Seller's Disclosure Statement for Residential Property
(e.g.,Seller& Property) Reference
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ASSoc rA-lroN oFREALToR'@
Seller's DisclosureStatementfor ResidentialProperty Note: The following is a disclosure statement made by Seller concerning the following Propefty (the "Property"):
543 DriftwoodCircle
Clima69Frings
MO
65324
Camden
County Zip Code Stafe Sfreef Address This disclosure statem ent may assist a Buyer in evaluating the Propefty, but-it is not a warranty of any kind by Seller or any broker or liceniee in this transaction, and is not a substitute for any inspection or warranties a Buyer may wish to obtain. Real esfate brokers and licensees involved in the sale do not inspect the Propefty for defects or guarantee the accuracy of the information provided in this form. TO THE SELLER; Please complete the following form, including past history or problems if known. ?q not legYe anv spaces blank. If the condition is not applicable to your Property (or unknown), mark "N/A' (or "Unknown") in representations of any any broker broker or tiv the Seller tlowinq are representat-i6ns made tiy Sdller-and and are not representations representat'i6nsmade lffitimffe l6dianTTn;mnlowing
licensee.Completeand truthf-uldisclosure of the history and condition of the Property gives you the best Your ?nswersor the protectionagqingt,future.charg.e.s that you violated a legal disclosureobligation -toa,Buyer. -closing yoi the sale. This
of fait to provide, dither wiy, may have legal consequences, even after the bnswers questionnaire should help you meet your disclosure obligations, but it may not cover all aspects of the Property. If you know of or suspect some coidition which may negatively affect the value of the Property or impair the health or safety of future occupants (e.9., environmental hazards, physical condition or material defects in the Property or titie thereto), then-you may use the space at the end of this form to further describe that condition andlor attach additional pages if additional space is requiredTO THE BUYER: Since fhese disclosures are based on the Seller's knowledge, yo.t cannof be sure that there are, in fact, no problems with the Property simply because the Seller is nof aware of them. The answers given by the Seller are not warranties of the condition of the Property. Thus, you may want to condition your offer on a professional inspection(s) of the Property. You may also wish to obtain a home protection planlwarranty. Conditions of the Property that you can see on a reasonable inspection and/or that are disclosed herein should either be taken into account in the purchase price or you should make the correction of these conditions by the Seller a requirement of the sale contract. lF YOU SrGrVA SALE CONTRACT TO PURCHASE THE PROPERTY, THAT CONTRACT,AND NOT THIS D'SCLOSURESTATEMENT, WILL PROVIDEFOR WHAT 'S TO BE INCLUDED IN THE SAIE. IF YOU EXPECT CERTAIN ITEMS, APPLIANCESOR EQUIPMENT TO BE INCLUDED,THEY MUST BE SPECIF'EDAS INCLUDEDIN THE SALE CONTRACT. 1. HEATING, COOUNG AND VENTILATING(Sale Contract will controlas fo ifems actually included in sale)
(a)Airconditionins electric system: central lcentraleas
untt, ) Other: ru:i?:ffij].1"rtoit"t ffi (b) HeatingSystem: Electric NaturalGas n Propane FuelOil Other: , t . A / 1tl Jh'A"f whom purchased/leased?: /ya--t lf any tanks, indicatewhether: o*n"d"o' d)"J"F;; (c) Type of heatingequipment: 1 Forcedair Radiant Heat pump Hot water radiators Steam radiators '\ Age of system: Baseboard Other (d)Area(s)of housenot servedby centralheating/cooling.1/642 (e) Fireplace: ^y Wood burning Other: Gas (t; nOOitionat: Ceilingfan(s) Atticfan Humidifier Wood burningstove Electronicair filter ; Other: (g) lnsulation: Known i Unknown(Descrlbeif known, includingR-Factor). (F)nre you awareof any pr6blemsor rdpairsneededwith any item-inthis secfion? Yes A ruo P/ease explainany "yes" answeryou gave in this secfion, includingrepair history @ttachadditionalpagesif needed) :
2. ELECTRICAL
Gferectii'clibystem:110vv zzov AMps:
(b) Type of servicepanel: Fus€s { CircuitBreakers. (c)Typeof wiring: Knoband Tube Alunlihum Copper DSC-8000
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Wyatt
Reference (e.9., Seller & Property)
(d) Are you awareof any problemsor repairsneededin the electricalsystem?
