Residential Property Condition Disclosure Report (Page 4 of 4) in pdf

The Seller should use this area to further explain any item above. Attach additional pages if necessary and

indicate here

the number of additional pages attached.

I. Seller's Certification

To the extent of the Seller(s) knowledge as a property owner, the Seller acknowledges that the

information contained above is true and accurate for those areas of the property listed. In the event a real

estate broker or salesperson is utilized, the Seller authorizes the broker or salesperson to provide the above

information to prospective buyers, selling agents or buyer's agents.

DATE

SELLER

(Type or Print)

(Signature)

DATE

SELLER

(Signature)

(Type or Print)

II. Responsibilities of Real Estate Brokers

This report in no way relieves a real estate broker of his or her obligation under the provisions of Section

20-328-5a of the Regulations of Connecticut State Agencies to disclose any material facts. Failure to do

so could result in punitive action taken against the broker, such as fines, suspension or revocation of

license.

III. Statements Not to Constitute a Warranty

Any representations made by the seller on this report shall not constitute a warranty to the buyer.

IV. Nature of Disclosure Report

This residential disclosure report is not a substitute for inspections, tests, and other methods of

determining the physical condition of the property.

V. Information on the Residence of Convicted Felons

Information concerning the residence address of a person convicted of a crime may be available from

law enforcement agencies or the department of public safety.

VI. Buyer's Certification

The buyer is urged to carefully inspect the property and, if desired, to have the property inspected by an

expert. The buyer understands that there are areas of the property for which the seller has no knowledge

and this disclosure statement does not encompass those areas. The buyer also acknowledges that the

buyer has read and received a signed copy of this statement from the seller or seller's agent.

DATE

BUYER

(Signature)

(Type or Print)

DATE

BUYER

(Signature)

(Type or Print)

Questions or Comments? Consumer Problems?

Contact the Department of Consumer Protection at (860) 713-6150 or occprotrades@po.state.ct.us

Residential Property Condition Disclosure Report Page 4