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Vermont Seller's Property Information Report - seller information form real estate


Vermont Seller's Property Information Report-seller information form real estate

SELLER'S PROPERTY INFORMATION REPORT
TO BE COMPLETED BY SELLER
Seller's Name(s): Date: ,
Property Address:
Street City/Town
Type of Property: Single Family Residence, Multi-Family Residence (duplex, triplex, etc.), Condominium/Townhouse,
Land Only, Commercial
Use of Property: Primary Residence, Vacation Property, Rental Property, Other:
INTRODUCTION: This Report provides information from the Seller based on Seller's personal knowledge concerning the above
Property. Unless otherwise disclosed, Seller does not have any expertise in construction, architecture, engineering, surveying or any
other skills that would provide Seller with special knowledge concerning the condition of the Property. Other than having owned the
Property, Seller has no greater knowledge about the Property than that which could be obtained by a careful inspection performed by or
on behalf of a potential buyer. The real estate agents involved with the sale of this Property do not conduct or perform any inspection of
the Property. Unless otherwise disclosed, Seller has not inspected or examined those portions of the Property that are generally
inaccessible. THIS REPORT DOES NOT CONSTITUTE A WARRANTY OF ANY KIND BY THE SELLER OR BY ANY
REAL ESTATE AGENT CONCERNING THE CONDITION OF THE PROPERTY. THIS REPORT IS NOT A SUBSTITUTE
FOR A PROPERTY INSPECTION. BUYER HAS THE OPPORTUNITY TO REQUEST THAT SELLER AGREE TO A
PROPERTY INSPECTION AS PART OF ANY CONTRACT FOR THE SALE OF THE PROPERTY.
INSTRUCTIONS TO SELLER: (1) Complete this form yourself. (2) Answer ALL questions. (3) Disclose conditions that you know
about that affect the Property. (4) Attach additional pages to this Report if additional information is required. IF YOU DO NOT
KNOW THE FACTS, WRITE "DON'T KNOW." DO NOT GUESS THE ANSWER TO ANY QUESTION.
THE STATEMENTS IN THIS REPORT ARE MADE BY THE SELLER.
THEY ARE NOT STATEMENTS OR REPRESENTATIONS MADE BY ANY REAL ESTATE AGENT(S).
1. LAND (SOILS, DRAINAGE, BOUNDARIES AND EASEMENTS)
(a) Has any fill or off-site material been placed on the Property? YES NO DON'T KNOW
(b) Do you know of any sliding, settling, subsidence, earth movement, upheaval or earth
stability problems that have affected the Property? YES NO DON'T KNOW
(c) Is the Property located in a federal flood hazard zone or wetlands, public waters or conservation
zones designated by federal, state or local statute, regulation or ordinance? YES NO DON'T KNOW
(d) Do you know of any past or present drainage, high water table, or flood problems affecting
the Property? YES NO DON'T KNOW
(e) Is the Property served by a road maintained by the municipality? YES NO DON'T KNOW
(f) If the answer to (e) above is "No," how is the road serving the property maintained?
Road Maintenance Agreement Homeowners/Road Association Private (by owner)
Annual Cost(s):
Other (explain)
(g) Are there public or private landfills or dumps (compacted or otherwise) on the Property?
or on any abutting property? YES NO DON'T KNOW
(h) Are there currently any underground fuel storage tanks
on the Property? YES NO DON'T KNOW
If "yes", Fuel Type:
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(i) Have there been any underground fuel storage tanks on the Property in the past? YES NO DON'T KNOW
If yes, have they been removed? YES NO DON'T KNOW
When? By whom?
(j) Do you know the location of the boundary lines of the Property? YES NO DON'T KNOW
(k) Are the boundary lines of the Property marked in any way? YES NO DON'T KNOW
If yes, how are they marked?
(l) Has the Property been surveyed? YES NO DON'T KNOW
If yes, when? By whom?
(m) Is a copy of the survey available? YES NO DON'T KNOW
(n) Are there any easements or rights of way affecting the Property? YES NO DON'T KNOW
(o) Are there any boundary line disputes, claims of adverse possession, encroachments,
shared driveways, party walls or zoning set back violations affecting the Property? YES NO DON'T KNOW
Further explanation of any of the above:
2. MECHANICAL, ELECTRICAL, APPLIANCES & OTHER SYSTEMS
HEATING/AIR CONDITIONING/HOT WATER SYSTEMS
(a) Heating System: Base Board Hot Air Radiant Other (explain) Age of Furnace/Boiler Don't Know
Fuel Type: Oil Natural Gas Propane Electric Wood Wood Pellet Coal Solar Geothermal
Other (explain) (Check all that apply). Annual Fuel Usage:
Gallons (or other measure). Provider . Property used: Full Time Seasonally
Fuel consumption may vary by user, number of occupants and weather conditions
(b) Air Conditioning: Yes No If "yes", describe (central, heat pump, window, etc.)
.
(c) Hot Water System: Hot Water Tank Domestic/Off Boiler On Demand Age of Hot Water System Don't Know
Fuel Type: Oil Electric Natural Gas Propane Coal Solar Wood Pellet
Other (Check all that apply).
