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_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ PAGE TWO OF TWO — FORM 304 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
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C. Are you (Seller) aware of any of the following:
1. Substances, materials, or products which may be an environmental hazard such as, but not limited
to, asbestos, formaldehyde, radon gas, lead-based paint, fuel or chemical storage tanks, and
contaminated soil or water on the subject property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
2. Features of the property shared in common with adjoining landowners, such as walls, fences, and
driveways, whose use or responsibility for maintenance may have an effect on the subject property . . .
Yes
No
3. Any encroachments, easements or similar matters that may affect your interest in the subject property . . .
Yes
No
4. Room additions, structural modifications, or other alterations or repairs made without necessary permits .
Yes
No
5. Room additions, structural modifications, or other alterations or repairs not in compliance with
building codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
6. Landfill (compacted or otherwise) on the property or any portion thereof . . . . . . . . . . . . . . . . . . .
Yes
No
7. Any settling, from any cause, or slippage, sliding, or other soil problems . . . . . . . . . . . . . . . . . .
Yes
No
8. Flooding, drainage, or grading problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
9. Major damage to the property or any of the structures from fire, earthquake, floods, or landslides . . . .
Yes
No
10. Any zoning violations, nonconforming uses, violations of “setback” requirements . . . . . . . . . . . . . . .
Yes
No
11. Neighborhood noise problems or other nuisances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
12. CC&Rs or other deed restrictions or obligations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
13. Homeowners’ Association which has any authority over the subject property . . . . . . . . . . . . . . . .
Yes
No
14. Any “common area” (facilities such as pools, tennis courts, walkways, or other areas co-owned in
undivided interest with others) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
15. Any notices of abatement or citations against the property . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
16. Any lawsuits by or against the seller threatening to or affecting this real property
including any lawsuits alleging a defect or deficiency in this real property or
“common areas” (facilities such as pools, tennis courts, walkways, or other areas
co-owned in undivided interest with others) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If the answer to any of these is yes, explain: ____________________________________________________________
_____________________________________________________________________________________________________
______________________________________________________
ee additional explanation in attached addendum.
S
Seller certifies that the information herein is true and correct to the best of the Seller’s knowledge as of the date signed by
the Seller.
Seller: ______________________________________________
Date: ______________________________, 20____________
Seller: ______________________________________________
Date: ______________________________, 20____________
SELLER’S AGENT’S INSPECTION DISCLOSURE
:
(To be completed only if the Seller is represented by an agent in this transaction)
THE UNDERSIGNED, BASED ON THE ABOVE INQUIRY OF THE SELLER(S) AS TO THE CONDITION OF THE PROPERTY
AND BASED ON A REASONABLY COMPETENT AND DILIGENT VISUAL INSPECTION OF THE ACCESSIBLE AREAS OF
THE PROPERTY IN CONJUNCTION WITH THAT INQUIRY, STATES THE FOLLOWING:
Agent notes no items for disclosure.
Agent notes the following items:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Agent: ______________________________ By: ________________________________ Date: ________________, 20_______
(Broker representing Seller — Please print)
(Ass oc iate Lic ensee or Broker — Signature)
BUYER’S AGENT’S INSPECTION DISCLOSURE
:
(To be completed only if the agent who has obtained the offer is other than the agent above)
THE UNDERSIGNED, BASED ON A REASONABLY COMPETENT AND DILIGENT VISUAL INSPECTION OF THE ACCESSIBLE
AREAS OF THE PROPERTY, STATES THE FOLLOWING:
Agent notes no items for disclosure.
Agent notes the following items:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Agent: ______________________________ By: _________________________________ Date: _______________, 20_______
(Broker obtaining the Offer — Please print)
( Ass o c iate L icens e e or Br oker — Sign atu re )
BUYER(S) AND SELLER(S) MAY WISH TO OBTAIN PROFESSIONAL ADVICE AND/OR INSPECTIONS OF THE PROPERTY
AND TO PROVIDE FOR APPROPRIATE PROVISIONS IN A CONTRACT BETWEEN BUYER(S) AND SELLER(S) WITH
RESPECT TO ANY ADVICE/INSPECTIONS/DEFECTS.
A REAL ESTATE BROKER IS QUALIFIED TO ADVISE ON REAL ESTATE. IF YOU DESIRE LEGAL ADVICE CONSULT YOUR
ATTORNEY.
Buyer’s Broker:
Seller’s Broker:
Agent
____________________________
Agent
____________________________
(Broker obtaining the Offer):
(Broker representing Seller):
Date: ____________________________, 20_____________
Date: ____________________________, 20_____________
By: ______________________________________________
By: ______________________________________________
(Associate Licensee or Broker — Signature)
(Associate Licensee or Broker — Signature)
I have read and received a copy of this statement.
I have read and received a copy of this statement.
Date: ____________________________, 20_____________
Date: ____________________________, 20_____________
Buyer: ___________________________________________
Seller: ____________________________________________
Buyer: ___________________________________________
Seller: ____________________________________________
SECTION 1102.3 OF THE CIVIL CODE PROVIDES A BUYER WITH THE RIGHT TO RESCIND
A PURCHASE CONTRACT FOR AT LEAST THREE DAYS AFTER THE DELIVERY OF THIS
DISCLOSURE IF DELIVERY OCCURS AFTER THE SIGNING OF AN OFFER TO PURCHASE.
IF YOU WISH TO RESCIND THE CONTRACT, YOU MUST ACT WITHIN THE PRESCRIBED
PERIOD.

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