C. Are you (Seller) aware of any of the following:
1. Substances, materials, or products that may be an environmental hazard such
as, but not limited to, asbestos, formaldehyde, radon gas, lead-based paint, mold, fuel or
chemical storage tanks, and contaminated soil or water on the subject property. Yes No
2. Features of the property shared in common with adjoining landowners, such as walls, fences,
and driveways, whose use or responsibility for maintenance may have an effect on the
subject property. Yes No
3. Any encroachments, easements, or similar matters that may affect your interest in the
subject property. Yes No
4. Room additions, structural modifications, or other alterations or repairs made without
necessary permits. Yes No
5. Room additions, structural modifications, or other alterations or repairs not in compliance
with building codes. Yes No
6. Fill (compacted or otherwise) on the property or any portion thereof. Yes No
7. Any settling from any cause, or slippage, sliding, or other soil problems. Yes No
8. Flooding, drainage, or grading problems. Yes No
9. Major damage to the property or any other structures from fire, earthquake, floods, or landslides. Yes No
10. Any zoning violations, nonconforming uses, or violations of “setback” requirements. Yes No
11. Neighborhood noise problems or other nuisances. Yes No
12. CC&Rs or other deed restrictions or obligations. Yes No
13. Homeowners’ association that has any authority over the subject property. Yes No
14. Any “common area” (facilities such as pools, tennis courts, walkways, or other areas co-owned
in undivided interest with others). Yes No
15. Any notices of abatement or citations against the property. Yes No
16. Any lawsuits by or against the Seller threatening to or affecting this real property, including
any lawsuits alleging a defect or deficiency in this real property or “common areas“
(facilities such as pools, tennis courts, walkways, or other areas co-owned in undivided
interest with others). Yes No
If the answer to any of these is yes, explain (attach additional sheets if necessary):
Seller certifies that the information herein is true and correct to the best of the Seller’s knowledge as of the date signed
by the Seller.
Seller Date
Seller Date
III
AGENT’S INSPECTION DISCLOSURE LISTING AGENT
(To be completed only if the Seller is represented by an agent in this transaction.)
