California Transfer Disclosure Statement
CALIFORNIA CIVIL CODE § 1102, ET SEQ.
This discLOsUrE sTATEmEnT cOncErns ThE rEAL prOpErTy siTUATEd in ThE ciTy OF ,
cOUnTy OF
, sTATE OF cALiFOrniA, dEscribEd As
This sTATEmEnT is A discLOsUrE OF ThE cOndiTiOn OF ThE AbOvE-dEscribEd prOpErTy in cOmpLiAncE wiTh
sEcTiOn 1102 OF ThE civiL cOdE As OF
, . iT is nOT A wArrAnTy OF Any
kind by ThE sELLEr(s) Or Any AgEnT(s) rEprEsEnTing Any principAL(s) in This TrAnsAcTiOn, And iT is nOT A
sUbsTiTUTE FOr Any inspEcTiOns Or wArrAnTiEs ThE principAL(s) mAy wish TO ObTAin.
I
COORDINATION WITH OTHER DISCLOSURE FORMS
is Real Estate Transfer Disclosure Statement is made pursuant to Section 1102 of the Civil Code. Other statutes
require disclosures, depending upon the details of the particular real estate transaction (for example: special study zone
and purchase-money liens on residential property).
Substituted Disclosures: e following disclosures and other disclosures required by law, including the Natural Hazard
Disclosure Report/Statement that may include airport annoyances, earthquake, fire, flood, or special assessment
information, have or will be made in connection with this real estate transfer, and are intended to satisfy the disclosure
obligations on this form, where the subject matter is the same:
Inspection reports completed pursuant to the contract of sale or receipt for deposit.
Additional inspection reports or disclosures:
.
(List all substituted disclosure forms to be used in connection with this transaction.)
II
SELLER’S INFORMATION
e Seller discloses the following information with the knowledge that even though this is not a warranty, prospective
Buyers may rely on this information in deciding whether and on what terms to purchase the subject property. Seller
hereby authorizes any agent(s) representing any principal(s) 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 property.
ThE FOLLOwing ArE rEprEsEnTATiOns mAdE by ThE sELLEr(s) And ArE nOT ThE rEprEsEnTATiOns OF ThE
AgEnT(s), iF Any. This inFOrmATiOn is A discLOsUrE And iT is nOT inTEndEd TO bE pArT OF Any cOnTrAcT
bETwEEn ThE bUyEr And sELLEr.
Seller is is not occupying the property.
A. e subject property has the items checked below (read across):
Range Oven Microwave
Dishwasher Trash Compactor Garbage Disposal
Washer/Dryer Hookups Rain Gutters Smoke Detector(s)
Fire Alarm T.V. Antenna Satellite Dish
Intercom Central Heating Central Air Conditioning
Evaporator Cooler(s) Wall/Window Air Conditioning Sprinklers
Public Sewer System Septic Tank Sump Pump
Water Softener Patio/Decking Built-in Barbecue
Sauna Gazebo Burglar Alarms
Hot Tub Locking Safety Cover* Pool Child Resistant Barrier* Spa Locking Safety Cover*
Security Gate(s) Automatic Garage Door Opener(s)* # of Remote Controls
Garage: Attached Not Attached Carport
Pool/Spa Heater: Gas Solar Electric
Water Heater: Gas Water Heater Anchored, Braced, or Strapped* Electric
Water Supply: City Well Private Utility Other
Gas Supply: Utility Bottled
Window Screens Window Security Bars Quick Release Mechanism on Bedroom Windows*
Exhaust Fan(s) in 220 Volt Wiring in
Fireplace(s) in Gas Starter
Roof(s): Type: Age: (approx.)
Other:
Are there, to the best of your (Seller’s) knowledge, any of the above that are not in operating condition? Yes No
If yes, then describe. (Attach additional sheets if necessary.)
B. Are you (Seller) aware of any significant defects/malfunctions in any of the following?
Yes No If yes, check appropriate box(es) below.
Interior Walls Ceilings Floors Exterior Walls Insulation
Roof(s) Windows Doors Foundation Slab(s)
Driveways Sidewalks Walls/Fences Electrical Systems Plumbing/Sewers/Septics
Other Structural Components (describe):
If any of the above are checked, explain. (Attach additional sheets if necessary.)
*is garage door opener or child resistant pool barrier may not be in compliance with the safety standards relating to automatic
reversing devices as set forth in Chapter 12.5 (commencing with Section 19890) of Part 3 of Division 13, or with the pool safety
standards of Article 2.5 (commencing with Section 115920) of Chapter 5 of Part 10 of Division 104, of the Health and Safety Code. e
water heater may not be anchored, braced, or strapped in accordance with Section 19211 of the Health and Safety Code. Window
security bars may not have quick release mechanisms in compliance with the 1995 Edition of the California Building Standards Code.
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 Sellers 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.)
ThE UndErsignEd, bAsEd On ThE AbOvE inqUiry OF ThE sELLEr(s) As TO ThE cOndiTiOn OF ThE prOpErTy And
bAsEd On rEAsOnAbLy cOmpETEnT And diLigEnT visUAL inspEcTiOn OF ThE AccEssibLE ArEAs OF ThE prOpErTy
in cOnjUncTiOn wiTh ThAT inqUiry, sTATEs ThE FOLLOwing:
Agent notes no items for disclosure.
Agent notes the following items:
Agent (Print Name of Broker Representing Seller):
By (Associate Licensee or Brokers Signature)
Date
IV
AGENT’S INSPECTION DISCLOSURE SELLING AGENT
(To be completed only if the agent who has obtained the offer is other than the agent above.)
ThE UndErsignEd, bAsEd On A rEAsOnAbLy cOmpETEnT And diLigEnT visUAL inspEcTiOn OF ThE AccEssibLE
ArEAs OF ThE prOpErTy, sTATEs ThE FOLLOwing:
Agent notes no items for disclosure.
Agent notes the following items:
Agent (Print Name of Broker Obtaining Offer)
By (Associate Licensee or Brokers Signature)
Date
V
bUyEr(s) And sELLEr(s) mAy wish TO ObTAin prOFEssiOnAL AdvicE And/Or inspEcTiOns OF ThE prOpErTy And
TO prOvidE FOr ApprOpriATE prOvisiOns in A cOnTrAcT bETwEEn bUyEr(s) And sELLEr(s) wiTh rEspEcT TO Any
AdvicE/inspEcTiOn/dEFEcTs.
i/w
E AcknOwLEdgE rEcEipT OF A cOpy OF This sTATEmEnT.
Seller Date
Seller Date
Buyer Date
Buyer Date
Agent (Print Name of Broker Representing Seller)
By (Associate Licensee or Brokers Signature)
Date
Agent (Print Name of Broker Obtaining the Offer)
By (Associate Licensee or Brokers Signature)
Date
sEcTiOn 1102.3 OF ThE civiL cOdE prOvidEs A bUyEr wiTh ThE righT TO rEscind A pUrchAsE cOnTrAcT FOr AT
LEAsT ThrEE dAys AFTEr ThE dELivEry OF This discLOsUrE iF dELivEry OccUrs AFTEr ThE signing OF An OFFEr TO
pUrchAsE. iF yOU wish TO rEscind ThE cOnTrAcT, yOU mUsT AcT wiThin ThE prEscribEd pEriOd.
A rE
AL EsTATE brOkEr is qUALiFiEd TO AdvisE On rEAL EsTATE. iF yOU dEsirE LEgAL AdvicE, cOnsULT yOUr
ATTOrnEy.
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