Residential Property Disclosure And Disclaimer Statement Page 5
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6C. Are there any pending special assessments?
Yes
No
Unknown
D. Are there any shared “common areas” or any joint maintenance agreements (facilities such
Yes
No
Unknown
as walls, fences, landscaping, pools, tennis courts, walkways, or other areas co-owned in
undivided interest with others)?
If any such areas exist, explain:
7. APPLIANCES, HEATING, PLUMBING, ELECTRICAL and OTHER MECHANICAL SYSTEMS
Instructions: Mark INCL if the item is included in the sale. If item is included in sale, mark Yes or No to indicate whether item is in
working order. Indicate the item’s approximate age (in years) in the ‘age’ space, if provided-- if age is unknown, mark ‘?’ in space.
ITEM
INCL
Yes
No
ITEM
INCL
Yes
No
Attic Fan
Lawn Sprinkler Auto-timer
Air Conditioner (central)
age:
Lawn Sprinkler Backflow Valve
Air Conditioner (wall/window) age:
Microwave Oven
age:
Air Cleaner/Purifier
age:
Plumbing
Ceiling Fan(s), # included ____
Pool
age:
Clothes Washer
age:
Pool Equipment/ mechanisms
age:
Convection Oven
age:
Range/Oven
age:
Dishwasher
age:
Range Timer
Door Bells
Range Vent-hood
Drain Tile System
Refrigerator
age:
Dryer
age:
Security System
Exhaust Fans (bathroom)
Smoke Detectors (battery)
Fireplace
Smoke Detectors (hardwired)
Fireplace Mechanisms
Solar Collectors
Furnace
age:
Sump Pump
Furnace Mechanisms
Toilet Mechanisms
Freezer
age:
TV Antenna/ receiver/ dish
Garbage Compactor
TV Cable wiring
Garbage Disposal
Water Heater
age:
Garage Door Opener (GDO)
Window Treatments
GDO Auto-reverse Safety Mechanism
Whirlpool/Hot-tub
age:
GDO Remote Opener(s), # included: ___
Wood Burning Stove
Gas Grill
Yard Lights
Gas Logs
Other:
Heating System (central)
age:
Other:
Heating System (supplemental) age:
Other:
Humidifier
age:
Other:
Incinerator
Other:
Intercom
Other:
Lawn Sprinkler System
Other:
Explanations: if any item above is NOT in working order, list the item and explain the defect in the space below.
8. GENERAL
YES
NO
UNKNOWN
A. Is there any settling, soil, standing water, or drainage problems on the property?
If yes, explain:
B. Does the property contain fill material?
C. Is there any material damage to the property or any of the structure from fire, wind, floods, beach
movements, earthquake, expansive soils, or landslides?
If yes, explain:
D. Is the property in a designated flood plain?
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