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REAL ESTATE DIVISION NEVADA CAMPGROUND REGISTRATION STATEMENT (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/
03/20/17 Page 1 of 23 569
NEVADA CAMPGROUND REGISTRATION STATEMENT
This is a companion document to the "Campground Public Offering Statement," Document #570.
This form must be filed for any campground project being offered for sale, lease or use in a common promotional plan.
The fees for filing this registration are based on the following schedule:
Preliminary Permit .........................................................................................$275.00
Permit including 50 memberships .................................................................$500.00
51 - 250 memberships ....................................................................................$ 5.00 / membership
251 - 500 memberships ..................................................................................$ 4.00 / membership
501 - 750 memberships ..................................................................................$ 3.00 / membership
751 - 1500 memberships ................................................................................$ 2.50 membership
1501 - and over ..............................................................................................$ 1.00 / membership
Annual renewal of a permit ............................................................................$500.00
Amendment ....................................................................................................$150.00
The inspection fees for this registration are based on the following schedule:
At the time an inspection is scheduled, a deposit of inspection fees will be requested.
DO NOT SEND INSPECTION FEES WITH THIS FILING.
In-State Property ............................................................................................$300.00
Out-of State Property (up to 1000 miles) .......................................................$400.00
Out-of State Property (in excess of 1000 miles) ............................................$800
These inspection fees are estimated expenses only. Additional expenses over and above this estimate will be billed after
the actual inspection. Actual costs incurred less than the estimated amount will be refunded.
UNLESS OTHERWISE DETERMINED BY THE DIVISION, ALL FEES SUBMITTED PURSUANT TO NRS 119B.210
ARE DEEMED EARNED UPON RECEIPT. NOT MORE THAN ONE-HALF OF THE FEE SUBMITTED SHALL BE
SUBJECT TO REFUND. REFUNDS CAN ONLY BE MADE IN THE FISCAL YEAR IN WHICH THE FEES ARE
DEPOSITED.
Attach the registration fees only at the time of filing. Examination of the filing will not begin until all required fees are received.
No permit or public offering statement will be issued by the Division until all material required by the Division has been
supplied, the project has been inspected by the Division and all fees paid, including inspection fees, as may be required by the
Division.
This statement and, if necessary, the public offering statement must be continually kept up to date throughout the sales program.
Any material changes to the registration must be communicated to the Division within fifteen (15) days of its occurrence.
Failure to do so may render the public offering statement invalid, which means all purchasers purchasing subject to an invalid
public offering statement may have the opportunity to void their contract and receive back all the funds paid to date.
For each amendment to a public offering statement after the issuance of the report there will be a $100 fee.
NOTE: PLEASE READ INSTRUCTIONS ON THE FOLLOWING PAGES CAREFULLY.
BUSINESS AND INDUSTRY NEVADA REAL ESTATE DIVISION
PROJECT REGISTRATION
03/20/17 Page 2 of 23 569
THESE INSTRUCTIONS MUST BE FOLLOWED IN COMPLETING THE QUESTIONNAIRE AND
EXHIBITS SECTIONS:
The format must not be changed in any respect, except as follows:
1. Answer the questions in the spaces provided in this registration. If additional space is needed, attach
separate sheets to the subject page and identify the sheets with the number and letter of the question being
answered.
The answers shall be in black ink in standard elite or pica type. Deeds, title policies, maps, plats and other
supporting documents should be folded to legal size. Do not submit photocopies that are not clearly readable.
2. The supporting documents required under Section II, Exhibits shall be attached as exhibits. Each exhibit
shall be identified by affixing a tab on the right side of the cover sheet of the exhibit. Such identification
shall conform to the alphabetical format of Section II. Additional or supplementary exhibit material shall be
identified and numbered following the same system.
3. There shall be an “Index to Exhibits.” Such Index schedule shall be the cover page of Section II, Exhibits.
4. If the information in an exhibit is applicable to more than one part of the Questionnaire, the applicant may
incorporate that information by reference to the appropriate exhibit.
5. Where items in the Questionnaire do not apply, so state by stating “Not Applicable” in answer thereto and
briefly explain why.
