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NEW JERSEY REGISTER
VOLUME 35, NUMBER 8
MONDAY, APRIL 21, 2003
RULE PROPOSAL

LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
PROPERTY CONDITION DISCLOSURE FORM

Proposed Readoption: N.J.A.C. 13:45A-29.1

Authorized By: Division of Consumer Affairs, Reni Erdos, Director.

Authority: N.J.S.A. 56:8-1 et seq. specifically 56:8-19.1.
Calendar Reference: See Summary below for explanation of exception to calendar requirement. Proposal Number: PRN 2003-138.

Submit comments by June 20, 2003 to:

Reni Erdos, Director
New Jersey Division of Consumer Affairs
PO Box 45027
Newark, NJ 07101

The agency proposal follows:

Summary

Pursuant to its rulemaking authority, N.J.S.A. 56:8-1 et seq., the Division of Consumer Affairs is proposing a new subchapter, N.J.A.C. 13:45A-29, codifying N.J.S.A. 56:8-19.1, which sets forth the requirements for exempting real estate brokers, broker salespersons, and salespersons from certain provisions of the Consumer Fraud Act if they are in compliance with the property condition disclosure requirements of the new rule and have obtained a property condition disclosure statement from a seller of a property.

Proposed new N.J.A.C. 13:45A-29.1(a) states that the rule implements the provisions of N.J.S.A. 56:8-19.1 and proposed new subsection (b) contains words and terms which are used in the subchapter.

Proposed new subsection (c) states that real estate licensees are not subject to punitive damages, attorney's fees, or both under N.J.S.A. 56:8-19 for the communication of any false, misleading or deceptive information to a buyer which had been provided to the licensee by or on behalf of the seller of real estate located in the State of New Jersey if certain conditions are met. The licensee must have no actual knowledge of the false, misleading or deceptive character of the information. The licensee must also make a reasonable and diligent inquiry to determine if the information is false, misleading or deceptive and must provide specific communications that will satisfy this requirement. These include reports by specified State licensees and governmental officials or employees and a property condition disclosure statement. Proposed new subsection (d) sets forth the form and minimal information which is required in the property condition disclosure statement.

This proposal has not been calendared pursuant to the requirements of N.J.A.C. 1:30-3.1, and, therefore, a 60-day comment period is provided pursuant to N.J.A.C. 1:30-3.3(a)5.

Social Impact

Proposed new rule N.J.A.C. 13:45A-29.1 will have a positive impact on the public and real estate licensees. The property condition disclosure statement will provide the public with an expansive and accurate account of the property to be sold and will ensure that the purchaser has all relevant information before a purchase is completed. Real estate licensees will benefit from no longer being subject to punitive damages, attorneys fees or both for the communication of false, misleading or deceptive information provided to the licensee by the seller if the licensee meets requirements contained in the new rule.

Economic Impact

Proposed new rule N.J.A.C. 13:45A-29.1 will have a beneficial economic impact on real estate licensees and the public. Licensees will benefit from no longer being subject to punitive damages, attorneys fees, or both if they meet certain conditions. Licensees will incur costs from providing the property condition disclosure statement form. The public will benefit from the accurate information that will be providedin the property condition disclosure statement by allowing the purchaser of the property to make an informed decision on whether to purchase the property.

Federal Standards Statement

A Federal standards analysis is not required because the proposed new rule does not have any applicable Federal standards or requirements.

Jobs Impact

The Division does not anticipate that the proposed new rule will increase or decrease jobs in the State.

Agriculture IndustryImpact

The proposed new rule will have no impact on the agriculture industry in this State.

Regulatory Flexibility Analysis

If, for purposes of the Regulatory Flexibility Act, N.J.S.A. 52:14B-16 et seq., the 78,400 real estate licensees are deemed "small businesses," then the following analysis applies.

The Act requires the Division to set forth the reporting, recordkeeping, and other compliance requirements of the proposed rule including the kinds of personal services likely to be needed to comply with the requirements. The Act further requires the Division to estimate the initial and annual compliance costs and to outline the manner in which it has designed the rules to minimize any adverse economic impact upon small businesses.

