page 5 of 10 565
AFFIDAVIT OF SALES MANAGER
STATE OF
ss.
COUNTY OF
I,
, being first duly sworn, state that
I am the Broker-Salesman to act as sales manager herein named, that the statements made by me in this
application are true, that in acting as the broker salesman responsible for managing sales personnel for the
registered owner-developer I agree to be bound by and subject to the provisions found in NEVADA REVISED
STATUTES, CHAPTER 645 and the Nevada Administrative Code, with which I have made myself familiar,
and that should a change of address, name or status affecting me or the licensed salesmen or broker/salesmen in
my employ occur, I will immediately notify the Real Estate Division
Signature of Sales Manager
Subscribed and sworn to before me this
day of
, 20
Signature of Notary
AFFIDAVIT OF OWNER-DEVELOPER
STATE OF
ss.
COUNTY OF
I,
, being first duly sworn, state that
I am the Owner-Developer herein named, that the statements made in this application are true, that in acting as a
Registered Owner-Developer I agree to be bound by and subject to the provisions found in NEVADA
REVISED STATUTES, CHAPTER 645 and the Nevada Administrative Code, that I am responsible for the act
of the salesmen, broker/salesmen and the authorized sales manager, and that should a change of address, name
or status affecting me, the licensed salesmen, broker/salesmen or the authorized sales manager in my employ
occur, I will immediately notify the Real Estate Division.
Signature of Owner-Developer
Subscribed and sworn to before me this
day of
, 20
Signature of Notary
06/05/17 Page 6 of 10 565
CONFIDENTIAL FINANCIAL STATEMENT
Name
Social Security #
Address
Business Ph.
Residence Ph.
Occupation
Employer
Employer’s Address
Spouse’s Name
Social Security #
Address
Business Ph.
Residence Ph.
Occupation
Employer
Employer’s Address
ASSETS
ALL LIQUID ASSETS MUST BE ACCOMPANIED BY VERIFICATION
Cash (other than amounts shown in banks)
$
Automobiles
$
Cash in Banks (Schedule 1)
$
Other investments (Schedule 3)
$
Accounts Receivable (Schedule 2)
$
Personal Property
$
Notes Receivable (Schedule 2)
$
Net Worth of any Business Owned
Stocks and Bonds (Schedule 3)
$
(Please include financial statement)
$
Cash Value of Life Insurance (Schedule 6)
Other Assets
Real Estate (Schedule 4)
$
Sub Total
$
Sub Total
$
Total
$
LIABILITIES
Notes Payable to Others (Schedule 7)
$
Loans Against Life Insurance
(Schedule 6)
$
Installment Loans Payable (Schedule 7)
$
Other Liabilities
$
Accounts Payable
$
Liens on Real Estate (Schedule 5)
$
Taxes Payable
$
Long Term Debts
$
Sub Total
$
Sub Total
$
Total
$
Net Worth
$
Salary
$
Taxes & Assessments
$
Spouse’s Salary
$
Income Taxes
$
Dividends
$
Child Support/Alimony
$
Interest
$
Mortgage Payments
$
Commissions
$
Contract Payments
$
Rentals
$
Insurance
$
Other
$
Other
$
Total
$
Total
$
06/05/17 Page 7 of 10 565
SCHEDULES
Schedule 1 Cash in Banks & Savings and Loan & Checking Accounts**
Bank Name
90 Day Avg Balance
Account #
Balance
Total
$
** For each account, submit a verified statement letter from each banking institution, to include Name of Account,
Current Balance, Account Number, Length and Specific Dates of Account. The accounts must have been open and on
deposit for a minimum of ninety (90) days prior to the date of application. This financial statement cannot be approved
without verification letters. NAC 645.150(2).
Schedule 2 Receivables
Name of Debtor
Collateral
Payments
Maturity Date
Unpaid Balance
Total
$
Schedule 3. Stocks and Bonds
# of Shares
Description
Amount Carried on My Books
Present Market Value
Total
$
Schedule 4. Real Estate (If additional space is necessary, attach separate sheet)
Address or Legal Description
Type of Property
Monthly
Income
Original Cost
Estimated
Present
Value
Total
$
Schedule 5. Mortgages of liens on Real Estate
Name of Creditor
Payments
Unpaid Balance
Total
$
Schedule 6. Cash Surrender Value of Life Insurance
Company
Face Amount
Cash Value
Loans Against Policy
Totals
Total
$
Schedule 7. Notes Payable to Others
Name of Creditor
Address
Payments
Collateral
Unpaid Balance
Total
$
I, by signing and filing this application, authorize any person or institution to which reference is made by me in connection with the application, to
release or divulge to the Real Estate Division or its representative any information in the possession of such person or institution regarding me. I
hereby approve any investigation on my credit background.
