Georgia Residential Real Estate Form PDF Details

Navigating the complexity of real estate transactions in Georgia is made more straightforward with the structured guidance of the Georgia Residential Real Estate form. This comprehensive document plays a crucial role in ensuring transparency and honesty in real estate dealings by requiring sellers to disclose the condition and specifics of their property. Sellers are instructed to provide detailed information without leaving any sections incomplete, ensuring clarity on various aspects of the property, from legal authority to sell, to potential encroachments or easements, and conditions affecting water sources or septic systems. The form also delves into structural details, inquiring about any known defects in systems, fixtures, or the structural integrity of the property itself. It serves as a disclosure form rather than a contractual agreement, highlighting its purpose to inform rather than bind parties to terms. Moreover, it advises potential buyers about the merits of seeking professional inspections, thereby encouraging informed decision-making. Sellers disclose based on their knowledge, aiming to bridge the information gap and foster a trustful transaction environment. This document not only assists in making informed decisions but also exemplifies the legal ethos of fairness in property transactions.

QuestionAnswer
Form NameGeorgia Residential Real Estate Form
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other namesreal estate disclosure statement, seller disclosure form georgia, ga seller's disclosure form, property disclosure form

Form Preview Example

RESIDENTIAL PROPERTY DISCLOSURE AND DISCLAIMER STATEMENT

INSTRUCTIONS TO THE SELLER

Please complete the following form. Do not leave any spaces blank. If the question clearly does not apply to the property write "NA". If the answer to any items requires explanation, explain on attached sheets, if necessary.

NOTICE TO THE BUYER

THE FOLLOWING DISCLOSURES ARE MADE BY THE SELLER(S), CONCERNING THE CONDITION OF THE PROPERTY LOCATED AT ______________________________________________________________________________________________

___________________________________________________________________________________________________________.

("THE PROPERTY"), OR AS LEGALLY DESCRIBED ON ATTACHED EXHIBIT A.

DISCLOSURES CONTAINED IN THIS FORM ARE PROVIDED BY THE SELLER ON THE BASIS OF SELLER'S ACTUAL KNOWLEDGE OF THE PROPERTY AT THE TIME THIS DISCLOSURE FORM IS COMPLETED BY THE SELLER. THE FOLLOWING ARE DISCLOSURES MADE BY THE SELLER AND ARE NOT THE REPRESENTATIONS OF ANY REAL ESTATE LICENSEE OR OTHER PARTY. THIS INFORMATION IS FOR DISCLOSURE ONLY AND IS NOT INTENDED TO BE A PART OF ANY WRITTEN AGREEMENT BETWEEN THE BUYER AND THE SELLER.

FOR A MORE COMPREHENSIVE EXAMINATION OF THE SPECIFIC CONDITION OF THIS PROPERTY YOU ARE ADVISED TO OBTAIN AND PAY FOR THE SERVICES OF A QUALIFIED SPECIALIST TO INSPECT THE PROPERTY ON YOUR BEHALF, FOR EXAMPLE, ARCHITECTS, ENGINEERS, LAND SURVEYORS, PLUMBERS, ELECTRICIANS, ROOFERS, BUILDING INSPECTORS, OR PEST AND DRY ROT INSPECTORS. THE PROSPECTIVE BUYER AND THE OWNER MAY WISH TO OBTAIN PROFESSIONAL ADVICE OR INSPECTIONS OF THE PROPERTY AND TO PROVIDE FOR APPROPRIATE PROVISIONS IN A CONTRACT BETWEEN THEM WITH RESPECT TO ANY ADVICE, INSPECTION, DEFECTS OR WARRANTIES.

Seller(s), ____________________________________________________________, [is] / [is not] currently occupying the property.

Seller has owned the property for ______ years.

I. SELLER’S DISCLOSURES. If explanation is needed, use attached sheet if necessary. Approximations should be labeled as such.

1. TITLE

YES

NO

UNKNOWN

A. Do you have legal authority to sell the property?

B. Is title to the property subject to any of the following:

(1) First right of refusal

If yes, explain:

(2) Option

If yes, explain:

(3) Lease or Rental Agreement

If yes, explain:

(4) Life Estate

If yes, explain:

C. Are there any encroachments, boundary disputes, or boundary agreements?

If yes, explain:

D. Are there any rights of way, easements, or access limitations that may affect the owner's use of the property?

If yes, explain:

E. Are there any written agreements for joint maintenance of an easement or right of way?

If yes, explain:

F. Is there any study, survey project, or notice that would adversely affect the property?

If yes, explain:

G. Are there any pending or existing assessments against the property?

If yes, explain:

H. Are there any zoning violations, nonconforming uses, or any unusual restrictions on the subject property that would affect future construction or remodeling?

