This is a document that a seller uses to disclose the condition of real property they are
trying to sell. The seller discloses whether the property has certain features, including
an oven, microwave, dishwasher, washer, dryer, trash compactor, and much more. It
also requires the seller to disclose known defects of the property including any damage
or malfunction to fixtures, walls, and drainage. This document can be used by
individuals or small businesses that want to sell property and want to provide a
disclosure to potential buyers.
SELLER'S DISCLOSURE OF PROPERTY CONDITION
The information in this form is based upon the undersigned’s observation and knowledge about
the property during the period beginning on the date of his or her purchase of it on _____
[Month] ___ [Date], 20____ [Instruction: Insert the date of purchase] and ending on _____
[Month] ___ [Date], 20____ [Instruction: Insert the date of this form]
CONCERNING THE PROPERTY AT:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
[Instruction: Insert the property address]
NOTICE TO SELLER AND PURCHASER: THIS NOTICE IS A DISCLOSURE OF ALL
SELLER'S KNOWLEDGE OF THE PHYSICAL CONDITION OF THE PROPERTY
INCLUDING DISCLOSURE TO A BUYER ALL KNOWN MATERIALS OR ADVERSE
FACTS RELATING TO THE PHYSICAL CONDITION OF THE PROPERTY THAT ARE
NOT READILY OBSERVABLE AS OF THE DATE SIGNED BY SELLER AND IS NOT A
SUBSTITUTE FOR ANY INSPECTIONS OR WARRANTIES THE PURCHASER MAY
WISH TO OBTAIN. IT IS NOT A WARRANTY OF ANY KIND BY SELLER OR SELLER'S
AGENTS.
1. The Property has the items checked below:
[Comment: Write Yes (Y) No (N), or Unknown (U) as per applicable]
Property Items Yes(Y) No(N) Unknown (U)
Range
Oven
Microwave
Dishwasher
Trash Compactor
Disposal
Washer/Dryer
Hookups
Window Screens
Rain Gutters
Security System
Fire Detection
Equipment
Intercom System
TV Antenna
Cable TV Wiring
Satellite Dish
Ceiling Fan(s)
Attic Fan(s
Exhaust Fan(s)
Central Heating
Wall/Window
Air Conditioning
Plumbing System
Septic System
Public Sewer System
Patio/Decking
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Outdoor Grill
Fences
Pool
Sauna
Spa
Hot Tub
Pool Equipment
Pool Heater
Automatic Lawn
Sprinkler
Fireplace(s)/Chimney
(Wood)
Fireplace(s)/Chimney
(Mock)
Gas Lines (Nat. /LP)
Gas Fixtures
Carport
Garage Door
Opener(s)
Electronic
Control(s)
Water Heater
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Gas
Electric
Water Supply
Well
Mud
Roof Type: __________________ [Instruction: Insert the type of roof E.g., Metal, Tile, Slate]
Age: ________ (___) [Fifty (50)] years [◊ Instruction: Insert approximate age of the
property].
2. Are you (Seller) aware of any of the above items that are not in working condition, that
have known defects, or that are in need of repair?
[Instruction: Choose any one as applicable] Yes (Y) ___ No (N) ___ Unknown (U) ___.
If yes, then describe. [Instruction: Attach additional sheets if necessary]:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
_________________________________________________________________________
3. Are you (Seller) aware of any known defects/malfunctions in any of the following?
[Comment: Write Yes (Y) if you are aware; write No (N) if you are not aware as
applicable.]
Property Items Yes (Y) No (N)
Interior Walls
Exterior Walls
Doors
Windows
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Ceilings
Roof
Floors
Basement
Walls/Fences
Driveways
Sidewalks
Plumbing/Sewers/Septic
Electrica