Disclosure of Information on Lead-Based Paint and/or Lead-Based Paint Hazards
General Radon Disclosure
Additional Disclosures

		Yes	No	N/A	See Experts Report
C.1.	I am aware of defects in the roof.
C.2.	I am aware of defects in the electrical system.
C.3.	I am aware of defects in part of the plumbing system (including the water heater, water softener and swimming pool) that is included in the sale.
C.4.	I am aware of defects in the heating and air conditioning system (including the air filters and humidifiers).
C.5.	I am aware of defects in the well, including unsafe well water.
C.6.	I am aware that this property is served by a joint well
C.7.	I am aware of defects in the septic system or other sanitary disposal system.
C.8.	I am aware of underground or aboveground fuel storage tanks on or previously located on the property. (if "yes'', the owner, by law, may have to register the tanks with the Department of Commerce at P.O. Box 7970, Madison, Wisconsin 53707, whether the tanks are in use or not Regulations of the Department of Commerce may require the closure or removal of unused tanks.)
C.9.	I am aware of an "LIP'' tank on the property. (If ''yes , state whether or not the owner of the property either owns or leases the tank).
C.10.	I am aware of defects in the basement or foundation (including cracks, seepage and bulges).
C.11.	I am aware that the property is located in a floodplain, wetland or shoreland zoning area.
C.12.	I am aware of defects in the structure of the property .
C.13.	I am aware of defects in mechanical equipment included in the sale either as fixtures or personal property.
C.14.	I am aware of boundary or lot line disputes, encroachments or encumbrances (including a joint driveway).
C.15.	I am aware of a defect caused by unsafe concentrations of, or unsafe conditions relating to, radon, radium in water supplies, lead in paint, lead in soil, lead in water supplies or plumbing system, or other potentially hazardous or toxic substances on the premises.
C.16.	I am aware of the presence of asbestos or asbestos-containing materials on the premises.
C.17.	I am aware of a defect caused by unsafe concentrations of, unsafe conditions relating to, or the storage of, hazardous or toxic substances on neighboring properties.
C.18.	I am aware of current or previous termite, powder-post beetle or carpenter ant infestations.
C.19.	I am aware of defects in a wood burning stove or fireplace or of defects caused by afire in a stove or fireplace or elsewhere on the property.
C.20.	I am aware either that remodeling affecting the property's structure or mechanical systems was done or that additions to this property were made during my period of ownership without the required permits.
C.21.	I am aware of federal, state, or local regulations requiring repairs, alterations or corrections of an existing condition.
C.22.	I have received notice of property tax increases, other than normal annual increases, or am aware of a pending property reassessment.
C.23.	I am aware that remodeling that may increase the property's assessed value was done.
C.24.	I am aware of proposed or pending special assessments.
C.25.	I am aware of the proposed construction of a public project that may affect the use of the property.
C.26.	I am aware of subdivision homeowners' associations, common areas co-owned with others, zoning violations or nonconforming uses, rights-of-way, easements, or another use of a part of the property by nonowners, other than recorded utility easements.
C.27.	I am aware of other defects affecting the property.
ADDITIONAL INFORMATION
D.1.	I am aware that a structure on the property is designated as a historic building or that part of the property is in a historic district.
D.2.	The owner has lived on the property for years.
D.3.	Explanation of "yes" responses. (See B.3.)

		YES	NO	N/A
1.	Seller has occupied the property within the last 12 months. (If “no,” please identify capacity or explain relationship to property.)
2.	I currently have flood hazard insurance on the property.
3.	I am aware of flooding or recurring leakage problems in the crawl space or basement.
4.	I am aware that the property is located in a floodplain.
5.	I am aware of material defects in the basement or foundation (including cracks and bulges).
6.	I am aware of leaks or material defects in the roof, ceilings, or chimney.
7.	I am aware of material defects in the walls, windows, doors, or floors.
8.	I am aware of material defects in the electrical system.
9.	I am aware of material defects in the plumbing system (includes such things as water heater, sump pump, water treatment system, sprinkler system, and swimming pool).
10.	I am aware of material defects in the well or well equipment.
11.	I am aware of unsafe conditions in the drinking water.
12.	I am aware of material defects in the heating, air conditioning, or ventilating systems.
13.	I am aware of material defects in the fireplace or wood burning stove.
14.	I am aware of material defects in the septic, sanitary sewer, or other disposal system.
15.	I am aware of unsafe concentrations of radon on the premises.
16.	I am aware of unsafe concentrations of or unsafe conditions relating to asbestos on the premises.
17.	I am aware of unsafe concentrations of or unsafe conditions relating to lead paint, lead water pipes, lead plumbing pipes or lead in the soil on the premises.
18.	I am aware of mine subsidence, underground pits, settlement, sliding, upheaval, or other earth stability defects on the premises.
19.	I am aware of current infestations of termites or other wood boring insects.
20.	I am aware of a structural defect caused by previous infestations of termites or other wood boring insects.
21.	I am aware of underground fuel storage tanks on the property.
22.	I am aware of boundary or lot line disputes.
23.	I have received notice of violation of local, state or federal laws or regulations relating to this property, which violation has not been corrected.
24.	I am aware that this property has been used for the manufacture of methamphetamine as defined in Section 10 of the Methamphetamine Control and Community Protection Act.