If yes, explain:

I. Is there a boundary survey for the property? If yes, attach survey.

- 1 -

1. TITLE

 

 

 

 

YES

 

 

NO

UNKNOWN

J. Are the property’s boundaries marked?

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

K. Are there fences on the property?

 

 

 

 

 

 

 

 

 

 

 

If yes, were the fences put up by the property owner?

 

 

 

 

 

 

 

 

 

 

 

L. Are any trees or other flora on the property diseased, dead or damaged?

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

M. Are there any covenants, conditions, or restrictions which affect the property?

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

N. Is the property accessed by public or private road?

 

 

 

PUBLIC

 

PRIVATE

 

UNKNOWN

If private, what yearly upkeep amount is paid by the property owner?

 

 

 

 

 

 

 

 

 

 

 

If private, explain road upkeep in detail:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. WATER

 

 

 

 

 

 

 

 

 

 

 

A. Household Water

 

 

 

 

 

 

 

 

 

 

 

(1) The source of the water is:

Public

 

Community

 

Private

 

Shared

(2) Water source information:

 

 

 

 

YES

 

 

NO

UNKNOWN

a. Are there any written agreements for shared water source?

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

b. Is there an easement (recorded or unrecorded) for access to and/or maintenance of

 

 

 

 

 

 

 

 

 

the water source?

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

c. Are any known problems or repairs needed?

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

d. Does the source provide an adequate year round supply of potable water?

 

 

 

 

 

 

 

 

 

e. Are there any water treatment systems (softener, purifier, etc.) for the property?

If yes, explain, and state if the system(s) is/are leased or owned:

B. Irrigation

(1) Are there any water rights for the property?

If yes, explain:

(2)If they exist, to your knowledge, have the water rights been used during the last five- year period?

If yes, explain:

(3) If so, is the certificate available?

Explain:

C. Outdoor Sprinkler System

(1) Is there an outdoor sprinkler system for the property?

(2) Are there any defects in the outdoor sprinkler system?

If yes, explain:

3. SEWER/SEPTIC SYSTEM

A. The property is served by (circle one):

Public Sewer Main

Septic Tank System

 

Other Disposal System

If other, describe:

 

 

 

 

 

 

B. If the property is served by a public or community sewer main, is the house connected to the main?

Yes

No

Unknown

If no, explain:

 

 

 

 

 

 

C. Is the property currently subject to a sewer capacity charge?

 

 

Yes

No

Unknown

If yes, explain:

 

 

 

 

 

 

D. If the property is connected to a septic system:

 

 

 

 

 

 

(1) Was a permit issued for its construction, and was it approved by the city or county following its

Yes

No

Unknown

construction?

 

 

 

 

 

 

(2) On what date was it last pumped:

 

 

 

 

 

 

(3) Are there any defects in the operation of the septic system?

 

Yes

No

Unknown

If yes, explain:

 

 

 

 

 

 

(4) On what date was it last inspected:

By whom:

- 2 -

(5) How many bedrooms was the system approved for?

 

E. Do all plumbing fixtures, including laundry drain, go to the septic/sewer system?

 

Yes

No

 

Unknown

 

 

If no, explain:

 

 

 

 

 

 

 

 

F. Are you aware of any changes or repairs to the septic system?

 

Yes

No

 

Unknown

 

 

If yes, explain:

 

 

 

 

 

 

 

 

G. Is the septic system, including drainage field, located entirely within the property’s boundaries?

 

Yes

No

 

Unknown

 

 

If no, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. STRUCTURAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. How old is the current roof? ____ years. (If unknown, mark Unknown.)

 

 

 

 

 

Unknown

 

 

Roof is constructed of: Asphalt Shingle, Wood Shingle, Slate, Metal, Tile, Asbestos,

 

Unknown,

 

 

 

Other:

 

 

 

 

 

 

 

 

B. Has the roof leaked during your ownership?

 

Yes

No

Unknown

 

 

If yes, has it been repaired?

