Copyright, U.S. Legal Forms, Inc. - 2015 statutory changes incorporated herein. - If the disclosure statement is being completed for new
construction which has never been occupied, the disclosure statement is not required to contain and the seller is not required to complete
the questions listed in item 4. Structural or item 5. Systems and Fixtures. (Per RCW 64.06.020 (2).)
STATE OF WASHINGTON SELLER’S DISCLOSURE STATEMENT
FOR IMPROVED RESIDENTIAL REAL ESTATE
Revised Code of Washington 64.06.020
INSTRUCTIONS TO THE SELLER
Please complete the following form. Do not leave any spaces blank. If the
question clearly does not apply to the property write "NA". If the answer is
"yes" to any * items, please explain on attached sheets. Please refer to the line
number(s) of the question(s) when you provide your explanation(s). For your
protection you must date and sign each page of this disclosure statement and each
attachment. Delivery of the disclosure statement must occur not later than five
business days, unless otherwise agreed, after mutual acceptance of a written
contract to purchase between a buyer and a seller.
NOTICE TO THE BUYER
THE FOLLOWING DISCLOSURES ARE MADE BY SELLER ABOUT THE CONDITION OF THE PROPERTY
LOCATED AT _______________________________________________________________ ("THE
PROPERTY"), OR AS LEGALLY DESCRIBED ON ATTACHED EXHIBIT A.
SELLER MAKES THE FOLLOWING DISCLOSURES OF EXISTING MATERIAL FACTS OR MATERIAL
DEFECTS TO BUYER BASED ON SELLER'S ACTUAL KNOWLEDGE OF THE PROPERTY AT THE TIME
SELLER COMPLETES THIS DISCLOSURE STATEMENT. UNLESS YOU AND SELLER OTHERWISE AGREE
IN WRITING, YOU HAVE THREE BUSINESS DAYS FROM THE DAY SELLER OR SELLER'S AGENT
DELIVERS THIS DISCLOSURE STATEMENT TO YOU TO RESCIND THE AGREEMENT BY DELIVERING
A SEPARATELY SIGNED WRITTEN STATEMENT OF RESCISSION TO SELLER OR SELLER'S AGENT.
IF THE SELLER DOES NOT GIVE YOU A COMPLETED DISCLOSURE STATEMENT, THEN YOU MAY
WAIVE THE RIGHT TO RESCIND PRIOR TO OR AFTER THE TIME YOU ENTER INTO A SALE
AGREEMENT.
THE FOLLOWING ARE DISCLOSURES MADE BY SELLER AND ARE NOT THE REPRESENTATIONS OF
ANY REAL ESTATE LICENSEE OR OTHER PARTY. THIS INFORMATION IS FOR DISCLOSURE ONLY
AND IS NOT INTENDED TO BE A PART OF ANY WRITTEN AGREEMENT BETWEEN BUYER AND
SELLER.
FOR A MORE COMPREHENSIVE EXAMINATION OF THE SPECIFIC CONDITION OF THIS PROPERTY
YOU ARE ADVISED TO OBTAIN AND PAY FOR THE SERVICES OF QUALIFIED EXPERTS TO
INSPECT THE PROPERTY, WHICH MAY INCLUDE, WITHOUT LIMITATION, ARCHITECTS,
ENGINEERS, LAND SURVEYORS, PLUMBERS, ELECTRICIANS, ROOFERS, BUILDING INSPECTORS,
ON-SITE WASTEWATER TREATMENT INSPECTORS, OR STRUCTURAL PEST INSPECTORS. THE
PROSPECTIVE BUYER AND SELLER MAY WISH TO OBTAIN PROFESSIONAL ADVICE OR
INSPECTIONS OF THE PROPERTY OR TO PROVIDE APPROPRIATE PROVISIONS IN A CONTRACT
BETWEEN THEM WITH RESPECT TO ANY ADVICE, INSPECTION, DEFECTS OR WARRANTIES.
Seller ______ is/ ______ is not occupying the property.
I. SELLER'S DISCLOSURES: *If you answer "Yes" to a question with an asterisk
(*), please explain your answer and attach documents, if available and not
otherwise publicly recorded. If necessary, use an attached sheet.