Date: _____________________	Date: _____________________
Seller:_____________________	Seller: _____________________

Attachment to Contract to Buy and Sell Real Estate for the Property known as:
Street Address City State Zip

	Seller's Disclosure to Buyer and Real Estate Licensee(s) and Acknowledgment
1.	Seller acknowledges that Seller has been informed of Seller's obligations. Seller is aware that Seller must retain a copy of this disclosure for not less than three years from the completion date of the sale.
2.	Presence of lead-based paint and/or lead-based paint hazards (check one box below):
	Seller has no knowledge of any lead-based paint and/or lead-based paint hazards present in the housing.
	Seller has knowledge of lead-based paint and/or lead-based paint hazards present in the housing (explain):

3.	Records and reports available to Seller (check one box below):
	Seller has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing
	Seller has provided Buyer with all available records and reports pertaining to lead-based paint and/or lead-based paint hazards in the housing (list documents below):

1.	Home Performance Programs	Home Performance with ENERGY STAR
2.	Construction Type:	SIPS	ICF	Material Efficient Framing
		Improved Insulation	Straw Bale	Earthen Build/Rammed Earth
		Other

3.	Heating, Cooling and Ventilation: (check box for each type)	Ground Source Heat Pump	High Efficiency Furnace/Boiler (eg. >= 90% AFUE)
		Tankless/On Demand Water Heater	High Efficiency Water Heater (eg. >=90%, or EF>=.82 for gas)
		Evaporative Cooling	Whole House Fan	Ceiling Fans
		High SEER A/C	Insulation Air Sealing Upgrades Completed
		SEER Rating:	Home Orientation (South Facing Overhangs)

4.	Water Efficient Features:	Low Flow Toilets	Low Flow Fixtures/Shower Heads
		Low Water sod	Hot Water Recirculation Pump/Structured Plumbing
		Xeriscaping	Hot Water Recirculation Pump/Structured Plumbing
		WaterSense by ENERGY STAR

5.	Indoor Air Quality:	Indoor Air Quality Plus by ENERGY STAR	No or Low VOC Paint
		Heat Recovery Ventilator/Fresh Air System	Radon Mitigation System
		Green Guard Certified Carpet / Flooring (documentation required)
		No Formaldehyde Certified Cabinetry (documentation required)

6.	Sustainable Materials:	FSC Certified Lumber	FSC Certified Cabinets	Recycled Content
		Reclaimed Flooring	Sustainable Flooring	Regionally Harvested

7.	Energy Features:	ENERGY STAR/Low E Windows (documentation required)	Automated Lighting Controls
		Orientation/Passive Solar Design	High Efficiency Lighting
		ENERGY STAR Rated Roof (documentation required)	Programmable Thermostat


