PROPERTY DISCLOSURE STATEMENT
PROPERTY IDENTIFICATION AND OWNERSHIP INFORMATION
Property Address: [PROPERTY ADDRESS]
Legal Description: [LEGAL DESCRIPTION AS IT APPEARS ON DEED/TITLE]
Current Owner(s):
- Name(s): [OWNER NAME(S)]
- Ownership Type: [INDIVIDUAL/JOINT TENANTS/TENANTS IN COMMON/TRUST/OTHER]
- Ownership Period: From [MONTH/YEAR] to present
Property Type: [SINGLE-FAMILY/MULTI-FAMILY/CONDOMINIUM/COMMERCIAL/OTHER]
INTRODUCTION AND PURPOSE
This Property Disclosure Statement ("Disclosure") is provided by the Seller(s) to prospective Buyer(s) regarding the real property identified above (the "Property"). This Disclosure is intended to satisfy the Seller's obligation to disclose known material defects about the Property as required under applicable state and federal laws. The information contained in this Disclosure is based on the Seller's actual knowledge and belief as of the date signed below.
DISCLAIMER
THIS DISCLOSURE IS NOT A WARRANTY OR GUARANTEE OF ANY KIND BY THE SELLER OR ANY AGENT REPRESENTING THE SELLER. THIS DISCLOSURE IS NOT A SUBSTITUTE FOR ANY INSPECTIONS, TESTS, OR WARRANTIES THAT THE BUYER MAY WISH TO OBTAIN. INDEPENDENT PROFESSIONAL INSPECTIONS OF THE PROPERTY ARE STRONGLY RECOMMENDED. THE REPRESENTATIONS IN THIS DISCLOSURE ARE MADE BY THE SELLER AND NOT BY ANY AGENT REPRESENTING THE SELLER.
INSTRUCTIONS TO SELLER
Please complete this form by answering all questions to the best of your knowledge and belief. If you do not have actual knowledge of a particular matter, please indicate "Unknown" or "N/A" (Not Applicable). If you need additional space for explanations, please use the "Additional Comments" section at the end of this document or attach additional pages as needed, clearly identifying the section and item number being explained.
STRUCTURAL COMPONENTS
1. Foundation
a. Are you aware of any past or present problems with the foundation of the Property?
□ Yes □ No □ Unknown
If yes, please explain: _______________________________________________________
b. Has the foundation ever been repaired?
□ Yes □ No □ Unknown
If yes, when and describe repairs: _____________________________________________
c. Are there any known foundation cracks, settling, or shifting?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
d. Has there been any water intrusion in the basement or crawl space?
□ Yes □ No □ Unknown □ Not Applicable
If yes, please describe: _____________________________________________________
2. Roof
a. Age of current roof: _____ years □ Unknown
b. Has the roof ever leaked during your ownership?
□ Yes □ No □ Unknown
If yes, please describe location, extent, and repair history: _________________________
c. Has the roof been repaired or replaced during your ownership?
□ Yes □ No □ Unknown
If yes, please provide date and nature of repair/replacement: ______________________
d. Are there any existing roof warranties that may transfer to the buyer?
□ Yes □ No □ Unknown
If yes, please provide details: ________________________________________________
3. Walls and Ceilings
a. Are you aware of any past or present problems with the walls or ceilings?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
b. Are there any known water stains or water damage to any walls or ceilings?
□ Yes □ No □ Unknown
If yes, please describe location and repair history: _______________________________
c. Are there any known structural issues with the walls?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
d. Are there any known cracks in the walls or ceilings?
□ Yes □ No □ Unknown
If yes, please describe location and size: _______________________________________
4. Windows and Doors
a. Are there any windows or doors that are not operational or have broken seals?
□ Yes □ No □ Unknown
If yes, please identify: ______________________________________________________
b. Are there any windows or doors with known defects or damage?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
c. Have any windows or doors been replaced during your ownership?
□ Yes □ No □ Unknown
If yes, please provide dates and details: ________________________________________
d. Are there any windows or doors with warranties that may transfer to the buyer?
□ Yes □ No □ Unknown
If yes, please provide details: ________________________________________________
SYSTEMS AND UTILITIES
5. Electrical System
a. Age of electrical system: _____ years □ Unknown
b. Type of wiring: □ Copper □ Aluminum □ Knob & Tube □ Other: ________ □ Unknown
c. Are you aware of any problems with the electrical system?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
d. Are there any known non-working outlets, fixtures, or switches?
□ Yes □ No □ Unknown
If yes, please identify locations: ______________________________________________
e. Has the electrical system been modified or updated during your ownership?
