Tennessee Residential Property Condition Disclosure Template Page 2
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3INSTRUCTIONS TO THE SELLER
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Complete this form yourself and answer each question to the best of your knowledge. If an answer is an estimate, clearly label it
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as such. Explain any YES answers and describe the nature and extent of any defects or repairs. If more space is needed, attach
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additional sheets. You may also attach any documents pertaining to repairs or corrections. The Seller hereby authorizes any real
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estate licensee involved in this transaction to provide a copy of this statement to any person or entity in connection with any actual
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or anticipated sale of the subject property.
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1. Property age: _______________
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2. Date seller acquired the property: ______________
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3. Does seller currently occupy the property?
Seller occupies property
Seller does not occupy property
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4. If not currently seller-occupied, how long has it been since the seller did occupy the property, if ever?
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5. The property is a
site-built home
non-site-built home (e.g. - modular, manufactured, mobile)
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6. Roof type (e.g. - composition asphalt shingle, wood, metal, tile): ________________________ Approx. age of roof:
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7. Is there a Homeowners Association (HOA) which has any authority over the subject property?
Yes
No
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Name & address of HOA:
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Monthly Dues: _________ Transfer Fees: _________ Special Assessments:
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A. The property includes the items checked below:
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Range
Spa/Whirlpool Tub
Access to Public Streets
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Oven
Hot Tub
Current Termite Contract
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Microwave
Sauna
TV Antenna/Satellite Dish
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Dishwasher
All Landscaping and Outdoor Lighting
excluding components
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Garbage Disposal
Patio/Decking/Gazebo
Burglar Alarm/Security System
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Trash Compactor
Irrigation System
including components and controls
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Water Softener
Installed Outdoor Cooking Grill
Smoke Detector/Fire Alarm
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220 Volt Wiring
Pool
In-ground
Above-ground
Garage
Attached
Not Attached
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Washer/Dryer Hookups
Rain Gutters
Garage Door Opener(s) and remotes.
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Window Screens
Sump Pump
How many remotes?______
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Fireplace (How many? _____)
Central Vacuum System and attachments
Carport
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Gas Starter for Fireplace
A key to all exterior doors
Wall/Window Air Conditioning
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Gas Fireplace Logs
Intercom
Heat Pump (Approx. age: _______)
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Central Heating
Age: __________
Electric
Gas
Other:
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Central Air Conditioning Age: __________
Electric
Gas
Other:
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Water Heater
Age: __________
Electric
Gas
Other (solar, geothermal, tankless, etc):
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Water Supply
City Water
Private Well
Shared Well
Other:
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Sewage Disposal
City Sewer
Septic Tank
STEP System
Other:
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Gas Supply
Utility
Bottled Gas or Private LP Tank
Other:
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Other items included:
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To the best of seller’s knowledge, are any in Part A above NOT in operating condition:
YES
NO
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If YES, then describe:
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B. Is Seller AWARE of any defects or malfunctions in any of the following?
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Yes
No
N/A
Yes
No
N/A
Interior Walls
Roof
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Ceilings
Basement
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Floors
Foundation
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Windows
Slab
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Doors
Driveway
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Insulation
Sidewalks
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Plumbing
Central Heating
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Sewer/Septic
Heat Pump
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Electrical System
Central Air Conditioning
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Exterior Walls
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If any of the above in Part B are marked YES, please explain:
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__________________________________________________________________________________________________________________
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Please describe any repairs made by you or any previous owners of which you are aware (attach separate sheets if necessary):
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Page 2 of 3
Modified on 01/01/2013
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