6. Where documentation required in the Exhibit Section does not apply, in lieu of an exhibit, the applicant shall
insert a page reciting the exhibit identification and description as set forth and indicate thereon “Not
Applicable” and briefly explain why.
7. Where required documentation cannot be obtained, a page shall be inserted indicating “Not Available” and
briefly explain why.
8. Do not incorporate by reference to a previous filing the answers to questions in Section I. The applicant may
incorporate specifically by reference documentation required in Section II, Exhibits from a previous filing
with the Division. The applicant must state exactly where the documentation can be found, e.g., project
name and previous exhibit number.
9. After completing this campground registration statement and the exhibits section. Please bind them at the top
with a fastner.
When this registration has been completed, complete the Campground Public Offering Statement. The
answers to the questions in the public offering statement are based upon your information in this
registration.
BUSINESS AND INDUSTRY NEVADA REAL ESTATE DIVISION
PROJECT REGISTRATION
03/20/17 Page 3 of 23 569
QUESTIONNAIRE/APPLICATION
SECTION I
TYPE OR PRINT
Date
1.
Applicant
a.
Name and address and Social Security Number or Federal Tax Identification Number.
b.
If incorporated, state where and when:
c.
If the developer is a partnership or any other association other than a corporation, give the name and
address and principal occupation of each individual owning or controlling an interest of 10% or more.
Not Applicable See Attached Sheets
d.
What is applicant’s interest in the project?
e.
If other than Owner, explain and fully identify Owner:
f.
State whether the applicant, any affiliate of the applicant, or , if the applicant or any affiliate is a
corporation, any principal officer or director thereof, or, if the applicant is a partnership or any other
association other than a corporation, any of the individuals described in question 1(c) has:
(1)
Been convicted of or pled nolo contendere to a felony or other crime involving moral turpitude,
fraud or misrepresentation, land sales or investments, securities sales, campgrounds, timeshares
Yes No
(2)
Been permanently enjoined by a court of competent jurisdiction from selling real estate,
timeshares, campgrounds, securities Yes No
(3)
Had a registration as a broker-dealer in securities or a license to act as a real estate broker or
salesman, project broker or sales agent revoked Yes No
03/20/17 Page 4 of 23 569
(4)
Been convicted of or pled nolo contendere to selling real estate, investments, securities,
timeshares or campgrounds without a license Yes No
(5)
Had a permit to sell timeshares, securities, real estate or campgrounds revoked
Yes No
g.
List all current or pending litigation or disciplinary proceedings by any individual or agency in county
courts of record or higher which may have an effect upon the developer, the subdivision, or any of the
persons described in question 1(f) hereof. Any case for which a complaint or initial pleading has been
filed 7 days or more prior to the mailing of this application or amendment must be included. Describe
the action and give names and addresses of parties and counsel, identification of the court, pertinent
dates, gist of the action or the disposition at the time the filing is submitted. A new action or the
disposition of any action is a material change and must be reported by filing an amendment within 15
days of its occurrence.
h.
List by date of occurrence, any denial order or suspension or loss of permits to sell issued by any
governmental agency. Explain the basis of each order and the final disposition.
Not Applicable See Attached Sheets
i.
Give a brief history of the developer’s business background and experience in real estate, timesharing or
campground projects in which he has been involved.
2.
Project
a.
Name and address of individual to be contacted regarding this registration.
b.
Physical address of project.
c.
Location of sales or project records. (Records for all project sales and project sales and project records are
required to be kept in the State of Nevada. If originals of these documents will be kept out of state, then
duplicate records must be kept in the State of Nevada).
d.
Common promotional name.
03/20/17 Page 5 of 23 569
e.
Type of campground plan. (Ownership, Right to Use, Membership, Vacation Club, etc.) Explain.
f.
Number of campsites in this filing:
g.
Number of memberships in this filing:
h.
Ratio of memberships to campsites:
i.
Number of campsites in this entire project:
j.
Number of memberships in this entire project:
k.
Ratio of memberships to campsites in this entire project:
l.
Is the project comprised of more than one location:
Yes No
m.
Reservation procedure.
3.
Location
a.
County/State/Country.
b.
Name and location of the County Seat.
c.
List the names and populations of surrounding communities and list distances over paved and unpaved
roads to the project.
