Property Disclosure Statement.... - Amazon Simple Storage Service
CB
G:r
Form & Home Realty
l[QUAJ.. tt()U$1N(J
REALTOR®
O,.P'Oftf\.INrrY
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 INSTRUCTIONS AND ACKNOWLEDGMENT REGARDING THIS FORM This Statement discloses Seller's current, ach1al knowledge of the condition of the Property as of the date signed by Seller, and is not a subslih1te for any inspections ot waJTanties that Buyer may wish to obtain. This Statement is designed to assist Seller to provide information about the Property and to assist Buyer in evaluating the Prope1ty being considered. Conditions may exist which are unknown to Seller. Buyer is encouraged to address concerns about the Property whether or not included in this Statement. This Statement does not relieve Seller of the obligation to disclose a condition of the Property that may not be addressed on this form or a change in any condition after the date of this Statement, and is not a substih1te for inspection by the Buyer. Neither the Broker, nor the Board or Association of REAL TORS® nor the REAL TORS® Association of New Mexico warrant or guarantee the information in this disclosure.
Do not leave any questions blank. Attach additional pages if needed. Buyer _ _ _
Initials:
Seller
1J ·] -, 11L_
22 & 23 Palomino Dr
Moriarty
87025
City
Zip Code
Address
Lots 22, 23, Unit 10, Moriarty Heights Legal Description
Or see metes & bounds description attached as Exhibit
---
____T~o=-=r_r"'a=n-c....e...____ County, New Mexico.
OCCUPANCY: Is Seller currently occupying the Property? 0 Yes. If yes, ___ years/months Seller occupied. If no, ___ years/months since Seller occupied. Ii(Never Occupied Property. O Other-----
I.
0 No. 2.
TITLE, ZONING, LEGAL INFORMATION:
I I I YES
0
NO
IS THE SELLER Aw ARE OF: A. Was tbe Property part of a Jarger tract of land that was subdivided within the last five (5) years? If yes, and the subdivided Property was not previously subdivided in accordance with the New Mexico Subdivision Act (Act), a subsequent sale, lease or other conveyance of the Property within five (5) years of the original subdivision and sale, lease or conveyance may trigger the requirements of the Act. SELLER/BUYER SHOULD CONSULT A TITLE COMPANY AND AN ATTORNEY TO DETERMINE THE APPLICABILITY OF THE ACT TO THIS PROPERTY.
Titis fonn and all REALTORS•!!l Association of New Mexico (RANM) fom1s arc for the sole use of RANM members and those New Mexico Real Estate Licensees to w!t~m RANM has granted prior written authorization. Distribution of RANM Fom1s to non-Ri\l\'l\1 members or unauthorized Real Estate Licensees is strictly prob1bllcd. RANM makes no warranty of the legal effectiveness or validity of this form and disclaims any liability for damages rt$Ulting from its use. By use of this ~on~\ the i;a!1ies agree to 1hc limita~ons set forth in this paragraph. TI1c panics hereby release RANM, the Real Estate Brokers, their Agents nnd employees from any habthty nnsmg out of 1hc use orth1s fonn. You should consult your attorney with regards to the effectiveness, validity or consequences or any use of this foml. 111c ~sc of this fonn is not intended to identify lhc user as o REALTOR®. REALTOR® is a registered collective membership mark which may be used only by real estate licensees who arc members orthc National Association of REALTORS•l!> and who subscribe to tbe Association's strict Code of Ethics. RANM Forni 4103 (2013 JAN) Page I of 10
0 2008 REALTORS·l!> Association of New Mexico
United Country Fann & Home Realty 200 US Route 66 East Moriarty, Nllf 87035 Phone: 505-553-3504 Fax : 505-832-6996 Cherie Wallin Produced wilh zlpFor-by zlploglx 18070 Fine en Mdo Road, Fraser, Miehigan 48026
Initials: Buyer____
Seller'-
"9 • 1·..i!Lf;'. ,
Hix . Palomino \Wifi
ziplogix com
REALTORS® ASSOCIATION OF.NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 YES
NO
IS THE SELLER AW ARE OF: B. Are there any title problems (for example, unrecorded or disputed easements, lot line disputes, liens, cncroaclunent, access iss11es, third party claims)? C. Any Property taxes that are not current? D. Any existing or proposed bonds, assessments, liens, mortgages, judgments, Deed of Trnst, Impact Fees, Real Estate Contracts, etc. against the Property? lfyes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
0
0
0
~
0
0
0
~
0
Ii
0
li
E. Any violations of applicable subdivision laws at the time the Property was subdivided? If yes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ F. Any alleged violations of applicable laws, regulations, ordinances or zoning laws? Ifycs,explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
G. Any zoning variances/exceptions or non-confo1111ing use of the Property? Ifyes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ H. Any legal issues, proposed buildings, bridges, roadways or real estate developments, etc. in the immediate area? If yes, e x p l a i n : - - - - - - - - - - - - - - - - - - - - - - - - !. Any restrictive covenants or other limitations on use? If yes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ a. Any violation thereof? ff yes, e x p l a i n : - - - - - - - - - - - - - - - Any building code or environmental regulation violations?