Yes l1 No
Please explain any "yes" answer you gave in fhrs section, includingrepair history @ttach additionalpages if needed)
(Sale Contract will control as fo ifems actually included in sale.) 3. APPLIANCES/FIXTURES/EQUIPMENT good items The workingorder: belowarelare not in t, ril"r, ARE ARE N/A ARE N/A ARE ; ."/fi lL'-NOT Nor tw. Ovens/Ranges& Attachments i'/ Fans $tticy'Ceiling/Exhaust u, Tanks (propane/LPfuet) Dr6hwasher V t-/ Refrigerator Trash compactor l/' t/' Security& Alarm Systems GarageDoor Openet t/ 2.. lntercomSystem GarageRemoteControls ,/ SprinklerSystems& Controls ExteriorLights t-/ Fences(includingpet systems, SatelliteDish ,/' collarsand controls) t/ SatelliteReceiver(s):# // Fireand SmokeAlarms Remotes: # l/ ,/ FireplaceEquipmentand CableTV Wiring Doors(if attached,including TV Antenna (if attached) artificiallogs) CentralVacuum Systemand L/ GarbageDisposal equipment / Gas BBQ G'tll (Built-in) Water Heaters t/ Heating,Cooling,Electrical& Water Softener t/ Plumbing Fixtures/System s S u m pP u m p t/ \-/ Humidifier(if attached) t' Washer/Dryer t/ Locks/RemoteEntry Controls WindowAC Units t/ )/ LightingFixtures Other Microwaves(Built-ln) Pleaseexplain any "Are Not" responses(aftach additionalpages if necessary)
U 4. ROOF,GUTTERSAND DOWNSPOUTS ./ (a) What is the approximateage of the roof? Years.Documented?{ Yes No | S (b) Has the roof ever leakedduringyour ownership?ylYes No gave in this secffon,iqcludingrepair,history@ttachadditionalpagesif needed). P.leqsee-tplainany "yps" qnsvyery)you
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(c) Has the roof'orany portionof it bddn repaired,recciveredor replacedrddring your ownership?pYes No (d) Are you awareof any problemswith the roof, guttersor downspouts? Yes LDls Pleaseexplain any "yes" answer you gave in fhr'ssecfrbn,including repair history @ftachadditionalpages if needed) :
5 . P L U M B I N GS Y S T E M .F I X T U R E SA N D E Q U l P M E N T (a) PlumbingSystem: "Copper Galvanized Other: (b) Water Heater: ,,€as Electric Age of System/Size: Other: (c) Hot tub/WhirlpoollJacuzzi? Yes '/No (d) Lawn SprinklerSystem: Yes .,{llo lf "yes",date of last backflowdeviceinspectionor ce(ificate: Unknown. (e)nre you awareof'anyproblemsor repaiisneededin the plumbingsystems?' Yes v{o Pleaseexplainany "yes" answer you gave in this section,includingrepair history @ttachadditionalpages if needed) :
DSC-8000
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Reference (e.9., Seller & Property)
Wyatt
6. WATER (a) Water Systems/Source. Public rzWell Other: lf "well," specifytype of well and approximatedepth: Haswell beentested? Yes y' No/f 'yes,"identifydateof reportandexptainresu/fsbeloworprovidecopy. (b) Do you have a softener,filter or otherpurificationsystem? Yes 6'No lf "yes", Owned Leased (c)Are you awareof any problemsrelatingto the water system,includingqualityor sourceof water? Yes 2Dlo Please explain any "yes" answer you gave in this section, includingrepair history @ttachadditionalpages if needed) : 7. SEWAGE (a) What is the type of sewagesystemto which the house is connected? Public Private Aerator lSeptic tanks/laterals/drainfields Other: (b) ls there a sewagelift system? ' Yes X No lf "yes,"is it in good workingcondition? Yes No (c) When was the septic/aerator system last serviced? (d)Are you awareof any leaks,backupsor otherproblemsrelatingto the sewagesystem? Yes /No Pleaseexplain any "yes" answeryou gave in this section, includingrepair history @ttachadditionalpagesif needed) .
