Fillable Sellers Mandatory Property Condition Disclosure

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Sellers Mandatory Property Condition Disclosure

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Seller’s Mandatory Property Condition Disclosure
Frequently Asked Questions
Who fills out the form?
All sellers of existing 1-4 family homes and town homes must complete and sign the Property Condition Disclosure Statement.
Some exemptions to the rule are:
New construction (never inhabited)
Condominium units and cooperative apartments
Commercial properties
Foreclosed properties
Multi-family dwellings (i.e. 5 + units)
Vacant land
Transfer due to court order (i.e. estate, bankruptcy, eminent domain, divorce decree)
HUD properties or government entities
Vacant Land
What are the seller’s responsibilities?
The seller must truthfully complete and sign a property condition disclosure statement based on seller’s actual knowledge of the
condition of the property. The disclosure statement must be delivered to the buyer or buyer’s agent before the buyer enters a purchase
and sale contract.
What is actual knowledge?
The seller has the option to answer “yes,” “no,” “not applicable,” or “unknown.” Sellers must answer the questions based upon their
actual knowledge at the time of signing the disclosure statement. The seller is under no obligation to conduct any type of inspection of
the property or to check public records in an effort to complete the disclosure statement.
What happens if the seller refuses to sign the disclosure statement or does not do so in a timely manner?
If a seller fails to timely complete and sign the disclosure statement and deliver it to the buyer before the buyer enters a purchase and
sale contract, the buyer will receive, upon transfer of the title, a $500 credit against the agreed upon purchase price, which credit shall
not relieve seller of any other obligations to buyer concerning the condition of the property under the purchase and sale contract or
applicable law.
What are the agent’s responsibilities?
The listing broker must timely inform the seller of the seller’s obligation to complete the disclosure statement. An agent representing a
buyer must timely inform such buyer of buyer’s right to receive the disclosure statement before buyer enters a purchase and sale
contract. If a buyer is not represented by an agent, seller’s agent must inform buyer of buyer’s right to receive the disclosure statement
before buyer enters a purchase and sale contract. The seller and buyer must sign the disclosure statement, and a copy of the disclosure
statement must be attached to the purchase and sale contract.
Should this form take the place of a home inspection or other testing?
Absolutely not. On the contrary, the disclosure statement strongly urges buyers to have a home inspection performed as well as other
professional and environmental tests.
Does the disclosure statement create a warranty?
No. The property condition disclosure statement clearly states that the statement does not serve as any kind of warranty by the seller or
by any agent representing the seller in the transaction.
What if the seller discovers a defect after the seller has already completed the disclosure statement and
has delivered it to the buyer?
If a seller acquires knowledge that renders inaccurate a previous disclosure statement, the seller must complete and deliver a revised
disclosure statement to the buyer as soon as possible. Under no circumstances is the seller required to provide a revised disclosure
statement to the buyer after transfer of title or after the buyer takes occupancy of the property, whichever is earlier.
Is New York the only state with this requirement?
On the contrary, nearly 30 states have mandatory seller’s property condition disclosure. The general experience in other states has
been very positive. The consensus has been that it does not hinder the transaction. Further, all parties report that their level of
satisfaction with the transfer process has been enhanced through the use of the disclosure statement.
New York State
Department of State
Division of Licensing Services
P.O. Box 22001
Albany, NY 12201-2001
Customer Service: (518) 474-4429
www.dos.ny.gov
Property Condition Disclosure Statement
Name of Seller or Sellers:
Property Address:
General Instructions:
The Property Condition Disclosure Act requires the seller of residential real property to cause this disclosure statement or a copy of
thereof to be delivered to a buyer or buyer’s agent prior to the signing by the buyer of a binding contract of sale.
Purpose of Statement:
This is a statement of certain conditions and information concerning the property known to the seller. This Disclosure Statement is not a
warranty of any kind by the seller or by any agent representing the seller in this transaction. It is not a substitute for any inspections or tests
and the buyer is encouraged to obtain his or her own independent professional inspections and environmental tests and also is encouraged to
check public records pertaining to the property.
A knowingly false or incomplete statement by the seller on this form may subject the seller to claims by the buyer prior to or after the
transfer of title. In the event a seller fails to perform the duty prescribed in this article to deliver a Disclosure Statement prior to the signing by
the buyer of a binding contract of sale, the buyer shall receive upon the transfer of title a credit of $500 against the agreed upon purchase price
of the residential real property.
“Residential real property” means real property improved by a one to four family dwelling used or occupied, or intended to be used or
occupied, wholly or partly, as the home or resident of one or more persons, but shall not refer to (a) unimproved real property upon which such
dwellings are to be construction or (b) condominium units or cooperative apartments or (c) property on a homeowners’ association that is not
owned in fee simple by the seller.