0
G1'
].
0
li!f
If yes, e x p l a i n : - - - - - - - - - - - - - - - - - - - - - - - - K. Any necessa1y permits, approvals or inspections for all constrnction, repairs and improvements that have not been obtained? Ifyes,explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
D
0
0
fZ1'
0
L. Any existing or threatened legal actions concerning the Property or the Homeowners Association? If yes, e x p l a i n : - - - - - - - - - - - - - - - - - - - - - - - - M. Any well-sharing, driveway-sharing, road-sharing or other contract to which the Property is subject?
If yes, e x p l a i n : - - - - - - - - - - - - - - - - - - - - - - - - N. Anyone with a Right of First Refosal, option to buy or lease the Property, or any other similar agreement? If yes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 0. Any other restrictions on resale? If yes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
D
Ii ri
P. Is this Property subject to Right of Reversion?
0
ri
If yes, e x p l a i n : - - - - - - - - - - - - - - - - - - - - - - - - Q. Any exemptions you claim to Property Taxes (i.e., Veteran, Head of Household)?
0
Ifyes,explain:~-----------------------For additional information or fiutber explanation (indicate item#):
RANMFom14103 (2013JAN) Pagc2ofl0
------------------
0 2008 RF.ALTORS® Association of New Mexico
Produced with zip Font>!> by ziplogix 18070 Fllteen Mne Road. Fraser. Michigan 48028
Initials: Buyer____ ww.y zip! Qlll•
CQO'!
Selle;}) :
JJ-.p lf
Hix • Palomino
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 3. PROPERTY CONDITIONS
I I I YES
NO
0 0
ci
IS THE SELLER Aw ARE OF: A. Any mi.nor damage tbat bas occurred to the Property? B. Any smoke damage or a fire on the Property? c. Any problems with driveways, walkways, sidewalks (such a large cracks, potholes or raised sections)? D. Any history of wood infestation, insects, pests or tree root problems? Specify date and type of last treatment: E. Any flowing or drainage problems on the Property? F. Any flowing or drainage problems on adjacent Properties that may impact this Property? G. Any standing water after rainfalls? H. Any active springs? I. Any history of moldy conditions or treatment for mold? J. Any land on the Property that has been filled in? K. Any earth movement, subsidence, or settlement problems? L. Any additional stmctures? If yes, list:
r2f
0
~
0
f2f
0 0
~ ~
0
ul
0
g
0 0 0 0
~
For additional information or further explanation (indicate item#): - - - - - - - - - - - - - - - - - 4.
WATER SUPPLY
YES
NO
0
DON'T KNOW
0
0
0
0
0
0
0
0
l2f
0 0
0
0
0
0 0
0 0
0
A. Is the water supplyO City/Municipal? 0 Community/Subdivision 0 Domestic Well 0 Private Well 0 Shared Well IBNone (If none, skip to Paragraph 5) If yes, 1. Is there a requirement to connect to the City/Municipal/Community/ Subdivision water? If yes, what are the requirements? _ _ _ _ _ _ _ __ NOTE: Additional expenses may be 1·equired B. If the water supply is City/Municipal/Community/Subdivision, list name and address of s u p p l i e r : - - - - - - - - - - - - - - - - - - - - - - - - - Are there any p r o b l e m s ? - - - - - - - - - - - - - - - - - - - - - 1.
Any water supply problems? If yes, explain: - - - - - - - - - - -
ii. Fees per m o n t h : $ - - - - - - - - - iii. Is there a Transfer Fee? If yes, how much? iv. Any restrictions or regulations? If yes, explain:
------------
-----------
NOTE: Additional expenses may be required C. If water supply is domestic/private/shared well, any problems with well equipment? If yes, explain: i. Any restrictions or regulations? ii. If this is a shared well, is a written agreement available? iii. Is well registered with the State Engineer's Office? Permit Number:
RANM Fonn 4103 (2013 JAN) Page 3 of JO
0 2008 REALTORS•l!> Ass-oc-io-tio_n_o_fN-C\-,.-M-c-xic-o--lni.ti-als: Buyer____
P by zlplogiK 18070 Flfteen Mi!e Road. Fraser. Michigan 4ll026
www zip! ~ i x mm
Scllc;1J
.Jt$Jj,
Hix - Palomino
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 NO
DON'T KNOW
0
0
0
0
0
0
0
0
0
iv. v. vi.
0
D
0
vii.