□ Yes □ No □ Unknown
If yes, please provide dates and details: ________________________________________
f. Are you aware of any electrical code violations?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
6. Plumbing System
a. Type of supply pipes: □ Copper □ PEX □ Galvanized □ PVC/CPVC □ Other: ________ □ Unknown
b. Type of drain pipes: □ PVC □ Cast Iron □ Lead □ Other: ________ □ Unknown
c. Are you aware of any problems with the plumbing system?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
d. Are there any known leaks, slow drains, or other plumbing issues?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
e. Has the plumbing system been modified or updated during your ownership?
□ Yes □ No □ Unknown
If yes, please provide dates and details: ________________________________________
f. Are you aware of any polybutylene piping in the Property?
□ Yes □ No □ Unknown
g. Are you aware of any lead piping in the Property?
□ Yes □ No □ Unknown
7. HVAC System (Heating, Ventilation, and Air Conditioning)
a. Type of heating system: □ Forced Air □ Radiant □ Heat Pump □ Baseboard □ Other: ________
b. Energy source for heating: □ Gas □ Electric □ Oil □ Propane □ Other: ________
c. Age of heating system: _____ years □ Unknown
d. Type of cooling system: □ Central Air □ Window Units □ Heat Pump □ None □ Other: ________
e. Age of cooling system: _____ years □ Unknown □ Not Applicable
f. Are you aware of any problems with the heating system?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
g. Are you aware of any problems with the cooling system?
□ Yes □ No □ Unknown □ Not Applicable
If yes, please describe: _____________________________________________________
h. When was the HVAC system last serviced? Date: ____________ □ Unknown
i. Are there any zones that do not properly heat or cool?
□ Yes □ No □ Unknown
If yes, please identify: ______________________________________________________
8. Water and Sewer
a. Water supply: □ Public □ Private Well □ Shared Well □ Other: ________
b. If private or shared well:
- Age of well: _____ years □ Unknown □ Not Applicable
- Depth of well: _____ feet □ Unknown □ Not Applicable
- Has the water been tested? □ Yes □ No □ Unknown □ Not Applicable
- If yes, date of last test: ____________ Results: ____________
c. Sewage disposal: □ Public Sewer □ Private Septic System □ Other: ________
d. If septic system:
- Age of septic system: _____ years □ Unknown □ Not Applicable
- Date of last inspection: ____________ □ Unknown □ Not Applicable
- Date of last pumping: ____________ □ Unknown □ Not Applicable
- Location of septic tank: ____________ □ Unknown □ Not Applicable
- Location of leach field: ____________ □ Unknown □ Not Applicable
e. Are you aware of any problems with the water supply or sewage disposal system?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
ENVIRONMENTAL CONCERNS
9. Water Damage and Flooding
a. Has the Property ever flooded or experienced water intrusion?
□ Yes □ No □ Unknown
If yes, please provide dates and details: ________________________________________
b. Is the Property located in a designated flood zone or floodplain?
□ Yes □ No □ Unknown
If yes, please provide details: ________________________________________________
c. Are you aware of any drainage or grading problems?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
d. Has flood insurance ever been maintained on the Property?
□ Yes □ No □ Unknown
If yes, please provide details: ________________________________________________
10. Mold
a. Are you aware of any past or present mold issues in the Property?
□ Yes □ No □ Unknown
If yes, please describe location and extent: _____________________________________
b. Has any mold testing or remediation been performed?
□ Yes □ No □ Unknown
If yes, please provide dates and results: ________________________________________
c. Are you aware of any conditions conducive to mold growth (e.g., persistent dampness, humidity)?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
11. Pest Infestations
a. Are you aware of any past or present infestations of termites or other wood-destroying insects?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
b. Has the Property been treated for termites or other wood-destroying insects?
□ Yes □ No □ Unknown
If yes, please provide dates and details: ________________________________________
c. Is there a termite bond or warranty in effect?
□ Yes □ No □ Unknown
If yes, is it transferable? □ Yes □ No □ Unknown
d. Are you aware of any past or present infestations of rodents, bats, snakes, or other pests?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
12. Hazardous Materials
a. Was the Property built before 1978?
□ Yes □ No □ Unknown
b. Are you aware of any lead-based paint in the Property?
□ Yes □ No □ Unknown
If yes, please describe location: ______________________________________________
c. Are you aware of any asbestos materials in the Property?
□ Yes □ No □ Unknown
If yes, please describe location: ______________________________________________
d. Has the Property been tested for radon?
□ Yes □ No □ Unknown
If yes, date of test: ____________ Results: ____________
e. Are you aware of any underground storage tanks on the Property?
□ Yes □ No □ Unknown
If yes, please describe location, contents, and age: ______________________________
f. Are you aware of any other hazardous or toxic substances on the Property (e.g., formaldehyde, methane gas, radioactive material, benzene, etc.)?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
13. Soil and Geological Issues
a. Are you aware of any soil problems such as expansive soils, unstable soil conditions, or sinkholes?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
b. Are you aware of any past or present erosion or landslide problems affecting the Property?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
c. Are you aware of any fill soil on the Property?