8. CONSTRUCTION (a)Are you awareof any problemswith the footings,foundation,sub-floor,interioror exteriorwalls, roof construction, decks/porches or otherloadbearingor slructuralcomponents? Yes (No (b)Are you awareof any repairsor replacements relatingto any items listedin (a) above? Yes f No Pleaseexplain any "yes" answer you gave in this section, includingrepair history @ttachadditionalpagesif needed) .
9 . E X T E R I O RF I N I S H ( a )l s a n e x t e r i o rf i n i s h a n d i n s u l a t i o ns y s t e m ( E F I S - s y n t h e t i cs t u c c o )p r e s e n ti n t h e h o m e ? Yes ANo Unknown.ldentifydate installed,brandname and installer,if known: (b) Are you awareof any hardboardsidingon your Property? Yes t' No /f "yes,"which type? (c) Are you awareof any claims made againstthe manufacturerfor ddfe-ctsin the siding? Yes X' No (d) Was any money receivedfor the claim? Yes No (e)Are you awareof any repairsor replacements madeto the exteriorfinish? YesI No Pleaseexplainany "yes" answer you gave in fhis secfrbn,includingrepair history @ttachadditionalpages if needed):
10. BASEMENTAND CRAWL SPACE (,a)Are you aware of any dampness,water leakageor accumulation,in the basementor crawl space? Yes /\y' No (b)Are you awareof any repairsor otherattemptsto controlany wateror dampnessproblems? Yes No { Please explain any "yes" answer you gave in this section,including repair history @ttach additionatpages if needed) :
11.TERMITES/WOOD DESTROYINGINSECTS,PESTS (a) Are you awareof any termiteslwooO OestroyinflnsecGor pestsaffectingthe PropertyZ v(a No(b) Arg you awareof any uncorrecteddamageto the Propertycausedby any of the above? Yes ut{o (c) ls Propertyunderawarrantycontractby a pestcontrolcompany?rtz Yes No lf "yes",transferable? v/{es No (d) Are you awareof any termite/pestcontrolreportsfor or treatmentof the Property? No ;(Yes Pleqsegxglain any "yes"Fnsger you gave in this section, including repair history @ttach additionalpages if needed) .
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I2. SOIL AND DRAINAGE (a) Are you awareof any fill, expansivesoil or sinkholeson the Property? Yes )No (b) Are you awareof any soil,earth movement,flood,drainageor gradingproblem's? Yes 'yfNo DSC-8000
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Reference(e.9.,Seller& Property)
Wyatt (c)Are you awareof any past,.present or proposedmining,strip-mining,or any otherexcavationsthat affector might affect the Property? Yes I No P/easeexptainany "yes" answer you gave in this section,includingrepair history @ttachadditionalpagesif needed):
ENVIRONMENTALCONCERNS 13. HAZARDOUSSUBSTANCES'OTHER (a) Lead ( 1 ) A r e y o u a w a r e o f t h e p r e s e n c eo f a n y l e a d h a z a r d s( e . 9 . , p a i n t ,w a t e r s u p p l y l i n e s ,e t c . ) o n t h e P r o p e r t y ? Yes INo (Nofe: Productionof lead based paint was banned in 1978. MAR Form DSC-2000 may need to be completid in connection with this form). (2) Are you aware of the presenceof any lead in the soils? Yes lN o (3) Are you aware if lead has ever been coveredor removed? Yes ,FNo (a) nre you aware if the Propertyhas been testedfor lead? Yes .y' N o (b) AsbestosMaterials (1) Are you aware of the presenceof asbestosmaterialson the Property,such as roof shingles,siding,insulation, ceiling,flooring,pipewrap,etc.? Yes /No (2) Are you awareof any asbestosmaterialt(at has been encapsulatedor removed? Yes (t{o (3) Are you aware if the Propertyhas been testedfor the presenceof asbestos? Yes /No (c) Mold (1) Are you awareof the presenceof any mold on the Property? Yes y'tto (Z)nre you aware if anythingwith mold 6n the Propertyhas ever been coiered or removed? Yes >cNo (Si nre you aware if the Propertyhas ever been testedfor the presenceof mold? Yes ltto (4) Are you aware if the Propertyhas ever been treatedfor the presenceof mold? Yes ,y'No (d) Radon (1) Are you aware if the Propertyhas been testedfor radon gas? Yes dNo (2) Are you aware if the Propertyhas ever been treatedor m itigatedfor radon gas?
