Farm or Vacant Land or Lot Disclosure Statement ttrhl
Reference
OFREALTORS@ MISSOURIASSOCIATION
Farmor VacantLandor Lot DisclosureStatement This document has legal conseguences.lf you do not understand it, consult your attorney.
ttrhl
5- t2
1 PropertyAddress: z
madeby theSellerregarding theaboveproperty. is a disclosure statement Thefollowing
3 4 5 6 7 B
NOTICETO SELLER:Eachselleris obligatedto discloseto a buyerall "adversematerialfacts"relatedto the or knownto a partyand which physicalcondition of the propertybeingsold that are not readilyascertainable is designedto assistSellerin complying statement negativelyaffectsthe value of the property.This disclosure The listingreal requirements the propertybeingconsidered. and to assistBuyerin evaluating with disclosure when they agentswill rely uponthis information estatebroker,the sellingreal estatebrokerand theirrespective to prospective buyers. marketandpresentSeller'sproperty evaluate,
9 10 11 12
of the conditionof the propertyas of the date of Seller'sknowledge NOTICETO BUYER:This is a disclosure that Buyermay or warranties for inspections, testsor otherinvestigation signedby Sellerand is not a substitute broker,the the listing by wish to obtain.lt is not a warrantyof any kind by Selleror a warrantyor representation to obtain. may wish theBuyer or warranty for anyinspection sellingbroker,or theiragentsandis nota substitute
A . S U R V E YE,A S E M E N TFSL,O O D I N G (1) Whendidyoupurchase theland? (21 Hasthelandbeensurveyed? Yearsurveyed JJf cr 1 16 1?
14
a CJ
. JOO
1 ........ Kes
IJ
1-l ta
1a 1q
(3) What companyor personperformedthe survey? Name
Phone
Address
........... of surveybeencompleted? (4) lf thisis plattedland,hasa certificate 20 "Yes," If whom? by 21 (5) Hastheplatbeenrecordedin the landrecords? 22 Page# If "Yes,"PlatBook# 23 24 To the bestof yourknowledge: (6) Arethereanyencroachments linedisputes? ................ or boundary 25 (71 Arethereanyeasements easements? otherthanutilityor drainage 26 area?......... (8) ls theproperty 100yearfloodplainorwetlands in a designated 27 ............ (9) Hasthereeverbeena floodor otherdisaster at theproperty? 28 problems theproperty (10)Havethereeverbeendrainage affecting 29 a t a A i ^ a a a t ^ r o p e r t i e s ? yroperties? u{ qulqvs,,r 30 JI
JO
37 AQ
39 40 41
K Yesfl t'to When?-_ (Ves n ruo
...-..tr YesffNo ......I yes BNo ..Ef-Vesf No ...D Ves(No I
yes Kt'lo
"Yes." 9 areanswered (11)Givethedetails if anyof questions 6 through
32 To the bestof your knowledge: 33 B. USERESTRICTIONS. or restrictions affecttheland: conditions, typesof covenants, (1) Do the following any of 34 1C
D t'to
.............. or restrictions? conditions, covenants, or otherrecorded a. Subdivision ..........,.... l p u r c h a s e. ? b . A r i g hot f f i r s tr e f u s at o specific or otherzoningrestrictions specialusepermits, c. Variances, to thrsproperty? "Yes,"do youhavewrittencopiesof (B1) areanswered (2) lf anyof theabovequestions or restrictions? conditions thesecovenants. 'Yes,' describe: lf
....E Vesfl No D Ves{t'to F Yes&ho
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DSC€020 BeachMO 65079 CNIACP 0 Box410, Sunrise CaslightProperties Properties Gaslight GMAC F.rx:5711740048 Phone:57317453i1 48035, www.zioform.com produced Michigan Township, MileRoad,Clinton LLC18025Fifteen wrthZioFormNbv REFormsNet,
fltto Page1 of 3 g.zfx
Rererence 42 43 44
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(3) Haveyoueverreceived noticefromanyperson or authority as to anybreach of anyof thesecovenants, conditions or restrictions? lf "Yes,"describe:
45 C. CONDITION OF THE PROPERW.To the best of your knowledge: (1) Are thereany structures,improvements,or personalpropefi includedin the sale? 46 47 lf "Yes,"list alliterns; Are thereany problemsor defectswith any of theseitems? 48 If 'Yes," describeall problems or defecfs; 49 ' (2) Are thereany operatingor abandonedoil wells,buriedstoragetanks,or burieddebrisor 50 waste on the property? 51 lf "Yes,' give details: 52
53 54 55
....n VesKtto
. fJ yes Kruo Yes ENo
[
I ves ffNo
property (3) ls thereanyhazardous or toxicsubstance in or on thisproperty or anyadjacent (including but not limitedto mold or lead in the soils)? "Yes,' give details: lf
fl YesEltto
56
(4) Haveanysoiltestsbeenperformed? .........
57 58 59 60 61 62 63 64
lf "Yes,'When?_ By Whom? Results: (5) Doesthe propertyhave any fill or uncompacted I Vesfff.fo soils?......... If 'Yes,'describelocationand depth: (6) Are thereany settlingor soilmovement problems ...fl Ves&Uo on thispropertyor any adjacentproperty? lf "Yes,"givedetails. (7) ls therea large-scale infestation, ................ rotor disease in thetreeson theproperty? I YesE t to lf "Yes,"givedetails:
....... fl Yesffitrto
To the best of your knowledge: 65 D. UTILITIES. (1) Haveany percolation 66 testsbeen performed? If "Yes," When? 67 By Whom? Results: 68
...!
yes
KNo
(2) Areanyof thefollowing presently withintheproperty? 69 existing to publicwater? 70 a. Connection d. A waterwell?......... ! YesKNo f yes E'tto to publicsewer? I YesEtto 71 b. Connection E VesEtr,tto e. Septictank?......... to privatewater 72 c. Connection f. Connection to electricutility? 8l yes tr Uo g. Connection 73 systemoff property? .....D Yes EXNo to naturalgas service?........n Yes,,E[,f.{o (3) Areanyof thefollowing 74 existingat theboundary of theproperty? gas access?............... D ves 4 ruo 75 a. Publicwatersystemaccess? d. Natural e. Telephone systemaccess? 76 b. Privatewatersystemaccess?........ fl YesElNo ruo 77 c. Electricserviceaccess? D Kyes 78 79
(4) Haveanyutilityaccesscharges beenpaid? fl Ves(tto If "Yes," which charges have been paid?
FARMPROGRAMS 80 E. FEDERAL/STATE/LOCAL property (1) CRP(Conservation Program)Was enrolled in CRP? Reserve 81 If "Yes,"completethe following: 82 totalacresput in CRP lastyearof participation 83 per acrebid in year 84 enrollment 85
! yes EIruo ..pVes I tto
(2) V/RP(Wetlands was property in WRP? ReserveProgram) enrolled
86
If 'Yes,* complete the following:
87 88
totalacresoutin WRP peracrebidin
lastyearof participation enrollment vear
DSC.8020 Producedwith ZipFormNby RE FormsNet,LLC 18025FifteenMile Road,ClintonTownship,Michigan4t1035,g|t/l/.zip&fnC9!Q
! vesEl'l''to annualpayment .......! Ves.ft*No
payment annual Page2 of 3 g.zfx
Reference OY
(3) DCP(Directand Counter-cyclical PaymentProgram)
YZ VJ
94
...I yes Rtto
V/asproperty in DCP? enrolled
90 91
lf "Yes,"whatis the annualpayment?$
( 4 ) C S P( C o sSt h a r eP r o g r a m ) ( u s u a l1l y0 - y e aprr o g r a m ) . l s t h ep r o p e r ct yu r r e n t pl ya r t i c i p a t i n ga n yC S P ?. . . . . . . . . lf "Yes,"checkapplicahleboxes.'
. . .t r Y e sE l N o
Sorl/Water Terracing Seeding (Cost ShareProgram must be maintainedor the original owner can be fined.) (5) Other Programs (please identify any olher federal, state or local farm loan, price suppotl or subsidy programsin which the propefty currentlyparticipates):
96 97 9B 99 1 0 0 F. OTHERMATTERS (1) Areyouawarethattheproperty production is or wasusedas a siteformethamphetamine 101 or theplaceof residence 102 of a personconvicted anycontrolled substance of a crimeinvolving rclatedthereto? 103 li'Yes," MAR Form DSC-5000must be filled out in conjunction with this form. 104
! vesffiNo
(2) ls thereanythingelse that may materiallyand adverselyaffectthe valueor desirability 105 of property, e.9.,pendingclaimsor litigation, 106 noticefromany governmental authorityof violation proposedzoningchanges,streetchanges,threatof condemnation, of anylawor regulation, 107 I vesK'tto or nerqhborhon oo d i s eo r n u i s a n c e ? 108 ................ " Y e s , " g i v e l f d e t a i l s : 109 1 1 0 G. SELLER'SSTATEMENT(fo be signed at time of listing) The undersignedSeller representsthat the informationset forth in the foregoing disclosurestatementis 111 112 accur3teand completeto the best of Seller'sknowledge.Seller does not intend this disclosurestatementto be a warrantyor guaranteeof any kind. Sellerherebyauthorizesthe listingBrokerto providethis information 113 to prospectivebuyers of the propertyand to real estate brokersand sales people representingsuch buyers. 114 pertaining 115 that is and promptlydisclosein writingto Buyerany new information to the Property 116 known to Seller at any time prior to closing or settlementand constitutesan adverse 411 I lI ake tinqinformation setforthhereinfalseor materiallv (ll (118 ,l ----r 119 Date
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, l, .1,
*
A.CKNOU/LEDGEMENT 120 BUYER'S ANDAGREEMENT 121 1. I understand of whichSellerhas actual and agreethat the information in this formis limitedto information knuwledge requested. andthatSellerneedonlymakean honesteffortat fullyrevealing 122 theinformation 2. Tirrspropertyis beingsold to me withoutwarranties of any kind by Selleror any Broker 123 or guaranties concerning thecondition 124 or valueof theproperty. I have the right to make an independent 3. I understand 125 investigation of my own. I have beenspecifically property professional advisedto havethe by inspectors. 126 examined physical defectsin that neitherSellernor any Brokeris an expertat detecting or repairing 4. I acknourleCge 127 theproperty 128 representthat there are no importantrepresentations concerningthe conditionor value of 5. I specifically 129 property thr madeby Selleror any Brokeron whichlam relyingexceptas may be fullyset forthin writing 130 by eitherof them. andsigned 131 132 1 3 3 Buyer
Date
Buyer
Date
65205'No by membersof tfreMissouri Association of Realtors,P. O. Box 1327,Colu.mbia,.Missouri Approved';y tegalcouirselfor useexclusively or adequacy or thatit compliesin everyrespectwLth.F9 lawor thatits useis as to the tegatvbtiOity of thisdocument, wahantyi" irrao!or rnrplied mayeachdictatethatamendments for ail situaiions. in eabhtransactidn, circumstances Locallaw,dustoms6nd practice, bnddiffering appropriat" be made.LastRevised6114/06. are no longerapprovecl. All previousversions of thisdocument to thisdocument Association of Realtors @1996Missouri Page3 of 3 DSC-8020 g.ztx Producedwith ZipFormIuby RE FormsNet,LLC 18025FifteenMile Road,ClintonTownship,Michigan48035, www.zioform.com
OFREALTORS@ MISSOURIASSOCIATION
Farmor VacantLandor Lot DisclosureStatement This document has legal conseguences.lf you do not understand it, consult your attorney.
ttrhl
5- t2
1 PropertyAddress: z
madeby theSellerregarding theaboveproperty. is a disclosure statement Thefollowing
3 4 5 6 7 B
NOTICETO SELLER:Eachselleris obligatedto discloseto a buyerall "adversematerialfacts"relatedto the or knownto a partyand which physicalcondition of the propertybeingsold that are not readilyascertainable is designedto assistSellerin complying statement negativelyaffectsthe value of the property.This disclosure The listingreal requirements the propertybeingconsidered. and to assistBuyerin evaluating with disclosure when they agentswill rely uponthis information estatebroker,the sellingreal estatebrokerand theirrespective to prospective buyers. marketandpresentSeller'sproperty evaluate,
9 10 11 12
of the conditionof the propertyas of the date of Seller'sknowledge NOTICETO BUYER:This is a disclosure that Buyermay or warranties for inspections, testsor otherinvestigation signedby Sellerand is not a substitute broker,the the listing by wish to obtain.lt is not a warrantyof any kind by Selleror a warrantyor representation to obtain. may wish theBuyer or warranty for anyinspection sellingbroker,or theiragentsandis nota substitute
A . S U R V E YE,A S E M E N TFSL,O O D I N G (1) Whendidyoupurchase theland? (21 Hasthelandbeensurveyed? Yearsurveyed JJf cr 1 16 1?
14
a CJ
. JOO
1 ........ Kes
IJ
1-l ta
1a 1q
(3) What companyor personperformedthe survey? Name
Phone
Address
........... of surveybeencompleted? (4) lf thisis plattedland,hasa certificate 20 "Yes," If whom? by 21 (5) Hastheplatbeenrecordedin the landrecords? 22 Page# If "Yes,"PlatBook# 23 24 To the bestof yourknowledge: (6) Arethereanyencroachments linedisputes? ................ or boundary 25 (71 Arethereanyeasements easements? otherthanutilityor drainage 26 area?......... (8) ls theproperty 100yearfloodplainorwetlands in a designated 27 ............ (9) Hasthereeverbeena floodor otherdisaster at theproperty? 28 problems theproperty (10)Havethereeverbeendrainage affecting 29 a t a A i ^ a a a t ^ r o p e r t i e s ? yroperties? u{ qulqvs,,r 30 JI
JO
37 AQ
39 40 41
K Yesfl t'to When?-_ (Ves n ruo
...-..tr YesffNo ......I yes BNo ..Ef-Vesf No ...D Ves(No I
yes Kt'lo
"Yes." 9 areanswered (11)Givethedetails if anyof questions 6 through
32 To the bestof your knowledge: 33 B. USERESTRICTIONS. or restrictions affecttheland: conditions, typesof covenants, (1) Do the following any of 34 1C
D t'to
.............. or restrictions? conditions, covenants, or otherrecorded a. Subdivision ..........,.... l p u r c h a s e. ? b . A r i g hot f f i r s tr e f u s at o specific or otherzoningrestrictions specialusepermits, c. Variances, to thrsproperty? "Yes,"do youhavewrittencopiesof (B1) areanswered (2) lf anyof theabovequestions or restrictions? conditions thesecovenants. 'Yes,' describe: lf
....E Vesfl No D Ves{t'to F Yes&ho
{v.r
DSC€020 BeachMO 65079 CNIACP 0 Box410, Sunrise CaslightProperties Properties Gaslight GMAC F.rx:5711740048 Phone:57317453i1 48035, www.zioform.com produced Michigan Township, MileRoad,Clinton LLC18025Fifteen wrthZioFormNbv REFormsNet,
fltto Page1 of 3 g.zfx
Rererence 42 43 44
&-a-*at/
(3) Haveyoueverreceived noticefromanyperson or authority as to anybreach of anyof thesecovenants, conditions or restrictions? lf "Yes,"describe:
45 C. CONDITION OF THE PROPERW.To the best of your knowledge: (1) Are thereany structures,improvements,or personalpropefi includedin the sale? 46 47 lf "Yes,"list alliterns; Are thereany problemsor defectswith any of theseitems? 48 If 'Yes," describeall problems or defecfs; 49 ' (2) Are thereany operatingor abandonedoil wells,buriedstoragetanks,or burieddebrisor 50 waste on the property? 51 lf "Yes,' give details: 52
53 54 55
....n VesKtto
. fJ yes Kruo Yes ENo
[
I ves ffNo
property (3) ls thereanyhazardous or toxicsubstance in or on thisproperty or anyadjacent (including but not limitedto mold or lead in the soils)? "Yes,' give details: lf
fl YesEltto
56
(4) Haveanysoiltestsbeenperformed? .........
57 58 59 60 61 62 63 64
lf "Yes,'When?_ By Whom? Results: (5) Doesthe propertyhave any fill or uncompacted I Vesfff.fo soils?......... If 'Yes,'describelocationand depth: (6) Are thereany settlingor soilmovement problems ...fl Ves&Uo on thispropertyor any adjacentproperty? lf "Yes,"givedetails. (7) ls therea large-scale infestation, ................ rotor disease in thetreeson theproperty? I YesE t to lf "Yes,"givedetails:
....... fl Yesffitrto
To the best of your knowledge: 65 D. UTILITIES. (1) Haveany percolation 66 testsbeen performed? If "Yes," When? 67 By Whom? Results: 68
...!
yes
KNo
(2) Areanyof thefollowing presently withintheproperty? 69 existing to publicwater? 70 a. Connection d. A waterwell?......... ! YesKNo f yes E'tto to publicsewer? I YesEtto 71 b. Connection E VesEtr,tto e. Septictank?......... to privatewater 72 c. Connection f. Connection to electricutility? 8l yes tr Uo g. Connection 73 systemoff property? .....D Yes EXNo to naturalgas service?........n Yes,,E[,f.{o (3) Areanyof thefollowing 74 existingat theboundary of theproperty? gas access?............... D ves 4 ruo 75 a. Publicwatersystemaccess? d. Natural e. Telephone systemaccess? 76 b. Privatewatersystemaccess?........ fl YesElNo ruo 77 c. Electricserviceaccess? D Kyes 78 79
(4) Haveanyutilityaccesscharges beenpaid? fl Ves(tto If "Yes," which charges have been paid?