0
0
0
0
0
0
Does Seller have well record? Is well metered? Is there sufficient water yield at all times? Ifno, explain: ______________________________
Is there a separate electrical meter for the shared well? If yes, what is the location of the meter? and other well components & equipment? viii. ls there a requirement to connect to the City/Municipal/Community/ Subdivision water? If yes, what are the requirements?---------NOTE: Additional expenses may be required
ix. ls there any other water source for the Property for any other use? If so, explain: - - - - - - - - - - - - - - - - - - - - - - - - - - - -
For more information , see RANM Form 2307 - Infommtion Sheet - Water Rights and Domestic Wells) For additional information or further explanation (indicate item #): - - - - - - - - - - - - - - - - - - - - - - - - - -
5.
SEWER/WASTEWATER TREATMENT DON'T YES NO KNOW
A. ls the sewer/wastewater treatment system?
O City/Muuicip~
0 0 0 0
0 0 0
0 0 0
Community/Subdivision D Onsite Liquid Waste System M None Any problems? i. If none, is sewer available ii. If yes, ls there a requirement to coru1ect to the City/Municipal/Community/ Subdivision Sewer Wastewater Treatment System? What are the
0
0
0
requirements: - - - - - - - - - - - - - - - - - - - - - - - - - B. If the sewer/wastewater treatment system is City/Municipal/Community/ Subdivision? List name and address of provider:
-------------------
../In
0
0
0
0 0 0
0 0 0
0 0 0
i. Fees per month: $ - - - - - - - - - - - - - - - - - - - - - - - - - - - - ii. Any restrictions or regulations? If yes, explain: - -- - - - - - - - - - - - - - - - - - - - iii. Is a written agreement available? iv. Is there a transfer fee? If yes, how much? - - - - - - - - - - - - - - - v.
c.
ls there a requirement to connect to the City/Municipal/Sewer Wastewater Treatment System? If yes, what are the requirements?--------
If there is an Onsite Liquid waste system, type: 0 Advanced Treatment System (See #D)
0 Conventional
0
0
0
O Cesspool
i. Any problems? - - - - - - - - - - - - - - - - - - - - ii. List name and address of service company: - - - - - - - - - - - - - - iii. Date last serviced:
"'·
-----------------------------
RANM Fonn 4103 (2013 JAN) Page 4 of 10
.02008 REALTORS•!!> Association of New Mexico
Produced with ripF~ by ziptog;•
18070 Afteen Mile Road, Fraser, Michigan ~8026
Initials: Buyer _ _ _ _ www zipLog;x rom
Sell~~ ·: i.11} . Hix - Palomino
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 NO
DON'T KNOW
0 0
D 0
D
D
D
0 0
D
0
0 0
D
0
0
D
D
0
0
D
0
0
D
0
iv. Is there an available installation permit? v. New Mexico Environmental Department (NMED) Environmental Improvement District (EID) Certification? NMED (EID) Certification vi. vii.
number and d a t e : - - - - - - - - - - - - - - - - - - - Location of the system: - - - - - - - - - - - ------"""""". Is there a requirement to connect to the City/Municipal/Community/ Subdivision Sewer/Wastewater Treatment System? If yes, what arc the
requirements? - - - - - - - - - - - - - - - - - - - - D. Are there any ALTERNATIVE LIQUID WASTE SYSTEMS? 1. Is there an ADVANCED ON-SITE LIQUID WASTE SYSTEM (Multi-Flow Septic System): ORA Y WATER and/or BLACK WATER? 1) Does the Property have a harvesting system utilizing Gray and/or black waler? If yes, please explain: - - - - - - - - - - - -
ii.
111.
2)
How is the harvested liquid waste utilized? - - - - - - - - -
3)
W11ere is the location of the Multi-Flow Septic System? _ _ _ __
4)
What year was the Multi-Flow Septic System installed? _ _ _ __
NOTE: Additional expenses may be required Does the Property have an OUT HOUSE (Outdoor Latrine Facilities)? I) If yes, how many are on the Prope11y? - - - - - - - - - 2) Is the Out House a permanent strncture? 3) If existing, please describe any additional details - - - - - - NOTE: Additional expenses may be required Does the Property have a COMPOSTING TOILET? l) If yes, what is the method of operation? 0 electric 0 solar 0 other: explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
2)
0
0
0
0
0
0
If existing, please describe any additional details - - - - - - -
NOTE: Additional expenses may be required Does the Property have a Liquid Waste STORAGE TANK? 1) If yes, please list: Capacity amount _ _ _ _ Location of Liquid Waste Storage Tank _ _ _ _ Date of installation Frequency the Liquid Waste Storage Tank needs to be pumped NOTE: Additional expenses may be 1·equlred E. Have there been any problems with the sewer/septic system? If yes, explain: _ __
iv.
RANM Fonu 4103 (2013 JAN) Page 5of10
t'.12008 REAL TORS® Association of New Mexico
Produced will> zipForm:!l by ziplogix 18070 Fifteen M~e Road. Fraser. Michigan 48026
Initials: Ruycr _ _ __ WMV
zipLog!x com
Sell~J;))J-_~H ' HiK - Palomino
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 IF THE PROPERTY HAS AN ONSITE LIQUID WASTE SYSTEM, IT IS SUBJECT TO THE REGULATIONS OF THE NEW MEXICO ENVIRONMENTAL DEPARTMENT (NMED), WHICH REQUJRE INSPECTIONS AND POSSIBLE REPAIR. CONTACT THE NMED FOR INFORMATION REGARDING APPROPRIATE INSPECTION FORMS AND REQUIREMENTS. For more infonnation, see RANM Fonn 2308 Information Sheet - Septic Systems. For additional infonnation or fmther explanation (indicate item #): - - - - - - - - - - - - - - - - -
6.