Yes X No
(e) Methamphetamine Are you aware if the Propertyis or was used as a site for methamphetamineproductionor the place of residenceof a personconyictedof a crime involvingany controlledsubstancerelatedthereto? Yes urtlo lf "yes," MAR Form DSC-5000 must be filled out in conjunction with this form. (f) OtherEnvironmental Concerns biphenyls Are you aware of any otherenvironmentalconcernsthat may affectthe Propertysuch as polychlorinated (PCB's),electro-magnetic fuel tanks,discoloration of soil or vegetation,oil sheensin wet fields(EMF's),underground (e.9.,commercial,farming,landfill, areas,unusedsepticor storagetanks,usesof the Propertyotherthan residential dumping site), etc.? Yes ,r'ttlo Please explain any "yes" answeryou gave in this section, including repair history, date(s) performed, type of fests or treatmentand results,and name of person/companywho did the testing or mitigation(attach additionalpages if needed):
1 4 .I N S U R A N C E (a) Are you aware of any claims that have been filed for damages to the Propertyin the last 5 years? Yes *+t6 tf "yes," p/ease explain and include the following. Date of claim, description of claim, repairs and/or replacements completed: (b) Are you awarethat any insurancegpplicationor priorcoverageregardingany partof the Propertyhas been rejected or will not be renewed? Yes t{{o (c)Are you awarethat any existinginsurancecoveragewill be subjectedto increasedrates? Yes -No 15. ROADS,STREETS& ALLEYS private? (a) The roads,streetsand/oralleysservingthe Propertyare p{ublic (b) ls there a recordedroad/street/alley maintenanceagreement? Yes .;Xo osc-8000
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Reference (e.9., Seller & Property)
Wyatt
(c)Are you awareof any rightof way, unrecordedeasementor similarmatterwhich affect the Property? Yes trI,lo Please explain any "yes" answer you gave in this section,includingrepair history and identify maintenanceprovider and cosfs below (attach additionalpagesif needed) 16. MISCELLANEOUS j 9' yeafs-. (a) The approximate age of the residenceis Sellerhas been the ownerof the Propertyfor Years if ; Sellerhas continuouslyoccupiedthe Propertyfor years J_< lf ever vacant,when and how long? (b) ls the Propertylocatedin an areathat requiresan occupancy(codecompliance)inspection? Yes i-tto (c) ls the Propertydesignatedas a historicalhome or locatedin a historicdistrict? Yes i2fro (d) Do you have a surveythat includesall existingimprovementson the Property? Yes ,'No (e) Are you awareof any pets ever havingbeen kept in the home at the Property? Yes p^D{o (f) Are you aware of any pets ever having been kept on the Property? Yes y)7o (g) ls the Buyer being offereda protectionplan/homewarrantyat closingat Seller'sexpense? Yes 4o (h)Are you awareof any: Inoperablewindows? Yes -.1(o inoperabledoors? Yes rr'No brokenthermalseals? Yes ffio O ls any portionof the Propertylocatedwithinthe 100 year flood hazardarea (flood plain)? Yes qfio (i) Are you aware if carpethas been laid over a damagedwood floor? Yes No (k)Are you awareof any. Sharedor common featureswith adjoiningproperties,(e.g.,walls,wells, sewers,fences, roads,etc.)? Yes iZ(o Encroachments which affectthe Property? Yes rr{'lo Existingor threatenedlegalactionaffectingthe Property? Yes pz1rlo Violationsof local,state,or federallaws/regulations, includingzoning,relatingto the Property? Yes -(o Additions,modifications,or alterationsmade to the Propertywithoutnecessarypermits? Yes y'No Consentrequiredof anyoneother thaq the signer(s)of this forgr to convey title to the Property? Yes r-'l(o (l) CurrentUtilityServiceproviders: L (zc / t,-, ,/i;c.t A*",/ ElectricCompany: Water Service: Cable Service: UJ" ilLL,**/ Sewer: Telephone: Gas: Garbage: Fire District. L{41
Wyatt {ftt,tso.*t
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ASSoc rA-lroN oFREALToR'@
Seller's DisclosureStatementfor ResidentialProperty Note: The following is a disclosure statement made by Seller concerning the following Propefty (the "Property"):
