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SELLER’S PROPERTY DISCLOSURE
COPYRIGHTED AND SUGGESTED FOR USE BY THE MEMBERS OF THE
NORTHEAST FLORIDA ASSOCIATION OF REALTORS®, INC.
NOTICE TO SELLER
In Florida a seller of residential property is obligated to disclose to a buyer all facts known to a seller that materially and
adversely affect the value of the Property being sold which are not readily observable by a buyer. This Disclosure is designed to
assist a seller in complying with the disclosure requirements under Florida law and to assist a buyer in evaluating the Property
described below (“the Property”). All parties, including the listing real estate Broker(s) and cooperating Broker(s), may wish to refer to
this information when they evaluate, market or present the Property to prospective buyers.
NOTICE TO BUYER
This Disclosure is not a warranty by SELLER or a representation of any kind by any REALTOR to this transaction and is not considered
a substitute for inspections or warranties a buyer may wish to obtain. This Disclosure is based only upon SELLER’s knowledge of the
Property’s condition as of the date signed by SELLER.
SELLER ____________________________________________________________________________________________________
Street Address ____________________________________________________________________________________________
City ________________________________________________________________________ State ___________ Zip _________
Year Built: ___________ Date SELLER purchased Property: ________________________
Is each individual named above a U.S. Citizen or resident alien?
Yes No
Do you currently occupy the Property?
Yes No
If not, when did you vacate the Property? ________________________________________
Is the Property tenant occupied?
Yes No
If yes, is there a written lease?
Yes No
Date lease began _____________________ Deposit amount $____________ Date lease ends _______________________
Monthly payment due under lease $________________________________ Date payable _________________________
1. PROPERTY INFORMATION:
The Property has the items checked below, which are installed and, to SELLER’s actual
knowledge, are in working condition unless otherwise indicated:
Dishwasher Brand: _____________________
Disposal Brand: _____________________
Dryer Brand: ____________________
Microwave Oven Brand: ____________________
Oven Brand: _____________________
Range Brand: _____________________
Refrigerator Brand: ____________________
Trash Compactor Brand: _____________________
Washer Brand: ____________________
Ceiling Fans - Number of fans: ____________________
Light Fixtures
Bathroom Mirrors
Drapery Hardware
All Window Treatments
Garage Door Opener(s) and Number of Control(s): _______
Fireplace Gas Logs Wood burning Electric
Smoke Detectors
Security Cameras/System Owned Leased
Surveillance System Owned Leased
Window/Wall A/C(s) - Number of units: _____________
Built-In Generator
Wine Cooler Built-In Free Standing
In-ground Pool
Above Ground Pool
Pool Heater
Pool Fence/Barrier
Pool Sweep
Spa or Hot Tub with Heater
Sauna
Solar Panels
Security Gate and other Access Devices Individual Mailbox
Storage Shed Cluster Mailbox and Key-Box Number________
Audio Visual System Wiring Smart Home Devices (specify):
Mounted/Installed Speakers ____________________________________________
Satellite Dish Owned Leased ____________________________________________
Water Softener/Treatment System Owned Leased ____________________________________________
Storm Shutters and Panels ____________________________________________
Built-In Grill Gas Supply: Utility Bottled/Tank
Irrigation System Full Partial
Water Heater: Electric Gas Solar Brand: _____________________
Clear Form
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2.
CLAIMS AND ASSESSMENTS:
a. Are you aware of any existing, pending or proposed legal or administrative action affecting
the Property? Yes No
b. Are you aware of any existing or proposed municipal or county special assessments or Property
Assessed Clean Energy Financing (“PACE”) affecting the Property?
Yes No
c. Have any local, state or federal authorities notified you that repairs, alterations or corrections
to the Property are required?
Yes No
d. Are you aware of any existing, pending or proposed legal action or administrative action affecting
homeowners’/condominium association common areas (such as clubhouse, pools, tennis courts,
walkways or other areas)?
Yes No
If yes to any of these items, please explain: _________________________________________________________________
________________________________________________________________________________________________________
3. DEED/HOMEOWNERS’/CONDOMINIUM ASSOCIATION RESTRICTIONS:
a. Are there any deed, homeowners’ or condominium restrictions? Yes No
b. Are there any mandatory homeowners’ or condominium associations?