Signature _____________________________________________________________ Date ______________________________________
STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY
REAL ESTATE DIVISION
3300 W. Sahara Ave., Suite 350, Las Vegas, Nevada 89102 * (702) 486-4033
e-mail: realest@red.nv.gov * http://red.nv.gov/
06/05/17 Page 8 of 10 565
APPLICATION FOR ENLARGEMENT OF OWNER-DEVELOPER REGISTRATION
IMPORTANT: Each detail of this application must be completed. Applications will not be considered
unless all information and companion forms called for are furnished.
This application is submitted for enrollment of my Owner-Developer (OWN) Registration under NRS 645.283
and the Nevada Administrative Code.
PLEASE PRINT OR TYPE:
Original Registration Issued on:
Assigned OWN No.
Date
1.
Owner-Developer's Name
First
Middle
Last
2.
Address of Owner-Developer
3.
Name of Sales manager if different from Owner-Developer
4.
Address of Sales manager if different from Owner-Developer
5.
Recorded name and location of subdivision
6.
Legal description of the property covered by this registration enlargement
7.
The Owner-Developer must file for an exemption under the provisions of Chapter 119 of NRS for this
particular unit(s).
8.
Attach $50.00 enlargement fee.
9.
Sales manager and Owner-Developer sign the attached affidavits.
10.
Attach a current preliminary title report with lot and block legal description.
06/05/17 Page 9 of 10 565
AFFIDAVIT OF SALES MANAGER
STATE OF
ss.
COUNTY OF
I,
, being first duly sworn, state that
I am the person authorized to act as sales manager herein named, that the statements made by me in this
application are true, that in acting as the duly authorized person responsible for managing sales personnel for
the registered owner-developer I agree to be bound by and subject to the provisions found in NEVADA
REVISED STATUTES, CHAPTER 645 and the Nevada Administrative Code, with which I have made myself
familiar, and that should a change of address, name or status affecting me or the licensed salesmen in my
employ occur, I will immediately notify the Real Estate Division
Signature of Sales manager
Subscribed and sworn to before me this
day of
, 20
Signature of Notary
AFFIDAVIT OF OWNER-DEVELOPER
STATE OF
ss.
COUNTY OF
I,
, being first duly sworn, state that
I am the Owner-Developer herein named, that the statements made in this application are true, that in acting as a
Registered Owner-Developer I agree to be bound by and subject to the provisions found in NEVADA
REVISED STATUTES, CHAPTER 645 and the Nevada Administrative Code, that I am responsible for the act
of the salesmen and the authorized sales manager, and that should a change of address, name or status affecting
me, the licensed salesmen, or the authorized sales manager in my employ occur, I will immediately notify the
Real Estate Division.
Signature of Owner-Developer
Subscribed and sworn to before me this
day of
, 20
Signature of Notary
06/05/17 Page 10 of 10 565
EXEMPTION DETERMINATION REQUIREMENTS
The Nevada Real Estate Division understands that you wish an exemption determination under the
Nevada Revised Statutes, Chapter 119.120(4), the Land Sales Law
In order to make this determination, the Division will need the following items:
1. Cover letter requesting the exemption.
2. A copy of the recorded and approved final subdivision/plat map in 11 x 17 readable size..
3. The promotional name of the subdivision.
4. The physical address of the subdivision
5. A copy of the Nevada contractor's license.
6. Submit evidence of the contractor's ownership interest in the project.
7. A sworn statement signed by the contractor stating that each lot offered or disposed of will
include a residential building when disposition is completed.
8. A copy of the purchase agreement including verification that the purchasers will take title free
and clear of any encumbrances.
9. A preliminary title report issued within 30 days of the date of the request for exemption.
10.
$500 exemption determination fee per NRS 119.320 (per unit or phase), and $25 for Form 649,
revised by the 78
th
Legislative Session, effective July 1, 2015,
http://leg.state.nv.us/Session/78th2015/Bills/AB/AB478_EN.pdf
NOTE: When applying for an exemption determination in conjunction with an owner-developer
registration pursuant to NRS 645.285, it is not necessary to duplicate documents which are requested
on both applications.
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REAL ESTATE DIVISION OWNER-DEVELOPER APPLICATION (Nevada Real Estate Division)

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Completed 28 December 2021

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