543 DriftwoodCircle
Clima69Frings
MO
65324
Camden
County Zip Code Stafe Sfreef Address This disclosure statem ent may assist a Buyer in evaluating the Propefty, but-it is not a warranty of any kind by Seller or any broker or liceniee in this transaction, and is not a substitute for any inspection or warranties a Buyer may wish to obtain. Real esfate brokers and licensees involved in the sale do not inspect the Propefty for defects or guarantee the accuracy of the information provided in this form. TO THE SELLER; Please complete the following form, including past history or problems if known. ?q not legYe anv spaces blank. If the condition is not applicable to your Property (or unknown), mark "N/A' (or "Unknown") in representations of any any broker broker or tiv the Seller tlowinq are representat-i6ns made tiy Sdller-and and are not representations representat'i6nsmade lffitimffe l6dianTTn;mnlowing
licensee.Completeand truthf-uldisclosure of the history and condition of the Property gives you the best Your ?nswersor the protectionagqingt,future.charg.e.s that you violated a legal disclosureobligation -toa,Buyer. -closing yoi the sale. This
of fait to provide, dither wiy, may have legal consequences, even after the bnswers questionnaire should help you meet your disclosure obligations, but it may not cover all aspects of the Property. If you know of or suspect some coidition which may negatively affect the value of the Property or impair the health or safety of future occupants (e.9., environmental hazards, physical condition or material defects in the Property or titie thereto), then-you may use the space at the end of this form to further describe that condition andlor attach additional pages if additional space is requiredTO THE BUYER: Since fhese disclosures are based on the Seller's knowledge, yo.t cannof be sure that there are, in fact, no problems with the Property simply because the Seller is nof aware of them. The answers given by the Seller are not warranties of the condition of the Property. Thus, you may want to condition your offer on a professional inspection(s) of the Property. You may also wish to obtain a home protection planlwarranty. Conditions of the Property that you can see on a reasonable inspection and/or that are disclosed herein should either be taken into account in the purchase price or you should make the correction of these conditions by the Seller a requirement of the sale contract. lF YOU SrGrVA SALE CONTRACT TO PURCHASE THE PROPERTY, THAT CONTRACT,AND NOT THIS D'SCLOSURESTATEMENT, WILL PROVIDEFOR WHAT 'S TO BE INCLUDED IN THE SAIE. IF YOU EXPECT CERTAIN ITEMS, APPLIANCESOR EQUIPMENT TO BE INCLUDED,THEY MUST BE SPECIF'EDAS INCLUDEDIN THE SALE CONTRACT. 1. HEATING, COOUNG AND VENTILATING(Sale Contract will controlas fo ifems actually included in sale)
(a)Airconditionins electric system: central lcentraleas
untt, ) Other: ru:i?:ffij].1"rtoit"t ffi (b) HeatingSystem: Electric NaturalGas n Propane FuelOil Other: , t . A / 1tl Jh'A"f whom purchased/leased?: /ya--t lf any tanks, indicatewhether: o*n"d"o' d)"J"F;; (c) Type of heatingequipment: 1 Forcedair Radiant Heat pump Hot water radiators Steam radiators '\ Age of system: Baseboard Other (d)Area(s)of housenot servedby centralheating/cooling.1/642 (e) Fireplace: ^y Wood burning Other: Gas (t; nOOitionat: Ceilingfan(s) Atticfan Humidifier Wood burningstove Electronicair filter ; Other: (g) lnsulation: Known i Unknown(Descrlbeif known, includingR-Factor). (F)nre you awareof any pr6blemsor rdpairsneededwith any item-inthis secfion? Yes A ruo P/ease explainany "yes" answeryou gave in this secfion, includingrepair history @ttachadditionalpagesif needed) :
2. ELECTRICAL
Gferectii'clibystem:110vv zzov AMps:
(b) Type of servicepanel: Fus€s { CircuitBreakers. (c)Typeof wiring: Knoband Tube Alunlihum Copper DSC-8000
\Unknown
Page 1 of 6
Wyatt
Reference (e.9., Seller & Property)
(d) Are you awareof any problemsor repairsneededin the electricalsystem?
