TENNESSEE RESIDENTIAL PROPERTY CONDITION DISCLOSURE
The Tennessee Residential Property Disclosure Act states that anyone transferring title to residential real property must provide
information about the condition of the property. This completed form constitutes that disclosure by the seller. This is not a warranty,
or a substitute for any professional inspections or warranties that the purchasers may wish to obtain. Buyers and sellers should be
aware that any sales agreement executed between the parties will supersede this form as to any obligations on the part of the
seller to repair items identified below and/or the obligation of the buyer to accept such items "as is."
Instructions to Seller
Complete this form yourself and answer each question to the best of your knowledge. If an answer is an estimate, clearly label it as
such. The seller hereby authorizes any agent representing any party in this transaction to provide a copy of this statement to any
person or entity in connection with any actual or anticipated sale of the subject property.
Property Address _____________________________________________________________________________________________
City ________________________________________________________________________________________________________
Seller's Name(s) ______________________________________________________________________________________________
Property Age ________________________________________________________________________________________________
Date Seller Acquired the Property ________________________________________________________________________________
Do You Occupy the Property? ___________________________________________________________________________________
If Not Owner-Occupied, How Long Has It Been Since the Seller Occupied the Property? ____________________________________
A. The Subject Property Includes the Items Checked Below:
Item Checked
1. Range
2. Oven
3. Microwave
4. Dishwasher
5. Garbage Disposal
6. Trash Compactor
7. Water Softener
8. 220 Volt Wiring
9. Washer/Dryer Hookups
10. Central Heating
11. Heat Pump
12. Wall/Window Air
Conditioning Item Checked
13. Central Air Conditioning
14. Window Screens
15. Rain Gutters
16. Fireplace(s) (Number)
17. Gas Starter for Fireplace
18. Smoke Detector/
Fire Alarm
19. Burglar Alarm
20. Patio/Decking/Gazebo
21. Irrigation System
22. Sump Pump
23. Garage Door Opener(s)
(Number of openers ___) Item Checked
24. Intercom
25. TV Antenna/
Satellite Dish
26. Pool
27. Spa/Whirlpool Tub
28. Hot Tub
29. Sauna
30. Current Termite Contract
31. Access to Public Streets
32. Other:
33. Other:
34. Garage (Circle if Applicable) Attached Not Attached Carport
35. Water Heater (Circle if Applicable) Gas Solar Electric
36. Water Supply (Circle if Applicable) City Well Private Utility Other
If other, please explain:
37. Waste Disposal (Circle if Applicable) City Sewer Septic Tank Other
If other, please explain:
38. Gas Disposal (Circle if Applicable) Utility Bottled Other
If other, please explain:
39. Roof Type: Age(approx.):
40. Other Items:
41. To the best of your knowledge, are any of the above NOT in operating condition? Yes No
If YES, then describe (attach additional sheets if necessary):
B. Are You (Seller) Aware of Any Defects/Malfunctions in Any of the Following?
1. Interior Walls Yes No Unknown
If yes, please explain:
2. Ceilings Yes No Unknown
If yes, please explain:
3. Floors Yes No Unknown
If yes, please explain:
4. Windows Yes No Unknown
If yes, please explain:
5. Doors Yes No Unknown
If yes, please explain:
6. Insulation Yes No Unknown
If yes, please explain:
7. Plumbing Yes No Unknown
If yes, please explain:
8. Sewer/Septic Yes No Unknown
If yes, please explain:
9. Electrical System Yes No Unknown
If yes, please explain:
10. Exterior Walls Yes No Unknown
If yes, please explain:
11. Roof Yes No Unknown
If yes, please explain:
12. Basement Yes No Unknown
If yes, please explain:
13. Foundation Yes No Unknown
If yes, please explain:
14. Slab Yes No Unknown
If yes, please explain:
15. Driveway Yes No Unknown
If yes, please explain:
16. Sidewalks Yes No Unknown
If yes, please explain:
17. Central heating Yes No Unknown
If yes, please explain:
18. Heat Pump Yes No Unknown
If yes, please explain:
19. Central air conditioning Yes No Unknown
If yes, please explain:
