Arizona Department of Real Estate (ADRE)
Development Services Division
100 North 15
Avenue, Suite 201, Phoenix, Arizona 85007
FormY-Amended_Timeshare_Disclosure_Report_App Page 1 of 7
APPLICATION FOR AMENDED TIMESHARE PUBLIC REPORT (FORM Y)
hereby provides notice of the following changes to our development/project and sales offering or information
previously provided to the Arizona Department of Real Estate under Registration No. .
(Attach to this application a “red line” copy of the existing, or Out-of-State (situs), Public Report showing the changes
Until such time as the Amended Public report is received by ADRE, the above Timeshare Developer agrees
that sales of lots/interests in the above cited development/project will be suspended. Upon confirmation that
ADRE has received the application, the developer may continue sales under current guidelines by providing all potential
Purchasers with a copy of the current Public Disclosure Report, and all requested amendment changes, prior to signing
the Purchase Agreement, and obtaining an ADRE required Receipt. It is understood that the final sale is conditioned
upon Purchasers’ receiving the Amended Public Disclosure Report in paper format, with a dated and signed receipt
obtained from Purchasers.
The undersigned, , being duly sworn deposes and says:
• I have the legal authority to execute and provide this notice on behalf of the above named Owner/Applicant;
• I have throughly reviewed all information submitted to ADRE and confirm that it is in compliance with Arizona
Statutes and Rules pertaining to Timeshare Development.
• The statements herein contained, and the documents submitted herewith, are full, true and complete; and
• There are no necessary changes to our development, our sales offering, or information previously provided to
the Department, other than as listed herein, prior to the completion of sale.
• Receipts will be obtained from purchasers for all public reports and disclosures of changes.
• If used, an "Out-of-State Public Report " (Situs Approval) conforms to all Arizona statutes and rules, including, but
not limited to, A.R.S. §32-2197.08, the rescission requirements of §32-2197.03, as well as all requirements of this
Application for Amended Timeshare Public Report (Form Y)
Print Name Signature
PLEASE NOTE THAT YOU MUST SIGN IN THE PRESENCE OF A NOTARY PUBLIC
Subscribed and sworn before me this date:
Place Notary Seal / Stamp below
Notary Public Signature
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