Seller	Date	Seller	Date

	ADVISORY TO BUYER:
1.	Even though Seller has answered the above questions to Seller’s current actual knowledge, Buyer should thoroughly inspect the Property and obtain expert assistance to accurately and fully evaluate the Property to confirm the status of the matters set forth herein.
2.	Seller states that the information is correct to “Seller’s current actual knowledge” as of the date of this form. The term “current actual knowledge” is intended to limit Seller’s disclosure only to facts actually known by the Seller and does not include “constructive knowledge” or “common knowledge” or what Seller “should have known” about the Property. The Seller has no duty to inspect the Property when this Disclosure is filled in and signed.
3.	Valuable information may be obtained from various local/state/federal agencies, and other experts may assist Buyer by performing more specific evaluations and inspections of the Property. Additional documentation such as receipts or information from manufacturers is also helpful.
4.	Whether any item is included or excluded is determined by the contract between Buyer and Seller and not this Green Disclosure.
5.	Buyer acknowledges that Seller does not warrant that the Property is fit for Buyer’s intended purposes or use of the Property. Buyer acknowledges that Seller’s indication that an item is “working” is not to be construed as a warranty of its continued operability or as a representation or warranty that such item is fit for Buyer’s intended purposes.
6.	Buyer hereby receipts for a copy of this Disclosure.