~ Seller’s Disclosure Statement, Page 1 ~
Copyright, U.S. Legal Forms, Inc. - 2015 statutory changes incorporated herein. - If the disclosure statement is being completed for new
construction which has never been occupied, the disclosure statement is not required to contain and the seller is not required to complete
the questions listed in item 4. Structural or item 5. Systems and Fixtures. (Per RCW 64.06.020 (2).)
1. TITLE
[ ] Yes [ ] No [ ] Don't know A. Do you have legal authority to
sell the property? If no, please
explain.
[ ] Yes [ ] No [ ] Don't know *B. Is title to the property
subject to any of the following?
(1) First right of refusal
(2) Option
(3) Lease or rental agreement
(4) Life estate?
[ ] Yes [ ] No [ ] Don't know *C. Are there any encroachments,
boundary agreements, or boundary
disputes?
[ ] Yes [ ] No [ ] Don't know *D. Is there a private road or
easement agreement for access to
the property?
[ ] Yes [ ] No [ ] Don't know *E. Are there any Rights-of-way,
easements, or access limitations
that may affect the Buyer's use of the
property?
[ ] Yes [ ] No [ ] Don't know *F. Are there any written agreements
for joint maintenance of an easement
right-of-way?
[ ] Yes [ ] No [ ] Don't know *G. Is there any
study, survey project, or notice that
would adversely affect the property?
[ ] Yes [ ] No [ ] Don't know *H. Are there any
pending or existing assessments
against the property?
[ ] Yes [ ] No [ ] Don't know *I. Are there any
zoning violations, nonconforming uses,
or any unusual restrictions on the
property that would affect future
construction or remodeling?
[ ] Yes [ ] No [ ] Don't know *J. Is there a
boundary survey for the property?
[ ] Yes [ ] No [ ] Don't know *K. Are there any
covenants, conditions, or restrictions
which affect the property?
~ Seller’s Disclosure Statement, Page 2 ~
Copyright, U.S. Legal Forms, Inc. - 2015 statutory changes incorporated herein. - If the disclosure statement is being completed for new
construction which has never been occupied, the disclosure statement is not required to contain and the seller is not required to complete
the questions listed in item 4. Structural or item 5. Systems and Fixtures. (Per RCW 64.06.020 (2).)
2. WATER
A. Household Water
(1) The source of water for the
property is:
[ ] Private or
publicly owned water system
[ ] Private well serving only the
subject property ___________
*[ ] Other water system
[ ] Yes [ ] No [ ] Don't know *If shared, are there any written
agreements?
[ ] Yes [ ] No [ ] Don't know *(2) Is there an easement (recorded
or unrecorded) for access to
and/or maintenance of the water
source?
[ ] Yes [ ] No [ ] Don't know *(3) Are there any known problems
or repairs needed?
[ ] Yes [ ] No [ ] Don't know (4) During your ownership, has the
source provided an adequate
year-round supply of potable
water? If no, please explain.
[ ] Yes [ ] No [ ] Don't know *(5) Are there any water treatment
systems for the property? If yes,
are they [ ] Leased [ ] Owned
[ ] Yes [ ] No [ ] Don't know *(6) Are there any water rights
for the property associated with
its domestic water supply, such as
a water right permit, certificate,
or claim?
[ ] Yes [ ] No [ ] Don't know (a) If yes, has the water right
permit, certificate, or claim been
assigned, transferred, or
changed?
*(b) If yes, has all or any portion
of the water right not been used
for five or more successive years?
(If yes, please explain.)
[ ] Yes [ ] No [ ] Don't know *(7) Are there any defects in the
operation of the water system (e.g.
pipes, tank, pump, etc.?)
__________________________________
~ Seller’s Disclosure Statement, Page 3 ~
Copyright, U.S. Legal Forms, Inc. - 2015 statutory changes incorporated herein. - If the disclosure statement is being completed for new
construction which has never been occupied, the disclosure statement is not required to contain and the seller is not required to complete
the questions listed in item 4. Structural or item 5. Systems and Fixtures. (Per RCW 64.06.020 (2).)
