NAME:
SELLER
HAS q HAS NOT q OCCUPIED THE PROPERTY.
IS
THE PROPERTY CURRENTLY LEASED? NO q YES q; TERMINATION DATE OF LEASE:
DOES
THE PROPERTY CURRENTLY HAVE HOMESTEAD EXEMPTION? NO q YES q; YEAR
GENERAL
INFORMATION ABOUT PROPERTY:
PROPERTY
ADDRESS:
LEGAL
DESCRIPTION:
NOTICE TO BUYER AND SELLER:
In Florida, a Seller is obligated to disclose to a Buyer all known facts that materially affect the value of the property being sold and that are not readily observable. This disclosure statement is designed to assist Seller in complying with the disclosure requirements under Florida law and to assist the Buyer in evaluating the property being considered. This disclosure statement concerns the condition of the real property located at above address. It is not a warranty of any kind by the Owner(s) or any Licensee in this transaction. It is not a substitute for any inspections or warranties the parties may wish to obtain. It is based only upon Seller’s knowledge of the property condition. This disclosure is not intended to be a part of any contract for sale and purchase. All parties may refer to this information when they evaluate, market, or present Seller’s property to prospective Buyers.
The following representations are made by the Seller(s) and are not the representations of any real estate licensees.
1. CLAIMS & ASSESSMENTS:
Are You Aware of
existing, pending, or proposed legal actions, claims, special assessments,
municipal service taxing or benefit unit charges or unpaid assessments
(including homeowners’ association maintenance fees or proposed increases in
assessments and/or maintenance fees) affecting the property? NO q YES q If
yes, explain:
Have any local,
state, or federal authorities notified you that repairs, alterations or
corrections of the property are required? NO q YES q If yes,
explain:
2. DEED/HOMEOWNERS’ ASSOCIATION RESTRICTIONS:
Are You Aware:
a. of any deed or homeowner restrictions? NO q YES q
b. of any proposed changes to any of the restrictions? NO q YES q
c. of any resale restrictions? NO q YES q
d. of any restrictions on leasing the property? NO q YES q
If any answer to
questions 2a-2d is yes, please explain:
Are access roads
private q public q? If private, describe the terms and conditions of the maintenance
agreement:
If there is a
homeowner association, is membership mandatory? NO q YES q, and are fees charged by the homeowner
association? NO q YES q If yes,
explain:
3. PROPERTY-RELATED ITEMS:
Are You Aware:
a. if the property has been surveyed while the seller owned the property? NO q YES q Date:
b. of any walls, driveways, fences or other features shared in common with adjoining landowners or any encroachments, boundary line disputes, setback violations, or easements affecting the property? NO q YES q
c. of any portion of the property that is fenced? NO q YES q
If any answer to
questions 3a-3c is yes, please explain:
4. THE LAND:
Are You Aware:
a. of any past or present settling, soil movement, or sinkhole problems on the property or on adjacent properties? NO q YES q
b. of any past or present drainage or flood problems affecting the property or adjacent properties? NO q YES q
c. of any past or present problems with driveways, walkways, patios, seawalls, or retaining walls on the property or adjacent properties due to drainage, flooding, or soil movements? NO q YES q
If any answer to
questions 4a-4c is yes, please explain:
5. ENVIRONMENT:
Was the property
built before 1978? NO q YES q
Are You Aware:
a. of any substances, materials, or products which may be an environmental hazard, such as, but not limited to, asbestos, urea formaldehyde, radon gas, lead-based paint, fuel, propane or chemical storage tanks (active or abandoned), or contaminated soil or water on the property? NO q YES q
b. of any condition or proposed change in the vicinity of the property that does or will materially affect the value of the property, such as, but not limited to, proposed development or proposed roadways? NO q YES q
c. of wetlands, mangroves, archaeological sites, or other environmentally sensitive areas located on the property? NO q YES q
If any answer to
questions 5a-5c is yes, please explain:
6. ZONING:
Are You Aware:
a. of any zoning violations or nonconforming uses? NO q YES q
b. if the property is zoned for its current use? NO q YES q
c. of any restrictions affecting additions, improvements or replacement of the property? NO q YES q
d. if there are any zoning, land use or administrative regulations which are in conflict with the existing or intended use of the property? NO q YES q
If any answer to
questions 6a-6d is yes, please explain:
7. FLOOD:
Are You Aware:
a. if any portion of the property is in a special flood hazard area? NO q YES q If yes, does the property require flood insurance? NO q YES q
b. whether any improvements including additions, are located below the base flood elevation? NO q YES q
c. whether such improvements have been constructed in violation of applicable local flood guidelines? NO q YES q
d. if any portion of the property is seaward of the coastal construction control line? NO q YES q
If any answer to
questions 7a-7d is yes, please explain:
8. TERMITES, DRY ROT, PESTS, WOOD DESTROYING ORGANISMS:
Do you have any
knowledge of termites, dry rot, pests or wood destroying organisms on or
affecting any improvements located on the property or any structural damage to
the property by them? NO q YES q If yes,
explain:
Has the property
been inspected since you have owned the property? NO q YES q Date of
inspection
If so, what was
the outcome of the inspection?