ELECTRICAL
I I YES
NO
1~~~1
,..
N(H (
0 0 0 0
0 0
0 0
D D
0
0
0
0
0
0
0
D
D
D
explain: - - - - - - - - - - - - - - - - - - - - - - - - - E. Are you aware of any defective, malfunctioning, or in1properly installed electrical equipment? If yes, explain: -------------------~ F. Has electrical service been modified since originally installed? If yes, explain: _ _
0
0
0
G. Do any circuits trip regularly? If yes, explain: - - - - - - - - - - - - - -
0
0
H. Are you aware of any electric lines encroaching on the Property? If yes, explain: _ _
D
0
I.
\: \
D
A. Is tbe electrical wiring copper? B. Is the electrical wiring aluminum? i. If yes, has the aluminum wiring been pig-tailed with copper wiring? C . Are you aware of any damaged or malfunctioning receptacles or switches? If yes, which ones? D . Are you aware of any extension cords used to create new electrical outlets? If yes,
-----------------------:----
Are there encroaclunent agreements with any utility companies? If yes, explain: _ _
For additional information or further explanation (indicate item #): - - - - - - - - - - - - - - - - -
MISCELLANEOUS
7.
I I ,~/+)
YES
NO
1~~~1
0
D
0
0 0
0 0
D
ii.
0
iii. iv. v.
0
0
0
0
0
0
0
0 0
A. Does the Property include a landscape watering system? If yes, is it 0 Auto-timed 0 Manual 0 Front yard 0 Back yard 0 Side yard 1. Type of watering system? O Sprinklers O Bubblers O Drip System
VI.
M Fonn 4 103 (2013 JAN) Page 6of 10
Other: ----------------------~
Is the watering system in good working order? Are there any areas where the watering system does not properly water? If yes, please explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Are there auy areas of excessive standing water? Are any areas not served by the watering system? Is the drip and/or sprinkler system (if present) on auto-timer? ©2008 REA LTORS·lO Association of New Mex ico
Produced with zipForm:l> by :zlplogO< 18070 Flfteen Mil e Road, F~ser, ~t Association of New Mexico
Produced with zlpFocm® by zlplogix 18070 F"iltoen M ~e Road, Fraser, M2008 REALTORS® Association of New Mexico
Produced witll tipForm® by z;ptog;x 18070 Fifteen M ~• Road, Fraser. Mic11;gan 48026
Initials: Buyer _ _ __
www zlOlogix com
Hix • Palomino
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT- VACANT LAND - 2013 PLEASE NOTE: Tltel'e is currently 110 legal or stat11tory requirement in the Stale of New Mexico that obligates or req11il'es Sellers or Brokers to disclose to any prospective Buyer tltat the s11bject Property is or ltas bee11: 1) Tile site of a 11at11ral deatlt, lto111iclde, s11icide or any otlter crime classified as "felony; 2) Owned or occupied by a perso11 or persons exposed lo HIV or diagnosed witlt AIDS or any other disease not k11011111 to be tra11s111itterl through the co111111011 occ11pa11cy of real estate; 3) Located in the vicinity of a c01wicted se.Y of/ender. If buyer ltas co11cems about a11y of the conditions cited above, Buyer is urged to conduct /tis/her own due tlilige11ce mu/ co11tnct tlte appropriate Local, State or Federal Ilea/tit a11d law enforcement authorities to obtain acc11rate am/ reliable i11/ormatio11.
THIS IS NOTA CONTRACT. The above disclosures are made to the best of the Seller's knowledge. The person who signed as or on behalf of Seller lacks actual knowledge of the Property for the following reason: 0 Personal Representative O Administrator of Estate D Trustee O Receiver O Does not occupy the Property 0 Other: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
The law does not protect a Seller who makes an intentional misrepresentation.
SELLER Brian Hix
It is Buyer's responsibility to undertake hls/be1· owu due diligence and verify the accuracy of the Property Disclosur·e Statement. Buyer· is not relieved of this responsibility by virtue of delivery of tWs Statement to Buyer.
BUYER Buyer acknowledges receipt of this Statement.
