Concerning the Property at
(TAR-1406) 02-01-18 Initialed by: Buyer: _______,________ and Seller: ________, ________ Page 3 of 5
Historic Property Designation
Termite or WDI damage needing repair
Previous Use of Premises for Manufacture
of Methamphetamine
Single Blockable Main Drain in Pool/Hot
Tub/Spa*
If the answer to any of the items in Section 3 is yes, explain (attach additional sheets if necessary):
*A single blockable main drain may cause a suction entrapment hazard for an individual.
Section 4. Are you (Seller) aware of any item, equipment, or system in or on the Property that is in need
of repair, which has not been previously disclosed in this notice? yes no If yes, explain (attach
additional sheets if necessary):
Section 5. Are you (Seller) aware of any of the following (Mark Yes (Y) if you are aware. Mark No (N) if
you are not aware.)
Y N
Room additions, structural modifications, or other alterations or repairs made without necessary
permits, with unresolved permits, or not in compliance with building codes in effect at the time.
Homeowners’ associations or maintenance fees or assessments. If yes, complete the following:
Name of association:
Manager’s name: Phone:
Fees or assessments are: $ per and are: mandatory voluntary
Any unpaid fees or assessment for the Property? yes ($ ___) no
If the Property is in more than one association, provide information about the other associations
below or attach information to this notice.
Any common area (facilities such as pools, tennis courts, walkways, or other) co-owned in undivided
interest with others. If yes, complete the following:
Any optional user fees for common facilities charged? yes no If yes, describe:
Any notices of violations of deed restrictions or governmental ordinances affecting the condition or
use of the Property.
Any lawsuits or other legal proceedings directly or indirectly affecting the Property. (Includes, but is
not limited to: divorce, foreclosure, heirship, bankruptcy, and taxes.)
Any death on the Property except for those deaths caused by: natural causes, suicide, or accident
unrelated to the condition of the Property.
Any condition on the Property which materially affects the health or safety of an individual.
Any repairs or treatments, other than routine maintenance, made to the Property to remediate
environmental hazards such as asbestos, radon, lead-based paint, urea-formaldehyde, or mold.
If yes, attach any certificates or other documentation identifying the extent of the
remediation (for example, certificate of mold remediation or other remediation).
Any rainwater harvesting system located on the Property that is larger than 500 gallons and that uses
a public water supply as an auxiliary water source.
The Property is located in a propane gas system service area owned by a propane distribution system
retailer.
Any portion of the Property that is located in a groundwater conservation district or a subsidence
district.
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