□ Yes □ No □ Unknown
If yes, please describe location and depth: _____________________________________
d. Has a soil or geological evaluation ever been performed on the Property?
□ Yes □ No □ Unknown
If yes, please provide dates and results: ________________________________________
LEGAL AND REGULATORY ISSUES
14. Zoning and Building Code Compliance
a. Current zoning classification of the Property: ____________ □ Unknown
b. Are you aware of any zoning violations or non-conforming uses?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
c. Are you aware of any building code violations?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
d. Are you aware of any notices of violation from any government agency?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
15. Permits and Improvements
a. Have any structural additions, alterations, or improvements been made to the Property during your ownership?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
b. Were building permits obtained for all significant improvements or additions?
□ Yes □ No □ Unknown □ Not Applicable
If no, please explain: _______________________________________________________
c. Were final inspections and approvals obtained for all permitted work?
□ Yes □ No □ Unknown □ Not Applicable
If no, please explain: _______________________________________________________
d. Are there any outstanding building permits that have not received final approval?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
16. Boundary Disputes
a. Are you aware of any boundary disputes, encroachments, or shared features (e.g., driveways, fences) with adjoining landowners?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
b. Has a survey of the Property been conducted during your ownership?
□ Yes □ No □ Unknown
If yes, date of survey: ____________
c. Are you aware of any discrepancies between the legal description, property lines, or acreage and the current use of the Property?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
17. Easements and Restrictions
a. Are you aware of any easements, rights-of-way, or similar matters that might affect the Property?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
b. Are you aware of any deed restrictions, covenants, or other restrictions on the use of the Property?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
c. Are you aware of any conservation easements or historical designations affecting the Property?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
18. Homeowners Association (HOA) Information
a. Is the Property part of a homeowners association, condominium association, or other community association?
□ Yes □ No □ Unknown
If no, skip to section 19.
b. Name of association: ____________
c. Contact information for association: ____________
d. Current regular assessment/dues: $_____ per □ Month □ Quarter □ Year
e. Are there any pending special assessments?
□ Yes □ No □ Unknown
If yes, please provide amount and purpose: _____________________________________
f. Are there any pending or ongoing litigation matters involving the association?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
g. Are you aware of any homeowners association violations or non-compliance issues?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
19. Litigation History
a. Are there any pending lawsuits, foreclosures, or other legal proceedings affecting the Property?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
b. Has there been any litigation or legal proceedings affecting the Property in the past five years?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
c. Have any insurance claims been filed relating to the Property in the past five years?
□ Yes □ No □ Unknown
If yes, please provide dates and details: ________________________________________
RENTAL PROPERTY SPECIFICS
(Complete this section only if the Property is currently or was recently tenant-occupied)
20. Tenant Information
a. Is the Property currently tenant-occupied?
□ Yes □ No □ Not Applicable
b. If yes, current lease term: From ____________ to ____________
c. Current monthly rent: $____________
d. Security deposit held: $____________
e. Are there any other deposits held? □ Yes □ No
If yes, please describe type and amount: _______________________________________
f. Are you aware of any tenant disputes or issues?
□ Yes □ No □ Not Applicable
If yes, please describe: _____________________________________________________
g. Will the Property be delivered vacant to the buyer?
□ Yes □ No □ Unknown □ Not Applicable
If no, please explain: _______________________________________________________
21. Rental History
a. How long has the Property been used as a rental? _____ years □ Not Applicable
b. Rental amounts for the past three years:
- Current year: $_____ per month
- Previous year: $_____ per month
- Two years ago: $_____ per month
□ Not Applicable
c. Average length of tenant occupancy: _____ □ Not Applicable
d. Average vacancy period between tenants: _____ □ Not Applicable
22. Rent Control Status
a. Is the Property subject to rent control, rent stabilization, or similar local ordinances?
□ Yes □ No □ Unknown □ Not Applicable
If yes, please describe current status and restrictions: ____________________________
b. Are there any pending changes to rent control status?
□ Yes □ No □ Unknown □ Not Applicable
If yes, please describe: _____________________________________________________
DEATH AND STIGMATIZED PROPERTY
23. Deaths on Property
a. Are you aware of any deaths that have occurred on the Property within the past three years?
□ Yes □ No □ Unknown
If yes, please provide details: ________________________________________________
b. Are you aware of any deaths that have occurred on the Property due to violent crimes?
□ Yes □ No □ Unknown
If yes, please provide details: ________________________________________________
24. Criminal Activity
a. Are you aware of any illegal drug manufacturing (such as methamphetamine) that has occurred on the Property?
□ Yes □ No □ Unknown
If yes, please provide details: ________________________________________________
b. Are you aware of any other criminal activity that has occurred on the Property?