Yes No
If yes, how many? _________________
If yes, please see Homeowners’ Association/Community Disclosure Addendum or Condominium Rider
Fees are payable to: _______________________________________________________________________________________
Payee’s address:__________________________________________________________________________________________
Payee’s phone number:_____________________________________________________________________________________
Homeowners’ Association fees and assessments are payable in the amount of $__________ per ___________
Master Association fees and assessments are payable in the amount of $__________ per ___________
Condominium Association maintenance fees are payable in the amount of $__________ per ___________
Condominium Association special assessment fees are payable in the amount of $__________ per ___________
________________________ fees or assessments are payable in the amount of $__________ per ___________
________________________ fees or assessments are payable in the amount of $__________ per ___________
________________________ Association transfer/access fees payable by BUYER $__________
________________________ Association Capital Contribution fee payable by BUYER $__________
c. Are any of your Association fees delinquent?
Yes No
d. Are you aware of any pending Association special assessment(s)? Yes No
e. Are you aware of any proposed changes to any of the restrictions? Yes No
f.Are there any resale restrictions?
Yes No
g. Are there any restrictions to leasing the Property? Yes No
h. Are you aware of any violations of the restrictive covenants affecting the Property including failure
to obtain Association approval for improvements or changes to the Property?
Yes No
If yes to d, e, f, g, or h please explain:________________________________________________________________________
i. Is the Property part of a Community Development District (CDD)? Yes No
If yes, please see Community Development District Disclosure.
4. ENVIRONMENT:
a. Was the Property built before 1978?
Yes No
If yes, complete the Lead-Based Paint Disclosure.
b. Are there or have there been any substances, materials or products which may be an
environmental hazard such as, but not limited to, asbestos, urea formaldehyde, methamphetamine,
radon gas, mold, lead-based paint, defective
drywall, defective flooring,
fuel oil, propane or chemical
storage tanks (active or abandoned), or contaminated soil or water on the Property?
Yes No Unknown
c. Has there been any clean up, repair or remediation of the Property due to any of the substances,
materials or products listed in subsection (b) above?
Yes No Unknown
d. Are there any wetlands, conservation easements/buffers, archeological sites or other
environmentally sensitive areas located on the Property active or abandoned?
Yes No Unknown
If yes to any of these items, please explain:__________________________________________________________________
_______________________________________________________________________________________________________
5. ROADS/LAND USE
a.
Are access roads Public Private? If private, is there a recorded road maintenance
agreement? Yes No Unknown
b. Is the Property zoned for its current use? Yes No Unknown
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c. Are there any restrictions governing reconstruction of the Property following casualty loss or damage
(e.g. for oceanfront or historic district properties)? Yes No Unknown
d. If the property is in Jacksonville, Florida is it in an Airport Noise Zone as defined in ordinance code
section 656.1010 For information you may contact the Jacksonville Planning Department
Yes No Unknown
e. Does anyone other than SELLER have any mineral rights in the property? Yes No
If yes to any of these items, please explain: __________________________________________________________________
________________________________________________________________________________________________________
6. ADDITIONS/REMODELING/INSURANCE CLAIMS
a. Has there been any structural damage or damage to personal property which may have resulted
from casualties including, but not limited to, fire, wind, water, flood, hail or sinkholes?
Yes No Unknown
b. If yes, are you aware if any insurance claims were filed? Yes No
c. Have you made any additions, structural changes or other alterations to the Property? Yes No
If yes, did you obtain all necessary permits?
Yes No
Was/Were the permit(s) closed out (finalized)? Yes No Unknown
d. Was any of the work in violation of any building codes?
Yes No
e. Were there any additions, structural changes or other alterations made to the Property by any
previous owner? Yes No Unknown
f. Please provide the name of any contractor or individual who constructed any addition or made any
structural change to the Property. ____________________________________________________________________________
g. Are you aware of any active or open permits on the Property which have not been closed by a final
inspection?
Yes No
If yes to any of these items, please explain: _________________________________________________________________
_______________________________________________________________________________________________________
7. ROOF-RELATED ITEMS
a. What is the approximate age of the roof? __________________
Unknown
b. Has the roof leaked during your ownership of the Property? Yes No
If yes, what was done to correct the leak(s)? _________________________________________________________________
c. Has the roof been replaced or repaired or reroofed over existing shingles during your ownership of the
Property?
Yes No
If yes to any of these items, please explain, please provide the date and name of contractor
_________________________________________________ is there a transferable warranty?
Yes No
If yes, please provide a copy of the warranty.
8.
POOL/SPA OR HOT TUB
a. Does the Property have any of the following?
