Residential Property Disclosure And Disclaimer Statement Page 6
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104. Chimneys
9. Patio
14. Windows
19. Garage Floors
5. Interior walls
10. Ceilings
15. Window locks
20. Walkways
If you checked any of the above items, explain the defect(s):
G. In the last 4 years, was a pest, dry rot, structural or "whole house" inspection done?
Yes
No
Unknown
If yes, which test(s), when, and by whom was the inspection done? (Attach documentation)
H. Has the property had a problem with pest control, infestations, or vermin?
Yes
No
Unknown
If yes, explain:
I. Are you aware of:
(1) Any termites, wood destroying insects or pests on or affecting the property?
Yes
No
(2) Property damage by termites, wood destroying insects or pests?
Yes
No
If yes, describe:
(3) Any termite/pest control treatments on the property in the last 4 years?
Yes
No
If yes, list company and where treated:
(4) Current warranty or other coverage by a licensed pest control company on the property?
Yes
No
If yes, explain warranty and attach documentation:
J. Have you made a homeowner’s insurance claim(s) regarding the property in the last 4 years?
Yes
No
If yes, explain when and why:
5. SYSTEMS AND FIXTURES
If the following systems or fixtures are included with the transfer, do they have any existing defects:
YES
NO
UNKNOWN
A. Electrical system, including wiring, all switches, all outlets, and service
If yes, explain:
What type of wiring comprises the electrical system?
Copper
Aluminum
Unknown
B. Plumbing system, including pipes, faucets, fixtures, and toilets
If yes, explain:
C. Hot water heater (mark one):
Electric
Natural Gas
Other:
Age: ____ years
If yes, explain:
D. Oven/stove:
Electric
Natural Gas
Other:
Age: _____ years
If yes, explain:
E. List ANY OTHER APPLIANCES TO REMAIN, attach separate sheet if necessary.
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