Minnesota Administrative Rules
Agency 120 - Commerce Department
Chapter 2810 - SUBDIVIDED LAND
REPORTING FORMS
Part 2810.9950 - FORMAT OF ANNUAL REPORT
Current through Register Vol. 49, No. 13, September 23, 2024
STATE OF MINNESOTA
DEPARTMENT OF COMMERCE, REGISTRATION AND LICENSING DIVISION
5th Floor Metro Square Building
ANNUAL REPORT -- SUBDIVIDED LAND
THIS REPORT MUST BE FILED NOT LATER THAN 120 DAYS AFTER THE FISCAL YEAR END OF THE SUBDIVIDER.
1. Name of subdivider __________________________________
2. Business Address ____________________________________
3. Name of Subdivision _________________________________
4. Description of Units ________________________________
5. Number of Units Registered __________________________
6. Date of Registration ________________________________
7. Registration Number _________________________________
8. Please check one of the following boxes:
Continued registration is desired.
Cancellation of registration is desired.
9. State the aggregate number of units sold pursuant to the above described registration or any amendment thereof to residents of the state of Minnesota. ______________________
10. State the aggregate number of units outstanding at the date of the last annual report filed with the Registration and Licensing Division, Department of Commerce, State of Minnesota.
11. Specify by date of transaction, number of units, and aggregate dollar amount, all sales of any subdivided land by the subdivider or an agent to Minnesota residents since the date of the last annual report filed with the Registration and Licensing Division, Department of Commerce, State of Minnesota.
12. Specify any exemption from registration claimed for any sale described in 11 above.
13. State the aggregate number of units outstanding at the date of this report.
14. Attach the following exhibits.
| Signed _____ | |
| By: _____ | |
| its _____ |
APPLICANT'S VERIFICATION
| State of _____ | ) |
| ) SS. | |
| County of _____ | ) |
On this ______ day of _______, ____, _______________________, appeared before me, a Notary Public, and being first duly sworn, says that it is the applicant; that it has read the foregoing application and accompanying exhibits, and that the contents thereof are true of its own knowledge.
| _____ | ||
| (NOTARIAL SEAL) | Notary Public, _____ County _____ | |
| My Commission Expires _____ |
INDIVIDUAL VERIFICATION
| State of _____ | ) |
| ) SS. | |
| County of _____ | ) |
On this ________ day of __________, ____, ______________________, appeared before me, a Notary Public, and being first duly sworn, says that ..he is the __________________________ of __________________________ and that ..he is duly authorized and empowered to execute this application on its behalf.
| _____ | ||
| (NOTARIAL SEAL) | Notary Public, _____ County _____ | |
| My Commission Expires _____ |
Statutory Authority: MS s 83.38
