appendix a. residential property condition disclosure
APPENDIX A. RESIDENTIAL PROPERTY CONDITION DISCLOSURE STATEMENT [NEW] Notice to Seller: Oklahoma Law (the "Residential Property Condition Disclosure Act," Title 60, 0.S., Sections 831 et.seq., effective July 1, 1995) requires Sellers of 1 and/or 2 residential dwelling units to complete this form. A Seller must complete, sign and date this disclosure form and deliver it or cause it to be delivered to a Purchaser as soon as practicable, but in any event no later than before an offer is accepted by the Seller. If the Seller becomes aware of a defect after delivery of this statement, but before the Seller accepts an offer to purchase, the Seller must deliver or cause to be delivered an amended disclosure statement disclosing the newly discovered defect to the Purchaser. If the disclosure form or amendment is delivered to a Purchaser after an offer to purchase has been made by the Purchaser, the offer to purchase shall be accepted by the Seller only after a Purchaser has acknowledged receipt of this statement and confirmed the offer to purchase in writing. Notice to Purchaser: The declarations and information contained in this disclosure statement are not warranties, express or implied of any kind, and are not a substitute for any inspections or warranties the purchaser may wish to obtain. The information contained in this disclosure statement is not intended to be a part of any contract between the Purchaser and Seller. The information and statements contained in this disclosure statement are declarations and representations of the Seller and are not the representations of the real estate licensee.
Instructions to the Seller: (1) Answer ALL questions. (2) Report known conditions affecting the property. (3) Complete this form yourself. (4) If some items do not apply to your property, circle N/A (not applicable). If you do not know the facts, circle Unk (unknown). (5) The date of completion by you may not be more than 180 days prior to the date this form is received by a purchaser.
LOCATION OF SUBJECT PROPERTY:
35233 EW 1230
Seminole SELLER IS
OK
74868
OCCUPYING THE SUBJECT PROPERTY.
IS NOT
Appliances/Systems/Services: (The items below are in NORMAL working order) Circle below Yes No Yes No
Sprinkler System Swimming Pool Hot Tub/Spa Water Heater Electric Gas Solar Water Purifier Water Softener Leased Owned Sump Pump Plumbing Whirlpool Tub Sewer System Public .Septic Lagoon
3
Air Conditioning System \(_ Electric Gas Heat Pump Window Air Conditioner(s) Attic Fan Fireplaces Heating System c(--Electric Gas Heat Pump Seller's Initials (OREC-7/12)
Unk
Humidifier
Unk Unk Unk
N/A i Yes No Yes No
Unk Unk
Gas Supply )(Public Propane Butane Propane Tank Leased Owned Ceiling Fans Electric Air Purifier
No No No No
Unk
Garage Door Opener/ Control 01)- Skoc
Yes N/A
Yes N/A N/A N/A
Yes
No No
N/A (ys, No
N/A N/A
Unk Unk
Unk
Yes No
Unk
Yes No No No
Unk Unk Unk
Seller's Initials
Intercom Central Vacuum Security System Rent )LOwn Monitored
N/A A
Circle below Yes No No
Unk
Yes No
Unk
Yes) No
Unk Unk
Yes No
Unk
N/A Unk es No N/A No Unk N/A es ' No Unk N/A Yes No Unk
No Unk
Smoke Detectors Dishwasher Electrical Wiring Garbage Disposal Gas Grill Vent Hood c ∎nvi
N/A
Microwave Oven Built-in Oven/Range Kitchen Stove Trash Compactor
A N/A CD No Unk No Unk N/A N/A No Unk
Buyer's Initials
N/A N/A N/A
a
No NEW es No
Unk Unk
No al es No
Unk Unk Unk Yes No es No Unk
ftr 0
Buyer's Initials Page 1 of 3
lostatO rorms
LOCATION OF SUBJECT PROPERTY
35233 EW 1230 OK
Seminole
Source of Household Water
C5)?0 I
74868
Other Items
Yes
No
Unk
Other
Yes
No
Unk
Public Private Well Yes No Unk Other
S\nv VI \
Yes No Unk
IF YOU HAVE ANSWERED NO to any of the above, please explain. Attach additional pages with your signature(s).