Yes l1 No
Please explain any "yes" answer you gave in fhrs section, includingrepair history @ttach additionalpages if needed)
(Sale Contract will control as fo ifems actually included in sale.) 3. APPLIANCES/FIXTURES/EQUIPMENT good items The workingorder: belowarelare not in t, ril"r, ARE ARE N/A ARE N/A ARE ; ."/fi lL'-NOT Nor tw. Ovens/Ranges& Attachments i'/ Fans $tticy'Ceiling/Exhaust u, Tanks (propane/LPfuet) Dr6hwasher V t-/ Refrigerator Trash compactor l/' t/' Security& Alarm Systems GarageDoor Openet t/ 2.. lntercomSystem GarageRemoteControls ,/ SprinklerSystems& Controls ExteriorLights t-/ Fences(includingpet systems, SatelliteDish ,/' collarsand controls) t/ SatelliteReceiver(s):# // Fireand SmokeAlarms Remotes: # l/ ,/ FireplaceEquipmentand CableTV Wiring Doors(if attached,including TV Antenna (if attached) artificiallogs) CentralVacuum Systemand L/ GarbageDisposal equipment / Gas BBQ G'tll (Built-in) Water Heaters t/ Heating,Cooling,Electrical& Water Softener t/ Plumbing Fixtures/System s S u m pP u m p t/ \-/ Humidifier(if attached) t' Washer/Dryer t/ Locks/RemoteEntry Controls WindowAC Units t/ )/ LightingFixtures Other Microwaves(Built-ln) Pleaseexplain any "Are Not" responses(aftach additionalpages if necessary)
U 4. ROOF,GUTTERSAND DOWNSPOUTS ./ (a) What is the approximateage of the roof? Years.Documented?{ Yes No | S (b) Has the roof ever leakedduringyour ownership?ylYes No gave in this secffon,iqcludingrepair,history@ttachadditionalpagesif needed). P.leqsee-tplainany "yps" qnsvyery)you
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(c) Has the roof'orany portionof it bddn repaired,recciveredor replacedrddring your ownership?pYes No (d) Are you awareof any problemswith the roof, guttersor downspouts? Yes LDls Pleaseexplain any "yes" answer you gave in fhr'ssecfrbn,including repair history @ftachadditionalpages if needed) :
5 . P L U M B I N GS Y S T E M .F I X T U R E SA N D E Q U l P M E N T (a) PlumbingSystem: "Copper Galvanized Other: (b) Water Heater: ,,€as Electric Age of System/Size: Other: (c) Hot tub/WhirlpoollJacuzzi? Yes '/No (d) Lawn SprinklerSystem: Yes .,{llo lf "yes",date of last backflowdeviceinspectionor ce(ificate: Unknown. (e)nre you awareof'anyproblemsor repaiisneededin the plumbingsystems?' Yes v{o Pleaseexplainany "yes" answer you gave in this section,includingrepair history @ttachadditionalpages if needed) :
DSC-8000
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Reference (e.9., Seller & Property)
Wyatt
6. WATER (a) Water Systems/Source. Public rzWell Other: lf "well," specifytype of well and approximatedepth: Haswell beentested? Yes y' No/f 'yes,"identifydateof reportandexptainresu/fsbeloworprovidecopy. (b) Do you have a softener,filter or otherpurificationsystem? Yes 6'No lf "yes", Owned Leased (c)Are you awareof any problemsrelatingto the water system,includingqualityor sourceof water? Yes 2Dlo Please explain any "yes" answer you gave in this section, includingrepair history @ttachadditionalpages if needed) : 7. SEWAGE (a) What is the type of sewagesystemto which the house is connected? Public Private Aerator lSeptic tanks/laterals/drainfields Other: (b) ls there a sewagelift system? ' Yes X No lf "yes,"is it in good workingcondition? Yes No (c) When was the septic/aerator system last serviced? (d)Are you awareof any leaks,backupsor otherproblemsrelatingto the sewagesystem? Yes /No Pleaseexplain any "yes" answeryou gave in this section, includingrepair history @ttachadditionalpagesif needed) .
