Real Estate Owner Document

REAL ESTATE OWNER DOCUMENT

Parties and Contact Information

Entity type (check all that apply): Individual Corporation LLC Trust Other

Property Identification

Certification of Ownership and Authority

The undersigned Owner certifies that Owner is the lawful owner of the Property identified above and holds the power and authority to convey, lease, encumber, or otherwise bind the Property subject to the terms set forth herein. Owner further certifies that ownership is vested in:

Owner represents and warrants that, except as expressly disclosed below in the Encumbrances and Disclosures sections, there are no outstanding unrecorded sales contracts, judgments, bankruptcy proceedings, or known adverse claims affecting title to the Property.

Encumbrances, Liens and Assessments

Any other recorded liens, easements, covenants, restrictions, or recorded judgments affecting the Property are described here:

Are there any known unrecorded liens, assessments, or pending special assessments? Yes No

Taxes, Utilities and Association

Is the Property subject to a homeowners association (HOA) or other community regime? Yes No

Sale Terms (if applicable)

Proposed Purchase Price: $    Earnest Money Amount: $

Proposed Closing Date:    Possession Date:

Financing contingency required? Yes No    If yes, financing contingency deadline:

Inspection period (number of days):

Property Condition and Disclosures

The Owner discloses the following known conditions affecting the Property. Check the applicable boxes and provide explanation when "Yes" is checked.

Lead-based paint (for properties built before 1978): Yes No

Mold or water intrusion history: Yes No

Structural damage, prior major repairs, or prior material damage (fire, flood, earthquake): Yes No

Hazardous materials (asbestos, underground storage tanks, petroleum contamination, etc.): Yes No

Default, Remedies and Governing Law

If any representation or warranty in this Owner Document is false or if Owner fails to perform any obligation described herein, Owner shall be responsible for actual damages, reasonable attorneys' fees, and any costs incurred by the non-breaching party in enforcing rights under this document. Remedies are cumulative and are in addition to any remedies provided by law.

Governing Law: This document shall be governed by and construed in accordance with the laws of the state where the Property is located, without regard to conflict of laws principles.

Entire Agreement: This Owner Document constitutes the entire agreement between the parties with respect to the matters set forth herein and supersedes all prior written or oral agreements, representations and understandings between the parties regarding the Property, except as otherwise expressly provided in a duly executed purchase and sale agreement or lease.

Owner Certification

The undersigned Owner certifies under penalty of perjury that the foregoing statements and the information provided in this document are true, complete, and accurate to the best of Owner's knowledge as of the date signed below. Owner agrees to promptly notify the other party in writing of any change in circumstances that would render these statements inaccurate prior to closing or transfer of the Property.

Recipient / Intended Acquirer (if known)

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