Sellers Disclosure Statement

Seller’s Disclosure Statement for Vacant Land

Properly Address (or Tax Description):

Purpose of Statement: This statement is a disclosure of the condition of the property and information concerning the property as known by the Seller. Unless otherwise advised, the Seller does not possess any expertise in matters pertaining to the law, taxation, engineering, land surveying or any other specific matter related to the condition of the property, and the Buyer is advised to seek the advice of professionals regarding these matters. This statement is not a warranty of any kind by the Seller or by any real estate agent representing the Seller or Buyer in this transaction, and is not a substitute for any inspections of the property that the Buyer may wish to obtain.

Seller’s Disclosure: The Seller discloses the following information with the knowledge that, although the disclosures herein are not a warranty, the Seller specifically makes the following disclosures based on the Seller’s knowledge at the time the Seller signs this form. The Seller authorizes the Seller’s agent(s) to provide a copy of this form to any prospective Buyer in connection with any actual or anticipated sale of property. The following are representations made solely by the Seller and are not the representations of the Seller’s agent(s) or Buyer’s agent(s), if any. This information is a disclosure only and is not intended to be a part of any contract between the Buyer and the Seller.

Instructions to the Seller:

1. Complete this form yourself.

2. Answer all questions.

3. Report known conditions about or affecting the property by selecting either YES or NO.

4. Attach additional pages with your signature if additional space is required to adequately report known conditions.

5. If you do not have knowledge of a particular condition, check UNKNOWN.

Part 1: General Property Information

1. Property dimensions: Are you aware of the property’s approximate dimensions and/or size in square feet or acres?

Yes No

If yes please state:

2. Survey: Do you have an engineering survey of the property in your possession?

Yes No

If yes, can you provide the Buyer with a copy?

Yes No

3. Zoning: Are you aware of the property’s zoning classification as designated by the municipality?

Yes No

If yes, please state:

4. Services/Utilities: Are any of the following services and/or utilities available to the property line?

A. Municipal water Yes No Unknown

B. Municipal sewer Yes No Unknown

C. Electric Yes No Unknown

D. Natural gas Yes No Unknown

E. Cable television Yes No Unknown

If either municipal water or sewer is available, are laterals extended into the property?

Yes No Unknown

5. Assessments, etc. Are there any outstanding, deferred or pending assessments or other similar charges against the property?

Yes No Unknown

If yes, please describe and state approximate amounts if known:

6. Soil conditions:

A. Have soil borings ever been conducted on the property?

Yes No Unknown

If yes, can you provide the Buyer with a copy of the report?

Yes No Unknown

B. Has a percolation test ever been conducted on the property?

Yes No Unknown

If yes, can you provide the Buyer with a copy of the report?

Yes No Unknown

C. Have you ever been denied a septic or building permit because of adverse soil conditions?

Yes No Unknown

If yes, please explain:

7. Drainage/flooding: Does the property periodically or regularly experience drainage and/or flooding problems?

Yes No Unknown

If yes, please describe:

8. Mineral rights: Do you own the property’s mineral rights?

Yes No Unknown

9. Topography: Has there been filling or grading of the property other than by natural forces?

Yes No Unknown

If yes, please describe:

Part 2: Property Restrictions

Are you aware of any of the following restrictions or conditions that may limit or restrict the Buyer’s use, enjoyment and/or development of the property?

1. Oral or written leases for crops, hunting, logging, oil, gas, mineral rights, etc.?

Yes No Unknown

2. Public or private use restrictions or limitations including, but not limited to, deed or subdivision restrictions, conservation, forestry or agricultural agreements, or any tax deferral programs?

Yes No Unknown

3. Any sale, transfer or reservation of development, water or drainage rights?

Yes No Unknown

4. Any sale, transfer or reservation of oil, gas or mineral rights?

Yes No Unknown

5. Encroachments, easements, zoning violations, nonconforming uses, or condemnations?

Yes No Unknown

6. Any portions or features of the property co-owned or shared in common with other persons?

Yes No Unknown

7. Any association that has authority over the property and that may charge fees or enact restrictions?

Yes No Unknown

8. Any pending litigation that could affect the property or the Seller’s ability to convey marketable title to the property?

Yes No Unknown

9. Previous divisions or splits of the property since pursuant to the .

If the answer to any of the previous questions is yes, please explain. Attach additional signed pages, if necessary:

Part 3: Environmental Conditions

1. Are you aware of any of the following environmental conditions that may limit or restrict the Buyer’s use, enjoyment and/or development of the property?

A. Any past or present use of the property that may have created soil or water contamination? Yes No Unknown

B. Any past or present drilling for oil or gas, or mining for minerals? Yes No Unknown

C. Any operating, capped, uncapped or abandoned wells? Yes No Unknown

D. Any past or present above-ground or underground storage tanks used for fuel or other chemicals? Yes No Unknown

E. Any past or present use of any portion of the property as a farm or household dump or as a landfill? Yes No Unknown

F. Any known soil or water contamination? Yes No Unknown

If the answer to any of the previous questions is yes, please explain. Attach additional signed pages, if necessary:

2. Have there been any environmental assessments or studies done on the property?

Yes No Unknown

If yes, Phase I Phase II Phase III Other

If yes, can you provide the buyer with a copy or copies of any reports?

Yes No Unknown

3. Has there ever been any determination that any portion of the property constitutes a wetlands, antiquities or dunes, or similar determination?

Yes No Unknown

Part 4: Off-Site Conditions

Are you aware of any of the following off-site conditions within the vicinity of the property that may limit or restrict the Buyer’s use, enjoyment and/or development of the property?

1. Farm or farm operation Yes No Unknown

2. Dump or landfill Yes No Unknown

3. Airport Yes No Unknown

4. Shooting range Yes No Unknown

5. Racetrack Yes No Unknown

If the answer to any of the previous questions is yes, please explain. Attach additional signed pages, if necessary:

Part 5: Notices to the Buyer

1. The Seller has owned the property since .

2. The Seller has indicated above the condition of the property based on information known to the Seller. If any changes occur in the property’s condition as disclosed or if the Seller becomes aware that any disclosures herein are inaccurate, from the date of this form to the date of closing, the Seller will immediately disclose the changes to the Buyer. In no event shall the parties hold the Seller’s agent(s) or Buyer’s agent(s) liable for any representations not directly made by the Seller’s agent(s) or Buyer’s agent(s).

3. The Seller acknowledges that the information in this statement is true and correct to the best of the Seller’s knowledge as of the date of the Seller’s signature below.

4. The Buyer should obtain professional advice and inspections of the property to more fully determine its condition.

5. The Buyer is advised that certain information compiled pursuant to is available to the public. If the Buyer seeks such information, the Buyer should contact the appropriate local law enforcement agency or sheriff’s department directly.

6. The Buyer is advised that ’s Right to Farm Act protects farming operations from litigation if those operations meet generally accepted agricultural practices regarding noise, dust, odors and other assorted conditions.

7. The Buyer is advised that the state equalized value, taxable value, tax exemption information and other real property tax information pertaining to the property is available from the appropriate local assessor’s office. The Buyer should not assume that the Buyer’s future property tax bills will be the same as the Seller’s present property tax bills. Pursuant to ’s General Property Tax Act, real property tax obligations can change significantly when the Seller re-conveys legal or equitable title to the Buyer.

Buyer has read and acknowledges receipt of this two-page disclosure statement.

Witness our signatures this day of , 20.

Sign Now