Form 609 - Reserve Study Summary Form Page 2
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1
2ADDITIONAL INFORMATION
Are there major components in this reserve study that were not previously identified? Yes
No If yes, explain and attach
supporting documents, if appropriate.
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
FINANCIAL/FUNDING INFORMATION
Accounting fiscal year end (Mo
/day): ____/____
Reconciliation of Reserve Fund Account: (NRS 116.31151)
Reserve account balance at beginning of current fiscal year:
_____________________________
$_____________________
Plus: Current year budgeted reserve transfer:
___________________________
+ $_____________________
Plus: Current year projected investment income:
________________________ _____________
+ $_____________________
Plus: Anticipated reserve assessment, if any (**provide info below):
________
+ $_____________________
Less: Current year projected major repairs and replacements:
______________ _____________
- $_____________________
Other reconciling items: (indicate + or – dollar amounts)
_________________
+/- $_____________________
Projected reserve account balance at the end of current fiscal year end:
_______
= $_____________________
Required reserve account balance at end of current fiscal year based upon this reserve study:
___
$_____________________
Is there a difference between the projected and required balances? If so, list the reason(s) for the difference:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
How does the executive board propose resolving the difference?
___________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
**Provide detailed information pertaining to any anticipated reserve assessments: ________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
Are the reserve funds held in separate accounts?
No
Yes
If no, why not? _____________________________________________________________________________________________
RESERVE STUDY INFORMATION:
Total estimated current replacement costs of the major component inventory:
$_____________________
Funding plan selected: Full funding
Threshold funding
Baseline funding
“I declare under penalty of perjury under the law of the State of Nevada that the foregoing, to the best of my knowledge
and belief, is true and correct.”
Name of person completing this form (print) ___________________________________________ Title: __________________________
Person authorized to sign form: □ Board Member (title: ___________) □ Community Manager (License #___________) □ Declarant
Director
Signature: __________________________________Print name: ________________________________ Date signed: ____/____/____
Revised 01/20/16
Page 2 of 2
Form 609
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