TERM	DEFINITION
AFUE	A central furnace or boiler's efficiency is measured by annual fuel utilization efficiency (AFUE).
Automated Lighting Controls	Automatic controls for lighting range from a simple outdoor light fixture with a built-in photo sensor to whole-house programmable controls that can activate lights for various scenarios
Ceiling Fans	Fans, set to push warm air into living spaces, can reduce winter heating bills, & cut cooling costs when they are used in lieu of air-conditioners
Earthen Built / Rammed Earth	A technique used in the building of walls using the raw materials of earth, chalk, lime & gravel.
ENERGYSTAR® / Low E Windows	In general, Colorado requires a U-factor of 0.35 or less to meet ENERGY STAR guidelines.
ENERGYSTAR® Rated Roof	ENERGY STAR qualified roof products reflect more of the sun's rays.
ENERGYSTAR® Refrigerator, Dishwasher,Clothes-Washer	ENERGY STAR qualified refrigerators are 20% more energy efficient than the minimum federal standard. ENERGYSTAR® qualified dishwasher models are, on average, 10% more energy efficient than non-qualified models. ENERGYSTAR® qualified clothes washers use about 30% less energy & use over 50% less water than regular washers.
Evaporative Cooling	AKA swamp cooler. A simple cooling system that operates by moving air across or through a wet pad.
FSC Certified Cabinets	Independent certification & labeling of forest products, such as lumber used for cabinets, administered by the Forest Stewardship Council
FSC Certified Lumber	Independent certification & labeling of forest products, such as lumber used for framing, administered by the Forest Stewardship Council.
Green Guard Certified Carpet/Flooring	Third-party certification program for carpet & flooring.
Grey water System	Untreated wastewater resulting from lavatory wash basins, laundry & bathing. Waste water from kitchen sinks is often excluded because of the high food & grease content.
Ground Source Heat Pump (Geothermal heat pumps/geothermal heat exchange)	Ground source heat pumps (GSHPs) are electrically powered systems that tap the stored energy of the earth. These systems use the earth's relatively constant temperature to provide heating, cooling, & hot water.
High Efficiency Furnace / Boiler	The Federal Trade Commission requires new furnaces or boilers to display their AFUE so consumers can compare heating efficiencies of various models. AFUE is a measure of how efficient the appliance is in the energy in its fuel over the course of a typical year.
High Efficiency Lighting (CFLs, LED)	New lighting technologies use less energy, last longer, & give off the same amount of light as old incandescent technologies. Compact fluorescent lights (CFLs) use about a quarter of the energy while giving off the same amount of light & lasting up to 10 times longer. Light-emitting Diodes (LEDs)create light without releasing heat, last longer than CFLs & do not contain mercury.
High Efficiency Water Heater	High efficiency water heaters use 10 to 50 percent less energy than standard models. Models with an ENERGYSTAR rating are considered highly efficient.
High SEER Air Conditioning	Air conditioners manufactured after January 26, 2006 must achieve a Seasonal Energy Efficiency Ratio (SEER) of 13 or higher
Home Orientation (South Facing Overhangs)	The home is located on the property to maximize solar gain in winter, & provide shade in summer. In general, a south-facing orientation, within 30° east or west of true south, will provide around 90% of the maximum static solar collection potential.
Home Performance with ENERGY STAR®	Home Performance with ENERGYSTAR is a national program administered by the U.S. Environmental Protection Agency (EPA) & the U.S. Department of Energy (DOE). It offers a comprehensive, "whole-house" approach to improving energy efficiency & comfort of existing homes.
Hot Water Recirculation Pump / Structured Plumbing	Hot water recirculation systems use a pump to move hot water through the plumbing system from the water heater to near the fixtures. Structured Plumbing is a method of designing the hot water plumbing layout to minimize hot water delivery times.
ICF	Rigid plastic foam forms that hold concrete in place during curing & remain in place afterwards to serve as thermal insulation for concrete walls. The foam sections are lightweight & result in energy efficient, durable construction
Indoor air PLUS By ENERGYSTAR®	A variety of construction practices & technologies to decrease the risk of poor indoor air quality. The Environmental Protection Agency administers a builder program called Indoor air PLUS.
Improved Insulation	Building codes typically require a minimum insulation level for each component of the building envelope. Improved Insulation refers to increasing the insulation levels beyond the minimum code requirements.
Insulation Air Sealing Upgrades	For existing homes, Insulation & Air Sealing upgrades are typically implemented in conjunction with an energy audit. These steps help seal a home from drafts & leakage, & increase the insulation levels of the home.
Low Flow Fixtures / Shower Heads	A faucet with aerator installed to reduce the flow of water but not reduce water pressure. Low-flow shower heads use about 2 ½ gallons of water per minute compared to between four & five gallons per minute used by conventional heads.
Low Flow Toilets	A toilet that uses less water per flush when compared to the current federal requirements. Such toilets often have the EPA's WaterSense label. In general, low-flow toilets use a maximum of 1.28 gallons of water per flush.
Low-water Sod	Landscaping that has significantly lower watering requirements than conventional turf. Most of these types come with certificates of installation in Colorado.
No Formaldehyde Certified Cabinetry	The Kitchen Cabinet Manufacturers Association (KCMA) created the Environmental Stewardship Program (ESP) to help cabinet manufacturers demonstrate their commitment to environmental sustainability & help consumers easily identify environmentally-friendly products.
No or Low VOC Paint	Paints that release no, or minimal Volatile Organic Compound (VOC) pollutants, & are virtually odor free.
Orientation / Passive Solar Design	Solar geometry, window technology & local climate are used to direct building design. Helps reduce or even eliminate the need for mechanical cooling & heating & daytime artificial lighting.
Programmable Thermostat	A thermostat that can be programmed to increase &decrease a home's temperature setting automatically.
Radon Mitigation System	A system that detects radon, a naturally occurring gas, colorless &odorless, that causes adverse health effects. Radon gas often enters a structure by seeping through cellar walls & floors.
Reclaimed Flooring	Material that is recovered for reuse or another purpose, such as wood barn siding hat becomes flooring.
Recycled Content	Recycled-content products are made from materials that would otherwise have been discarded. These products are made totally or partially from material contained in recycled products, like aluminum soda cans or newspaper.
Regionally Harvested	Harvested within 500 miles of home.
SEER Rating	The rating & performance standard developed by the U.S. government & equipment manufacturer's to produce an energy consumption rating that is easy to understand by consumers. The lower the SEER rating, the more energy required to produce the desired effect.
SIPS	Panels made from a thick layer of foam sandwiched between two layers of Oriented Strand Board (OSB), plywood or fiber-cement. They are an alternative to the foam core & are available with a core of agriculture fibers (such as wheat straw) thatprovides similar thermal & structural performance.
Straw Bale	A construction method that uses waste straw left over from crops, such as wheat, oats, barley, rye, rice & flax, after all the food has been extracted. Straw is gathered, baled, compressed & tied together. Bales are placed over a "stemwall" to protect the straw from the ground soil & the straw bales are stuccoed & plastered over for finishing.
Sustainable Flooring	Sustainable flooring is produced from sustainable materials (& by a sustainable process) that reduces demands on ecosystems during its life-cycle. This includes harvest, production, use & disposal.
Tankless/On Dem & Water Heater	A system that delivers hot water at a preset temperature when needed, but without requiring the storage of water. The approach reduces or eliminates energy standby losses. Tankless water heaters can be used for supplementary heat, such as a booster to a solar hot water system, or to meet all hot water needs. Tankless water heaters have an electric, gas, or propane heating device that is activated by the flow of water.
Whole House Fan	A whole-house fan is a type of fan installed in a building's ceiling, designed to pull hot air out of the building
Xeriscaping	A method of landscaping that promotes water conservation.

