Georgia Residential Real Estate Form – Fill Out and Use This PDF

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 -