B. Irrigation Water
[ ] Yes [ ] No [ ] Don't know (1) Are there any irrigation
water rights for the property,
such as a water right ,
permit, certificate, or claim?
[ ] Yes [ ] No [ ] Don't know *(a) If yes, has all or any portion
of the water right not been used for
five or more successive years?
[ ] Yes [ ] No [ ] Don't know *(b) If so, is the certificate
available? (If yes, please attach
a copy.)
[ ] Yes [ ] No [ ] Don't know (c) If so, has the water right
permit, certificate, or claim been
assigned, transferred, or changed?
If so, explain:
[ ] Yes [ ] No [ ] Don't know (2) Does the property receive
irrigation water from a ditch
company, irrigation district, or
other entity? If so, please
identify the entity that supplies
water to the property:
_________________________________
C. Outdoor Sprinkler System
[ ] Yes [ ] No [ ] Don't know (1) Is there an outdoor sprinkler
system for the property?
[ ] Yes [ ] No [ ] Don't know *(2) If yes, are there any defects
in the system? ___________
[ ] Yes [ ] No [ ] Don't know *(3) If yes, is the sprinkler
system connected to irrigation
water?
3. SEWER/ON-SITE SEWAGE SYSTEM
A. The property is served by:
[ ] Public sewer system,
[ ] On-site sewage system (including
pipes, tanks, drainfields, and all
other component parts)
[ ] Other disposal system, please
describe:
_____________________________________
[ ] Yes [ ] No [ ] Don't know B. If public sewer system service
is available to the property, is
~ Seller’s Disclosure Statement, Page 4 ~
Copyright, U.S. Legal Forms, Inc. - 2015 statutory changes incorporated herein. - If the disclosure statement is being completed for new
construction which has never been occupied, the disclosure statement is not required to contain and the seller is not required to complete
the questions listed in item 4. Structural or item 5. Systems and Fixtures. (Per RCW 64.06.020 (2).)
the house connected to the sewer
main? If no, please explain:
_________________________________
[ ] Yes [ ] No [ ] Don't know *C. Is the property subject to any
sewage system fees or charges in
addition to those covered in your
regularly billed sewer or on-site
sewage system maintenance service?
D. If the property is connected to
an on-site sewage system:
[ ] Yes [ ] No [ ] Don't know *(1) Was a permit issued for its
construction, and was it approved
by the local health department or
district following its
construction?
(2) When was it last pumped:
________________________________
[ ] Yes [ ] No [ ] Don't know *(3) Are there any defects in the
operation of the on-site sewage
system?
[ ] Don't know (4) When was it last inspected?
________________________________
By whom: _______________________
[ ] Don't know (5) For how many bedrooms was the
on-site sewage system approved?
______________________ bedrooms
[ ] Yes [ ] No [ ] Don't know E. Are all plumbing fixtures,
including laundry drain, connected
to the sewer/on-site sewage
system? If no, please explain:
______________________________
[ ] Yes [ ] No [ ] Don't know *F. Have there been any changes or
repairs to the on-site sewage
system?
[ ] Yes [ ] No [ ] Don't know G. Is the on-site sewage system,
including the drainfield, located
entirely within the boundaries of
the property? If no, please
explain __________________________
~ Seller’s Disclosure Statement, Page 5 ~
Copyright, U.S. Legal Forms, Inc. - 2015 statutory changes incorporated herein. - If the disclosure statement is being completed for new
construction which has never been occupied, the disclosure statement is not required to contain and the seller is not required to complete
the questions listed in item 4. Structural or item 5. Systems and Fixtures. (Per RCW 64.06.020 (2).)
[ ] Yes [ ] No [ ] Don't know H. Does the on-site sewage system
require monitoring and maintenance
services more frequently than once
a year? If yes, please explain
__________________________________
NOTICE: IF THIS RESIDENTIAL REAL PROPERTY DISCLOSURE STATEMENT IS BEING COMPLETED
FOR NEW CONSTRUCTION WHICH HAS NEVER BEEN OCCUPIED, THE SELLER IS NOT REQUIRED TO
COMPLETE THE QUESTIONS LISTED IN ITEM 4. STRUCTURAL OR ITEM 5. SYSTEMS AND
FIXTURES
4. STRUCTURAL
[ ] Yes [ ] No [ ] Don't know *A. Has the roof leaked?