The compliance requirement in the proposed new rule, which codifies N.J.S.A. 56:8-19.1, states that in order to be exempt from punitive damages, attorneys fees or both, licensees must demonstrate that they had no actual knowledge of the false, misleading or deceptive character of the information conveyed by or on behalf of the seller and they have made a reasonable and diligent effort to determine the accuracy of the information supplied by or on behalf of the seller. The reporting requirement in the proposed new rule states that the real estate licensee may utilize reports from specified licensees or from government officials or employees to demonstrate that the real estate licensee has made a reasonable and diligent inquiry to ascertain whether the information is of a false, misleading or deceptive character. The recordkeeping requirement in the proposed new rule states that a property condition disclosure statement may be utilized to demonstrate that they have made a reasonable and diligent inquiry to ascertain whether the information is of a false, misleading or deceptive character. The Division believes that no professional services are likely to be needed to comply with the proposed new rule.

The Division believes that because the proposed new rule is intended to protect the public from fraudulent, misleading or deceptive information in the purchase of property, the provisions of the new rule must be applied uniformly to all real estate licensees regardless of the size of the business.

Smart Growth Impact

The proposed new rule shall have no impact on the achievement of smart growth or the implementation of the State Development and Redevelopment Plan.

Full text of the proposed new rule follows:

<<+SUBCHAPTER 29. PROPERTY CONDITION DISCLOSURE+>>

<< NJ ADC 13:45A-29.1 >>

<<+13:45A-29.1 Property Condition Disclosure Form+>>

<<+(a) This section implements the provisions of P.L. 1999, c.76, N.J.S.A. 56:8-19.1, concerning the exemption of real estate brokers, broker- salespersons and salespersons from provisions of the Consumer Fraud Act, N.J.S.A. 56:8-1 et seq.+>>

<<+(b) The following words and terms, when used in this section, shall have the following meanings, unless the context clearly indicates otherwise:+>>

<<+"Real estate licensee" means a real estate broker, broker-salesperson or salesperson licensed under N.J.S.A. 45:15-1 et seq.+>>

<<+"Property condition disclosure statement" means a writing, as set forth in (d) below, signed by the seller and containing information on the physical condition of the land and improvements thereon, if any, being sold.+>>

<<+(c) A real estate licensee shall not be subject to punitive damages, attorneys fees, or both under N.J.S.A. 56:8-19 for the communication of any false, misleading or deceptive information to a buyer which had been provided to the real estate licensee by or on behalf of the seller of real estate located in the State of New Jersey if the real estate licensee:+>>

<<+1. Had no actual knowledge of the false, misleading or deceptive character of the information; and+>>

<<+2. Made a reasonable and diligent inquiry to ascertain whether the information is of a false, misleading or deceptive character. A real estate licensee will have been deemed to have made a "reasonable and diligent inquiry" in circumstances including, but not limited to, those in which the false information communicated to the buyer can be shown to have been:+>>

<<+i. Provided in a report or upon a representation by a person, licensed or certified by the State of New Jersey, including, but not limited to, an appraiser, engineer, architect, home inspector, plumber or electrical contractor, of a particular physical condition pertaining to the real estate derived from inspection of the real estate by that person;+>>

<<+ii. Provided in a report or upon a representation by any governmental official or employee, if the particular information of a physical condition is likely to be within the knowledge of that governmental official or employee; or+>>

<<+iii. Obtained from the seller in a property condition disclosure statement as set forth in (d) below, so long as the buyer is informed by the real estate licensee that the seller is the source of the information, and that prior to advising the buyer that the seller is the source of information, the real estate licensee visually inspected the property with reasonable diligence to ascertain the accuracy of the information disclosed by the seller.+>>

<<+(d) The property condition disclosure statement shall be in the following form and contain, at a minimum, the following information. Additional information may be requested if, in the opinion of the real estate licensee, and under the facts and circumstances of a particular real estate transaction, it would be appropriate to do so.+>>

SELLER'S PROPERTY CONDITION

DISCLOSURE STATEMENT

Property Address: ___________________________________

_________________________________________________

Seller: ____________________________________________

The purpose of this Disclosure Statement is to disclose, to the best of Seller's knowledge, the condition of the Property, as of the date set forth below. The Seller is aware that he or she is under an obligation to disclose any known material defects in the Property even if not addressed in this printed form. Seller alone is the source of all information contained in this form. All prospective buyers of the Property are cautioned to carefully inspect the Property and to carefully inspect the surrounding area for any off-site conditions that may adversely affect the Property. Moreover, this Disclosure Statement is not intended to be a substitute for prospective buyer's hiring of qualified experts to inspect the Property.