 

Yes

No

 

 

 

Explain any roof repairs of which you are aware:

 

 

 

 

 

 

 

 

C. Has the house undergone any conversions, additions, or remodeling?

 

Yes

No

Unknown

 

 

1. If yes, were all building permits obtained?

 

Yes

No

Unknown

 

 

2. If yes, were all final inspections obtained?

 

Yes

No

Unknown

 

Explain any conversions/additions/remodeling:

D. Do you know the age of the house?

Yes

No

If yes, give year of original construction (if approximation, indicate such):

 

 

E. Are you aware of:

Yes

No

(1)

Any movement, shifting, deterioration or other problems with walls, foundation, crawl space or slab?

Yes

No

(2)

Any cracks or flaws in the walls, ceilings, foundations, concrete slab, crawl space, basement, floors or garage?

Yes

No

(3)

Any water leakage or dampness in the crawl space or basement?

Yes

No

(4)

Any dry rot on the property?

Yes

No

(5)

Any repairs or other attempts to control the cause or effect of any problem described above?

Yes

No

Explain any ‘Yes’ answer(s) to 1-5 above. When describing repairs or control efforts, describe the location, extent, date, and name of person/company who did the work. Attach any reports and/or other documentation:

F. If you know of any defect(s) regarding the following items, mark the defective item with a check:

1. Foundation

6. Fire Alarm

11. Slab Floors

 

16. Sidewalks

21. Balconies

2. Deck

7. Doors

12. Driveways

 

17. Outbuildings

22. Wood Stoves

3. Exterior walls

8. Door locks

13. Attic Stairs

 

18. Fireplaces

 

 

4. Chimneys

9. Patio

14. Windows

 

19. Garage Floors

 

 

5. Interior walls

10. Ceilings

15. Window locks

 

20. Walkways

 

 

If you checked any of the above items, explain the defect(s):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

G. In the last 4 years, was a pest, dry rot, structural or "whole house" inspection done?

 

Yes

No

Unknown

 

 

 

 

If yes, which test(s), when, and by whom was the inspection done? (Attach documentation)

 

 

 

 

 

 

 

 

 

 

 

 

H. Has the property had a problem with pest control, infestations, or vermin?

 

Yes

No

Unknown

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I. Are you aware of:

 

 

 

 

 

 

 

 

 

 

 

 

(1) Any termites, wood destroying insects or pests on or affecting the property?

 

Yes

No

 

 

 

 

 

 

(2) Property damage by termites, wood destroying insects or pests?

 

Yes

No

 

 

 

 

 

 

 

 

 

- 3 -

If yes, describe:

(3) Any termite/pest control treatments on the property in the last 4 years?

 

 

 

 

 

 

 

 

 

 

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, list company and where treated:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(4) Current warranty or other coverage by a licensed pest control company on the property?

 

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, explain warranty and attach documentation:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

J. Have you made a homeowner’s insurance claim(s) regarding the property in the last 4 years?

 

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, explain when and why:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. SYSTEMS AND FIXTURES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If the following systems or fixtures are included with the transfer, do they have any existing defects:

 

YES

 

NO

 

UNKNOWN

 

A. Electrical system, including wiring, all switches, all outlets, and service

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What type of wiring comprises the electrical system?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Copper

 

Aluminum

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B. Plumbing system, including pipes, faucets, fixtures, and toilets

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C. Hot water heater (mark one):

 

 

Electric

 

Natural Gas

 

Other:

 

 

Age: ____ years

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D. Oven/stove:

Electric

Natural Gas

 

Other:

 

 

 

 

 

 

 

 

Age: _____ years

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E. List ANY OTHER APPLIANCES TO REMAIN, attach separate sheet if necessary.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

 

 

 

 

 

 

Age: _____ years

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

 

NO

 

UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

Age: _____ years

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

 

Age: _____ years

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

F. Cooling and Heating systems

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Air Conditioning (mark one):

 

 

 

 

Central Electric

 

Central Gas

Heat Pump

 

Window Unit(s) ____ # included in sale

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other (describe):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Air Conditioning (continued):

 

 

 

 

Age of cooling system: _____ years.

 

Zoned cooling? [Yes] [No]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Air Conditioning defects?