Has the property
been treated since you have owned the property? NO q YES q Date and
type of treatment
,
Company name:
9. STRUCTURE-RELATED ITEMS:
Are You Aware:
a. of any structural damage which may have resulted from events including, but not limited to, fire, wind, flood, hail, landslide, or blasting, and which materially affect the value of the property? NO q YES q
b. of any structural condition or, in the case of a homeowner association, any condition in the common elements that materially affects the value of the property? NO q YES q
c. of any improvements or additions to the property, whether by you or by others, that have been constructed in violation of building codes or without necessary permits? NO q YES q
d. of any active permits on the property which have not been closed by a final inspection? NO q YES q
If any answer to
questions 9a-9d is yes, please explain:
10. ROOF-RELATED ITEMS:
Are You Aware:
a. of any roof or overhang defects? NO q YES q
b. if the roof has leaked since you owned the property? NO q YES q
c. if anything was done to correct the leaks? NO q YES q
d. if the roof has been replaced? NO q YES q If yes, when:
If any answer to
questions 10a-10d is yes, please explain:
Is there a
warranty on the roof? NO q YES q If yes,
is it transferable? NO q YES q If yes,
provide a copy of the warranty. Has the roof been inspected within the last
twelve months? NO q YES q If yes,
explain:
11. PLUMBING-RELATED ITEMS:
What is your
drinking water source? Public q Private
Well q Other Source q. If your drinking water is from a well or other
source, when was your water last checked for safety and what was the result of
the test?
Do you have a
water conditioning system? NO q YES q If yes,
type: Owned q Leased q
What is the
balance owed on the system? $ Do you have a sewer q or septic system q? If septic system describe the location of each
system:
Are You Aware of
any septic tanks or wells on the property which are not currently being used?
NO q YES q If yes,
explain:
Are You Aware of
any plumbing leaks? NO q YES q If yes,
explain:
Are You Aware of
any conditions that materially affect the value of the property relating to the
septic tank/drain field, sewer lines, or any other plumbing related items? NO q YES q If yes,
explain:
12. POOLS/HOT TUBS/SPAS:
a. Does the property have a swimming pool? NO q YES q Hot tub? NO q YES q Spa? NO q YES q
b. If you answered yes to any part of 12a, was the certificate of completion received after Oct. 1, 2000 for the pool? NO q YES q For the spa? NO q YES q For the hot tub? NO q YES q
c. Check the pool safety features (as defined by Section 515.27, Florida Statutes) your swimming pool, hot tub or spa has: Enclosure that meets the pool barrier requirements q Approved safety pool cover q
d. Required door and window exit alarms q Required door locks q none q
e. Are You Aware of any conditions regarding these items that materially affect the value of the property?
NO q YES q If yes,
explain:
13. MAJOR APPLIANCES:
Indicate existing
equipment:
Range q Oven q
Microwave q Dishwasher q Garbage
Disposal q Trash Compactor q
Refrigerator q
Freezer q Washer q Dryer q
Are any of these appliances leased? NO q YES q Are any
of these gas appliances? NO q YES q
Is the water heater: owned q leased q,
electric q gas q
Are You Aware of
any problems with these appliances? NO q YES q If yes,
explain:
14. ELECTRICAL SYSTEM:
Are You Aware:
a. of any damaged or malfunctioning switches, receptacles, or wiring? NO q YES q
b. of any conditions that materially affect the value or operating capacity of the electrical system? NO q YES q
If answers to
questions 14a or 14b is yes, please explain:
15. HEATING AND AIR CONDITIONING:
Indicate existing
equipment:
Air conditioning: Heating:
Central q Window/Wall q Number
of units Electric q Fuel
Oil q Gas q Other q
Solar Heating: Owned q Leased q
Wood-burning stove: NO q YES q
Fireplace: NO q YES q
Describe fireplace equipment:
Are You Aware of any defects or malfunctioning regarding these items? NO
q YES q If yes, explain:
16. OTHER EQUIPMENT:
Indicate existing
equipment:
Security System: NO q YES q Leased q Owned q Connected to Central Monitor q Monthly
Fee $
Smoke Detectors: NO q YES q
Lawn Sprinkler System: NO q YES q
Sprinkler water source: If well source, is there an iron filter? NO q YES q Is
there a timer? NO q YES q Is the
timer automatic? NO q YES q
Garage door openers? NO q YES q, Number
of transmitters? ,
Humidistat? NO q YES q
Humidifier? NO q YES q
Electric air filters? NO q YES q Vent
fans? NO q YES q
17. OTHER MATTERS:
Is there anything
else that materially affects the value of the property? NO q YES q
If yes, explain:
The
undersigned Seller represents that the information set forth in the above
disclosure statement is accurate and complete to the best of the Seller’s
knowledge on the date signed below. Seller does not intend for this disclosure
statement to be a warranty or guaranty of any kind. Seller hereby authorizes
disclosure of the information contained in this disclosure statement to
prospective Buyers of the property. Seller understands and agrees that Seller
will notify the Buyer in writing within five business days after Seller becomes
aware that any information set forth in this disclosure statement has become
inaccurate or incorrect in any way during the term of the pending purchase by
the Buyer.
Seller:
Date:
Seller:
Date:
Seller is using this form to disclose Seller’s knowledge of the
condition of the real property and improvements located on the property as of
the date signed by Seller. This disclosure form is not a warranty of any kind.
The information contained in the disclosure is limited to information to which
the seller has knowledge. It is not intended to be a substitute for any
inspections or professional advice the Buyer may wish to obtain. An independent
professional inspection is encouraged and may be helpful to verify the
condition of the property and to determine the cost of repairs, if any. Buyer
understands these representations are not made by any real estate licensee.
Buyer
hereby acknowledges having received a copy of this disclosure statement.
Buyer:
Date:
Buyer:
Date: