Residential Property Seller Disclosure

Property Information

Property Address Seller Name(s) Date

General Information

Year Built How long have you owned the property? Is the property owner-occupied? Yes No

Structural, Systems & Appliances

Feature	Known Issues/Defects	Comments
Roof	Yes No
Foundation	Yes No
Heating/Cooling System	Yes No
Plumbing	Yes No
Electrical System	Yes No
Appliances	Yes No

Hazards & Environmental

Any history of water damage, flooding, or mold? Yes No Is there known lead-based paint on the property? Yes No Unknown Are there any environmental issues (radon, asbestos, etc.)? Yes No

Legal & Miscellaneous

Are there any legal disputes or title issues? Yes No Is the property part of a Homeowners Association (HOA)? Yes No Additional Comments

Seller Certification

I/we certify that the above information is true and complete to the best of my/our knowledge.

Seller Signature Date