.48jergiiti VNt:.- t,‘=-Zoning, Flood and Water historical commercial 1. Property is zoned: (Check one) industrial office agricultural other unknown urban conservation 2. What is the flood zone status of the property? 3. Are you aware of any flood insurance requirements concerning the property? 4. Do you have flood insurance on the property? 5. Has the property been damaged or affected by flood, storm run-off, sewer backup, drainage or grading problems? 6. Are you aware of any surface or ground water drainage systems which assist in draining the property, e.g. french drains? 7 Has there been any occurrence of water in the heating and air conditioning duct system? 8. Are you aware of water seepage, leakage or other drainage problems in any of the improvements on the property?
Additions/Alterations/Repairs 9. Have any additions or alterations been made without required permits? 10. Are you aware of previous foundation repairs? 11.Are you aware of any alterations or repairs having been made to correct defects or problems? 12. Are you aware of any defect or condition affecting the interior or exterior walls, ceilings, slab/foundation, basement/storm cellar, floors, windows, doors, fences or garage? 13. Has the roof ever been repaired or replaced during your ownership of the property? number of layers, if known 14. Approximate age of roof covering, if known / 15. Do you know of any current problems with the roof? 16. Are you aware of treatment for termite or wood-destroying organism infestation? 17.Do you have a termite bait system installed on the property? 18. If yes, is it monitored by a licensed exterminating company? yes no Annual cost $ (Check one) 19. Are you aware of any damage caused by termites or wood-destroying organisms? 20. Are you aware of major fire, tornado, hail, earthquake or wind damage? 21. Are you aware of problems pertaining to sewer, septic, lateral lines or aerobic system? Environmental 22. Are you aware of the presence of asbestos? 23. Are you aware of the presence of radon gas? 24. Have you tested for radon gas? 25. Are you aware of the presence of lead-based paint? 26. Have you tested for lead-based paint? 27. Are you aware of any underground storage tanks on the property? 28. Are you aware of the presence of a landfill on the property? 29. Are you aware of existence of hazardous or regulated materials and other conditions having an environmental impact? 30. Are you aware of existence of prior manufacturing of methamphetamine? 31. Have you had the property inspected for mold? 32. Have you had any remedial treatment for mold on the property? 33. Are you aware of any condition on the property that would impair the health or safety of the occupants?
Circle below
,G, Yes Yes
No
Yes
Unk Unk Unk Unk
Yes Yes Yes
Unk
Yes Yes Yes
Unk Unk Unk
Yes No
Unk Unk
Yes Yes Yes
Unk Unk
Yes Yes Yes
Unk Unk Unk
No
Yes Yes Yes Yes Yes Yes Yes
Unk Unk Unk Unk Unk Unk Unk
Yes Yes Yes Yes
Unk Unk Unk Unk
Yes
Unk
Yes
Unk
Yes
Unk
Property Shared in Common, Easements, Homeowner's Association, Legal
34. Are you aware of features of the property shared in common with adjoining landowners, such as fences, driveways, and roads whose use or responsibility has an affect on the property? 35. Other than utility easements serving the property, are you aware of easements or right-of-ways affecting the property? Seller's Initials (OREC-7/12)
Seller's Initials
Buyer's Initials
Buyer's Initials Page 2 of 3
/osta
rcwins
LOCATION OF SUBJECT PROPERTY
35233 EW 1230
Seminole
OK
36. Are you aware of encroachments affecting the property? 37. Are you aware of a mandatory homeowner's association? Special Assessment $ Amount of dues $ annually monthly quarterly Payable: (Check one) yes )4 no Are there unpaid dues or assessments for the Property? (Check one) Manager's Name: If yes, amount $ Phone No. 38. Are you aware of any zoning, building code or setback requirement violations? 39. Are you aware of any notices from any government or government-sponsored agencies or any other entities affecting the property? 40. Are you aware of any filed litigation or lawsuit(s), directly or indirectly, affecting the property, including a foreclosure? 41. Is the property located in a fire district which requires payment? To Whom Paid Amount of fees $ Payable (Check one) _ monthly _quarterly _annually 42. Is the property located in a private utility district? (Check applicable) water_ garbage _ sewer_ other_ If other, explain: annual membership fee $ Initial membership fee $ (If more than one (1) utility, attach additional pages.)
74868
Ye
Unk Unk
No
Yes
Unk
Yes
Unk
Yes No Yes 09
Unk Unk
Yes
Unk
No
Miscellaneous
43. Are you aware of other defect(s), affecting the property, not disclosed above? 44. Are you aware of any other fees or dues required on the property that you have not disclosed?
Yes Yes
Unk o
Unk
If you answered "YES" to any of the items 1-44 above, list the item number(s) and explain. (If needed, attach
additional pages, with your signature(s), date(s) and location of subject property,
13- A IQ) A),/es Ale.) 11 112 We Aqd t-efla red.
