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