OCCUPANCY
   
Yes
No
Unknown
   
[    ]
1. Age of House, if known _______
[    ]
[    ]
2. Does the Seller currently occupy this property? If not, how long has it been since Seller occupied the property? _______
3. What year did the seller buy the property? _______
[    ]
[    ]
3a. Do you have in your possession the original or a copy of the deed evidencing your ownership of the property? If "yes," please attach a copy of it to this form.

 

ROOF
   
Yes
No
Unknown
   
[    ]
4. Age of roof _______
[    ]
[    ]
5. Has roof been replaced or repaired since seller bought the property?
[    ]
[    ]
[    ]
6. Does the roof leak?
7. Explain any "yes" answers that you give in this section:____________________________________________
__________________________________________________
__________________________________________________

 

ATTIC, BASEMENTS AND CRAWL SPACES (Complete only if applicable)
Yes
No
Unknown
   
[    ]
[    ]
  8. Does the property have one or more sump pumps?
[    ]
[    ]
  8a. Are there any problems with the operation of any sump pump?
[    ]
[    ]
  9.

Are you aware of any water leakage, accumulation or dampness within the basement or crawl spaces or any other areas within any any of of the structures on the property?

[    ]
[    ]
  9a. Are you aware of the presence of any mold or similar natural substance within the basement or crawl spaces or any other areas within any of the structures on the property?
[    ]
[    ]
  10. Are you aware of any repairs or other attempts to control any water or dampness problem in the basement or crawl space? If "yes," describe the location, nature and date of the repairs__________________
_________________________________________________
_________________________________________________
[    ]
[    ]
  11. Are you aware of any cracks or bulges in the basement floor or foundation walls. If "yes," specify location._______________________
_________________________________________________
[    ]
[    ]
  12. Are you aware of any restrictions on how the attic may be used as a result of the manner in which the attic or roof was contructed?
[    ]
[    ]
  13. Is the attic or house ventilated by:
_______ a whole house fan?
_______ an attic fan?
[    ]
[    ]
  13a.. Are you aware of any problems with the operation of such a fan?
      14.

Is what manner is access to the attic space provided?
_______ staircase
_______ pull down stairs
_______ crawl space with aid of ladder or other device
_______ other

      15. Explain any "yes" answers that you give in this section:_______
_________________________________________________
_________________________________________________
_________________________________________________

 

TERMITES/WOOD DESTROYING INSECTS, DRY ROT, PESTS
Yes
No
Unknown
   
[    ]
[    ]
16. Are you aware of any termites/wood destroying insects, dry rot, or pests affecting the property?
[    ]
[    ]
17. Are you aware of any damage to the property caused by termites/wood destroying insects, dry rot, or pests?
[    ]
[    ]
18. If "yes," has work been performed to repair the damage?
[    ]
[    ]
19. Is your property under contract by a licensed pest control company? If "yes," state the name and address of the licensed pest control company:_________________________________________
_________________________________________________
[    ]
[    ]
  20. Are you aware of any termite/pest control inspections or treatments performed on the property in the past?
[    ]
[    ]
  21. Explain any "yes" answers that you give in this section: _______
_________________________________________________
_________________________________________________

 

STRUCTURAL ITEMS    
Yes
No
Unknown
   
[    ]
[    ]
  22. Are you aware of any movement, shifting, or other problems with walls, floors, or foundations?
[    ]
[    ]
  23. Are you aware if the property or any of the structures on it have ever been damaged by fire, smoke, wind or flood?
[    ]
[    ]
  24. Are you aware of any fire retardant plywood used in the construction?
[    ]
[    ]
  25. Are you aware of any current or past problems with driveways, walkways, patios, sinkholes, or retaining walls on the property?
[    ]
[    ]
  26. Were any efforts made to repair any problems with the items in this section?
      27. Explain any "yes" answers that you give in this section. Please describe the location and nature of the problem. ____________
__________________________________________________
__________________________________________________