C. Are You (Seller) Aware of Any of the Following?
1. Substances, materials or products which may be an environmental hazard such as, but
not limited to: asbestos, radon gas, lead-based paint, fuel or chemical storage tanks
and/or contaminated soil or water on the subject property? Yes No Unknown
2. Features shared in common with adjoining landowners, such as walls, but not limited
to, fences, and/or driveways, with joint rights and obligations for use and maintenance? Yes No Unknown
3. Any authorized changes in roads, drainage or utilities affecting the property, or
contiguous to the property? Yes No Unknown
4. Any changes since the most recent survey of the property was done? Yes No Unknown
5. Any encroachments, easements, or similar items that may affect your ownership
interest in the property? Yes No Unknown
6. Room additions, structural modifications or other alterations or repairs made without
necessary permits? Yes No Unknown
7. Room additions, structural modifications or other alterations or repairs not in
compliance with building codes? Yes No Unknown
8. Landfill (compacted or otherwise) on the property or any portion thereof? Yes No Unknown
9. Any settling from any cause, or slippage, sliding or other soil problems? Yes No Unknown
10. Flooding, drainage or grading problems? Yes No Unknown
11. Any requirement that flood insurance be maintained on the property? Yes No Unknown
12. Property or structural damage from fire, earthquake, floods or landslides? Yes No Unknown
13. Any zoning violations, nonconforming uses and/or violations of "setback"
requirements? Yes No Unknown
14. Neighborhood noise problems or other nuisances? Yes No Unknown
15. Subdivision and/or deed restrictions or obligations? Yes No Unknown
16. A Homeowners Association (HOA) which has any authority over the subject
property? Yes No Unknown
Name of HOA:
HOA Address:
Monthly Dues:
Special Assessments:
17. Any "common area" (facilities such as, but not limited to, pools, tennis courts,
walkways, or other areas co-owned in undivided interest with others)? Yes No Unknown
18. Any notices of abatement or citations against the property? Yes No Unknown
19. Any lawsuits or proposed lawsuits by or against the seller which affects or will affect
the property? Yes No Unknown
20. Is any system, equipment or part of the property being leased? Yes No Unknown
If yes, please explain, and include a written statement regarding payment information:
21. Any exterior wall covering of the structures covered with exterior insulation and
finish systems (EIFS), also known as "synthetic stucco"? Yes No Unknown
If yes, has there been a recent inspection to determine whether the structure has
excessive moisture accumulation and/or moisture related damage? (The Tennessee Real
Estate Commission urges any buyer or seller who encounters this product to have a
qualified professional inspect the structure in question for the preceding concern and
provide a written report of the professional's finding.) Yes No Unknown
If yes, please explain. If necessary, please attach an additional sheet:
D. Certification: I/we certify that the information herein, concerning the real property located at _____________________________
is true and correct to the best of my/our knowledge as of the date signed. Should any of these conditions change prior to conveyance
of title to this property, these changes will be disclosed in addendum to this document.
________________________________________________ _______________________________________
Transferor (Seller) Date
________________________________________________ _______________________________________
Transferor (Seller) Date
Parties may wish to obtain professional advice and/or inspections of the property and to negotiate appropriate provisions in the
purchase agreement regarding advice, inspections or defects.
Transferee/Buyer's Acknowledgement:
I/we understand that this disclosure statement is not intended as a substitute for any inspection, and that I/we have a responsibility to
pay diligent attention to and inquire about those material defects which are evident by careful observation.
I/we acknowledge receipt of a copy of this disclosure.
________________________________________________ ________________________________________
Transferee (Buyer) Date
________________________________________________ ________________________________________
Transferee (Buyer) Date