Buyer Signature
Date
Time
Buyer Signature
Date
Time
RANMFom14103 (2013JAN) PagelOoflO
t.2008 REALTORS•XI Association of New Mexico
Produced Y.ith zlpFoon» by ziplogix 18070 Frll&en M ~ o Road, Ftaser, Michigan 48026
wt.W•iotogix oom
Hix - Palomino
G:r
Form & Home Realty
l[QUAJ.. tt()U$1N(J
REALTOR®
O,.P'Oftf\.INrrY
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 INSTRUCTIONS AND ACKNOWLEDGMENT REGARDING THIS FORM This Statement discloses Seller's current, ach1al knowledge of the condition of the Property as of the date signed by Seller, and is not a subslih1te for any inspections ot waJTanties that Buyer may wish to obtain. This Statement is designed to assist Seller to provide information about the Property and to assist Buyer in evaluating the Prope1ty being considered. Conditions may exist which are unknown to Seller. Buyer is encouraged to address concerns about the Property whether or not included in this Statement. This Statement does not relieve Seller of the obligation to disclose a condition of the Property that may not be addressed on this form or a change in any condition after the date of this Statement, and is not a substih1te for inspection by the Buyer. Neither the Broker, nor the Board or Association of REAL TORS® nor the REAL TORS® Association of New Mexico warrant or guarantee the information in this disclosure.
Do not leave any questions blank. Attach additional pages if needed. Buyer _ _ _
Initials:
Seller
1J ·] -, 11L_
22 & 23 Palomino Dr
Moriarty
87025
City
Zip Code
Address
Lots 22, 23, Unit 10, Moriarty Heights Legal Description
Or see metes & bounds description attached as Exhibit
---
____T~o=-=r_r"'a=n-c....e...____ County, New Mexico.
OCCUPANCY: Is Seller currently occupying the Property? 0 Yes. If yes, ___ years/months Seller occupied. If no, ___ years/months since Seller occupied. Ii(Never Occupied Property. O Other-----
I.
0 No. 2.
TITLE, ZONING, LEGAL INFORMATION:
I I I YES
0
NO
IS THE SELLER Aw ARE OF: A. Was tbe Property part of a Jarger tract of land that was subdivided within the last five (5) years? If yes, and the subdivided Property was not previously subdivided in accordance with the New Mexico Subdivision Act (Act), a subsequent sale, lease or other conveyance of the Property within five (5) years of the original subdivision and sale, lease or conveyance may trigger the requirements of the Act. SELLER/BUYER SHOULD CONSULT A TITLE COMPANY AND AN ATTORNEY TO DETERMINE THE APPLICABILITY OF THE ACT TO THIS PROPERTY.
Titis fonn and all REALTORS•!!l Association of New Mexico (RANM) fom1s arc for the sole use of RANM members and those New Mexico Real Estate Licensees to w!t~m RANM has granted prior written authorization. Distribution of RANM Fom1s to non-Ri\l\'l\1 members or unauthorized Real Estate Licensees is strictly prob1bllcd. RANM makes no warranty of the legal effectiveness or validity of this form and disclaims any liability for damages rt$Ulting from its use. By use of this ~on~\ the i;a!1ies agree to 1hc limita~ons set forth in this paragraph. TI1c panics hereby release RANM, the Real Estate Brokers, their Agents nnd employees from any habthty nnsmg out of 1hc use orth1s fonn. You should consult your attorney with regards to the effectiveness, validity or consequences or any use of this foml. 111c ~sc of this fonn is not intended to identify lhc user as o REALTOR®. REALTOR® is a registered collective membership mark which may be used only by real estate licensees who arc members orthc National Association of REALTORS•l!> and who subscribe to tbe Association's strict Code of Ethics. RANM Forni 4103 (2013 JAN) Page I of 10
0 2008 REALTORS·l!> Association of New Mexico
United Country Fann & Home Realty 200 US Route 66 East Moriarty, Nllf 87035 Phone: 505-553-3504 Fax : 505-832-6996 Cherie Wallin Produced wilh zlpFor-by zlploglx 18070 Fine en Mdo Road, Fraser, Miehigan 48026
Initials: Buyer____
Seller'-
"9 • 1·..i!Lf;'. ,
Hix . Palomino \Wifi
ziplogix com
REALTORS® ASSOCIATION OF.NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 YES
NO
IS THE SELLER AW ARE OF: B. Are there any title problems (for example, unrecorded or disputed easements, lot line disputes, liens, cncroaclunent, access iss11es, third party claims)? C. Any Property taxes that are not current? D. Any existing or proposed bonds, assessments, liens, mortgages, judgments, Deed of Trnst, Impact Fees, Real Estate Contracts, etc. against the Property? lfyes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
0
0
0
~
0
0
0
~
0
Ii
0
li
E. Any violations of applicable subdivision laws at the time the Property was subdivided? If yes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ F. Any alleged violations of applicable laws, regulations, ordinances or zoning laws? Ifycs,explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
G. Any zoning variances/exceptions or non-confo1111ing use of the Property? Ifyes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ H. Any legal issues, proposed buildings, bridges, roadways or real estate developments, etc. in the immediate area? If yes, e x p l a i n : - - - - - - - - - - - - - - - - - - - - - - - - !. Any restrictive covenants or other limitations on use? If yes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ a. Any violation thereof? ff yes, e x p l a i n : - - - - - - - - - - - - - - - Any building code or environmental regulation violations?