□ Yes □ No □ Unknown
If yes, please provide details: ________________________________________________
c. Are you aware of any other events that might stigmatize the Property?
□ Yes □ No □ Unknown
If yes, please provide details: ________________________________________________
NEIGHBORHOOD CONDITIONS
25. Nuisances and Noise
a. Are you aware of any neighborhood noise problems or other nuisances?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
b. Are you aware of any landfills, industrial sites, or other environmentally sensitive areas nearby?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
c. Are you aware of any other nuisances, odors, or problematic conditions near the Property?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
26. Nearby Development
a. Are you aware of any planned or ongoing construction or development projects in the immediate area?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
b. Are you aware of any planned or recently approved zoning changes in the area?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
c. Are you aware of any street or utility work planned or currently underway that may affect the Property?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
UTILITY COSTS AND INSURANCE
27. Utility Expense History
a. Average monthly electricity cost: $_____ □ Unknown
b. Average monthly gas/heating cost: $_____ □ Unknown □ Not Applicable
c. Average monthly water/sewer cost: $_____ □ Unknown □ Not Applicable
d. Are there any unusual utility costs or circumstances buyers should be aware of?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
28. Insurance Claims History
a. Have any insurance claims been filed relating to the Property in the past five years?
□ Yes □ No □ Unknown
If yes, please provide dates, types of claims, and outcomes: _______________________
b. Has insurance coverage for the Property ever been denied, canceled, or non-renewed?
□ Yes □ No □ Unknown
If yes, please explain: _______________________________________________________
c. Are you aware of any conditions that may affect the ability to obtain property insurance?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
APPLIANCES AND FIXTURES
29. Appliance and Fixture Defects
a. Are there any defects or malfunctions with any appliances or fixtures that will remain with the Property?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
b. Please list the approximate age of major appliances that will remain with the Property:
- Refrigerator: _____ years □ Unknown □ Not Included
- Range/Oven: _____ years □ Unknown □ Not Included
- Dishwasher: _____ years □ Unknown □ Not Included
- Microwave: _____ years □ Unknown □ Not Included
- Washer: _____ years □ Unknown □ Not Included
- Dryer: _____ years □ Unknown □ Not Included
- Water Heater: _____ years □ Unknown □ Not Included
- Other: ____________ _____ years □ Unknown □ Not Included
c. Are there any warranties for appliances or fixtures that may transfer to the buyer?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
ADDITIONAL INFORMATION
30. Additional Disclosures
a. Are there any other material defects affecting the Property not otherwise disclosed in this statement?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
b. Are there any other conditions or aspects of the Property that a buyer would want to know about when making a decision to purchase?
□ Yes □ No □ Unknown
If yes, please describe: _____________________________________________________
31. Additional Comments
Please use this space to provide any additional explanations or information:
SELLER'S KNOWLEDGE STATEMENT AND CERTIFICATION
I/We, the undersigned Seller(s), hereby state that the information contained in this Property Disclosure Statement is true and accurate to the best of my/our knowledge as of the date signed below. I/We have not knowingly withheld any information that would affect the value or desirability of the Property. I/We have not knowingly failed to disclose any material defect or material fact relating to the condition of the Property.
I/We understand that this information is being provided as a courtesy to assist prospective Buyer(s) and is not a warranty or guarantee of any kind by the Seller(s) or any real estate agent. I/We understand that it is my/our responsibility to disclose any material facts of which I/we have actual knowledge that could affect the value or desirability of the Property.
I/We authorize the real estate agent(s) involved in this transaction to provide a copy of this disclosure to any prospective Buyer(s) or their agent.
Seller's Signature: __________________________ Date: ______________
Printed Name: _____________________________
Seller's Signature: __________________________ Date: ______________
Printed Name: _____________________________
BUYER'S ACKNOWLEDGMENT
I/We, the undersigned Buyer(s), hereby acknowledge receipt of this Property Disclosure Statement. I/We understand that this disclosure is not a warranty and that I/we should conduct my/our own independent inspections and investigations regarding the Property. I/We understand that this disclosure is based on the Seller's knowledge and may not include all defects or issues with the Property.
Buyer's Signature: __________________________ Date: ______________
Printed Name: _____________________________
Buyer's Signature: __________________________ Date: ______________
Printed Name: _____________________________
AGENT'S ACKNOWLEDGMENT
I, the undersigned real estate agent, have informed the Seller of the Seller's obligation to provide this Property Disclosure Statement to the Buyer. I have not made any independent investigation or verification of the information contained in this disclosure. I have no knowledge of any material defect in the Property other than what may have been disclosed in this statement or otherwise disclosed in writing to the Buyer.
Agent's Signature: __________________________ Date: ______________
Printed Name: _____________________________
Brokerage: _______________________________