Pool/Spa Heater
Yes No Type: Gas Electric Solar
Pool Sweep
Yes No
Spa/Hot Tub
Yes No Type: Gas Electric Solar
What is the approximate age of the Pool _________ Spa_______ Hot Tub______?
b. Have repairs/replacements ever been made to any item mentioned above? Yes No Unknown
If yes, please explain:_____________________________________________________________________________________
c. What type of pool/spa or hot tub filtration system do you have? (salt or chlorine) _______________________________
d. The pool/spa has the following safety features (as defined by Section 515, Florida Statutes):
Enclosure that meets the pool barrier requirements Approved safety pool cover
Required door and window exit alarms Required door locks
9. HEATING AND AIR CONDITIONING
Please indicate existing equipment:
a. Air Conditioning:
Central Electric Brand Name: ____________________ Age ____
b. Heating:
Central Electric Gas Fuel Oil Brand Name: __________________ Age ____
c. If heat pump, type: _____________________
d. Air condenser age ___________ Air handler age __________
e. Window/Wall Unit (s) ______ Number and location of units included in sale: ___________________________________________
f. Do you have any fuel storage tanks?
Yes No
If yes,
Underground Above ground Both
g. Are you aware of any malfunction, condensation problem or defect regarding these items or
ductwork since you have owned the Property? Yes No
If yes, explain: ___________________________________________________________________________________________
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10. WATER INTRUSION
a. Are you aware of any past or present water intrusion, accumulation of water or dampness
affecting the interior or exterior of any part of the improvements or the land, including any
crawl spaces?
Yes No
b. Are you aware of any attempts to control any water or dampness problems, including in any crawl
Yes No
spaces?
If yes, to either of these, please explain______________________________________________________________________
c. Are you aware of any insurance claims filed for water intrusion?
Yes No
If yes, please indicate when_____________________________________________________________
If yes, has the claim been completely settled with your insurance company? Yes No
If yes, was the full amount of the claim proceeds used to repair the water intrusion? Yes No
11. SINKHOLES, SETTLING AND SOIL MOVEMENT
a. Are you aware of any past or present settling, soil movement or sinkhole(s) affecting the Property?
Yes No
If yes, please explain:__________________________________________________________________________
b. Are you aware of any insurance claims filed for a sinkhole with an insurance company?
Yes No
If yes, has the claim has been completely settled with your homeowner’s insurance company? Yes No
If yes, was the full amount of the claim proceeds used to repair the sinkhole damage? Yes No
12. WINDOWS/DOORS/LOCKS
a.Are
the windows insulated glass? Yes No Unknown
b. Are any windows low ”e” filtered windows?
Yes No Unknown
c. Are there any fogged windows? Yes No Unknown
d. Are any windows broken or cracked? Yes No Unknown
e. Do all operable windows open, stay open, close and lock properly?
Yes No Unknown
f. Are any screens missing or damaged? Yes No Unknown
g. Do all doors operate properly?
Yes No Unknown
13. PLUMBING
a. Have you updated any portion of the plumbing system?
Yes No
If yes, please explain:____________________________________________________________________________________
b. Are you aware of any problems with the plumbing system/fixtures? Yes No
c. Are you aware of any polybutylene pipes on the Property?
Yes No
d. Are you aware of any leaks, back-ups, water or sewer/septic tank problems? Yes No
e. What is your drinking water supply source? Public Private Well on Property Shared well
f. If your water is from a well, have there ever been repairs/replacements to the well or pump?
Yes No Unknown
g. Has the well water ever been tested? Yes No Unknown
h. Do you have a separate water supply source for irrigation?
Yes No
i. If yes, Irrigation Meter Shallow Well
j. What type of sewage system do you have? Public Private Septic Tank(s)
If septic, how many? _____________________ Locations: _______________________________________________________
When was septic tank last pumped? ________________________ Age of septic tank if known: ____________________________
Age of drain field if known: _______________________________
k. Number of water heaters? _____
Electric Gas Solar Tankless Age of water heater if known:_________________
If yes to any of these items, please explain: ___________________________________________________________________
________________________________________________________________________________________________________
14. ELECTRICAL/ENERGY SYSTEM
a. Have you updated any portion of the electrical system?
Yes No
If yes, please explain:____________________________________________________________________________________
b. Are you aware of any damaged or malfunctioning switches, receptacles, wiring or any problem with
the electrical system/fixtures?
