Ohio Residential Property Disclosure Form

Answer ALL questions.

Report known conditions affecting the property.

Attach additional pages with your signature if additional space is needed.

Complete this form yourself.

If some items do not apply to your property, write NA (not applicable). If the item to be disclosed is not within your actual knowledge, indicate Unknown.

Print the Property Address, the Owners Name(s) and the Date.

Mark Owner is or is not occupying the property. If owner is occupying the property, enter since what date. If owner is not occupying the property, enter since what date.

The following statements of the owner are based on owner's actual knowledge.

Check appropriate boxes for the source of water supply to the property: Public Water Service, Private Water Service, Private Well, Shared Well, Holding Tank, Cistern, Spring, Pond, Unknown or Other.

Water supply: do you know of any current leaks, backups or other material problems with the water supply system or quality of the water? Mark Yes or No. If Yes, please describe and indicate any repairs completed (but not longer than the past 5 years).

Check appropriate boxes for the nature of the sanitary sewer system servicing the property: Public Sewer, Private Sewer, Septic Tank, Leach Field, Aeration Tank, Filtration Bed, Unknown or Other.

If not a public or private sewer, enter the date of last inspection and Inspected By.

Sewer system: do you know of any previous or current leaks, backups or other material problems with the sewer system servicing the property? Yes or No. If Yes, describe the problems and indicate any repairs completed (but not longer than the past 5 years).

Information on the operation and maintenance of the type of sewage system serving the property is available from the department of health or the board of health of the health district in which the property is located.

Roof: mark Yes or No for any previous or current leaks or other material problems with the roof or rain gutters that you know of. If Yes, describe the leaks and indicate any repairs completed (but not longer than the past 5 years).

Any previous or current water leakage, water accumulation, excess moisture or other defects to the property, including but not limited to the basement or crawl space, that you know of? Yes or No. If Yes, describe and indicate any repairs completed.

Any water or moisture related damage to floors, walls or ceilings as a result of flooding; moisture seepage; moisture condensation; ice damming; sewer overflow/backup; or leaking pipes, plumbing fixtures, or appliances that you know of? Mark Yes or No. If Yes, describe the damage and any repairs completed.

Have you ever had the property inspected for mold by a qualified inspector? Yes or No. If Yes, please describe and indicate whether you have an inspection report and any remediation undertaken.

Purchaser is advised that every home contains mold.

Foundation, basement/crawl space, floors, walls: mark Yes or No for any previous or current movement, shifting, deterioration, material cracks/settling (other than visible minor cracks or blemishes) or other material problems that you know of. If Yes, describe them and any repairs to control the cause (but not longer than the past 5 years).

Fire or smoke damage: any previous or current damage to the property that you know of? Yes or No. If Yes, describe the damage and any repairs completed.

Wood destroying insects/termites: mark Yes or No for any previous/current presence in or on the property or any existing damage caused by them that you know of. If Yes, please describe and indicate any inspection or treatment (but not longer than the past 5 years).

For each existing mechanical system, mark YES, NO or N/A: 1) Electrical, 2) Plumbing (pipes), 3) Central heating, 4) Central Air conditioning, 5) Sump pump, 6) Fireplace/chimney, 7) Lawn sprinkler, 8) Water softener, 9) Security System, 10) Central vacuum, 11) Built in appliances, 12) Other mechanical systems.

If the answer to any of the questions 1) to 12) is Yes, please describe and indicate any repairs to the mechanical system (but not longer than the past 5 years).

For each hazardous material, mark Yes, No or Unknown: 1) Lead-Based Paint, 2) Asbestos, 3) Urea-Formaldehyde Foam Insulation, 4) Radon Gas, 5) Other toxic or hazardous substances. For 4) Radon Gas, if Yes, indicate level of gas if known.

If the answer to any of the hazardous substances questions is Yes, please describe and indicate any repairs, remediation or mitigation to the property.

Mark Yes or No for any underground storage tanks (existing or removed), oil or natural gas wells (plugged or unplugged), or abandoned water wells on the property that you know of. If Yes, please describe.

Oil, gas, or other mineral right leases on the property that you know of? Yes or No. Information may be obtained from the recorder's office in the county where the property is located.

Mark Yes, No or Unknown: is the property located in a designated flood plain? Mark Yes, No or Unknown: is the property or any portion of the property included in a Lake Erie Coastal Erosion Area?

Drainage and erosion: mark Yes or No for any previous or current flooding, drainage, settling or grading or erosion problems affecting the property that you know of. If Yes, please describe and indicate any repairs (but not longer than the past 5 years).

Code violations: any violations of building or housing codes, zoning ordinances affecting the property or any nonconforming uses of the property that you know of? Yes or No. If Yes, please describe.

Mark Yes or No: is the structure on the property designated by any governmental authority as a historic building or as being located in an historic district? (NOTE: such designation may limit changes or improvements that may be made to the property). If Yes, please describe.

Assessments: any recent or proposed assessments, fees or abatements, which could affect the property, that you know of? Yes or No. If Yes, please describe.

Association fees: any recent or proposed rules or regulations of, or the payment of any fees or charges associated with this property, including but not limited to a Community Association, SID, CID, LID, etc., that you know of? Mark Yes or No. If Yes, please describe (amount).

Mark Yes or No for each condition affecting the property: 1) Boundary Agreement, 2) Boundary Dispute, 3) Recent Boundary Change, 4) Shared Driveway, 5) Party Walls, 6) Encroachments From or on Adjacent Property.

If the answer to any of the Boundary questions is Yes, please describe.

List the other known material defects in or on the property.

For purposes of this section, material defects would include any non-observable physical condition existing on the property that could be dangerous to anyone occupying the property or any non-observable physical condition that could inhibit a person's use of the property.

By signing under CERTIFICATION OF OWNER, the owner certifies that the statements contained in this form are made in good faith and based on his/her actual knowledge as of the date signed by the Owner.

Each purchaser acknowledges receipt of a copy of this disclosure form and that the statements are made based on the owners actual knowledge as of the date signed by the owner. A purchaser's signature does not constitute approval of any disclosed condition.

Pursuant to Ohio Revised Code Section 5302.30(K), if this form is not provided to the purchaser prior to the time the purchaser enters into a purchase contract for the property, the purchaser may rescind the purchase contract by delivering a signed and dated document of rescission to Owner or Owner's agent, provided the document of rescission is delivered prior to all three of the following dates: 1) the date of closing; 2) 30 days after the Owner accepted the offer; and 3) within 3 business days following receipt or the agent's receipt of this form or an amendment of this form.

Potential purchasers are advised that the owner has no obligation to update this form but may do so according to Revised Code Section 5302.30(G).

The statements are not for purchasers in any subsequent transfers.