Name of Community
Population
Distance Over
Paved Roads
Total
03/20/17 Page 6 of 23 569
d.
Route and distance from nearest town to project in this filing.
4.
Platting
a.
Is the project in this filing platted of record?
Yes No
b.
If yes, did such platting require prior approval or acceptance by a government agency?
Yes No
c.
Name and location of government agency.
5.
Geology, Climate and Physical Conditions
a.
Do you know of any unusual safety factors or any proposed plans, private or governmental, for
construction of any facility which may cause a nuisance or adversely affect the project?
Yes No If yes, fully explain their origin and whether they are proposed or existing, and
whether temporary or permanent.
b.
Is the project affected by any unusual or unpleasant odors, noises, pollutants, or other nuisances?
Yes No If yes, fully explain their origin and whether they are proposed or existing, and
whether temporary or permanent.
c.
State whether any of the project is affected by water at any time during the year or is subject to
hurricanes, floods, tornadoes, dust storms, earthquakes, mud slides, brush fires, forest fires,
avalanches, volcanic eruptions or other natural hazards. The existence, severity and frequency of
natural hazards should be fully explained.
03/20/17 Page 7 of 23 569
d.
State the elevation and the general weather conditions of the area, the temperature ranges for summer
and winter including high, low and mean, and state annual rainfall and, if applicable, snowfall in
inches.
6.
Taxes, Assessments
a.
Are current real property taxes paid?
Yes No
b.
Date next payment due:
c.
State the method of assessing the project in the county in which the project is located.
d.
Does the member bear a proportional interest in the tax burden with the developer.
Yes No If yes, explain.
e.
Are the taxes paid from the annual maintenance fee?
Yes No
f.
What appraised value has the county assessor placed on the project in this filing? What are the
assessed values and the tax rate (give tax year)?
g.
Are there any assessments levied by any governmental authority? Yes No Explain.
03/20/17 Page 8 of 23 569
h.
Is the property located in a special district or affected by any bond issue?
Yes No
Explain. (A reasonable estimate, if applicable, of the amount of any indebtedness which has been or is
proposed to be incurred by an existing or proposed special district, entity, taxing area or assessment
district, within the boundaries of which the project, or any part thereof, is located, and which is to pay
for the construction or installation of any improvement or to furnish community or recreational
facilities to such project, and which amounts are to be obtained by ad valorem tax or assessment, or by
a special assessment or tax upon the project, or any part thereof).
i.
If the project described in this filing lies partly or wholly within a district now formed or to be formed
which has the power to tax or assess, will such taxes be included in the city or county taxes?
Yes No If yes, estimate the effect on the annual maintenance fee.
7.
Project description
a.
Physically describe the project in its entirety together with all amenities, whether in place or under
construction.
b.
State the extent to which the project has been completed.
c.
State the extent to which the project has yet to be constructed.
d.
If the project is proposed to be constructed or is under construction, what financial assurances have
been posted guaranteeing its completion?
03/20/17 Page 9 of 23 569
e.
If any promised improvements are not completed and no assurances have been posted to secure
completion, what means, if any, shall be employed to guarantee completion?
f.
Streets and Roads
(1)
Does each member have physical access (by conventional automobile, year round) to the
project? Yes No Please explain.
(2)
Who will maintain the access roads to the project and within the project to each campsite?
Explain. (State who will maintain the access roads. If the cost of maintenance will be borne by
association of members, so state and give the estimated cost to each member).
(3)
Who will clear the roads of snow? (State who will clear the roads of snow, if applicable. If the
cost of snow removal will be borne by the members or any association of members, so state and
give the estimated cost to each member).
g.
Estimate the cost of each member for the utilities provided (electricity, water, sewage disposal,
telephone, heat, solid waste disposal) if not included in the annual maintenance fee.
h.
Has the project been offered for sale in this state or any other state at any time prior to the date of this
filing. Yes No Please explain.
i.
What is the zoning classification? Is a special use permit required?
03/20/17 Page 10 of 23 569
8.
Area Facilities and Services
a.
Fire: Type, distance.
b.
Describe all provisions that will be made available within the project described in this filing for fire
protection.
c.
Police: Type, distance.
d.
Churches: Type, distance.
e.