 

ADDITIONS/REMODELS    
Yes
No
Unknown
   
[    ]
[    ]
28. Are you aware of any additions, structural changes or other alterations to the structures on the property?
[    ]
[    ]
[    ]
29. Were the proper building permits and approvals obtained? Explain any "yes" answers you give in this section: _______________
________________________________________________
________________________________________________

 

PLUMBING, WATER AND SEWAGE
 
Yes
No
Unknown
   
30.. What is the source of your drinking water?
[   ] Public
[   ] Community System
[   ] Well on Property
[   ] Other (explain) ____________________________
[    ]
[    ]
31. If your drinking water source is not public, have you performed any tests on the water? If so, when? ________________________
Attach a copy of or describe the results.
[    ]
[    ]
[    ]
32. Does the wastewater from any clothes washer, dishwasher, or other appliance discharge to any location other than the sewer, septic, or other system that services the rest of the property?
[    ]
[    ]
33. When was well installed? __________________________
Location of well? _______
[    ]
[    ]
34. Do you have a softener, filter, or other water purification system?
[   ] Leased
[   ] Owned
   
35. What is the type of sewage system?
[   ] Public Sewer
[   ] Private Sewer
[   ] Septic System
[   ] Cesspool
[   ] Other (explain):__________________________________
[    ]
[    ]
36. If you answered "septic system," have you ever had the system inspected to confirm that it is a true septic system and not a cesspool?
[    ]
37. If Septic System, when was it installed? __________________
[    ]
38. When was the Septic System or Cesspool last cleaned and/or serviced? ______________________
[    ]
[    ]
39. Are you aware of any abandoned Septic Systems or Cesspools on your property?
[    ]
[    ]
[    ]
39a. If "yes," is the closure in accordance with the municipality's ordinance? (explain): _________________________________
__________________________________________________
[    ]
[    ]
40. Are you aware of any leaks, backups, or other problems relating to any of the plumbing systems and fixtures (including pipes, sinks, tubs and showers), or of any other water or sewage related problems? If "yes," explain: ____________________________
_________________________________________________
_________________________________________________
[    ]
[    ]
41. Are you aware of any shut off, disconnected, or abandoned wells, underground water or sewage tanks, or dry wells on the property?
[    ]
42. Is either the private water or sewage system shared? If "yes," explain: ___________________________________________
43. . Water Heater:
[   ] Electric
[   ] Fuel Oil
[   ] Gas
[    ]
[    ]
43a. Are you aware of any problems with the water heater?
44. Explain any "yes" answers that you give in this section: _______
__________________________________________________

 

HEATING AND AIR CONDITIONING
Yes
No
Unknown
   
45. Type of Air Conditioning:
[    ] Central one zone
[    ] Central multiple zone
[    ] Wall/Window Unit
[    ] None
46. List any areas of the house that are not air conditioned: _______
__________________________________________________
[    ]
47. What is the age of Air Conditioning System? _______________
48. Type of heat:
[    ] Electric
[    ] Fuel Oil
[    ] Natural Gas
[    ] Propane
[    ] Unheated
[    ] Other
49. What is the type of heating system? (for example, forced air, hot water or base board, radiator, steam heat) _________________
50. If it is a centralizedheating system, is it one zone or multiple zones? __________________________________________________
[    ]
51. Age of furnace _______
Date of last service: _______
52. List any areas of the house that are not heated: ______________
[    ]
[    ]
[    ]
53. Are you aware of any tanks on the property, either above or underground, used to store fuel or other substances?
[    ]
[    ]
54. If tank is not in use do you have a closure certificate?
[    ]
[    ]
55. Are you aware of any problems with any items in this section? If "yes," explain: ______________________________________
__________________________________________________

 

WOODBURNING STOVE OR FIREPLACE
Yes
No
Unknown
   
[    ]
[    ]
56. Do you have
[    ] wood burning stove?
[    ] fireplace?
[    ] insert?
[    ] other
[    ]
[    ]
[    ]
57. Is it presently usable?
[    ]
[    ]
[    ]
57a. If you have a fireplace, when was the flue last cleaned? _________ Was the flue cleaned by a professional or non-professional? ___________________________________
[    ]
[    ]
[    ]
58. Have you obtained any required permits for any such item?
[    ]
[    ]
59. Are you aware of any problems with any of these items? If "yes," please explain: ____________________________________
________________________________________________