Hot Water Tank is: Owned Rented. If rented, from whom . Monthly rental fee: $
(d) Alternative Energy System(s): Solar Wind Hydroelectric Geothermal Unknown (Check all that apply). Energy
returned to grid: Yes No
(e) Electrical System: Electrical service panel has: Fuses Circuit Breakers Other (explain)
Main Breaker Amperes Amps Don't Know
(f) Are you aware of any problems or conditions that affect any of the above systems? Yes No If "yes", explain in detail:
Annual electricity usage: $ Electric utility provider: Property used Full Time Seasonally
Electricity consumption may vary by user, number of occupants, number of appliances and weather conditions
TELEPHONE / INTERNET / TELEVISION
(g) Is landline telephone service present at the Property? Yes No If "yes", current provider:
(h) Is cellular telephone service available at the Property? Yes No If "yes", list available provider(s):
(i) Is internet service present at the Property? Yes No If "yes", current provider:
If "yes", service is: Dial Up Broadband Cable Satellite DSL
(j) Is television service present at the Property? Yes No If "yes", current provider:
If "yes", source is: Antenna Cable Satellite DSL
(k) OTHER EQUIPMENT AND APPLIANCES INCLUDED IN SALE
Check the items that will be included in the sale of the Property:
Electric Garage Door Opener - Number of Transmitters Security Alarm System Owned Leased Humidifier
Dehumidifier Lawn Sprinklers Automatic Timer Smoke Detectors - How Many? Swimming Pool
Pool Heater Spa/Hot Tub Pool/Spa Equipment (list):
Refrigerator Stove Microwave Oven Washer Dryer Dishwasher Trash Compactor Intercom
Ceiling Fans Sump Pump Well Pump Central Vacuum Freezer Woodstove Satellite Dish
Indoor/Outdoor Grill Garbage Disposal Hood/Fan Whirlpool Bath Attic Window A/C
Wood/Gas/Pellet/Other Stove (describe)
OTHER:
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Are any of the items that will be included in the sale of the Property in need of repair or replacement? Yes No, if "yes,"
explain in detail:
List equipment and appliances, including any AC units that will be excluded from the sale of the Property:
3. STRUCTURAL COMPONENTS
Check any of the following items that have significant defects or malfunctions or that need significant repair:
Foundation Slab Chimney Fireplace Interior Walls Ceilings Floors
Windows Doors Storms/Screens Exterior Walls Driveway Sidewalks Pool Roof
Outside Retaining Walls Other Structures/Components:
If any of the above items are checked, describe the defect, malfunction or item(s) that need significant repair:
Has there been significant damage to the Property or any of the structures from fire, wind, floods, earth movements or landslides?
Yes No Don't Know If "yes", explain in detail, including any repairs:
BASEMENT/CELLAR/CRAWL SPACE:
Has there ever been any water leakage, accumulation of water, dampness or visible mold within the basement, cellar or any crawl space?
Yes No, if "yes," explain in detail:
Have there been any repairs or other attempts to control any water or dampness within the basement, cellar or crawl space?
Yes No Don't Know, if "yes", explain in detail:
Are any of the above recurring problems? Yes No, if "yes", what are the problems and how often have they recurred?
Has paint containing lead been used on the Property? YES NO DON'T KNOW
ROOF: Shingle Slate Metal Tile Other (describe) DON'T KNOW
Approximate age of roof?
Has the roof ever leaked since you have owned the Property? YES NO DON'T KNOW
If "yes", explain:
Has the roof been replaced or repaired since you have owned the Property? YES NO DON'T KNOW
If "yes," when?
Are there any current problems with the roof? YES NO DON'T KNOW
If "yes," explain:
4. WATER SUPPLY
Special Notice: Water supplies, especially those that are not public or municipal supplies, are affected by many conditions about which
Seller may have no knowledge or have any ability to control. These water supply systems can change, deteriorate or fail, often with no
warning signs. Seller makes no warranty or representation whatsoever that the water supply, including quality or quantity, will
operate or continue to function for any period of time. Inspection of these systems by a qualified inspector is strongly
recommended.
As required by law, any seller with a potable water supply that is not served by a public water system shall provide the Purchaser
with an informational brochure developed by the Vermont Department of Health regarding Testing Water from Private Water
Supplies within 72 hours of the execution of a contract for the purchase of the Property.
TYPE OF WATER SYSTEM:
The Property is connected to and serviced by (check all applicable boxes):
Public or Municipal Community Private Shared
On-site Off-site Drilled Well Dug Well Spring Lake/Pond Lake Well None Don't know
Water System Features: Cistern/Reservoir/Holding Tank Water Softener/Conditioner Reverse Osmosis Infrared Light
Ultraviolet Other: None Don't know
Water Pipes are: Copper Galvanized Metal Lead PVC (Plastic) Combination Don't know
If Drilled Well: Drilled by: Tag #: Depth:
Gallons Per Minute (at time of report): Date of driller's report:
Seller's initials Page 3 of 6 Buyer's initials
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What does seller represent on the form? Refer to line and question number in explanation. Seller represents that Seller has provided the answers and, if any, explanations and comments on this form and any attached addenda and that such information is true and correct to the best of Seller’s knowledge as of the date signed by Seller.