Property Condition Disclosure Form - Adams Law Group Llc

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Property Condition Disclosure Form
Seller(s) Name ______________________________________ _____________________________________________
Property Address ____________________________________ _____________________________________________
Purpose of Statement:
This statement of certain conditions and information concerning the property known to the seller. This disclosure statement is not a warranty of any kind by
the seller or by any agent representing the seller in this transaction. It is not a substitute for any inspections or tests and the buyer is encouraged to obtain his
or her own independent professional inspections and environmental tests and also in encouraged to check public records pertaining to the property.
“Residential real property” means real property improved by a one to four family dwelling used or occupied, or intended to be used or occupied, wholly or
partly, as the home or residence of one or more persons, but shall not refer to (a) unimproved real property upon which such swellings are to be constructed
or (b) condominium units or cooperative apartments or (c) property on a homeowners’ association that is not owned in fee simple by the seller.
Seller’s Statement:
The seller makes the following representations to the buyer based upon the seller’s actual knowledge at the time of signing this document. The seller
authorizes his or her agent, if any, to provide a copy of this statement to a prospective buyer of the residential real property. The following are representations
made by the seller and are not the representations of the seller’s agent.
NOT
N/A
YES
NO
KNOWN
General Information
1.
How long have you owned the property?
2.
How long have you occupied the property?
What is the age of the structure or structures?
(Note to buyer – If the structure was built before 1978
3.
you are encouraged to investigate for the presence of lead based paint.)
Does anybody other than yourself have a lease, easement or any other right to use any part of
your property other than those stated in documents available in the public record, such as
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4.
rights to use a road or path or cut trees or crops?
Does anybody else claim to own any part of your property? ( If Yes, explain in space
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5.
provided)
Has anyone denied you access to the property or made a formal legal claim challenging your
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6.
title to the property? (If Yes, explain in space provided)
Are there any features of the property shared in common with adjoining land owners or a
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7.
homeowners association, such as walls, fences or driveways? (If yes describe)
Are there any electric or gas utility surcharges for line extensions, special assessments or
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8.
homeowner or other association fees that apply to the property?
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9.
Are there certificates of occupancy related to the property? (If no, explain below)
Environmental
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10.
Is any or all of the property located in a designated flood plain? (If yes, explain below)
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11.
Is any or all of the property located in a designated wetland? (If yes, explain below)
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12.
Is the property located in an agricultural district? (If yes, explain below)
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13.
Was the property ever the site of a landfill? (If yes, explain below)
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14.
Are there or have there ever been fuel storage tanks above or below ground on the property?
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If yes, are they currently in use?
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Are they leaking or have they ever leaked? (If yes, explain below)
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15.
Is there asbestos in the structure? (If Yes, state location or locations below)
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16.
Is lead plumbing present? (If Yes, state location or locations below)
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17.
Has a radon test been done? (If Yes, attach a copy of the report)
Has motor fuel, motor oil, home heating fuel, lubrication oil or any other petroleum product,
methane gas, any hazardous or toxic substance spilled, leaked or otherwise been released on
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18.
the property or from the property onto any other property? (If yes, describe below)
Has the property been tested for the presence of motor fuel, motor oil, home heating fuel,
lubrication oil, or any other petroleum product, methane gas, or any hazardous or toxic
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19.
substance? (If Yes, attach report(s) )
Structural
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20.
Is there any rot or water damage to the structure or structures? (If yes, explain below)
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21.
Is there any fire or smoke damage to the structure or structures? (If yes, explain below)
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22.
Is there any termite, insect, rodent or pest infestation or damage? (If yes, explain below)
Has the property been tested for termite, insect rodent or pest infestation or damage?
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23.
(If yes, please attach report(s))
24.
What is the type of roof/roof covering (slate, asphalt, other.)?
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Any known material defects?
How old is the roof?
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Is there a transferable warrantee on the roof in effect now?
(If yes, explain below)
Are there any known material defects in any of the following structural systems:
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25.
footings, beams, girders, lintels, columns or partitions? (If yes, explain below)
Mechanical Systems & Services
MUNICIPAL
What is the water source (circle all that apply)
26
WELL
MUNICIPAL
PRIVATE OTHER

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