[ ] Yes [ ] No [ ] Don't know *B. Has the basement flooded or
leaked?
[ ] Yes [ ] No [ ] Don't know *C. Have there been any
conversions, additions, or
remodeling?
[ ] Yes [ ] No [ ] Don't know *(1) If yes, were all building
permits obtained?
[ ] Yes [ ] No [ ] Don't know *(2) If yes, were all final
inspections obtained?
[ ] Yes [ ] No [ ] Don't know D. Do you know the age of the
house? If yes, year of original
construction: __________________
[ ] Yes [ ] No [ ] Don't know *E. Has there been any settling,
slippage, or sliding of the
property or its improvements?
[ ] Yes [ ] No [ ] Don't know *F. Are there any defects with the
following: (If yes, please check
applicable items and explain.)
□ Foundations □ Decks □ Exterior Walls
□ Chimneys □ Interior Walls □ Fire Alarm
□ Doors □ Windows □ Patio
□ Ceilings □ Slab Floors □ Driveways
□ Pools □ Hot Tub □ Sauna
□ Sidewalks □ Outbuildings □ Fireplaces
□ Garage Floors □ Walkways □ Siding
□ Other □ Wood Stoves □ Stairway Chair Lifts
□ Elevators □ Incline Elevators □ Wheelchair Lifts
[ ] Yes [ ] No [ ] Don't know *G. Was a structural pest or "whole
house" inspection done? If yes,
when and by whom was the
inspection completed? ____________
~ Seller’s Disclosure Statement, Page 6 ~
Copyright, U.S. Legal Forms, Inc. - 2015 statutory changes incorporated herein. - If the disclosure statement is being completed for new
construction which has never been occupied, the disclosure statement is not required to contain and the seller is not required to complete
the questions listed in item 4. Structural or item 5. Systems and Fixtures. (Per RCW 64.06.020 (2).)
[ ] Yes [ ] No [ ] Don't know H. During your ownership, has the
property had any wood destroying
organism or pest infestation?
[ ] Yes [ ] No [ ] Don't know I. Is the attic insulated?
[ ] Yes [ ] No [ ] Don't know J. Is the basement insulated?
5. SYSTEMS AND FIXTURES
*A. If any of the following systems
or fixtures are included with the
transfer, are there any defects?
If yes, please explain.
[ ] Yes [ ] No [ ] Don't know Electrical system, including
wiring, switches, outlets, and service
[ ] Yes [ ] No [ ] Don't know Plumbing system, including pipes,
faucets, fixtures, and toilets
[ ] Yes [ ] No [ ] Don't know Hot water tank
[ ] Yes [ ] No [ ] Don't know Garbage disposal
[ ] Yes [ ] No [ ] Don't know Appliances
[ ] Yes [ ] No [ ] Don't know Sump pump
[ ] Yes [ ] No [ ] Don't know Heating and cooling systems
[ ] Yes [ ] No [ ] Don't know Security system
[ ] Owned [ ] Leased
Other _______________________
*B. If any of the following fixtures or
property is included with the transfer,
are they leased? (If yes, please attach
copy of lease.)
*C. Are any of the following kinds of wood
burning appliances present at the property?
[ ] Yes [ ] No [ ] Don't know (1) Wood stove?
[ ] Yes [ ] No [ ] Don't know (2) Fireplace insert?
[ ] Yes [ ] No [ ] Don't know (3) Pellet stove?
[ ] Yes [ ] No [ ] Don't know (4) Fireplace?
[ ] Yes [ ] No [ ] Don't know If yes, are all of the (1) wood stoves
or (2) fireplace inserts certified by the
the U.S. Environmental Protection Agency
as clean burning appliances to improve
air quality and public health?