Medical: Type, distance.
f.
Describe fully the type, location and distance from the project contained in this filing to the public
transportation available to the members. If none, so state.
g.
Describe fully whether television can be received in the project, the channels received.
03/20/17 Page 11 of 23 569
9.
Recreational and Common Facilities
a.
State what provisions have been made for the maintenance and operation of the facilities, if any, and
the estimate of the assessment or other recurring charges to be paid by the member.
b.
If a members association, or similar organization, owns or will own the facility, so state. If the
association has not been formed as a legal entity, state when it is expected to be formed and the
conditions under which the association will take title to the facility.
c.
If any association has been, or will be formed, state the requirements for membership in the
association, organization or other entity and state whether all owners will be members.
(1)
State voting rights of members.
(2)
State classes of membership (owner’s membership, developer’s membership).
(3)
Provisions for proxies.
(4)
Necessary quorum.
03/20/17 Page 12 of 23 569
(5)
State management provisions.
(6)
Outline developer’s subsidy agreement, if any.
(7)
State time, terms and conditions under which developer relinquishes control of the association.
10.
Filings with State/Federal/Provincial Authorities
If a registration has been filed with or accepted by any regulatory agency, list the jurisdictions:
11.
Terms and Conditions of Sale.
a.
Are cash sales allowed? Yes No
b.
At the time of conveying title, contract to use or campground membership, etc., will the project be free
and clear of all liens? Yes No Please explain.
c.
If a contract or similar device will be utilized in the sale of the project, state whether the contract will
be recorded at the time the contract becomes binding. If not, state whether the contract will be in
recordable form and any prohibitive factors why the contract cannot be recorded.
03/20/17 Page 13 of 23 569
d.
Could third parties or creditors of any person having an interest in the project acquire title to the
property with the legal right to cancel the membership or dishonor a contract to use?
Yes No Explain.
e.
Are there closing costs and who will bear them?
f.
Describe the manner by which the membership or other interest contracted for this is to be conveyed to
the purchaser.
g.
Minimum down payment on installment sales:
h.
Maximum term of installment contracts:
i.
Annual interest rate:
j.
Is interest charge included in payments?
Yes No
k.
Itemize and explain in detail every item of cost to the purchaser required as a result of the purchase,
lease or contract for membership in or use of the project described herein.
l.
What are the dues or maintenance fees charged each member?
m.
If there is a penalty for prepayment? Explain.
03/20/17 Page 14 of 23 569
n.
Will prepayment accelerate the seller’s obligation to complete promised improvements?
Yes No Explain.
o.
If there is a refund provision offered by the developer other than that provided by Nevada law as set
forth on the first page? Explain
p.
If the member defaults, will his loss be limited to the amount of his payments to date, or will he be
responsible to the developer or his assignees or a purchase money lender for additional damages or for
the balance of his contract/lease?
q.
Sales prices range from $
to $
r.
If the project is or will be leased by the developer, described any provision for increase or rental
payments during the term of the lease.
s.
What financial assurances have been, or what other security has been posted to insure the payment of
the rental obligation.
t.
Does the lease prohibit the lessee from mortgaging or otherwise encumbering the leasehold?
Yes No
u.
If the project is under a leasehold, has or will the lease be assigned to an association or third party as a
trustee? Yes No
03/20/17 Page 15 of 23 569
12.
Title
a.
Are there any mortgages, trusts, liens or other encumbrances on the project? Yes No
b.
If yes, give full particulars.
c.
If the project is burdened by a lien, mortgage, or deed of trust, state what provisions have been made to
protect the purchaser from defeat of his interest by third party creditors in the event of default of the
developer.
d.
Provide the name(s) and address(es) of the holder(s) of any lien or encumbrance on the project
together with their relationship to the developer.
13.
Promotional Activities
a.
Describe fully your proposed sales program to be employed for the procurement of prospective
purchasers, the sale to purchasers and the retention of purchasers after sale, which plan or methods
shall describe with particularity:
(1)
The form and content of advertising to be used.
(2)
If there are any inducements such as gifts, free offers or any other promises offered to
prospective purchasers, explain. (Disclose fully all information regarding inducements
including, but not limited to, the following: gifts, free offers, resale or lease program, exchange
privilege, inspection privilege, offered by the developer.)
