DO
DO
2. ROOF
4. OTHER DISCLOSURES
YES
NO
YES
NO
NOT
NOT
KNOW
KNOW
Do improvements have aluminum wiring?
Age, if known: ___________ Years.
Are there any foundation problems
Does the roof leak?
with the improvements?
Are there any encroachments?
Is there present damage to the roof?
Are there any violations of zoning,
Is there more than one roof on the house?
building codes or restrictive covenants?
Is the present use a non-conforming
If so, how many? __________ roofs.
use? Explain:
DO
3. HAZARDOUS CONDITIONS
YES
NO
NOT
KNOW
Ar e th e r e a n y e x is t in g h a za r d o us
conditions on the property, such as
Have you received any notices by any
methane gas, lead paint, radon gas in
governmental or quasi-governmental
house or well, radioactive material, landfill,
agencies affecting this property?
mineshaft, expansive soil, toxic materials,
Are there any structural problems with the
asbestos insulation or PCB's?
buildings?
Have any substantial additions or
alterations been made without a required
building permit?
Are there moisture and/or water problems
in the basement or crawl space area?
Is there any damage due to wind, flood,
termites or rodents?
Are the furnace/woodstove/chimney/flue
all in working order?
Is the property in a flood plain?
Do you currently pay flood insurance?
Does the property contain underground
storage tank(s)?
Is the seller a licensed real estate
salesperson or broker?
Is there any threatened or existing
litigation regarding the property?
Is the property subject to convenants,
conditions and/or restrictions of a
homeowner's association?
Is the property located within one (1)
mile of an airport?
E. ADDITIONAL COMMENTS AND / OR EXPLANATIONS: (Use additional pages if necessary.)
The information contained in this Disclosure has been furnished by the Seller, who certifies to the truth thereof, based on the Seller's CURRENT ACTUAL
KNOWLEDGE. A disclosure form is not a warranty by the owner or the owner's agent, if any, and the disclosure form may not be used as a substitute for any
inspections or warranties that the prospective buyer or owner may later obtain. At or before settlement, the owner is required to disclose any material change
in the physical condition of the property or certify to the purchaser at settlement that the condition of the property is substantially the same as it was when
the disclosure form was provided. Seller and Purchaser hereby acknowledge receipt of this Disclosure by signing below:
Signature of Seller
Date
Date
Signature of Buyer
Signature of Seller
Date
Signature of Buyer
Date
The seller hereby certifies that the property is substantially the same as it was when the Seller's Disclosure form was originally provided to the Buyer.
Signature of Seller
Date
Signature of Seller
Date