Source of Square Footage Information	Date	Square Footage
Prior appraisal (Date of document)
Building plans (Date of document)
Assessor’s office (Date obtained)
Other

A.	BUILDING CONDITIONS (all aspects of the Property to include decks and patios) If you know of any of the following problemsEVER EXISTING, check the “Yes” column:	Yes	Comments
1	Structural
2	Moisture and/or water
3	Damage due to termites, other insects, birds, animals, or rodents
4	Damage due to hail, wind, fire, flood, or other casualty
5	Cracks, heaving or settling
6	Exterior wall or window
7	Exterior Artificial Stucco (EIFS)
8	Subfloors
9
10

B.	ROOF If you know of any of the following problems EVER EXISTING, check the “Yes” column:	Yes	Comments
1	Roof leak
2	Damage to roof
3	Skylight
4	Gutter or downspout
5	Other roof problems, issues or concerns
6
7
	ROOF - Other Information Do you know of the following on the Property
8	Roof under warranty until Transferable? YES NO
9	Roof work done while under current roof warranty
10	Roof material: Age:
11

C.	APPLIANCES (if included in the sale) If you know of any problems NOW EXISTINGwith the following, check the “Yes” column:	Yes	Age If Known	Comments
1	Built-in vacuum system & accessories
2	Clothes dryer
3	Clothes washer
4	Dishwasher
5	Disposal
6	Freezer
7	Gas grill
8	Hood
9	Microwave oven
10	Oven
11	Range
12	Refrigerator
13	T.V. antenna: Owned Leased
14	Satellite system or DSS dish: Owned Leased
15	Trash compactor
16
17

D.	ELECTRICAL & TELECOMMUNICATIONS If you know of any problems NOW EXISTING with the following, check the “Yes” column:	Yes	Age If Known	Comments
1	Security system: Owned Leased
2	Smoke/fire detectors: Battery Hardwire
3	Carbon Monoxide Alarm: Battery Hardwire
4	Light fixtures
5	Switches & outlets
6	Telecommunications (T1, fiber, cable, satellite)
7	Inside telephone wiring & blocks/jacks
8	Ceiling fans
9	Garage door opener and remote control # of remote/openers:
10	Intercom/doorbell
11	In-wall speakers
12
13
	ELECTRICAL & TELECOMMUNICATIONSIf you know of any problems EVER EXISTINGwith the following, check the “Yes” column:
14	Electrical Service
15	Aluminum wiring at the outlets (110)
16	Solar panels: Owned Leased
17	Wind generators: Owned Leased
18	Electric Wiring or Panel
19
20
	ELECTRICAL & TELECOMMUNICATIONS - Other Information: Do you know of the following on the Property:
21	220 volt service
22	Electrical Service: Amps
23	Landscape lighting
24	Electric Provider:
25	Cable/TV provider
26	Seller’s Internet Provider
27

E.	MECHANICAL If you know of any problems NOW EXISTINGwith the following, check the “Yes” column:	Yes	Age If Known	Comments
1	Overhead doors (including garage doors)
2	Entry gate system
3	Elevator

4	Sump pump(s): # of
5	Recycle pump
6
7

F.	VENTILATION, AIR & HEAT If you know of any problems NOW EXISTINGwith the following, check the “Yes” column:	Yes	Age If Known	Comments
1	Heating system
2	Evaporative cooler
3	Window air conditioning units
4	Central air conditioningr
5	Attic/whole house fan
6	Vent fans
7	Humidifier
8	Air purifier
9	Fireplace
10	Fireplace insert
11	Heating Stove
12	Fuel tanks
13
14
	VENTILATION, AIR & HEAT - Other Information: Do you know of the following on the Property:
15	Heating system (including furnace): Type Fuel Type Fuel
16	Fireplace: Type Fuel
17	Heating Stove: Type Fuel
18	When was fireplace/wood stove, chimney/flue last cleaned: Date: Do not know
19	Fuel tanks: Owned Leased
20	Radiant heating system: Interior Exterior Type
21	Fuel Provider:
22