03/20/17 Page 16 of 23 569
(3)
The nature and of promotional meetings.
b.
Submit the name of the Nevada real estate broker who will be the broker of record and the names of all
sales personnel and the locations of branch offices at which they will be operating, and the name of the
broker or broker-salesman in charge of each location.
c.
Will your sales program state in any manner that your project will or may appreciate in value or may
or will be a hedge against inflation? Yes No Specify the statements that will be
made.
16.
Reciprocal Use information
a.
Is the project affiliated with a reciprocal use company? Yes No If so, please state
the name of the company.
b.
Is the project a multi-location project? Yes No If so, is the developer offering an
internal reciprocal use program? Yes No Explain.
03/20/17 Page 17 of 23 569
SECTION II - EXHIBITS
Exhibit A – If a corporation, submit a copy of Articles of Incorporation with all amendments thereto and a current
list of all the names and addresses of officers and directors with their principal occupation for the past 5
years. Submit name and address of any person whose interest in the applicant is 10% or more and the
extent and nature of such ownership.
Exhibit B – If the developer is a foreign corporation and is organized under the laws of another state, it may be
necessary to register with the Nevada Secretary of State as a foreign corporation doing business in the
State of Nevada. The developer should contact the Secretary of State to ascertain whether registration is
necessary.
Exhibit C – If the developer is a Nevada corporation, submit a certified copy of the certificate of incorporation for
the transaction of business issued by the Nevada Secretary of State, indicating the corporation’s resident
agent
Exhibit D – Submit a diagram indicating the position of the developer in relation to any subsidiaries and parent
corporation.
Exhibit E – If a partnership or association, submit a copy of the Articles of Partnership or Association or other
organizational documents.
Exhibit F – Consent to Service of Process.
File an irrevocable consent for service of process with the Nevada Secretary of State from the developer
and from each individual or entity owning or controlling a 10% or more interest in the developer. MAIL
DIRECTLY TO THE NEVADA SECRETARY OF STATE TOGETHER WITH A FILING FEE OF
$10.00 FOR EACH FORM.. Your filing will be considered incomplete without the consent(s). Exhibit
F attached.
Exhibit G – Copy of financial statement.
Submit a copy of the financial statement(s) of the developer. Such financial registration(s) shall not be
more than 6 months old and shall include a balance sheet and statement of profit and loss. They shall be
prepared by an independent certified public accountant.
Exhibit H – Submit a copy of the documents involved in the litigation or other action listed in Section I, (l,f,g,h), if
any. This includes but is not limited to copies of the following:
1. All Pleadings
2. Decision or other disposition
Exhibit I – A general location map showing total property offered or to be offered, drawn to scale, indicating
property included in this filing and property previously registered, if any, in Nevada..
Exhibit J – Legal description of the project in this registration.
Exhibit K – Submit the latest tax statement from the city and/or county assessor’s office covering the project
included in this filing.
Exhibit L – Submit evidence from the appropriate government authority or other verification that the use of the
campground being offered is not prohibited by local zoning ordinances.
03/20/17 Page 18 of 23 569
Exhibit M – Improvements and Facilities: (Not applicable if the project is completed and lien free).
Describe the project as to the structures, units and amenities:
1. What has been completed?
2. What is promised? Please submit the following on promised improvements:
a. Copy of the construction schedule for all promised improvements.
b. Copy of performance bonds or other financial assurances guaranteeing the
completion of the project.
c. Copy of contract with licensed contractor employed to complete the construction of
the project.
Exhibit N – Submit a copy of the Covenants, Conditions and Restrictions, if applicable.
Exhibit O – Submit a copy of the instrument which conveys membership or other interest to the purchaser.
Exhibit P – Submit a copy of property damage and liability insurance policy.
Exhibit Q – In Section I, 9, If the association, organization or other entity has been formed as a legal entity, attach as
exhibits, copies of articles of association and bylaws or similar documents.
Exhibit R – Evidence of Title:
1. Submit preliminary title report or equivalent document suitable to the Division, issued
after final unit maps are recorded. The title report shall not be dated earlier than 20
business days prior to the filing of this registration.