~ Seller’s Disclosure Statement, Page 7 ~
Copyright, U.S. Legal Forms, Inc. - 2015 statutory changes incorporated herein. - If the disclosure statement is being completed for new
construction which has never been occupied, the disclosure statement is not required to contain and the seller is not required to complete
the questions listed in item 4. Structural or item 5. Systems and Fixtures. (Per RCW 64.06.020 (2).)
[ ] Yes [ ] No [ ] Don't know D. Is the property located within a city,
county, or district or within a department
of natural resources fire protection zone
that provides fire protection services?
[ ] Yes [ ] No [ ] Don't know E. Is the property equipped with carbon
monoxide alarms?
(Note: Pursuant to RCW 19.27.530, seller
must equip the residence with carbon mon-
oxide alarms as required by the state
building code.)
[ ] Yes [ ] No [ ] Don't know F. Is the property equipped with smoke
alarms?
6. HOMEOWNERS' ASSOCIATION/
COMMON INTERESTS
[ ] Yes [ ] No [ ] Don't know A. Is there a Home Owners'
Association? Name of Association and
contact information for an officer,
director, employee, or other authorized
agent, if any, who may provide the
association's financial statements,
minutes, bylaws, fining policy, and other
information that is not publicly
available:
_________________________________
_________________________________
_________________________________
[ ] Yes [ ] No [ ] Don't know B. Are there regular periodic
assessments:
$____ per [ ] Month [ ] Year [ ]
Other __________________________
[ ] Yes [ ] No [ ] Don't know *C. Are there any pending special
assessments?
[ ] Yes [ ] No [ ] Don't know *D. Are there any shared "common
areas" or any joint maintenance
agreements (facilities such as
walls, fences, landscaping, pools,
tennis courts, walkways, or other
areas co-owned in undivided
interest with others)?
~ Seller’s Disclosure Statement, Page 8 ~
Copyright, U.S. Legal Forms, Inc. - 2015 statutory changes incorporated herein. - If the disclosure statement is being completed for new
construction which has never been occupied, the disclosure statement is not required to contain and the seller is not required to complete
the questions listed in item 4. Structural or item 5. Systems and Fixtures. (Per RCW 64.06.020 (2).)
7. ENVIRONMENTAL
[ ] Yes [ ] No [ ] Don't know *A. Have there been any flooding,
standing water, or drainage problems on
the property that affect the property or
access to the property?
[ ] Yes [ ] No [ ] Don't know *B. Does any part of the property contain
fill dirt, waste, or other fill material?
[ ] Yes [ ] No [ ] Don't know *C. Is there any material damage to
the property from fire, wind, floods
beach movements, earthquake, expansive
soils, or landslides?
[ ] Yes [ ] No [ ] Don't know D. Are there any shorelines, wetlands,
floodplains, or critical areas on the
property?
[ ] Yes [ ] No [ ] Don't know *E. Are there any substances,
materials, or products on the
property that may be environmental
concerns, such as asbestos,
formaldehyde, radon gas,
lead-based paint, fuel or chemical
storage tanks, or contaminated
soil or water ?
[ ] Yes [ ] No [ ] Don't know *F. Has the property been used for
commercial or industrial purposes?
[ ] Yes [ ] No [ ] Don't know *G. Is there any soil or
groundwater contamination?
[ ] Yes [ ] No [ ] Don't know *H. Are there transmission poles or other
electrical utility equipment installed,
maintained, or buried on the property that
do not provide utility service to the
structures on the property?
[ ] Yes [ ] No [ ] Don't know *I. Has the property been used as
a legal or illegal dumping site?
[ ] Yes [ ] No [ ] Don't know *J. Has the property been used as an
illegal drug manufacturing site?
[ ] Yes [ ] No [ ] Don't know *K. Are there any radio towers in the area
that may cause interference with cellular
telephone reception?
~ Seller’s Disclosure Statement, Page 9 ~
Copyright, U.S. Legal Forms, Inc. - 2015 statutory changes incorporated herein. - If the disclosure statement is being completed for new
construction which has never been occupied, the disclosure statement is not required to contain and the seller is not required to complete
the questions listed in item 4. Structural or item 5. Systems and Fixtures. (Per RCW 64.06.020 (2).)