 

ELECTRICAL SYSTEM
Yes
No
Unknown
   
60. What type of wiring is in this structure?
[    ] Copper
[    ] Aluminum
[    ] Other
[    ] Unknown
61. What amp service does the property have?
[    ] 60
[    ] 100
[    ] 150
[    ] 200
[    ] Other
[    ] Unknown
[    ]
[    ]
[    ]
62. Does it have 220 volt service? Which are present
[    ] Circuit Breakers or
[    ] Fuses?
[    ]
[    ]
63. Are you aware of any additions to the original service? If "yes," were the additions done by a licensed electrician? Name and address: _________________________________________________
__________________________________________________
[    ]
[    ]
[    ]
64. If "yes," were proper building permits and approvals obtained?
[    ]
[    ]
65. Are you aware of any wall switches, light fixtures or electrical outlets in need of repair?
      66. Explain any "yes" answers you give in this section: _________
_________________________________________________
_________________________________________________

 

LAND (SOILS, DRAINAGE AND BOUNDARIES)
Yes
No
Unknown
   
[    ]
[    ]
67. Are you aware of any fill or expansive soil on the property?
[    ]
[    ]
68. Are you aware of any past or present mining operations in the area in which the property is located?
[    ]
[    ]
69. Is the property located in a flood hazard zone?
[    ]
[    ]
70. Are you aware of any drainage or flood problems affecting the property?
[    ]
[    ]
[    ]
71. Are there any areas on the property which are designated as protected wetlands?
[    ]
[    ]
72. Are you aware of any encroachments, utility easements, boundary line disputes, or drainage or other easements affecting the property?
[    ]
[    ]
  73. Are there any water retention basins on the property or the adjacent properties?
[    ]
[    ]
  74. Are you aware if any part of the property is being claimed by the State of New Jersey as land presently or formerly covered by tidal water (Riparian claim or lease grant)? Explain: ______________
___________________________________________________
[    ]
[    ]
  75. Are you aware of any shared or common areas (for example, driveways, bridges, docks, walls, bulkheads, etc.) or maintenance agreements regarding the property?
      76. Explain any "yes" answers to the preceding questions in this section: ___________________________________________
_________________________________________________
_________________________________________________
[    ]
[    ]
  77. Do you have a survey of the property?

 

ENVIRONMENTAL HAZARDS
Yes
No
Unknown
   
[    ]
[    ]
78. Have you received any written notification from any public agency or private concern informing you that the property is adversely affected, or may be adversely affected, by a condition that exists on a property in the vicinity of this property? If "yes," attach a copy of any such notice currently in your possession.
[    ]
[    ]
78a. Are you aware of any condition that exists on any property in the vicinity which adversely affects, or has been identified as possibly adversely affecting, the quality or safety of the air, soil, water, and/or physical structures present on this property? If "yes," explain: _________________________________________________
_________________________________________________
_________________________________________________
[    ]
[    ]
79. Are you aware of any underground storage tanks (UST) or toxic substances now or previously present on this property or adjacent property (structure or soil), such as polychlorinated biphenyl (PCB), solvents, hydraulic fluid, petro-chemicals, hazardous wastes, pesticides, chromium, thorium, lead or other hazardous substances in the soil? If "yes," explain: __________________
_________________________________________________
[    ]
[    ]
80. Are you aware if any underground storage tank has been tested? (Attach a copy of each test report or closure certificate if available).
[    ]
[    ]
[    ]
81. Are you aware if the property has been tested for the presence of any other toxic substances, such as lead-based paint, urea-formaldehyde foam insulation, asbestos-containing materials, or others? (Attach copy of each test report if available).
   
82. If "yes" to any of the above, explain: ______________________
_________________________________________________
[    ]
[    ]
82a. If "yes" to any of the above, were any actions taken to correct the problem? Explain: ____________________________________
[    ]
[    ]
[    ]
83 Is the property in a designated Airport Safety Zone?