2. Copies of existing deeds of trust or mortgage(s).
3. Copy of any other lien or collateral instrument affecting the real or personal property.
Exhibit S – Encumbrances:
Copy of any escrow instructions, trust, subordination or non-disturbance agreement to be used to comply with the
foreclosure protection provisions set forth in NRS 119B.240
Exhibit T – If fire protection is to be available, submit a letter from the fire protection agency stating that protection
will be provided, including any charges or special conditions.
Exhibit U – Sales Documents.
1. Specimen copy of all sales contracts, agreements, option forms, escrow instructions to be
used in the sales program.
2. Specimen copy of lease forms, if applicable.
3. Specimen copy of form of deeds, notes, deeds of trust to be used to convey property or
secure purchase money indebtedness.
Sample forms are to be filled out to indicate actual terms and/or conditions of sale. All of the conveyance forms
mentioned should include thereon that the transfer is subject to recorded covenants, conditions and restrictions, if
any
03/20/17 Page 19 of 23 569
The following language must be printed clearly and conspicuously in 12-point boldface type at the top of all
contracts for the sale of a membership:
“This is a binding contract. You should examine the statement of your right to revoke this contract
which is contained elsewhere in this contract.” The following words must be printed clearly and
conspicuously above the purchaser’s signature line in each contract for the sale of a membership:
“The contract of membership may be canceled at the option of the member if he sends notice of cancellation
by certified mail, return receipt requested, to the developer, posted not later than midnight of the 5th calendar
day following the day on which the contract was signed..”
Every contract of sale of a membership located outside Nevada which is sold within this state must contain
one of the following sentences:
“This contract is to be construed according to the laws of Nevada and specifically chapter 119B of
NRS,”
or
“This contract is to be construed according to the laws of (name of the state or country). Any
purchaser solicited in Nevada retains those rights granted him under chapter 119B of NRS.”
Exhibit V – Submit all advertising, promotional or sales material, whether oral, photographic, electronic or printed,
for approval, prior to its use in a sales operation. The owner’s and/or developer’s name and connection
with the sales operation must be prominently shown on all advertising. A number will be provided by
the Division for each piece of advertising material that is approved which must be printed on all written
and film material.
Exhibit W – See attached statement to be completed and signed by the Broker of Record.
Exhibit X – See attached Affidavit of Registrant to be completed and signed by the applicant.
Exhibit Y – Submit a complete pro forma budget of the campground association, if any, or the developer’s budget
for maintenance and reserve, the financial assurances, provided by the developer assuring the
maintenance, together with the reserves, of the project.
Exhibit Z – Submit copy of management agreement, if applicable.
Exhibit AA – If the offering includes a reciprocal use program or is affiliated with a reciprocal use company, submit
the information required by NRS 119B.340.
Exhibit F
03/20/17 Page 20 of 23 569
STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY
REAL ESTATE DIVISION
CONSENT TO SERVICE OF PROCESS
(APPLICANT: MAIL THIS FORM DIRECTLY TO THE NEVADA SECRETARY OF STATE FOR FILING)
KNOW ALL MEN BY THESE PRESENTS: that pursuant to the provisions of Nevada Revised Statutes 119B
hereinafter referred to as “Developer,” hereby irrevocably
constitutes and appoints the Secretary of State of the State of Nevada or his successor in office, to be its true and lawful
attorney within this state, upon whom all legal process in any suit, action or proceeding arising under, or in any way connected
with the violation of any provision of Nevada Revised Statutes 119B or any rule or order pursuant thereto, or based upon any
fraud, deceit, breach of contract or other thing connected with the sale or offer for sale of campground interests, may be served
with the same force and validity as if in fact served upon said applicant, personally, within the State of Nevada. This
appointment and the authority of said attorney shall continue in force and effect so long as any such liability remains
outstanding, and a copy of any process served hereunder may be sent by registered mail addressed to:
Street Address
City
State
Zip
STATE OF
ss.