0
G1'
].
0
li!f
If yes, e x p l a i n : - - - - - - - - - - - - - - - - - - - - - - - - K. Any necessa1y permits, approvals or inspections for all constrnction, repairs and improvements that have not been obtained? Ifyes,explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
D
0
0
fZ1'
0
L. Any existing or threatened legal actions concerning the Property or the Homeowners Association? If yes, e x p l a i n : - - - - - - - - - - - - - - - - - - - - - - - - M. Any well-sharing, driveway-sharing, road-sharing or other contract to which the Property is subject?
If yes, e x p l a i n : - - - - - - - - - - - - - - - - - - - - - - - - N. Anyone with a Right of First Refosal, option to buy or lease the Property, or any other similar agreement? If yes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 0. Any other restrictions on resale? If yes, explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
D
Ii ri
P. Is this Property subject to Right of Reversion?
0
ri
If yes, e x p l a i n : - - - - - - - - - - - - - - - - - - - - - - - - Q. Any exemptions you claim to Property Taxes (i.e., Veteran, Head of Household)?
0
Ifyes,explain:~-----------------------For additional information or fiutber explanation (indicate item#):
RANMFom14103 (2013JAN) Pagc2ofl0
------------------
0 2008 RF.ALTORS® Association of New Mexico
Produced with zip Font>!> by ziplogix 18070 Fllteen Mne Road. Fraser. Michigan 48028
Initials: Buyer____ ww.y zip! Qlll•
CQO'!
Selle;}) :
JJ-.p lf
Hix • Palomino
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 3. PROPERTY CONDITIONS
I I I YES
NO
0 0
ci
IS THE SELLER Aw ARE OF: A. Any mi.nor damage tbat bas occurred to the Property? B. Any smoke damage or a fire on the Property? c. Any problems with driveways, walkways, sidewalks (such a large cracks, potholes or raised sections)? D. Any history of wood infestation, insects, pests or tree root problems? Specify date and type of last treatment: E. Any flowing or drainage problems on the Property? F. Any flowing or drainage problems on adjacent Properties that may impact this Property? G. Any standing water after rainfalls? H. Any active springs? I. Any history of moldy conditions or treatment for mold? J. Any land on the Property that has been filled in? K. Any earth movement, subsidence, or settlement problems? L. Any additional stmctures? If yes, list:
r2f
0
~
0
f2f
0 0
~ ~
0
ul
0
g
0 0 0 0
~
For additional information or further explanation (indicate item#): - - - - - - - - - - - - - - - - - 4.
WATER SUPPLY
YES
NO
0
DON'T KNOW
0
0
0
0
0
0
0
0
l2f
0 0
0
0
0
0 0
0 0
0
A. Is the water supplyO City/Municipal? 0 Community/Subdivision 0 Domestic Well 0 Private Well 0 Shared Well IBNone (If none, skip to Paragraph 5) If yes, 1. Is there a requirement to connect to the City/Municipal/Community/ Subdivision water? If yes, what are the requirements? _ _ _ _ _ _ _ __ NOTE: Additional expenses may be 1·equired B. If the water supply is City/Municipal/Community/Subdivision, list name and address of s u p p l i e r : - - - - - - - - - - - - - - - - - - - - - - - - - Are there any p r o b l e m s ? - - - - - - - - - - - - - - - - - - - - - 1.
Any water supply problems? If yes, explain: - - - - - - - - - - -
ii. Fees per m o n t h : $ - - - - - - - - - iii. Is there a Transfer Fee? If yes, how much? iv. Any restrictions or regulations? If yes, explain:
------------
-----------
NOTE: Additional expenses may be required C. If water supply is domestic/private/shared well, any problems with well equipment? If yes, explain: i. Any restrictions or regulations? ii. If this is a shared well, is a written agreement available? iii. Is well registered with the State Engineer's Office? Permit Number:
RANM Fonn 4103 (2013 JAN) Page 3 of JO
0 2008 REALTORS•l!> Ass-oc-io-tio_n_o_fN-C\-,.-M-c-xic-o--lni.ti-als: Buyer____
P by zlplogiK 18070 Flfteen Mi!e Road. Fraser. Michigan 4ll026
www zip! ~ i x mm
Scllc;1J
.Jt$Jj,
Hix - Palomino
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 NO
DON'T KNOW
0
0
0
0
0
0
0
0
0
iv. v. vi.
0
D
0
vii.
0
0
0
0
0
0
Does Seller have well record? Is well metered? Is there sufficient water yield at all times? Ifno, explain: ______________________________
Is there a separate electrical meter for the shared well? If yes, what is the location of the meter? and other well components & equipment? viii. ls there a requirement to connect to the City/Municipal/Community/ Subdivision water? If yes, what are the requirements?---------NOTE: Additional expenses may be required
ix. ls there any other water source for the Property for any other use? If so, explain: - - - - - - - - - - - - - - - - - - - - - - - - - - - -
For more information , see RANM Form 2307 - Infommtion Sheet - Water Rights and Domestic Wells) For additional information or further explanation (indicate item #): - - - - - - - - - - - - - - - - - - - - - - - - - -
5.