 

 

No

Unknown

 

 

Yes, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Heating system (mark one):

 

 

 

 

Electric

 

Natural Gas

Fuel Oil

 

Heat Pump

 

Propane

Other:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Age of heating system: _____ years.

 

Zoned heating? [Yes] [No]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Heating system defects?

 

 

No

Unknown

 

 

Yes, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last date of servicing:

 

Heating:

 

 

 

 

 

 

 

 

 

Cooling:

 

 

 

 

By whom:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are there rooms without heating/air conditioning vents?

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If yes, which rooms:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

G. Security system (Circle One):

 

 

 

 

Owned

 

 

Leased

 

 

 

 

 

 

 

 

 

 

 

 

Any defects?

Yes

No

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Describe security system:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If defects are indicated, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

H. Other:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Any defects?

 

 

 

 

Yes

No

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If defects are indicated, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. COMMON INTEREST

 

 

 

 

 

 

 

A. Is there a Home Owners' Association?

 

 

Yes

 

No

Unknown

 

 

 

 

 

 

 

 

If yes, what is the name of the association?

 

 

 

 

 

 

B. Are there regular periodic assessments:

 

 

Yes

 

No

Unknown

If yes, give amount per:

Month: $

 

Year: $

Other: $

 

If other, explain:

 

 

 

 

 

 

 

 

 

- 4 -

 

 

 

 

 

C. Are there any pending special assessments?

Yes

No

Unknown

 

 

 

 

D. Are there any shared “common areas” or any joint maintenance agreements (facilities such

Yes

No

Unknown

as walls, fences, landscaping, pools, tennis courts, walkways, or other areas co-owned in

 

 

 

undivided interest with others)?

 

 

 

If any such areas exist, explain:

 

 

 

 

 

 

 

 

 

 

 

7. APPLIANCES, HEATING, PLUMBING, ELECTRICAL and OTHER MECHANICAL SYSTEMS

Instructions: Mark INCL if the item is included in the sale. If item is included in sale, mark Yes or No to indicate whether item is in working order. Indicate the item’s approximate age (in years) in the ‘age’ space, if provided-- if age is unknown, mark ‘?’ in space.

 

ITEM

 

 

 

INCL

 

 

Yes

 

 

No

 

 

 

 

ITEM

 

 

 

INCL

 

 

Yes

 

 

No

 

 

Attic Fan

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Lawn Sprinkler Auto-timer

 

 

 

 

 

 

 

 

 

 

 

 

Air Conditioner (central)

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

Lawn Sprinkler Backflow Valve

 

 

 

 

 

Air Conditioner (wall/window) age:

 

 

 

 

 

 

 

 

 

 

 

 

 

Microwave Oven

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Air Cleaner/Purifier

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

Plumbing

 

 

 

 

 

 

 

 

 

 

 

 

Ceiling Fan(s), # included ____

 

 

 

 

 

 

 

 

 

 

 

 

 

Pool

age:

 

 

 

 

 

Clothes Washer

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

Pool Equipment/ mechanisms

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Convection Oven

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

Range/Oven

age:

 

 

 

 

 

Dishwasher

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

Range Timer

 

 

 

 

 

 

 

 

 

 

 

 

Door Bells

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Range Vent-hood

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Drain Tile System

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Refrigerator

age:

 

 

 

 

 

Dryer

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

Security System

 

 

 

 

 

 

 

 

 

 

 

 

Exhaust Fans (bathroom)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Smoke Detectors (battery)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fireplace

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Smoke Detectors (hardwired)

 

 

 

 

 

 

 

 

 

 

 

 

Fireplace Mechanisms

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Solar Collectors

 

 

 

 

 

 

 

 

 

 

 

 

Furnace

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

Sump Pump

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Furnace Mechanisms

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Toilet Mechanisms

 

 

 

 

 

 

 

 

 

 

 

 

Freezer

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

TV Antenna/ receiver/ dish

 

 

 

 

 

 

 

 

 

 

 

 

Garbage Compactor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TV Cable wiring

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Garbage Disposal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Water Heater

age:

 

 

 

 

 

Garage Door Opener (GDO)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Window Treatments

 

 

 

 

 

 

 

 

 

 

 

 

GDO Auto-reverse Safety Mechanism

 

 

 

 

 

 

 

 

 

 

 

 

 

