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AFFIDAVIT FORM AND INSTRUCTION PAGE OMBUDSMAN INTERVENTION REOPENING (Nevada Real Estate Division)

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STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY - REAL ESTATE DIVISION
OFFICE OF THE OMBUDSMAN FOR COMMON-INTEREST COMMUNITIES AND
CONDOMINIUM HOTELS
3300 W. Sahara Ave., Suite 325 * Las Vegas, Nevada 89102
(702) 486-4480 * Toll free: (877) 829-9907 * Fax: (702) 486-4520
E-mail: CICOmbudsman@red.nv.gov http://red.nv.gov
Revised: 04/08/05 Page 1 of 3 605
OMBUDSMAN INTERVENTION REOPENING
AFFIDAVIT FORM AND INSTRUCTION PAGE
The purpose of this information page is to help you understand the process for requesting the
reopening of an intervention case previously filed with the Office of the Ombudsman for Owners
in Common-Interest Communities, pursuant to Nevada Revised Statute (“NRS”) 116.760.
1. The original intervention Affidavit must have satisfied all statutory requirements, as
stated in NRS 116.760 and administered by the Real Estate Division (“Division”).
2. The documentation submitted in support of the reopening of the case must present new
and/or additional information regarding the issues presented in the original intervention
sufficient to warrant further exploration.
3. When completing question #3 of the reopening request, you must provide a concise
statement of the facts constituting the alleged violation. You may include additional
pages. However, the phrase “See Attachment” is not acceptable and does not satisfy your
obligation to provide the Division with a concise statement of the facts.
4. The Ombudsman Intervention Affidavit Reopening Request must be completed in its
entirety and notarized, prior to submission to the Office of the Ombudsman.
5. The Division highly recommends submitting your Affidavit by certified mail, return
receipt requested, as the Division cannot be held responsible for lost or misdirected mail.
STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY - REAL ESTATE DIVISION
OFFICE OF THE OMBUDSMAN FOR COMMON-INTEREST COMMUNITIES AND
CONDOMINIUM HOTELS
3300 W. Sahara Ave., Suite 325 * Las Vegas, Nevada 89102
(702) 486-4480 * Toll free: (877) 829-9907 * Fax: (702) 486-4520
E-mail: CICOmbudsman@red.nv.gov http://red.nv.gov
Revised: 04/08/05 Page 2 of 3 605
OMBUDSMAN INTERVENTION AFFIDAVIT REOPENING REQUEST
STATE OF NEVADA
COUNTY OF ___________________ Date: _______________
I,____________________________ , after being first duly sworn, state under penalty of perjury
and based upon personal knowledge:
1. I have been aggrieved by an alleged violation of Chapter 116 of the Nevada Revised Statutes
or Nevada Administrative Code:____________________________________, respondent(s).
2. The Homeowners Association involved in this intervention request is:
Name of the Homeowners Association: __________________________________________
Name of President or contact for the Homeowners Association:________________________
Address for the Homeowners Association:_________________________________________
Phone number for the Homeowners Association (President or other contact): ____________
3. Provide a concise statement of the new and/or additional facts regarding the issues presented
in the original intervention. You must indicate how the new and/or additional information
correlates with the original alleged violation(s). You may include additional pages. However,
the phrase “See Attachment” is not acceptable and does not satisfy your obligation to provide
the Division with a concise statement of the facts.
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STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY - REAL ESTATE DIVISION
OFFICE OF THE OMBUDSMAN FOR COMMON-INTEREST COMMUNITIES AND
CONDOMINIUM HOTELS
3300 W. Sahara Ave., Suite 325 * Las Vegas, Nevada 89102
(702) 486-4480 * Toll free: (877) 829-9907 * Fax: (702) 486-4520
E-mail: CICOmbudsman@red.nv.gov http://red.nv.gov
Revised: 04/08/05 Page 3 of 3 605
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4. I have read the foregoing Affidavit consisting of ___________pages (including all additional
attached pages), and it is true and correct to the best of my knowledge and belief.
(Signature)___________________________
Name_______________________________
Address_____________________________
Area Code ________Phone ______________
Subscribed and sworn to before me
This ___ day of _____________, 20 ____
NOTARY PUBLIC
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AFFIDAVIT FORM AND INSTRUCTION PAGE OMBUDSMAN INTERVENTION REOPENING (Nevada Real Estate Division)

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Completed 28 December 2021

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