Property Disclosure Statement Template

This property disclosure statement will be attached to a

This property disclosure statement will be attached to a Residential purchase agreementCommercial purchase agreementOther

Do you know the property's square footage?

Do you know the property's square footage? YesNo

Enter square footage:

Do you know what year the property was built?

Do you know what year the property was built? YesNo

Year:

Do you have an accurate survey?

Do you have an accurate survey? YesNo

Type of water system:

Type of water system: PublicWellOther

Water supply source:

Any issues with the water?

Any issues with the water? YesNo

Explain:

Any water treatment systems on the property?

Any water treatment systems on the property? YesNo

Explain:

Any fire sprinkler systems on the property?

Any fire sprinkler systems on the property? YesNo

Explain:

Any sewage disposal systems?

Any sewage disposal systems? Public sewerSeptic systemOther

Explain:

Do you know how many bedrooms the septic system services?

Do you know how many bedrooms the septic system services? YesNo

Number of bedrooms:

Is septic system functioning properly?

Is septic system functioning properly? YesNo

Explain:

Do you know when the septic system was last pumped?

Do you know when the septic system was last pumped? YesNo

System was last pumped on:

What is the heating system on the property?

What is the heating system on the property? NoneOilNatural gasElectricPropaneOther

Heating system:

Does system provide for all rooms?

Does system provide for all rooms? YesNoI don't know

Are heating systems in operating condition?

Are heating systems in operating condition? YesNoI don't know

Type of air conditioning:

Type of air conditioning: NoneElectricNatural gasOilOther

Describe A/C system:

Is the A/C in operating condition?

Is the A/C in operating condition? YesNoI don't know

Is A/C provided to all rooms?

Is A/C provided to all rooms? YesNoI don't know

How is hot water generated?

How is hot water generated? GasOilElectricNo hot waterI don't knowOther

Explain how hot water is generated:

Age of hot water system:

years

Any issues with the foundation?

Any issues with the foundation? YesNoI don't know

Describe problems:

Any leaks or excessive moisture in the basement/cellar/crawlspaces?

Any leaks or excessive moisture in the basement/cellar/crawlspaces? YesNoI don't know

Explain:

Leaks or evidence of moisture on the roof?

Leaks or evidence of moisture on the roof? YesNoI don't know

Explain:

Any fire-retardant treated plywood on the property?

Any fire-retardant treated plywood on the property? YesNoI don't know

Is the plumbing in operating condition?

Is the plumbing in operating condition? YesNoI don't know

Explain:

Any issues with electrical systems?

Any issues with electrical systems? YesNoI don't know

Explain:

Is there insulation in exterior walls?

Is there insulation in exterior walls? YesNoI don't know

Insulation in ceiling or attic?

Insulation in ceiling or attic? YesNoI don't know

Insulation under the floor?

Insulation under the floor? YesNoI don't know

Is there insulation in any other place?

Is there insulation in any other place? YesNoI don't know

Explain:

Does water "stand" on the property after a heavy rain?

Does water "stand" on the property after a heavy rain? YesNoI don't know

Explain:

Are gutters/downspouts in operating condition?

Are gutters/downspouts in operating condition? YesNoI don't know

Any current/past pest infestations on the property?

Any current/past pest infestations on the property? YesNoI don't know

Explain:

Any carbon monoxide alarms on the property?

Any carbon monoxide alarms on the property? YesNoI don't know

Any hazardous/regulated materials on the property?

Any hazardous/regulated materials on the property? YesNoI don't know

Examples include mold, asbestos, radon gas, licensed landfills, methamphetamine labs, underground storage tanks, and mining equipment.

Explain:

Any fireplaces, wood stoves, or chimneys on the property?

Any fireplaces, wood stoves, or chimneys on the property? YesNoI don't know

Enter how many and where they are located:

Any zoning violations, nonconforming uses, restriction violations, or non-utility easements?

Any zoning violations, nonconforming uses, restriction violations, or non-utility easements? YesNoI don't know

Explain:

Have improvements, repairs, or modifications been made to the property?

Have improvements, repairs, or modifications been made to the property? YesNoI don't know

Explain:

Is the property in a flood zone?

Is the property in a flood zone? YesNoI don't know

Any restrictions on the property?

Any restrictions on the property? YesNoI don't know

Explain:

Any mineral rights on the property?

Any mineral rights on the property? YesNoI don't know

Explain rights and ownership status:

Has there ever been a murder or suicide on the property?

Has there ever been a murder or suicide on the property? YesNoI don't know

Explain:

Has there ever been illegal/criminal activity on the property?

Has there ever been illegal/criminal activity on the property? YesNoI don't know

Explain:

Any additional material defects?

Any additional material defects? YesNoI don't know

Explain:

Any other disclosures?

Any other disclosures? YesNo

Explain:

What type of property is being sold?

What type of property is being sold? Single family homeCondominiumDuplexTriplexOther

Describe:

Do you want to enter the property address?

Do you want to enter the property address? YesNo - I'll do it later

Enter property's address:

Number of bedrooms:

Number of bathrooms:

A bathroom with only a toilet or shower is considered a half-bathroom.

Enter seller's name:

Do you know what year the seller purchased the property?

Do you know what year the seller purchased the property? YesNo

Enter the year:

Does the seller currently live on the property?

Does the seller currently live on the property? YesNo

Currently means at the time of completing the property disclosure.

When did the seller move in?

Save and finish later