8. CONSTRUCTION (a)Are you awareof any problemswith the footings,foundation,sub-floor,interioror exteriorwalls, roof construction, decks/porches or otherloadbearingor slructuralcomponents? Yes (No (b)Are you awareof any repairsor replacements relatingto any items listedin (a) above? Yes f No Pleaseexplain any "yes" answer you gave in this section, includingrepair history @ttachadditionalpagesif needed) .
9 . E X T E R I O RF I N I S H ( a )l s a n e x t e r i o rf i n i s h a n d i n s u l a t i o ns y s t e m ( E F I S - s y n t h e t i cs t u c c o )p r e s e n ti n t h e h o m e ? Yes ANo Unknown.ldentifydate installed,brandname and installer,if known: (b) Are you awareof any hardboardsidingon your Property? Yes t' No /f "yes,"which type? (c) Are you awareof any claims made againstthe manufacturerfor ddfe-ctsin the siding? Yes X' No (d) Was any money receivedfor the claim? Yes No (e)Are you awareof any repairsor replacements madeto the exteriorfinish? YesI No Pleaseexplainany "yes" answer you gave in fhis secfrbn,includingrepair history @ttachadditionalpages if needed):
10. BASEMENTAND CRAWL SPACE (,a)Are you aware of any dampness,water leakageor accumulation,in the basementor crawl space? Yes /\y' No (b)Are you awareof any repairsor otherattemptsto controlany wateror dampnessproblems? Yes No { Please explain any "yes" answer you gave in this section,including repair history @ttach additionatpages if needed) :
11.TERMITES/WOOD DESTROYINGINSECTS,PESTS (a) Are you awareof any termiteslwooO OestroyinflnsecGor pestsaffectingthe PropertyZ v(a No(b) Arg you awareof any uncorrecteddamageto the Propertycausedby any of the above? Yes ut{o (c) ls Propertyunderawarrantycontractby a pestcontrolcompany?rtz Yes No lf "yes",transferable? v/{es No (d) Are you awareof any termite/pestcontrolreportsfor or treatmentof the Property? No ;(Yes Pleqsegxglain any "yes"Fnsger you gave in this section, including repair history @ttach additionalpages if needed) .
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I2. SOIL AND DRAINAGE (a) Are you awareof any fill, expansivesoil or sinkholeson the Property? Yes )No (b) Are you awareof any soil,earth movement,flood,drainageor gradingproblem's? Yes 'yfNo DSC-8000
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Reference(e.9.,Seller& Property)
Wyatt (c)Are you awareof any past,.present or proposedmining,strip-mining,or any otherexcavationsthat affector might affect the Property? Yes I No P/easeexptainany "yes" answer you gave in this section,includingrepair history @ttachadditionalpagesif needed):
ENVIRONMENTALCONCERNS 13. HAZARDOUSSUBSTANCES'OTHER (a) Lead ( 1 ) A r e y o u a w a r e o f t h e p r e s e n c eo f a n y l e a d h a z a r d s( e . 9 . , p a i n t ,w a t e r s u p p l y l i n e s ,e t c . ) o n t h e P r o p e r t y ? Yes INo (Nofe: Productionof lead based paint was banned in 1978. MAR Form DSC-2000 may need to be completid in connection with this form). (2) Are you aware of the presenceof any lead in the soils? Yes lN o (3) Are you aware if lead has ever been coveredor removed? Yes ,FNo (a) nre you aware if the Propertyhas been testedfor lead? Yes .y' N o (b) AsbestosMaterials (1) Are you aware of the presenceof asbestosmaterialson the Property,such as roof shingles,siding,insulation, ceiling,flooring,pipewrap,etc.? Yes /No (2) Are you awareof any asbestosmaterialt(at has been encapsulatedor removed? Yes (t{o (3) Are you aware if the Propertyhas been testedfor the presenceof asbestos? Yes /No (c) Mold (1) Are you awareof the presenceof any mold on the Property? Yes y'tto (Z)nre you aware if anythingwith mold 6n the Propertyhas ever been coiered or removed? Yes >cNo (Si nre you aware if the Propertyhas ever been testedfor the presenceof mold? Yes ltto (4) Are you aware if the Propertyhas ever been treatedfor the presenceof mold? Yes ,y'No (d) Radon (1) Are you aware if the Propertyhas been testedfor radon gas? Yes dNo (2) Are you aware if the Propertyhas ever been treatedor m itigatedfor radon gas?