 

DEED RESTRICTIONS, SPECIAL DESIGNATIONS, HOMEOWNERS ASSOCIATION/CONDOMINIUMS AND CO-OPS
Yes
No
Unknown
   
[    ]
[    ]
84. Are you aware if the property is subject to any deed restrictions or other limitations on how it may be used due to its being situated within a designated historic district, or a protected area like the New Jersey Pinelands, or its being subject to similar legal authorities other than typical local zoning ordinances?
[    ]
[    ]
85. Is the property part of a condominium or other common interest ownership plan?
[    ]
[    ]
85a. If so, is the property subject to any covenants, conditions, or restrictions as a result of its being part of a condominium or other form of common interest ownership?
[    ]
[    ]
86. As the owner of the property, are you required to belong to a condominium association or homeowners association, or other similar organization or property owners?
86a. If so, what is the Association's name and telephone number? __________________________________________________
___________________________________________________
[    ]
[    ]
[    ]
86b. If so, are there any dues or assessments involved? If "yes," how much? _____________________________________________
[    ]
[    ]
  87. Are you aware of any defect, damage, or problem with any common elements or common areas that materially affects the property?
[    ]
[    ]
  88. Are you aware of any condition or claim which may result in an increase in assessments or fees?
      89. Since you purchased the property have there been any changes to the rules or by-laws of the Association that impact the property?
      90. Explain any "yes" answers you give in this section: __________
_________________________________________________
__________________________________________________

 

MISCELLANEOUS
Yes
No
Unknown
   
[    ]
[    ]
91. Are you aware of any existing or threatened legal action affecting the property or any condominium or homeowners association to which you, as an owner, belong?
[    ]
[    ]
92. Are you aware of any violations of Federal, State or local laws or regulations relating to this property?
[    ]
[    ]
93. Are you aware of any zoning violations, encroachments on adjacent properties, non-conforming uses, or set-back violations relating to this property?
[    ]
[    ]
94. Are you aware of any public improvement, condominium or homeowner association assessments against the property that remain unpaid? Are you aware of any violations of zoning, housing, building, safety or fire ordinances that remain uncorrected?
[    ]
[    ]
[    ]
95. Are there mortgages, encumbrances or liens on this property?
[    ]
[    ]
95a. Are you aware of any reason, including a defect in title, that would prevent you from conveying clear title?
[    ]
[    ]
  96. Are you aware of any material defects to the property, dwelling, or fixtures which are not disclosed elsewhere on this form? (A defect is "material," if a reasonable person would attach importance to its existence or non-existence in deciding whether or how to proceed in the transaction.) If "yes," explain: _______ _______
[    ]
[    ]
  97. Other than water and sewer charges, utility and cable tv fees, your local property taxes, any special assessments and any association dues or membership fees, are there any other fees that you pay on an ongoing basis with respect to this property, such as garbage collection fees?
      98. Explain any other "yes" answers you give in this section: _______
__________________________________________________
___________________________________________________

RADON GAS

Instructions to Owners

By law (N.J.S.A. 26:2D-73), a property owner who has had their property tested or treated for radon gas may require that information about such testing and treatment be kept confidential until the time that the owner and a buyer enter into a contract of sale, at which time a copy of the test results and evidence of any subsequent mitigation or treatment shall be provided to the buyer. The law also provides that owners may waive, in writing, this right of confidentiality. As the owner(s) of this property, do you wish to waive this right?

Yes
No
_______________
_______________
[    ]
[    ]
 
(Initials)
(Initials)

 

If you responded "yes," answer the following questions. If you responded "no," proceed to the next section.
Yes
No
Unknown
   
[    ]
[    ]
99. Are you aware if the property has been tested for radon gas? (Attach a copy of each test report if available.)
[    ]
[    ]
100. Are you aware if the property has been treated in an effort to mitigate the presence of radon gas? (If "yes," attach a copy of any evidence of such mitigation or treatment.)
[    ]
[    ]
101. Is radon remediation equipment now present in the property?
[    ]
[    ]
101a. If "yes," is such equipment in good working order?

 

MAJOR APPLANCES AND OTHER ITEMS

The terms of any final contract executed by the seller shall be controlling as to what appliances or other items, if any, shall be included in the sale of the property. Which of the following items are present in the property? (For items that are not present, indicate "not applicable.")

