Form 781 - Request For Books, Records And Other Documents Page 2

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Have the following steps been completed?
.
All questions must be answered in order to process your request
Have you formally requested the records in writing? ……………………………
Yes
No
Pursuant to NRS 116.31175(2), has the 21 day period expired from the date of the original writing
request for documents? …………………………….……………………………
Yes
No
Is this request for records due to? …………………………
Denial of request
No response
** Attached to this form, must be a copy of the written request that was submitted. **
(i.e. emails (entire conversation must be submitted); letters)
Records requested:
List numerically and legibly. Attach additional pages if necessary
1.
2.
3.
4.
5.
Request for records were sent to whom? ……
Community Manager
Board Members
Individual’s name: _______________________________________________________________
Company name (if applicable): _____________________________________________________
Please sign and send all original documentation:
Office of the Ombudsman
Marina Benn
2501 East Sahara Ave, Ste 202
Las Vegas, NV 89104
I have read and understand the foregoing information regarding my request.
_____________________________________________
Print the name of the person who is requesting the documents
_____________________________________________
_____________________
Signature of Requestor
Date
Revised: 8/13/15
2
781

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