8. MANUFACTURED AND MOBILE HOMES
If the property includes a
manufactured or mobile home,
[ ] Yes [ ] No [ ] Don't know *A. Did you make any alterations to
the home? If yes, please describe
the alterations: __________________
[ ] Yes [ ] No [ ] Don't know *B. Did any previous owner make any
alterations to the home? If yes,
please describe the alterations:
__________________________________
[ ] Yes [ ] No [ ] Don't know *C. If alterations were made, were
permits or variances for these
alterations obtained?
9. FULL DISCLOSURE BY SELLERS
A. Other conditions or defects:
[ ] Yes [ ] No [ ] Don't know *Are there any other existing
material defects affecting the
property that a prospective buyer
should know about?
B. Verification:
The foregoing answers and attached
explanations (if any) are complete
and correct to the best of my/our
knowledge and I/we have received a
copy hereof. I/we authorize all of
my/our real estate licensees, if
any, to deliver a copy of this
disclosure statement to other real
estate licensees and all prospective
buyers of the property.
DATE ____________ SELLER _______________________ SELLER _______________________
~ Seller’s Disclosure Statement, Page 10 ~
Copyright, U.S. Legal Forms, Inc. - 2015 statutory changes incorporated herein. - If the disclosure statement is being completed for new
construction which has never been occupied, the disclosure statement is not required to contain and the seller is not required to complete
the questions listed in item 4. Structural or item 5. Systems and Fixtures. (Per RCW 64.06.020 (2).)
NOTICE TO THE BUYER
INFORMATION REGARDING REGISTERED SEX OFFENDERS MAY BE OBTAINED FROM LOCAL LAW
ENFORCEMENT AGENCIES. THIS NOTICE IS INTENDED ONLY TO INFORM YOU OF WHERE TO
OBTAIN THIS INFORMATION AND IS NOT AN INDICATION OF THE PRESENCE OF REGISTERED
SEX OFFENDERS.
II. BUYER'S ACKNOWLEDGMENT
A. Buyer hereby acknowledges that: Buyer has a duty to pay diligent on to any
material defects that are known to Buyer or can be known to Buyer by utilizing
diligent attention and observation.
B. The disclosures set forth in this statement and in any amendments to this
statement are made only by the Seller and not by any real estate licensee or
other party.
C. Buyer acknowledges that, pursuant to RCW 64.06.050(2), real estate licensees
are not liable for inaccurate information provided by Seller, except to the
extent that real estate licensees know of such inaccurate information.
D. This information is for disclosure only and is not intended to be a part of
the written agreement between the Buyer and Seller.
E. Buyer (which term includes all persons signing the "Buyer's acceptance"
portion of this disclosure statement below) has received a copy of this
Disclosure Statement (including attachments, if any) bearing Seller's signature.
DISCLOSURES CONTAINED IN THIS DISCLOSURE STATEMENT ARE PROVIDED BY SELLER BASED
ON SELLER'S ACTUAL KNOWLEDGE OF THE PROPERTY AT THE TIME SELLER COMPLETES THIS
DISCLOSURE STATEMENT. UNLESS BUYER AND SELLER OTHERWISE AGREE IN WRITING, BUYER
SHALL HAVE THREE BUSINESS DAYS FROM THE DAY SELLER OR SELLER'S AGENT DELIVERS
THIS DISCLOSURE STATEMENT TO RESCIND THE AGREEMENT BY DELIVERING A SEPARATELY
SIGNED WRITTEN STATEMENT OF RESCISSION TO SELLER OR SELLER'S AGENT. YOU MAY WAIVE
THE RIGHT TO RESCIND PRIOR TO OR AFTER THE TIME YOU ENTER INTO A SALE AGREEMENT.
BUYER HEREBY ACKNOWLEDGES RECEIPT OF A COPY OF THIS DISCLOSURE STATEMENT AND
ACKNOWLEDGES THAT THE DISCLOSURES MADE HEREIN ARE THOSE OF THE SELLER ONLY, AND
NOT OF ANY REAL ESTATE LICENSEE OR OTHER PARTY.
DATE ____________ BUYER _______________________ BUYER _________________________
~ Seller’s Disclosure Statement, Page 11 ~
