Residential Real Property Disclosure Form Page 4
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5Property Address_
I) UNDERGROUND STORAGE TANKS/WELLS: Do you know of any underground storage tanks (existing or removed), oil or
natural gas wells (plugged or unplugged), or abandoned water wells on the property?
Yes
No
If “Yes”, please describe:
Do you know of any oil, gas, or other mineral right leases on the property?
Yes
No
Purchaser should exercise whatever due diligence purchaser deems necessary with respect to oil, gas, and other mineral rights.
Information may be obtained from records contained within the recorder’s office in the county where the property is located.
Yes
No
Unknown
J) FLOOD PLAIN/LAKE ERIE COASTAL EROSION AREA:
Is the property located in a designated flood plain?
Is the property or any portion of the property included in a Lake Erie Coastal Erosion Area?
K) DRAINAGE/EROSION: Do you know of any previous or current flooding, drainage, settling or grading or erosion problems
affecting the property?
Yes
No
If “Yes”, please describe and indicate any repairs, modifications or alterations to the property or other attempts to control any
problems (but not longer than the past 5 years):_
L) ZONING/CODE VIOLATIONS/ASSESSMENTS/HOMEOWNERS’ ASSOCIATION: Do you know of any violations of
building or housing codes, zoning ordinances affecting the property or any nonconforming uses of the property?
Yes
No
If “Yes”, please describe:
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).
Yes
No
If “Yes”, please describe:
Do you know of any recent or proposed assessments, fees or abatements, which could affect the property?
Yes
No
If “Yes”, please describe:
_
List any assessments paid in full (date/amount)
List any current assessments:
monthly fee
Length of payment (years
months
)
Do you know of 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.
Yes
No
If “Yes”, please describe (amount)
M) BOUNDARY LINES/ENCROACHMENTS/SHARED DRIVEWAY/PARTY WALLS: Do you know of any of the
following conditions affecting the property?
Yes
No
Yes
No
1) Boundary Agreement
4) Shared Driveway
2) Boundary Dispute
5) Party Walls
3) Recent Boundary Change
6) Encroachments From or on Adjacent Property
If the answer to any of the above questions is “Yes”, please describe:
N) OTHER KNOWN MATERIAL DEFECTS: The following are 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.
Owner’s Initials
Date
Purchaser’s Initials
Date
Owner’s Initials
Date
Purchaser’s Initials
Date
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