Fill and Sign the Natural Hazard Disclosure 497332450 Form

Natural Hazard Disclosure Statement This statement applies to the following property: property located at ____________________ ____________________________________ (street address, city, state, zip code) . The transferor and his or her agent(s) disclose the following information with the knowledge that even though this is not a warranty, prospective transferees may rely on this information in deciding whether and on what terms to purchase the subject property. Transferor hereby authorizes any agent(s) representing any principal(s) in this action to provide a copy of this statement to any person or entity in connection with any actual or anticipated sale of the property. The following are representations made by the transferor and his or her agent(s) based on their knowledge and maps drawn by the state and federal governments. This information is a disclosure and is not intended to be part of any contract between the transferee and the transferor. THIS REAL PROPERTY LIES WITHIN THE FOLLOWING HAZARDOUS AREA(S): A SPECIAL FLOOD HAZARD AREA (Any type Zone “A” or “V”) designated by the Federal Emergency Management Agency. Yes_____ No_____ Do not know and information not available from local jurisdiction_____ AN AREA OF POTENTIAL FLOODING shown on a dam failure inundation map pursuant to ______________________ (citation of state statute) Yes_____ No_____ Do not know and information not available from local jurisdiction_____ A VERY HIGH FIRE HAZARD SEVERITY ZONE pursuant to ______________________ (citation of state statutes) . The owner of this property is subject to the maintenance requirements of ______________________ (citation of state statute) . Yes_____ No_____ Do not know and information not available from local jurisdiction_____ A WILDLAND AREA THAT MAY CONTAIN SUBSTANTIAL FOREST FIRE RISKS AND HAZARDS pursuant to ______________________ (citation of state statute) . The owner of this property is subject to the maintenance requirements of ______________________ (citation of state statute) . Additionally, it is not the state's responsibility to provide fire protection services to any building or structure located within the wild lands unless the Department of Forestry and Fire Protection has entered into a cooperative agreement with a local agency for those purposes pursuant to ______________________ (citation of state statute) . Yes_____ No_____ Do not know and information not available from local jurisdiction_____ AN EARTHQUAKE FAULT ZONE pursuant to ______________________ (citation of state statute) . Yes_____ No_____ Do not know and information not available from local jurisdiction_____ A SEISMIC HAZARD ZONE pursuant to ______________________ (citation of state statute) . Yes_____ No_____ Landslide Zone _____ Yes_____ No_____ Liquefaction Zone _____ Map not released by state _____ THESE HAZARDS MAY LIMIT YOUR ABILITY TO DEVELOP THE REAL PROPERTY, TO OBTAIN INSURANCE, OR TO RECEIVE ASSISTANCE AFTER A DISASTER. THE MAPS ON WHICH THESE DISCLOSURES ARE BASED ESTIMATE WHERE NATURAL HAZARDS EXIST. THEY ARE NOT DEFINITIVE INDICATORS OR WHETHER OR NOT A PROPERTY WILL BE AFFECTED BY A NATURAL DISASTER. TRANSFEREE(S) AND TRANSFEROR(S) MAY WISH TO OBTAIN PROFESSIONAL ADVICE REGARDING THOSE HAZARDS AND OTHER HAZARDS THAT MAY AFFECT THE PROPERTY. Transferor represents that the information herein is true and correct to the best of the transferor's knowledge as of the date signed by the transferor. ______________________ Date: __________________ (Name of Transferor) ______________________ (Signature of Transferor) Agent represents that the information herein is true and correct to the best of the agent's knowledge as of the date signed by the agent. ___________________ Date: __________________ (Name of Agent) ______________________ (Signature of Agent) Transferee represents that he or she has read and understands this document. _______________________ Date: __________________ (Name of Transferee) ______________________ (Signature of Transferee)