SELLER'S DISCLOSURE OF PROPERTY CONDITION
CONCERNING THE PROPERTY AT:
____________________________________________________________
(Street Address and City)
THIS NOTICE IS A DISCLOSURE OF SELLER'S KNOWLEDGE OF THE CONDITION OF THE PROPERTY AS OF THE DATE SIGNED BY SELLER AND IS NOT A SUBSTITUTE FOR ANY INSPECTIONS OR WARRANTIES THE PURCHASER MAY WISH TO OBTAIN. IT IS NOT A WARRANTY OF ANY KIND BY SELLER OR SELLER'S AGENTS.
Seller [choose one:] _____is _____is not occupying the Property. If unoccupied, how long since Seller has occupied the Property? _____________________________________________________________
1. The Property has the items checked below [Write Yes (Y), No (N), or Unknown (U)]:
____ Range ____ Oven ____ Microwave
____ Dishwasher ____ Trash Compactor ____ Disposal
____ Washer/Dryer Hookups ____ Window Screens ____ Rain Gutters
____ Security System ____ Fire Detection Equipment ____ Intercom System
____ TV Antenna ____ Cable TV Wiring ____ Satellite Dish
____ Ceiling Fan(s) ____ Attic Fan(s) ____ Exhaust Fan(s)
____ Central A/C ____ Central Heating ____ Wall/Window Air Conditioning
____ Plumbing System ____ Septic System ____ Public Sewer System
____ Patio/Decking ____ Outdoor Grill ____ Fences
____ Pool ____ Sauna ____ Spa ____ Hot Tub
____ Pool Equipment ____ Pool Heater ____ Automatic Lawn Sprinkler
____ Fireplace(s)/Chimney (Wood) ____ Fireplace(s)/Chimney (Mock) ____ Gas Lines (Nat./LP)
____ Gas Fixtures Garage: ___Attached ___Not Attached ____ Carport
Garage Door Opener(s): ____ Electronic ____ Control(s)
Water Heater: ____ Gas ____ Electric
Water Supply: ____ City ____ Well ____ MUD ____ Co-op
Roof Type: ______________________________ Age: ______________________________ (approx)
Are you (Seller) aware of any of the above items that are not in working condition, that have known defects, or that are in need of repair? [choose one:] ____Yes ____No ____Unknown. If yes, then describe. (Attach additional sheets if necessary): ______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
2. Are you (Seller) aware of any known defects/malfunctions in any of the following? [Write Yes (Y) if you are aware, write No (N) if you are not aware.]
____ Interior Walls ____ Ceilings ____ Floors
____ Exterior Walls ____ Doors ____ Windows
____ Roof ____ Foundation/Slab(s) ____ Basement
____ Walls/Fences ____ Driveways ____ Sidewalks
____ Plumbing/Sewers/Septics ____ Electrical Systems ____ Lighting Fixtures
____ Other Structural Components (Describe):
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
If the answer to any of the above is yes, explain. (Attach additional sheets if necessary):
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
3. Are you (Seller) aware of any of the following conditions? Write Yes (Y) if you are aware, write No (N) if you are not aware.
____ Active Termites (includes ____ Termite or Wood Rot Damage ____ Previous Termite Damage
wood destroying insects) Needing Repair
____ Previous Termite Treatment ____ Previous Flooding ____ Improper Drainage
____ Water Penetration ____ Located in 100-Year Floodplain ____ Present Flood Insurance
____ Prior Structural/Roof Repair ____ Hazardous or Toxic Waste ____ Asbestos Components
____ Urea-formaldehyde Insulation ____ Radon Gas ____ Lead Based Paint
____ Aluminum Wiring ____ Previous Fires ____ Unplatted Easements
____ Landfill, Settling, Soil ____ Subsurface Structure or Pits
Movement, Fault Lines
If the answer to any of the above is yes, explain. (Attach additional sheets if necessary):
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
4. Are you (Seller) aware of any item, equipment, or system in or on the Property that is in need of repair? ____Yes (if you are aware) ____No (if you are not aware). If yes, explain (attach additional sheets as necessary). ______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
5. Are you (Seller) aware of any of the following? Write Yes (Y) if you are aware, write No (N) if you are not aware.
____ Room additions, structural modifications, or other alterations or repairs made without necessary permits or not in compliance with building codes in effect at that time.
____ Homeowners' Association or maintenance fees or assessments.
____ Any "common area" (facilities such as pools, tennis courts, walkways, or other areas) co-owned in undivided interest with others.
____ Any notices of violations of deed restrictions or governmental ordinances affecting the condition or use of the Property.
____ Any lawsuits directly or indirectly affecting the Property.
____ Any condition on the Property which materially affects the physical health or safety of an individual.
If the answer to any of the above is yes, explain. (Attach additional sheets if necessary):
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
_________________________________________ _________________________________________
Date Signature of Seller Date Signature of Seller
The undersigned purchaser hereby acknowledges receipt of the foregoing notice.
_________________________________________ _________________________________________
Date Signature of Purchaser Date Signature of Purchaser
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