G.	WATER If you know of any problems NOW EXISTINGwith the following, check the “Yes” column:	Yes	Age If Known	Comments
1	Water heater(s)
2	Water filter system
3	Water softener
4	Water system pump
5	Sauna
6	Hot tub or spa
7	Steam room/shower
8	Underground sprinkler system
9	Fire sprinkler system
10	Backflow prevention device
11	Irrigation pump
12
13
	WATER If you know of any problems EVER EXISTINGwith the following, check the “Yes” column:
14	Water system (including lines and water pressure)
15	Well
16	Pool
17	Irrigation system
18
19
	WATER - Other Information: Do you know of the following on the Property:
20	Water heater: Number of Fuel type Capacity
21	Water filter system: Owned Leased
22	Water softener: Owned Leased
23	Master Water Shutoff Location:
24	Well metered
25	Well Pump: Date of last inspection Date of last service
26	Galvanized pipe
27	Polybutylene pipe
28	Well Pump - GPM Date:
29	Cistern water storage gallons
30	Supplemental water purchased in past 2 years?
31

I.	SEWER If you know of any problems EVER EXISTING with the following, check the “Yes” column:	Yes	Comments
1	Sewage system (including sewer lines)
2	Lift station (sewage ejector pump)
3
4
	SEWER - Other Information: Do you know of the following on the Property:
5	Type of sanitary sewer service: Public Community Septic System None Other If the Property is served by an on-site septic system, provide buyer with a copy of the permit. Type of septic system: Tank Leach Lagoon
6	Sewer service provider:
7	Sewer line scoped? Date:
8	If a septic system, date latest Individual Use Permit issued:
9	If a septic system, date of latest inspection:
10	If a septic system, date of latest pumping:
11	Gray water storage/use
12

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Real Estate.
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Heidi Laros
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Are Broker Commissions
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J.	FLOODING AND DRAINAGE If you know of any problems EVER EXISTING with the following on the Property, check the “Yes” column:	Yes	Comments
1	Flooding or drainage
2
3
	DRAINAGE AND RETENTION PONDS - Other Information Do you know of the following on the Property:
4	Drainage, retention ponds
5

K.	OTHER DISCLOSURES - IMPROVEMENTSIf you know of any problems NOW EXISTINGG with the following, check the “Yes” column:	Yes	Comments
1	Included fixtures and equipment
2	Stains on carpet
3	Floors
4
5

L.	USE, ZONING & LEGAL ISSUES If you know of any of the following EVER EXISTING,check the “Yes” column:	Yes	Comments
1	Zoning violation, variance, conditional use, violation of an enforceable PUD, or non-conforming use
2	Notice or threat of condemnation proceedings
3	Notice of any adverse conditions from any governmental or quasi-governmental agency that have not been resolved
4	Notice of zoning action related to the Property
5	Building code, city, or county violations
6	Violation of restrictive covenants or owners’ association rules or regulations
7	Any building or improvements constructed within the past one year before this Date without approval by the owner’s association or its designated approving body
8	Any additions or alterations made with a Building Permit
9	Any additions or non-aesthetic alterations made without a Building Permit
10	Other legal action
11	Any part of the Property leased to others (written or oral)
12	Used for short-term rentals in the past year
13	Grandfathered conditions or uses
14
15

M.	ACCESS & PARKING If you know of any of the following EVER EXISTINGcheck, the “Yes” column:	Yes	Comments
1	Any access problems, issues or concerns
2	Roads, trails, paths, or driveways through the Property used by others
3	Public highway or county road bordering the Property
4	Any proposed or existing transportation project that affects or is expected to affect the Property
5	Encroachments, boundary disputes, or unrecorded easements
6	Shared or common areas with adjoining properties
7	Requirements for curb, gravel/paving, landscaping
8	Any limitations on parking or access due to size, number of vehicles, or type of vehicles in the past year
9
10

N.	ENVIRONMENTAL CONDITIONS If you know of any of the following EVER EXISTINGon any part of the Property, check the “Yes” column:	Yes	Comments
1	Hazardous materials on the Property, such as radioactive, toxic, or biohazardous materials, asbestos, pesticides, herbicides, wastewater sludge methane, mill tailings, solvents, or petroleum products
2	Underground storage tanks
3	Aboveground storage tanks
4	Underground transmission lines
5	Property used as, situated on, or adjoining a dump, landfill or municipal solid waste landfill
6	Monitoring wells or test equipment
7	Sliding, settling, upheaval, movement or instability of earth, or expansive soils on the Property
8	Mine shafts, tunnels, or abandoned wells on the roperty
9	Within a governmentally designated geological hazard or sensitive area
10	Within a governmentally designated floodplain or wetland area
11	Dead, diseased, or infested trees or shrubs
12	Environmental assessments, studies, or reports done involving the physical condition of the Property
13	Used for any mining, graveling, or other natural resource extraction operations such as oil and gas wells
14	Smoking inside improvements (including garages, unfinished space, or detached buildings) on Property
15	Animals kept in the residence
16	Other environmental problems, issues or concerns
17	Odors
18
19

