Residential Property Disclosure And Disclaimer Statement Page 4
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6If 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.
1.
Age: _____ years
YES
NO
UNKNOWN
If yes, explain:
2.
Age: _____ years
If yes, explain:
3.
Age: _____ years
If yes, explain:
F. Cooling and Heating systems
Air Conditioning (mark one):
Central Electric
Central Gas
Heat Pump
Window Unit(s) ____ # included in sale
Other (describe):
Air Conditioning (continued):
Age of cooling system: _____ years.
Zoned cooling? [Yes] [No]
Air Conditioning defects?
No
Unknown
Yes, explain:
Heating system (mark one):
Electric
Natural Gas
Fuel Oil
Heat Pump
Propane
Other:
Age of heating system: _____ years.
Zoned heating? [Yes] [No]
Heating system defects?
No
Unknown
Yes, explain:
Last date of servicing:
Heating:
Cooling:
By whom:
Are there rooms without heating/air conditioning vents?
Yes
No
If yes, which rooms:
G. Security system (Circle One):
Owned
Leased
Any defects? Yes
No
Unknown
Describe security system:
If defects are indicated, explain:
H. Other:
Any defects?
Yes
No
Unknown
If defects are indicated, explain:
6. COMMON INTEREST
A. Is there a Home Owners' Association?
Yes
No
Unknown
If yes, what is the name of the association?
B. Are there regular periodic assessments:
Yes
No
Unknown
If yes, give amount per:
Month: $
Year: $
Other: $
If other, explain:
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