Real Estate Purchase Agreement

Louisiana Residential Property Disclosure Document

Property Description (Address, City, State, Zip)

In accordance with Act 308 of the 2003 Louisiana Legislature (LSA-R.S. 9:3195-3199), effective July 1, 2004, a seller of residential real property must furnish purchasers with a Property Disclosure Document.

The following transfers are exempt from the requirement to provide a Property Disclosure Document.

Exemption: In accordance with Act 308 of the 2003 Louisiana Legislature, the seller of said property is exempt from the requirement to provide a Property Disclosure Document.

Section 1: Land

(1) Are there any servitudes/encroachments regarding the property, other than typical/customary utility servitudes, that would affect the use of the property? Y N NK

(2) Are there any rights vested in others? Check all that apply and explain at the end of this section.

Timber rights Y N NK    Common driveway Y N NK

Right of ingress or egress Y N NK    Mineral rights Y N NK

Right of way Y N NK    Surface rights Y N NK

Right of access Y N NK    Air rights Y N NK

Servitude of passage Y N NK    Usufruct Y N NK

Servitude of drainage Y N NK    Other Y N NK

(3) Has any part of the property been determined a wetland by the United States Army Corps of Engineers under §404 of the Clean Water Act? Y N NK (a) Is such a determination pending? Y N NK

(b) What date was determination made?

(4) Has any flooding, water intrusion, accumulation, or drainage problem been experienced with respect to the land? Y N NK

(5) What is/are the flood zone classification(s) of the property? (a) What is the source and date of this information? Survey Date

Flood Elevation Certificate Date    Flood Insurance Policy Date    Other Date

(b) Does seller have a flood elevation certificate in seller’s possession that will be shared with buyer? Y N NK

(6) If the property is mortgaged, did the lender require you to buy flood insurance? Y N NK

Question Number / Explanation of “Yes” answers Additional sheet is attached

Section 2: Termites, Wood-Destroying Insects and Organisms

(7) Has the property ever had termites or other wood-destroying insects or organisms? Y N NK

(8) Was there any damage to the property? Y N NK

(9) Was the damage repaired? Y N NK

(10) Is the property currently under a termite contract? Y N NK

(a) Name of company (b) Date contract expires

(c) List any structures not covered by contract

Question Number / Explanation of “Yes” answers Additional sheet is attached

Section 3: Structure

(11) Are there any defects regarding the following? Check all that apply and explain at the end of this section.

Roof Y N NK    Ceilings Y N NK

Interior walls Y N NK    Exterior walls Y N NK

Floor Y N NK    Foundation Y N NK

Attic spaces Y N NK    Basement Y N NK

Porches Y N NK    Overhangs Y N NK

Steps/Stairways Y N NK    Railings Y N NK

Pool Y N NK    Spa Y N NK

Decks Y N NK    Patios Y N NK

Windows Y N NK    Other Y N NK

(12) Has any structure on the property ever taken water by flooding (rising water or otherwise)? Y N NK

(13) What is the approximate age of all structures on the property? Main structure Other structures

(14) What is the approximate age of the roof of each structure? Main structure Other structures

(15) Does the property contain exterior insulation and finish system (EIFS) or other synthetic stucco? Y N NK

(16) What is the approximate square footage of the living area of each structure on the property? Include the source of this information.

Square footage of is square feet. Source

Square footage of is square feet. Source

Question Number / Explanation of “Yes” answers Additional sheet is attached

Section 4: Plumbing, Water, Gas, and Sewerage

(17) Are there any defects with the plumbing system? Y N NK

(18) Are there any defects with the water piping? Y N NK

(a) Are there any defects with the water quality, quantity, or pressure? Y N NK

(b) The water is supplied by: Municipality Private utility On-site system Shared well system None

(c) If there is a well, when was the last time the water was tested? Date Results

(19) Is there gas service available to the property/structure? Y N NK

(a) If yes, what type? Butane Natural Propane

(b) If yes, are there any defects with it? Y N NK

(20) Are there defects with any water heater? Y N NK

(a) Age of Unit 1 Gas Electric   (b) Age of Unit 2 Gas Electric

(21) The sewerage service is supplied by: Municipality Other NK

Question Number / Explanation of “Yes” answers Additional sheet is attached

Section 5: Electrical, Heating and Cooling, Appliances

(22) Are there any defects with the electrical system? Y N NK

(23) Are there any defects with the heating or cooling systems? Y N NK

(24) What type of cooling system is installed? Central Window unit Other

(a) Source: Electric Gas Heat pump Other

(25) What type of heating system is installed? Central Window unit Other

(a) Source: Electric Gas Heat pump Other

(26) If a fireplace exists, is it working? Y N NK

(a) What type is it? Gas Wood Vented Ventless Electric Other

(27) Are there any defects in any permanently installed or built-in appliances? Y N NK

Question Number / Explanation of “Yes” answers Additional sheet is attached

Section 6: Miscellaneous

(28) Has there been property damage related to the land or the improvements thereon, including, but not limited to, fire, windstorm, flood, hail, lightning, or other property damage? Y N NK

(a) If yes, were all related property damages, defects, and/or conditions repaired? Y N NK

(29) What is the zoning of the property?

(a) Has it ever been zoned for commercial or industrial use or is it located in a historical district? Y N NK

(30) Does the property and its present usage conflict with current zoning, building, and/or safety restrictions? Y N NK

(31) Are there any current or pending assessments, dues, liens, taxes owing on the property? Y N NK

(a) Is membership in an HOA, COA, or POA required as the result of owning this property? Y N NK

(b) Are any HOA, COA, or POA dues required? Y N NK

(c) If yes, what is the amount? $ per

(d) Are there any pending special assessments? Y N NK

(e) If yes, what is the amount? $ per

(32) Were any additions or alterations made to the property? Y N NK

(a) If yes, were the necessary permits and inspections obtained for all additions or alterations? Y N NK

(33) Is there a homestead exemption in effect? Y N NK

(34) Is there high speed Internet access available to the property? Y N NK

(35) Is there any pending litigation regarding the property? Y N NK

(36) Does the property or any of its structures contain any of the following? Check all that apply and provide the nature and frequency at the end of this section.

Asbestos Y N NK    Formaldehyde Y N NK

Radon gas Y N NK    Chemical storage tanks Y N NK

Contaminated soil Y N NK    Contaminated water Y N NK

Hazardous waste Y N NK    Toxic Mold Y N NK

Mold/Mildew Y N NK    Pets Y N NK

Electromagnetic fields Y N NK    Crystal meth exposure Y N NK

Other adverse materials or conditions Y N NK

Question Number / Explanation of “Yes” answers Additional sheet is attached

Acknowledgements

I/We attest that the above statements and explanations have been provided by me/us and are true and correct to the best of my/our knowledge.