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44
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On the date this form is signed, the seller states that based on seller's CURRENT ACTUAL KNOWLEDGE of the property, the information contained above is true and accurate. Are there 'onal s attached to this disclosure (circle one): Yes o. If yes, how many?
er's Signature Mi
Quisenberry
Date
Seller's Signature Rebecrduisenberry Date
A real estate licensee has no duty to the Seller or the Purchaser to conduct an independent inspection of the property and has no duty to independently verify the accuracy or completeness of any statement made by the seller in this disclosure statement.
The Purchaser understands that the disclosures given by the Seller on this statement is not a warranty of condition. The Purchaser is urged to carefully inspect the property and, if desired, to have the property inspected by a licensed expert. For specific uses, restrictions and flood zone status, contact the local planning, zoning and/or engineering department. The Purchaser acknowledges that the Purchaser has read and received a signed copy of this statement. This completed acknowledgement should accompany an offer to purchase on the property identified. This is to advise that this disclosure statement is not valid after 180 days from the date completed by the Seller. Purchaser's Signature
Date
Purchaser's Signature
Date
The disclosure and disclaimer statement forms and the Oklahoma Residential Property Condition Disclosure Act information pamphlet are made available at the Oklahoma Real Estate Commission (OREC), Denver N. Davison Building, 1915 N. Stiles, Suite 200, Oklahoma City, Oklahoma 73105, or visit OREC's Web site www.orec.ok.gov . (OREC-7/12) Page 3 of 3
60
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■ Technology Solutions for Oovernment A Industry
• ••
Visual Lease Services 200 E MAIN AVE. HOLDENVILLE, OK. 74848 www.vlsmaps.com
(800) 535-6467
O Cartography - GIS/GIS
O Oil & Gas Field Asset Database
■ Oil & Gas Field Appraisal
■ Government-to-Business Internet
O Asset Discovery & Inventory
O Wireless Broadband Internet
■ Appraisal Services
■ Online County Assessor Data
■ Database Design
111 Off-Site Data Backups
FAX: 405.379.2889
[email protected]
PH: 405.379.5280
See Page 12 GuES ONCE • mArnE RLE 40 72 AC
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19.4 2006 Copyright Visual Lease Services, Inc. Sep 05, 2006
Instructions to the Seller: (1) Answer ALL questions. (2) Report known conditions affecting the property. (3) Complete this form yourself. (4) If some items do not apply to your property, circle N/A (not applicable). If you do not know the facts, circle Unk (unknown). (5) The date of completion by you may not be more than 180 days prior to the date this form is received by a purchaser.
LOCATION OF SUBJECT PROPERTY:
35233 EW 1230
Seminole SELLER IS
OK
74868
OCCUPYING THE SUBJECT PROPERTY.
IS NOT
Appliances/Systems/Services: (The items below are in NORMAL working order) Circle below Yes No Yes No
Sprinkler System Swimming Pool Hot Tub/Spa Water Heater Electric Gas Solar Water Purifier Water Softener Leased Owned Sump Pump Plumbing Whirlpool Tub Sewer System Public .Septic Lagoon
3
Air Conditioning System \(_ Electric Gas Heat Pump Window Air Conditioner(s) Attic Fan Fireplaces Heating System c(--Electric Gas Heat Pump Seller's Initials (OREC-7/12)
Unk
Humidifier
Unk Unk Unk
N/A i Yes No Yes No
Unk Unk
Gas Supply )(Public Propane Butane Propane Tank Leased Owned Ceiling Fans Electric Air Purifier
No No No No
Unk
Garage Door Opener/ Control 01)- Skoc
Yes N/A
Yes N/A N/A N/A
Yes
No No
N/A (ys, No
N/A N/A
Unk Unk
Unk
Yes No
Unk
Yes No No No
Unk Unk Unk
Seller's Initials
Intercom Central Vacuum Security System Rent )LOwn Monitored
N/A A
Circle below Yes No No
Unk
Yes No
Unk
Yes) No
Unk Unk
Yes No
Unk
N/A Unk es No N/A No Unk N/A es ' No Unk N/A Yes No Unk
No Unk
Smoke Detectors Dishwasher Electrical Wiring Garbage Disposal Gas Grill Vent Hood c ∎nvi
N/A
Microwave Oven Built-in Oven/Range Kitchen Stove Trash Compactor
A N/A CD No Unk No Unk N/A N/A No Unk
Buyer's Initials
N/A N/A N/A
a
No NEW es No
Unk Unk
No al es No
Unk Unk Unk Yes No es No Unk
ftr 0
Buyer's Initials Page 1 of 3
lostatO rorms
LOCATION OF SUBJECT PROPERTY
35233 EW 1230 OK
Seminole
Source of Household Water
C5)?0 I
74868
Other Items
Yes
No
Unk
Other
Yes
No
Unk
Public Private Well Yes No Unk Other
S\nv VI \
Yes No Unk
IF YOU HAVE ANSWERED NO to any of the above, please explain. Attach additional pages with your signature(s).