FARMPROGRAMS 80 E. FEDERAL/STATE/LOCAL property (1) CRP(Conservation Program)Was enrolled in CRP? Reserve 81 If "Yes,"completethe following: 82 totalacresput in CRP lastyearof participation 83 per acrebid in year 84 enrollment 85
! yes EIruo ..pVes I tto
(2) V/RP(Wetlands was property in WRP? ReserveProgram) enrolled
86
If 'Yes,* complete the following:
87 88
totalacresoutin WRP peracrebidin
lastyearof participation enrollment vear
DSC.8020 Producedwith ZipFormNby RE FormsNet,LLC 18025FifteenMile Road,ClintonTownship,Michigan4t1035,g|t/l/.zip&fnC9!Q
! vesEl'l''to annualpayment .......! Ves.ft*No
payment annual Page2 of 3 g.zfx
Reference OY
(3) DCP(Directand Counter-cyclical PaymentProgram)
YZ VJ
94
...I yes Rtto
V/asproperty in DCP? enrolled
90 91
lf "Yes,"whatis the annualpayment?$
( 4 ) C S P( C o sSt h a r eP r o g r a m ) ( u s u a l1l y0 - y e aprr o g r a m ) . l s t h ep r o p e r ct yu r r e n t pl ya r t i c i p a t i n ga n yC S P ?. . . . . . . . . lf "Yes,"checkapplicahleboxes.'
. . .t r Y e sE l N o
Sorl/Water Terracing Seeding (Cost ShareProgram must be maintainedor the original owner can be fined.) (5) Other Programs (please identify any olher federal, state or local farm loan, price suppotl or subsidy programsin which the propefty currentlyparticipates):
96 97 9B 99 1 0 0 F. OTHERMATTERS (1) Areyouawarethattheproperty production is or wasusedas a siteformethamphetamine 101 or theplaceof residence 102 of a personconvicted anycontrolled substance of a crimeinvolving rclatedthereto? 103 li'Yes," MAR Form DSC-5000must be filled out in conjunction with this form. 104
! vesffiNo
(2) ls thereanythingelse that may materiallyand adverselyaffectthe valueor desirability 105 of property, e.9.,pendingclaimsor litigation, 106 noticefromany governmental authorityof violation proposedzoningchanges,streetchanges,threatof condemnation, of anylawor regulation, 107 I vesK'tto or nerqhborhon oo d i s eo r n u i s a n c e ? 108 ................ " Y e s , " g i v e l f d e t a i l s : 109 1 1 0 G. SELLER'SSTATEMENT(fo be signed at time of listing) The undersignedSeller representsthat the informationset forth in the foregoing disclosurestatementis 111 112 accur3teand completeto the best of Seller'sknowledge.Seller does not intend this disclosurestatementto be a warrantyor guaranteeof any kind. Sellerherebyauthorizesthe listingBrokerto providethis information 113 to prospectivebuyers of the propertyand to real estate brokersand sales people representingsuch buyers. 114 pertaining 115 that is and promptlydisclosein writingto Buyerany new information to the Property 116 known to Seller at any time prior to closing or settlementand constitutesan adverse 411 I lI ake tinqinformation setforthhereinfalseor materiallv (ll (118 ,l ----r 119 Date
-Uzt/fi
, l, .1,
*
A.CKNOU/LEDGEMENT 120 BUYER'S ANDAGREEMENT 121 1. I understand of whichSellerhas actual and agreethat the information in this formis limitedto information knuwledge requested. andthatSellerneedonlymakean honesteffortat fullyrevealing 122 theinformation 2. Tirrspropertyis beingsold to me withoutwarranties of any kind by Selleror any Broker 123 or guaranties concerning thecondition 124 or valueof theproperty. I have the right to make an independent 3. I understand 125 investigation of my own. I have beenspecifically property professional advisedto havethe by inspectors. 126 examined physical defectsin that neitherSellernor any Brokeris an expertat detecting or repairing 4. I acknourleCge 127 theproperty 128 representthat there are no importantrepresentations concerningthe conditionor value of 5. I specifically 129 property thr madeby Selleror any Brokeron whichlam relyingexceptas may be fullyset forthin writing 130 by eitherof them. andsigned 131 132 1 3 3 Buyer
Date
Buyer
Date
65205'No by membersof tfreMissouri Association of Realtors,P. O. Box 1327,Colu.mbia,.Missouri Approved';y tegalcouirselfor useexclusively or adequacy or thatit compliesin everyrespectwLth.F9 lawor thatits useis as to the tegatvbtiOity of thisdocument, wahantyi" irrao!or rnrplied mayeachdictatethatamendments for ail situaiions. in eabhtransactidn, circumstances Locallaw,dustoms6nd practice, bnddiffering appropriat" be made.LastRevised6114/06. are no longerapprovecl. All previousversions of thisdocument to thisdocument Association of Realtors @1996Missouri Page3 of 3 DSC-8020 g.ztx Producedwith ZipFormIuby RE FormsNet,LLC 18025FifteenMile Road,ClintonTownship,Michigan48035, www.zioform.com