O.	RADON If you know of any of the following EVER EXISTING,check the “Yes” column:	Yes	Comments
1	Radon test(s) conducted on the Property. Include the most recent records and reports pertaining to radon concentrations within the Property.
2	Radon concentrations detected or mitigation or remediation performed. Provide a full description.
3	Radon mitigation system installed on Property. Provide all information known by Seller about the radon mitigation system.
4
5

P.	COMMON INTEREST COMMUNITY - ASSOCIATION PROPERTY If you know of any of the following NOW EXISTING,check the “Yes” column:	Yes	Comments
1	Property is part of an owners’ association
2	Special assessments or increases in regular assessments approved by owners’ association but not yet implemented
3	Problems or defects in the Common Elements or Limited Common Elements of the Association Property
	COMMON INTEREST COMMUNITY - ASSOCIATION PROPERTY If you know of any of the following EVER EXISTED,check the “Yes” column:
4	Has the Association made demand or commenced a lawsuit against a builder or contractor alleging defective onstruction of improvements of the Association Property (common area or property owned or controlled by the Association but outside the Seller’s Property or unit)
5
6
7	Owner’s Association #1:
8	Owner’s Association #2:
9	Owner’s Association #3:
10	Owner’s Association #4:

Q.	GENERAL DISCLOSURES If you know of any of the following EVER EXISTING,check the “Yes” column:	Yes	Comments
1	Written reports of any building, site, roofing, soils, water, sewer, or engineering investigations or studies of the Property
2	Any property insurance claim submitted (whether paid or not)
3	Structural, architectural, and engineering plans and/or specifications for any existing improvements
4	Property was previously used as a methamphetamine laboratory and not remediated to state standards
5	Government special improvements approved, but not yet installed, that may become a lien against the Property
6	Pending: (1) litigation or (2) other dispute resolution proceeding regarding the Property
7	Property is subject to Deed Restrictions, other recorded document restrictions, or Affordable Housing Restrictions
8	Property is located in a historic district
9
10
	GENERAL - Other Information:
11	Location of Mailbox and No.
12

	ADVISORY TO BUYER:
1.	Even though Seller has answered the above questions to Seller’s current actual knowledge, Buyer should thoroughly inspect the Property and obtain expert assistance to accurately and fully evaluate the Property to confirm the status of the following matters are satisfactory to Buyer:
	the physical condition of the Property; the presence of mold or other biological hazards; the presence of rodents, insects, and vermin including termites; the legal use of the Property, including zoning and legal access to the Property; the availability and source of water, sewer, and utilities; the environmental and geological condition of the Property; the presence of noxious weeds; and any other matters that may affect Buyer’s use and ownership of the Property that are important to Buyer as Buyer decides whether to purchase the Property.
2.	Seller states that the information is correct to “Seller’s current actual knowledge” as of the date of this form. The term “current actual knowledge” is intended to limit Seller’s disclosure only to facts actually known by the Seller and does not include “constructive knowledge” or “common knowledge” or what Seller “should have known” about the Property. The Seller has no duty to investigate or inspect the Property or inclusions when this SPD is filled in and signed.
3.	Valuable information may be obtained from various local/state/federal agencies, and other experts may assist Buyer by performing more specific evaluations and inspections of the Property.
4.	Boundaries, location and ownership of fences, driveways, hedges, and similar features of the Property may become the subjects of a dispute between a property owner and a neighbor. A survey may be used to determine the likelihood of such problems.
5.	Whether any item is included or excluded is determined by the Contract between Buyer and Seller and not this SPD.
6.	Seller does not warrant that the Property or inclusions are fit for Buyer’s intended purposes or use of the Property. Disclosure of the condition of an item is not to be construed as a warranty of its continued operability or as a representation or warranty that such item is fit for Buyer’s intended purposes.
7.	Buyer receipts for a copy of this SPD.

Offer Price	$450,000
Earnest Money/Deposit	$250,000
Lender Name	Company Name
% Financing	70%
Type of Loan	Loan Name