.48jergiiti VNt:.- t,‘=-Zoning, Flood and Water historical commercial 1. Property is zoned: (Check one) industrial office agricultural other unknown urban conservation 2. What is the flood zone status of the property? 3. Are you aware of any flood insurance requirements concerning the property? 4. Do you have flood insurance on the property? 5. Has the property been damaged or affected by flood, storm run-off, sewer backup, drainage or grading problems? 6. Are you aware of any surface or ground water drainage systems which assist in draining the property, e.g. french drains? 7 Has there been any occurrence of water in the heating and air conditioning duct system? 8. Are you aware of water seepage, leakage or other drainage problems in any of the improvements on the property?
Additions/Alterations/Repairs 9. Have any additions or alterations been made without required permits? 10. Are you aware of previous foundation repairs? 11.Are you aware of any alterations or repairs having been made to correct defects or problems? 12. Are you aware of any defect or condition affecting the interior or exterior walls, ceilings, slab/foundation, basement/storm cellar, floors, windows, doors, fences or garage? 13. Has the roof ever been repaired or replaced during your ownership of the property? number of layers, if known 14. Approximate age of roof covering, if known / 15. Do you know of any current problems with the roof? 16. Are you aware of treatment for termite or wood-destroying organism infestation? 17.Do you have a termite bait system installed on the property? 18. If yes, is it monitored by a licensed exterminating company? yes no Annual cost $ (Check one) 19. Are you aware of any damage caused by termites or wood-destroying organisms? 20. Are you aware of major fire, tornado, hail, earthquake or wind damage? 21. Are you aware of problems pertaining to sewer, septic, lateral lines or aerobic system? Environmental 22. Are you aware of the presence of asbestos? 23. Are you aware of the presence of radon gas? 24. Have you tested for radon gas? 25. Are you aware of the presence of lead-based paint? 26. Have you tested for lead-based paint? 27. Are you aware of any underground storage tanks on the property? 28. Are you aware of the presence of a landfill on the property? 29. Are you aware of existence of hazardous or regulated materials and other conditions having an environmental impact? 30. Are you aware of existence of prior manufacturing of methamphetamine? 31. Have you had the property inspected for mold? 32. Have you had any remedial treatment for mold on the property? 33. Are you aware of any condition on the property that would impair the health or safety of the occupants?
Circle below
,G, Yes Yes
No
Yes
Unk Unk Unk Unk
Yes Yes Yes
Unk
Yes Yes Yes
Unk Unk Unk
Yes No
Unk Unk
Yes Yes Yes
Unk Unk
Yes Yes Yes
Unk Unk Unk
No
Yes Yes Yes Yes Yes Yes Yes
Unk Unk Unk Unk Unk Unk Unk
Yes Yes Yes Yes
Unk Unk Unk Unk
Yes
Unk
Yes
Unk
Yes
Unk
Property Shared in Common, Easements, Homeowner's Association, Legal
34. Are you aware of features of the property shared in common with adjoining landowners, such as fences, driveways, and roads whose use or responsibility has an affect on the property? 35. Other than utility easements serving the property, are you aware of easements or right-of-ways affecting the property? Seller's Initials (OREC-7/12)
Seller's Initials
Buyer's Initials
Buyer's Initials Page 2 of 3
/osta
rcwins
LOCATION OF SUBJECT PROPERTY
35233 EW 1230
Seminole
OK
36. Are you aware of encroachments affecting the property? 37. Are you aware of a mandatory homeowner's association? Special Assessment $ Amount of dues $ annually monthly quarterly Payable: (Check one) yes )4 no Are there unpaid dues or assessments for the Property? (Check one) Manager's Name: If yes, amount $ Phone No. 38. Are you aware of any zoning, building code or setback requirement violations? 39. Are you aware of any notices from any government or government-sponsored agencies or any other entities affecting the property? 40. Are you aware of any filed litigation or lawsuit(s), directly or indirectly, affecting the property, including a foreclosure? 41. Is the property located in a fire district which requires payment? To Whom Paid Amount of fees $ Payable (Check one) _ monthly _quarterly _annually 42. Is the property located in a private utility district? (Check applicable) water_ garbage _ sewer_ other_ If other, explain: annual membership fee $ Initial membership fee $ (If more than one (1) utility, attach additional pages.)