Yes No
c. Does the Property have any aluminum, knob-and-tube or cloth wiring? Yes No Unknown
d. Is any part of the Property powered by Solar? Yes No
If yes to any of these items, please explain:
_______________________________________________________________________________________________________
15. EXCLUSIONS/LEASED SYSTEMS
a. Are there any items that are affixed to the Property that are excluded from the sale?
Yes No
If yes, please itemize: _____________________________________________________________________________________
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b. Is there any leased equipment included in the sale? Yes No
If yes, please itemize: _____________________________________________________________________________________
16. WOOD-DESTROYING ORGANISMS
a. Are you aware of any past or present infestation or damage to the Property caused by any
wood-destroying organisms, including fungi?
Yes No
If yes, please explain: _____________________________________________________________________________________
b. Is the Property currently under service agreement or bond for wood-destroying organisms with
a licensed pest control company?
Yes No
If yes, with what company and renewal date?_________________________________________________________________
Is the service agreement or bond transferable?
Yes No
If yes, please attach a copy of the service agreement or bond.
c. Do you know of any wood-destroying organism reports on the Property issued in the past five years? Yes No
If yes, please explain and attached a copy if available:__________________________________________________________
________________________________________________________________________________________________________
17. FLOOD ZONE/DRAINAGE/BOUNDARIES
a. Is any portion of the Property in a special flood hazard area for which a lender may require
flood insurance?
Yes No
If yes, please attach a copy of the flood elevation certificate if available.
b. Are you aware of any past or present drainage/flood problems affecting the Property?
Yes No
c. Are you aware of any encroachments or boundary line disputes affecting the Property?
Yes No
d. Are you aware of any shared access/driveway, dock, well or other joint use agreements? Yes No
If yes, oral written. If written, please attach a copy.
e. Are you aware of any easements affecting the Property other than utility easements?
Yes No
If yes, please explain:______________________________________________________________________________________
f. Do you have a survey map showing all improvements of the Property?
Yes No
If yes, please attach a copy.
18. OTHER MATTERS
a. Does anyone, including any owner’s association, have a right of first refusal or an option to buy
the Property?
Yes No
b. Are you aware of any existing or threatened legal action affecting you or the Property? Yes No
c. Does the Property have homestead tax exemption for the current year? Yes No
d. Water/Sewer Provider: _____________________________________________________________________________________
Garbage Pick-up Provider: ____________________________ Gas/Fuel Oil Provider: ___________________________________
Electricity Provider: ________________________________________________________________________________________
e. Is there anything else you feel you should disclose to a prospective buyer that may materially
adversely affect the value or desirability of the Property? Yes No
If yes to any of these items, please explain: __________________________________________________________________
________________________________________________________________________________________________________
SELLER represents that the information set forth in this Property Disclosure is accurate and complete to the best of SELLER’s
knowledge. SELLER does not intend this Disclosure to be a warranty or guaranty of any kind. SELLER hereby authorizes the listing
Broker to provide a copy of this Disclosure to prospective buyers of the Property and to real estate brokers and licensees. SELLER
shall notify the listing Broker in writing immediately if any information set forth in this Disclosure becomes inaccurate or
incorrect.
___________________________ ____________
SELLER SIGNATURE DATE
___________________________ ____________
SELLER SIGNATURE DATE
___________________________ ____________
SELLER SIGNATURE DATE
___________________________ ____________
SE
LLER SIGNATURE DATE
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RECEIPT AND ACKNOWLEDGMENT BY BUYER
BUYER hereby acknowledges receipt of a copy of this Property Disclosure. BUYER is strongly
advised to obtain Property
inspection(s) as provided for in the Purchase and Sale Agreement. BUYER should select professionals with appropriate
qualifications to conduct inspections. BUYER acknowledges that this Property Disclosure is not intended as a warranty or guaranty of
any kind by SELLER.
BUYER hereby acknowledges that SELLER’s representations are made to BUYER based on SELLER’s knowledge and, further, that it
is BUYER’s responsibility to have the Property inspected. The statements in this Disclosure are those of SELLER only. The Brokers
and their licensees do not warrant or guarantee the statements contained in this Property Disclosure or the condition of the Property
and are not responsible for the condition of the Property. BUYER understands that the Property is being sold in its present condition
unless otherwise agreed upon in the Purchase and Sale Agreement.
___________________________ ____________ ___________________________ ____________
BUYER SIGNATURE DATE BUYER SIGNATURE DATE
___________________________ ____________ ___________________________ ____________
BUYER SIGNATURE DATE BUYER SIGNATURE DATE
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