SEWER/WASTEWATER TREATMENT DON'T YES NO KNOW
A. ls the sewer/wastewater treatment system?
O City/Muuicip~
0 0 0 0
0 0 0
0 0 0
Community/Subdivision D Onsite Liquid Waste System M None Any problems? i. If none, is sewer available ii. If yes, ls there a requirement to coru1ect to the City/Municipal/Community/ Subdivision Sewer Wastewater Treatment System? What are the
0
0
0
requirements: - - - - - - - - - - - - - - - - - - - - - - - - - B. If the sewer/wastewater treatment system is City/Municipal/Community/ Subdivision? List name and address of provider:
-------------------
../In
0
0
0
0 0 0
0 0 0
0 0 0
i. Fees per month: $ - - - - - - - - - - - - - - - - - - - - - - - - - - - - ii. Any restrictions or regulations? If yes, explain: - -- - - - - - - - - - - - - - - - - - - - iii. Is a written agreement available? iv. Is there a transfer fee? If yes, how much? - - - - - - - - - - - - - - - v.
c.
ls there a requirement to connect to the City/Municipal/Sewer Wastewater Treatment System? If yes, what are the requirements?--------
If there is an Onsite Liquid waste system, type: 0 Advanced Treatment System (See #D)
0 Conventional
0
0
0
O Cesspool
i. Any problems? - - - - - - - - - - - - - - - - - - - - ii. List name and address of service company: - - - - - - - - - - - - - - iii. Date last serviced:
"'·
-----------------------------
RANM Fonn 4103 (2013 JAN) Page 4 of 10
.02008 REALTORS•!!> Association of New Mexico
Produced with ripF~ by ziptog;•
18070 Afteen Mile Road, Fraser, Michigan ~8026
Initials: Buyer _ _ _ _ www zipLog;x rom
Sell~~ ·: i.11} . Hix - Palomino
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 NO
DON'T KNOW
0 0
D 0
D
D
D
0 0
D
0
0 0
D
0
0
D
D
0
0
D
0
0
D
0
iv. Is there an available installation permit? v. New Mexico Environmental Department (NMED) Environmental Improvement District (EID) Certification? NMED (EID) Certification vi. vii.
number and d a t e : - - - - - - - - - - - - - - - - - - - Location of the system: - - - - - - - - - - - ------"""""". Is there a requirement to connect to the City/Municipal/Community/ Subdivision Sewer/Wastewater Treatment System? If yes, what arc the
requirements? - - - - - - - - - - - - - - - - - - - - D. Are there any ALTERNATIVE LIQUID WASTE SYSTEMS? 1. Is there an ADVANCED ON-SITE LIQUID WASTE SYSTEM (Multi-Flow Septic System): ORA Y WATER and/or BLACK WATER? 1) Does the Property have a harvesting system utilizing Gray and/or black waler? If yes, please explain: - - - - - - - - - - - -
ii.
111.
2)
How is the harvested liquid waste utilized? - - - - - - - - -
3)
W11ere is the location of the Multi-Flow Septic System? _ _ _ __
4)
What year was the Multi-Flow Septic System installed? _ _ _ __
NOTE: Additional expenses may be required Does the Property have an OUT HOUSE (Outdoor Latrine Facilities)? I) If yes, how many are on the Prope11y? - - - - - - - - - 2) Is the Out House a permanent strncture? 3) If existing, please describe any additional details - - - - - - NOTE: Additional expenses may be required Does the Property have a COMPOSTING TOILET? l) If yes, what is the method of operation? 0 electric 0 solar 0 other: explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
2)
0
0
0
0
0
0
If existing, please describe any additional details - - - - - - -
NOTE: Additional expenses may be required Does the Property have a Liquid Waste STORAGE TANK? 1) If yes, please list: Capacity amount _ _ _ _ Location of Liquid Waste Storage Tank _ _ _ _ Date of installation Frequency the Liquid Waste Storage Tank needs to be pumped NOTE: Additional expenses may be 1·equlred E. Have there been any problems with the sewer/septic system? If yes, explain: _ __
iv.
RANM Fonu 4103 (2013 JAN) Page 5of10
t'.12008 REAL TORS® Association of New Mexico
Produced will> zipForm:!l by ziplogix 18070 Fifteen M~e Road. Fraser. Michigan 48026
Initials: Ruycr _ _ __ WMV
zipLog!x com
Sell~J;))J-_~H ' HiK - Palomino
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT - VACANT LAND - 2013 IF THE PROPERTY HAS AN ONSITE LIQUID WASTE SYSTEM, IT IS SUBJECT TO THE REGULATIONS OF THE NEW MEXICO ENVIRONMENTAL DEPARTMENT (NMED), WHICH REQUJRE INSPECTIONS AND POSSIBLE REPAIR. CONTACT THE NMED FOR INFORMATION REGARDING APPROPRIATE INSPECTION FORMS AND REQUIREMENTS. For more infonnation, see RANM Fonn 2308 Information Sheet - Septic Systems. For additional infonnation or fmther explanation (indicate item #): - - - - - - - - - - - - - - - - -
6.