74868
Ye
Unk Unk
No
Yes
Unk
Yes
Unk
Yes No Yes 09
Unk Unk
Yes
Unk
No
Miscellaneous
43. Are you aware of other defect(s), affecting the property, not disclosed above? 44. Are you aware of any other fees or dues required on the property that you have not disclosed?
Yes Yes
Unk o
Unk
If you answered "YES" to any of the items 1-44 above, list the item number(s) and explain. (If needed, attach
additional pages, with your signature(s), date(s) and location of subject property,
13- A IQ) A),/es Ale.) 11 112 We Aqd t-efla red.
"(
in
44
to;,, d
a cine/e
gy .0-
On the date this form is signed, the seller states that based on seller's CURRENT ACTUAL KNOWLEDGE of the property, the information contained above is true and accurate. Are there 'onal s attached to this disclosure (circle one): Yes o. If yes, how many?
er's Signature Mi
Quisenberry
Date
Seller's Signature Rebecrduisenberry Date
A real estate licensee has no duty to the Seller or the Purchaser to conduct an independent inspection of the property and has no duty to independently verify the accuracy or completeness of any statement made by the seller in this disclosure statement.
The Purchaser understands that the disclosures given by the Seller on this statement is not a warranty of condition. The Purchaser is urged to carefully inspect the property and, if desired, to have the property inspected by a licensed expert. For specific uses, restrictions and flood zone status, contact the local planning, zoning and/or engineering department. The Purchaser acknowledges that the Purchaser has read and received a signed copy of this statement. This completed acknowledgement should accompany an offer to purchase on the property identified. This is to advise that this disclosure statement is not valid after 180 days from the date completed by the Seller. Purchaser's Signature
Date
Purchaser's Signature
Date
The disclosure and disclaimer statement forms and the Oklahoma Residential Property Condition Disclosure Act information pamphlet are made available at the Oklahoma Real Estate Commission (OREC), Denver N. Davison Building, 1915 N. Stiles, Suite 200, Oklahoma City, Oklahoma 73105, or visit OREC's Web site www.orec.ok.gov . (OREC-7/12) Page 3 of 3
60
3 PAyre
Ekly.
NAT VP t 7AS -
A:11 4111-114fomitt
eta si► eP
3Sa35 EA3 e._\1\N\Nc∎ c; CD\
vim) tlevit
N~c~`
■ Technology Solutions for Oovernment A Industry
• ••
Visual Lease Services 200 E MAIN AVE. HOLDENVILLE, OK. 74848 www.vlsmaps.com
(800) 535-6467
O Cartography - GIS/GIS
O Oil & Gas Field Asset Database
■ Oil & Gas Field Appraisal
■ Government-to-Business Internet
O Asset Discovery & Inventory
O Wireless Broadband Internet
■ Appraisal Services
■ Online County Assessor Data
■ Database Design
111 Off-Site Data Backups
FAX: 405.379.2889
[email protected]
PH: 405.379.5280
See Page 12 GuES ONCE • mArnE RLE 40 72 AC
ou ... JOHNSON DEBORAH BOAC.
GUEST GARY 40 AC
, TIGER ANN 37.43 AC.
. • •
NINNESS DICK 120 AC.
•
•
CHOATE NANA RLE CHOATE NANA ALE W .35 Ac.
40 AC CHOATE NANA RLE AC.
8 12 5
rdiIi
...GM PAUL SR RLE 40 AC. MEHAGAN PAUL SR RLE 40 AC.
EwERA
40
BET BLL & ELVERA 40 AC
IT4.1 pV13 Itta
BAKER HENRIETTA leo AC.
To
H
.
E1210
,,,„„ • ,c.
WALLACE DAN 4•3 AC.
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EA ON E:AL EL IRA 40 AC
NOR 7 AC.
.
11111
0 fsl
IS AN DAVID & S FI0E2
DAVIS 23.08 AC
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19.4 2006 Copyright Visual Lease Services, Inc. Sep 05, 2006