Whirlpool/Hot-tub

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GDO Remote Opener(s), # included: ___

 

 

 

 

 

 

 

 

 

 

 

 

 

Wood Burning Stove

 

 

 

 

 

 

 

 

 

 

 

 

Gas Grill

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yard Lights

 

 

 

 

 

 

 

 

 

 

 

 

Gas Logs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Heating System (central)

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

Other:

 

 

 

 

 

 

 

 

 

 

 

 

Heating System (supplemental) age:

 

 

 

 

 

 

 

 

 

 

 

 

 

Other:

 

 

 

 

 

 

 

 

 

 

 

 

Humidifier

age:

 

 

 

 

 

 

 

 

 

 

 

 

 

Other:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Incinerator

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other:

 

 

 

 

 

 

 

 

 

 

 

 

Intercom

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other:

 

 

 

 

 

 

 

 

 

 

 

 

Lawn Sprinkler System

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanations: if any item above is NOT in working order, list the item and explain the defect in the space below.

8. GENERAL

 

YES

 

NO

UNKNOWN

A. Is there any settling, soil, standing water, or drainage problems on the property?

If yes, explain:

B. Does the property contain fill material?

C. Is there any material damage to the property or any of the structure from fire, wind, floods, beach movements, earthquake, expansive soils, or landslides?

If yes, explain:

D. Is the property in a designated flood plain?

- 5 -

E. Are there any substances, materials, or products that may be an environmental hazard such as, but not limited to, asbestos, formaldehyde, radon gas, lead-based paint, fuel or chemical storage tanks and contaminated soil or water on the subject property?

If yes, explain:

F. Are there any tanks or underground storage tanks (e.g., chemical, fuel, etc.) on the property?

If yes, explain, and give approx. position (attach map):

G. Has the property ever been used as an illegal drug-manufacturing site?

If yes, explain:

H. If the property contains a wood-burning stove or fireplace, when was/were the chimney(ies) last cleaned?

Detail date(s) and chimney(ies), or mark Unknown:

I. Are you aware of any of the following regarding the property?

Existing or threatened legal action

Violation of any law or regulation

General stains or pet stains to carpet or floor

Transferable warranties

Any locks without keys

Unrecorded interests affecting the property

Fire Damage at any time

Appraiser or Mechanic’s Lien

Landfills or underground problems

If any of the above are marked, explain:

 

 

J.If any tests to detect radon gas have been done on the property, provide documentation. If radon gas has been detected on the property, explain when, where, by whom, and all other details:

9.FULL DISCLOSURE BY SELLERS

A. Other conditions or defects:

Does the Seller know of any other material defects affecting this property or its value that a prospective buyer

Yes No

should know about?

If yes, explain:

B. Verification:

The foregoing answers and attached explanations (if any) are complete and correct to the best of my/our knowledge and I/we have received a copy hereof. I/we authorize all of my/our real estate licensees, if any, to deliver a copy of this disclosure statement to other real estate licensees and all prospective buyers of the property.

____________________________ _____________________________________ _____________________________________

Date

Seller

Seller

II. BUYER'S ACKNOWLEDGMENT

A.As buyer(s), I/we acknowledge the duty to pay diligent attention to any material defects which are known to me/us or can be known to me/us by utilizing diligent attention and observation.

B.Each buyer acknowledges and understands that the disclosures set forth in this statement and in any amendments to this statement are made only by the seller.

C.Buyer (which term includes all persons signing the buyer's acknowledgement portion of this disclosure statement below) hereby acknowledges receipt of a copy of this disclosure statement (including attachments, if any) bearing seller's signature.

DISCLOSURES CONTAINED IN THIS FORM ARE PROVIDED BY THE SELLER ON THE BASIS OF SELLER'S ACTUAL KNOWLEDGE OF THE PROPERTY AT THE TIME OF DISCLOSURE.

BUYER HEREBY ACKNOWLEDGES RECEIPT OF A COPY OF THIS REAL PROPERTY TRANSFER DISCLOSURE STATEMENT AND ACKNOWLEDGES THAT THE DISCLOSURES MADE HEREIN ARE THOSE OF THE SELLER ONLY, AND NOT OF ANY REAL ESTATE LICENSEE OR OTHER PARTY.

___________________________

______________________________

_____________________________

DATE

BUYER

BUYER

- 6 -

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