Yes
No
Unknown
Not Applicable
   
[    ]
[    ]
[    ]
102. Electric Garage Door Opener
[    ]
[    ]
[    ]
102a. If "yes," are they reversible? Number of Transmitters _______
[    ]
[    ]
[    ]
103. [    ] Smoke Detectors
[    ] Battery
[    ] Electric
[    ] Both How many _______
[    ] Carbon Monoxide Detectors
How many _______
Location ______________________
[    ]
[    ]
[    ]
[    ]
104. With regard to the above items, are you aware that any item is not in working order?
104a. If "yes," identify each item that is not in working order or defective and explain the nature of the problem: _________
________________________________________
[    ]
[    ]
[    ]
105. [    ] In-ground pool
[    ] Above-ground pool
[    ] Pool Heater
[    ] Spa/Hot Tub
[    ]
[    ]
[    ]
105a. Were proper permits and approvals obtained?
[    ]
[    ]
[    ]
[    ]
105b. Are you aware of any leaks or other defects with the filter or the walls or other structural or mechanical components of the pool or spa/hot tub?
[    ]
[    ]
[    ]
105c. If an in-ground pool, are you aware of any water seeping behind the walls of the pool?
106.

Indicate which of the following may be included in the sale? (Indicate Y for yes N for no.)
[       ] Refrigerator
[       ] Range
[       ] Microwave Oven
[       ] Dishwasher
[       ] Trash Compactor
[       ] Garbage Disposal
[       ] In-Ground Sprinkler System
[       ] Central Vacuum System
[       ] Security System
[       ] Washer
[       ]Dryer
[       ] Intercom
[       ] Other

[    ]
[    ]
107. Of those that may be included, is each in working order? If "no," identify each item not in working order, explain the nature of the problem: _________________________________________
________________________________________________
_________________________________________________

 

ACKNOWLEDGEMENT OF SELLER

The undersigned Seller affirms that the information set forth in this Disclosure Statement is accurate and complete to the best of Seller's knowledge, but is not a warranty as to the condition of the Property. Seller hereby authorizes the real estate brokerage firm representing or assisting the seller to provide this Disclosure Statement to all prospective buyers of the Property, and to other real estate agents. Seller alone is the source of all information contained in this statement.

SELLER: _______

DATE: _______

SELLER: _______

DATE: _______

EXECUTOR, ADMINISTRATOR, TRUSTEE

(If applicable)

The undersigned has never occupied the property and lacks the personal knowledge necessary to complete this Disclosure Statement.

___________________________________

___________________________________

DATE: _________________

RECEIPT AND ACKNOWLEDGEMENT BY PROSPECTIVE BUYER

The undersigned Prospective Buyer acknowledges receipt of this Disclosure Statement prior to signing a Contract of Sale pertaining to this Property. Prospective Buyer acknowledges that this Disclosure Statement is not a warranty by Seller and that it is Prospective Buyer's responsibility to satisfy himself or herself as to the condition of the Property. Prospective Buyer acknowledges that the Property may be inspected by three qualified professionals, at Prospective Buyer's expense, to determine the actual condition of the Property. Prospective Buyer further acknowledges that this form is intended to provide information relating to the condition of the land, structures, major systems and amenities, if any, included in the sale. This form does not address local conditions which may affect a purchaser's use and enjoyment of the property such as noise, odors, traffic volume, etc. Prospective Buyer acknowledges that they may independently investigate such local conditions before entering into a binding contract to purchase the property.

PROSPECTIVE BUYER: ___________________________________

DATE: ______________

PROSPECTIVE BUYER: ___________________________________

DATE: ______________

ACKNOWLEGEMENT OF REAL ESTATE BROKER/BROKER-SALESPERSON/SALESPERSON

The undersigned Real Estate Broker/broker-salesperson/salesperson acknowledges receipt of the Property Disclosure Statement form and that the information contained in the form was provided by the Seller.

The real estate broker/broker-salesperson/salesperson also confirms that he or she visually inspected the property with reasonable diligence to ascertain the accuracy of the information disclosed by the seller, prior to providing a copy of the property disclosure statement to the buyer.

REAL ESTATE BROKER: _________________________________

BROKER-SALESPERSON: _______________________________

SALESPERSON: ____________________________

DATE: ______________

 

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