COUNTY OF
IN WITNESS WHEREOF, the aforesaid developer has caused these presents to be executed this
day of
, 20
CORPORATE SEAL
(If corporation)
Developer
Attest:
BY
Signature
Secretary
Title
For
Corporation
Before me, a Notary Public, in and for said county and state, personally appeared
and
to me known to be the persons who executed the foregoing instrument, who being first duly
sworn, severally made oaths that they are the president and secretary, respectively, of said
corporation; that the seal affixed hereto is the seal of said corporation, and that said
instrument was signed, sealed and delivered in behalf of said corporation by authority of its
board of directors as its free and voluntary act for the use and purposes therein set forth.
WITNESS my hand and official seal this
day of
, 20
My Commission Expires:
(Seal)
Notary Public
Exhibit F
03/20/17 Page 21 of 23 569
For
Partnership
Or
Trust
Before me, a Notary Public, in and for said county and state, personally appeared
to me known to be the person who executed the foregoing instrument, who, being first duly
sworn, upon oath deposes and says that he is a (partner)(trustee) of said (partnership) (trust),
that said instrument was signed, sealed and delivered for and on behalf of said (partnership)
(trust) and with authority of its (partners)(trustees) as its free and voluntary act for the use and
purposes therein set forth.
WITNESS my hand and official seal this
day of
, 20
My Commission Expires:
(Seal)
For
Individual
Before me, a Notary Public, in and for said county and state, personally appeared
to me known to be the person who executed the foregoing instrument, who, being by me first
duly sworn, acknowledged under oath that he executed the said instrument as his free and
voluntary act for the use and purposes therein set forth.
WITNESS my hand and official seal this
day of
, 20
My Commission Expires:
(Seal)
Exhibit W
03/20/17 Page 22 of 23 569
STATEMENT OF BROKER OF RECORD
I,
a licensed real estate broker in the State of Nevada, accept
the responsibility of Broker of Record for the developer,
I am responsible for the sales activities of the licensed salesman and the campground sales agents and promoting
activities of the representatives as outlined in NRS 119B and NRS 645.
I further state that:
1. I have reviewed the filing for the above named project.
2. I have personally inspected the subject property.
3. I have completely read Chapter 119B NRS.
4. I am aware that it is my responsibility to see that the sales operation will be in complete
compliance with NRS 119B and NRS 645 and NAC 645.
5. Attached is my outline for the sales operation.
6. I understand it is my obligation to notify the Division, in writing, if I terminate my
relationship with this project, employ or terminate sales agents, licensed salesmen or
representatives, or of any change in location of offering sites within Nevada.
7. List below all offering sites within Nevada. If none, please indicate.
Nevada Sales Site Location(s)
(Please give complete address)
Responsible Broker of Record/Branch Manager
Project(s) Name
Broker of Record Name (Print) License Number
Street Address
Signature of Broker of Record
City
State
Zip
Firm Name of Broker of Record
Street Address
City
State
Zip
Date
Telephone
Subscribed and sworn to before me this
day of
, 20
My Commission expires:
Notary Public
Exhibit Y
03/20/17 Page 23 of 23 569
AFFIDAVIT OF REGISTRANT
STATE OF
ss.
RE:
COUNTY OF
Project
I hereby certify under penalty of perjury that the statements contained in this Campground Registration together with
any documents submitted herewith are full, true, complete and correct; and that I am the owner of the project herein
described or will be at the time it is offered for sale or lease to the general public.
I further affirm and swear that I will not dispose or offer to dispose of interests in the property not contained in or
described by the attached Public Offering Statement without first amending the registration in the manner set forth in
Chapter 119B, Nevada Revised Statutes, and that I will notify the Division of Real Estate within fifteen (15) days of
any material change to the information in this Public Offering Statement.
I hereby represent that as the owner of the above mentioned project, I will not place, or allow to be placed, any
mortgages or any other liens on the project, other than those already in existence as of this date, copies of which
have been furnished to the Nevada Division of Real Estate as a part of the Campground Registration for the
aforesaid project, unless said Division is notified and approves of the encumbrance.
I am duly authorized to prepare and am the person responsible for the content of the accompanying Public Offering
Statement.
Date
Signature
Subscribed and sworn to before me this
day of
, 20
My Commission expires:
Notary Public
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REAL ESTATE DIVISION NEVADA CAMPGROUND REGISTRATION STATEMENT (Nevada Real Estate Division)

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Completed 28 December 2021

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