Yes X No
(e) Methamphetamine Are you aware if the Propertyis or was used as a site for methamphetamineproductionor the place of residenceof a personconyictedof a crime involvingany controlledsubstancerelatedthereto? Yes urtlo lf "yes," MAR Form DSC-5000 must be filled out in conjunction with this form. (f) OtherEnvironmental Concerns biphenyls Are you aware of any otherenvironmentalconcernsthat may affectthe Propertysuch as polychlorinated (PCB's),electro-magnetic fuel tanks,discoloration of soil or vegetation,oil sheensin wet fields(EMF's),underground (e.9.,commercial,farming,landfill, areas,unusedsepticor storagetanks,usesof the Propertyotherthan residential dumping site), etc.? Yes ,r'ttlo Please explain any "yes" answeryou gave in this section, including repair history, date(s) performed, type of fests or treatmentand results,and name of person/companywho did the testing or mitigation(attach additionalpages if needed):
1 4 .I N S U R A N C E (a) Are you aware of any claims that have been filed for damages to the Propertyin the last 5 years? Yes *+t6 tf "yes," p/ease explain and include the following. Date of claim, description of claim, repairs and/or replacements completed: (b) Are you awarethat any insurancegpplicationor priorcoverageregardingany partof the Propertyhas been rejected or will not be renewed? Yes t{{o (c)Are you awarethat any existinginsurancecoveragewill be subjectedto increasedrates? Yes -No 15. ROADS,STREETS& ALLEYS private? (a) The roads,streetsand/oralleysservingthe Propertyare p{ublic (b) ls there a recordedroad/street/alley maintenanceagreement? Yes .;Xo osc-8000
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Reference (e.9., Seller & Property)
Wyatt
(c)Are you awareof any rightof way, unrecordedeasementor similarmatterwhich affect the Property? Yes trI,lo Please explain any "yes" answer you gave in this section,includingrepair history and identify maintenanceprovider and cosfs below (attach additionalpagesif needed) 16. MISCELLANEOUS j 9' yeafs-. (a) The approximate age of the residenceis Sellerhas been the ownerof the Propertyfor Years if ; Sellerhas continuouslyoccupiedthe Propertyfor years J_< lf ever vacant,when and how long? (b) ls the Propertylocatedin an areathat requiresan occupancy(codecompliance)inspection? Yes i-tto (c) ls the Propertydesignatedas a historicalhome or locatedin a historicdistrict? Yes i2fro (d) Do you have a surveythat includesall existingimprovementson the Property? Yes ,'No (e) Are you awareof any pets ever havingbeen kept in the home at the Property? Yes p^D{o (f) Are you aware of any pets ever having been kept on the Property? Yes y)7o (g) ls the Buyer being offereda protectionplan/homewarrantyat closingat Seller'sexpense? Yes 4o (h)Are you awareof any: Inoperablewindows? Yes -.1(o inoperabledoors? Yes rr'No brokenthermalseals? Yes ffio O ls any portionof the Propertylocatedwithinthe 100 year flood hazardarea (flood plain)? Yes qfio (i) Are you aware if carpethas been laid over a damagedwood floor? Yes No (k)Are you awareof any. Sharedor common featureswith adjoiningproperties,(e.g.,walls,wells, sewers,fences, roads,etc.)? Yes iZ(o Encroachments which affectthe Property? Yes rr{'lo Existingor threatenedlegalactionaffectingthe Property? Yes pz1rlo Violationsof local,state,or federallaws/regulations, includingzoning,relatingto the Property? Yes -(o Additions,modifications,or alterationsmade to the Propertywithoutnecessarypermits? Yes y'No Consentrequiredof anyoneother thaq the signer(s)of this forgr to convey title to the Property? Yes r-'l(o (l) CurrentUtilityServiceproviders: L (zc / t,-, ,/i;c.t A*",/ ElectricCompany: Water Service: Cable Service: UJ" ilLL,**/ Sewer: Telephone: Gas: Garbage: Fire District. L{41
