Property Condition Disclosure Statement Template (Page 2 of 4) in pdf

6. Has anyone denied you access to the property or made a formal legal claim challenging your title to the property?

Yes No UNKN NA (if yes, explain below)

7. Are there any features of the property shared in common with adjoining land owners or a homeowners association,

such as walls, fences or driveways? Yes No UNKN NA (if yes describe below)

Are there any electric or gas utility surcharges for line extensions, special assessments or homeowner or other

association fees that apply to the property? Yes No UNKN NA (if yes, explain below)

9. Are there certificates of occupancy related to the property? Yes No UNKN NA (if no, explain below)

Environmental

Note to Seller - In this section, you will be asked questions regarding petroleum products and hazardous or toxic

substances that you know to have been spilled, leaked or otherwise been released on the property or from the

property onto any other property. Petroleum products may include, but are not limited to, gasoline, diesel fuel, home

heating fuel, and lubricants. Hazardous or toxic substances are products that could pose short- or long-term danger to

personal health or the environment if they are not properly disposed of, applied or stored. These include, but are not

limited to, fertilizers, pesticides and insecticides, paint including paint thinner, varnish remover and wood preservatives,

treated wood, construction materials such as asphalt and roofing materials, antifreeze and other automotive products,

batteries, cleaning solvents including septic tank cleaners, household cleaners and pool chemicals and products

containing mercury and lead.

Note to Buyer - If contamination of this property from petroleum products and/or hazardous or toxic substances is a

concern to you, you are urged to consider soil and groundwater testing of this property.

10.

Is any or all of the property located in a designated floodplain? Yes No UNKN NA (if yes, explain below)

11.

Is any or all of the property located in a designated wetland? Yes No UNKN NA (if yes, explain below)

12.

Is the property located in an agricultural district? Yes No UNKN NA (if yes, explain below)

13.

Was the property ever the site of a landfill? Yes No UNKN NA (if yes, explain below)

14.

Are there or have there ever been fuel storage tanks above or below the ground on the property?

Yes No UNKN NA

_______________________

If yes, are they currently in use? Yes No UNKN NA Location(s)

Are they leaking or have they ever leaked? Yes No UNKN NA (if yes, explain below)

15.

Is there asbestos in the structure? Yes No UNKN NA (if yes, state location or locations below)

16.

Is lead plumbing present? Yes No UNKN NA (if yes, state location or locations below)

17.

Has a radon test been done? Yes No UNKN NA (if yes, attach a copy of the report)

18.

Has motor fuel, motor oil, home heating fuel, lubricating oil or any other petroleum product, methane gas, or any

hazardous or toxic substance spilled, leaked or otherwise been released on the property or from the property

onto any other property? Yes No UNKN NA (if yes, describe below)

19. Has the property been tested for the presence of motor fuel, motor oil, home heating fuel, lubricating oil, or any

other petroleum product, methane gas, or any hazardous or toxic substance?

Yes No UNKN NA (if yes, attach report(s))

Structural

20.

Is there any rot or water damage to the structure or structures? Yes No UNKN NA (if yes, explain below)

21.

Is there any fire or smoke damage to the structure or structures? Yes No UNKN NA (if yes, explain below)

22.

Is there any termite, insect, rodent or pest infestation or damage? Yes No UNKN NA (if yes, explain below)

This contract is for use by Greene Realty Group. Use by any other party is illegal and voids the contract.

Property Condition Disclosure Statement Template Page 2

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