ELECTRICAL
I I YES
NO
1~~~1
,..
N(H (
0 0 0 0
0 0
0 0
D D
0
0
0
0
0
0
0
D
D
D
explain: - - - - - - - - - - - - - - - - - - - - - - - - - E. Are you aware of any defective, malfunctioning, or in1properly installed electrical equipment? If yes, explain: -------------------~ F. Has electrical service been modified since originally installed? If yes, explain: _ _
0
0
0
G. Do any circuits trip regularly? If yes, explain: - - - - - - - - - - - - - -
0
0
H. Are you aware of any electric lines encroaching on the Property? If yes, explain: _ _
D
0
I.
\: \
D
A. Is tbe electrical wiring copper? B. Is the electrical wiring aluminum? i. If yes, has the aluminum wiring been pig-tailed with copper wiring? C . Are you aware of any damaged or malfunctioning receptacles or switches? If yes, which ones? D . Are you aware of any extension cords used to create new electrical outlets? If yes,
-----------------------:----
Are there encroaclunent agreements with any utility companies? If yes, explain: _ _
For additional information or further explanation (indicate item #): - - - - - - - - - - - - - - - - -
MISCELLANEOUS
7.
I I ,~/+)
YES
NO
1~~~1
0
D
0
0 0
0 0
D
ii.
0
iii. iv. v.
0
0
0
0
0
0
0
0 0
A. Does the Property include a landscape watering system? If yes, is it 0 Auto-timed 0 Manual 0 Front yard 0 Back yard 0 Side yard 1. Type of watering system? O Sprinklers O Bubblers O Drip System
VI.
M Fonn 4 103 (2013 JAN) Page 6of 10
Other: ----------------------~
Is the watering system in good working order? Are there any areas where the watering system does not properly water? If yes, please explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Are there auy areas of excessive standing water? Are any areas not served by the watering system? Is the drip and/or sprinkler system (if present) on auto-timer? ©2008 REA LTORS·lO Association of New Mex ico
Produced with zipForm:l> by :zlplogO< 18070 Flfteen Mil e Road, F~ser, ~t Association of New Mexico
Produced with zlpFocm® by zlplogix 18070 F"iltoen M ~e Road, Fraser, M2008 REALTORS® Association of New Mexico
Produced witll tipForm® by z;ptog;x 18070 Fifteen M ~• Road, Fraser. Mic11;gan 48026
Initials: Buyer _ _ __
www zlOlogix com
Hix • Palomino
REALTORS® ASSOCIATION OF NEW MEXICO PROPERTY DISCLOSURE STATEMENT- VACANT LAND - 2013 PLEASE NOTE: Tltel'e is currently 110 legal or stat11tory requirement in the Stale of New Mexico that obligates or req11il'es Sellers or Brokers to disclose to any prospective Buyer tltat the s11bject Property is or ltas bee11: 1) Tile site of a 11at11ral deatlt, lto111iclde, s11icide or any otlter crime classified as "felony; 2) Owned or occupied by a perso11 or persons exposed lo HIV or diagnosed witlt AIDS or any other disease not k11011111 to be tra11s111itterl through the co111111011 occ11pa11cy of real estate; 3) Located in the vicinity of a c01wicted se.Y of/ender. If buyer ltas co11cems about a11y of the conditions cited above, Buyer is urged to conduct /tis/her own due tlilige11ce mu/ co11tnct tlte appropriate Local, State or Federal Ilea/tit a11d law enforcement authorities to obtain acc11rate am/ reliable i11/ormatio11.
THIS IS NOTA CONTRACT. The above disclosures are made to the best of the Seller's knowledge. The person who signed as or on behalf of Seller lacks actual knowledge of the Property for the following reason: 0 Personal Representative O Administrator of Estate D Trustee O Receiver O Does not occupy the Property 0 Other: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
The law does not protect a Seller who makes an intentional misrepresentation.
SELLER Brian Hix
It is Buyer's responsibility to undertake hls/be1· owu due diligence and verify the accuracy of the Property Disclosur·e Statement. Buyer· is not relieved of this responsibility by virtue of delivery of tWs Statement to Buyer.
BUYER Buyer acknowledges receipt of this Statement.
Buyer Signature
Date
Time
Buyer Signature
Date
Time
RANMFom14103 (2013JAN) PagelOoflO
t.2008 REALTORS•XI Association of New Mexico
Produced Y.ith zlpFoon» by ziplogix 18070 Frll&en M ~ o Road, Ftaser, Michigan 48026
wt.W•iotogix oom
Hix - Palomino