Instruction to the Seller:
a. Answer all questions based upon your actual knowledge.
b. Attach additional pages with your signature if additional space is required.
c. Complete this form yourself.
d. If some items do not apply to your property, check “NA” (Non-applicable). If you do not know the answer
check “ Unknown.”
Seller’s Statement:
The seller makes the following representations to the buyer based upon the seller’s actual knowledge at the time of signing this
document. The seller authorized his or her agent, if any, to provide a copy of this statement to a prospective buyer of the residential real
property. The following are representations made by the seller and are not the representations of the seller’s agent.
GENERAL I
NFORMATION
1. How long have you owned the property? ......................................................................................................
2. How long have you occupied the property? ………………………………………………….....................
3. What is the age of the structure or structures? ……………………………………………………………
Note to buyer – If the structure was built before 1978 you are encouraged to investigate for the
presence of lead based paint.
4. Does anybody other than yourself have a lease, easement or any other right to use or occupy any
part of your property other than those stated in documents available in the public record, such as
rights to use a road or path or cut trees or crops? ………………………………………………………..
Yes No Unknown NA
5. Does anybody else claim to own any part of your property? If yes, explain below ………………….. Yes No Unknown NA
6. Has anyone denied you access to the property or made a formal legal claim challenging your title
to the property? If yes, explain below …………………………………………………………………….. Yes No Unknown NA
DOS-1614-f (Rev. 10/15) Page 1 of 6
Property Condition Disclosure Statement
7. Are there any features of the property shared in common with adjoining landowners or a home-
owner’s association, such as walls, fences or driveways? If yes, describe below …………………..... Yes No Unknown NA
8. Are there any electric or gas utility surcharges for line extensions, special assessments or home-
owner or other association fees that apply to the property? If yes, describe below ………………….. Yes No Unknown NA
9. Are there certificates of occupancy related to the property? If no, explain below …………………….
Yes No Unknown NA
ENVIRONMENTAL
Note to Seller:
In this section, you will be asked questions regarding petroleum products and hazardous or toxic substances that you know to have been
spilled, leaked or otherwise been released on the property or from the property onto any other property. Petroleum products may include, but
are not limited to, gasoline, diesel fuel, home heating fuel, and lubricants. Hazardous or toxic substances are products that could pose short or
long-term danger to personal health or the environment if they are not properly disposed of, applied or stored. These include, but are not
limited to, fertilizers, pesticides and insecticides, paint including paint thinner, varnish remover and wood preservatives, treated wood,
construction materials such as asphalt and roofing materials, antifreeze and other automotive products, batteries, cleaning solvents including
septic tank cleaners, household cleaners and pool chemicals and products containing mercury and lead.
Note to Buyer:
If contamination of this property from petroleum products and/or hazardous or toxic substances is a concern to you, you are urged to
consider soil and groundwater testing of this property.
10. Is any or all of the property located in a designated floodplain? If yes, explain below ……………..
Yes No Unknown NA
11. Is any or all of the property located in a designated wetland? If yes, explain below ……………….. Yes No Unknown NA
12. Is the property located in an agricultural district? If yes, explain below ……………………………... Yes No Unknown NA
13. Was the property ever the site of a landfill? If yes, explain below …………………………………….. Yes No Unknown NA
14. Are there or have there ever been fuel storage tanks above or below the ground on the property? Yes No Unknown NA
● If yes, are they currently in use? ………………………………………………………………………. Yes No Unknown NA
● Location(s)
● Are they leaking or have they ever leaked? If yes, explain below ………………………………….
Yes No Unknown NA
15. Is there asbestos in the structure? If yes, state location or locations below ………………………... Yes No Unknown NA
DOS-1614-f (Rev. 10/15) Page 2 of 6
Property Condition Disclosure Statement
16. Is lead plumbing present? If yes, state location or locations below ………………………………… .. Yes No Unknown NA
17. Has a radon test been d
one? If yes, attach a copy of the report ……………………………………. .. Yes No Unknown NA
18. Has motor fuel, motor oil, home he
ating fuel, lubricating oil or any other petroleum product,
methane gas, or any hazardous or toxic substance spilled, leaked or otherwise been released on
the property or from the property onto any other property? If yes, describe below ………………… Yes No Unknown NA
19. Has the property
been tested for the presence of motor fuel, motor oil, home heating fuel,
lubricating oil, or any other petroleum product, methane gas, or any hazardous or toxic
substance? If yes, attach report(s) ……………………………………………………………………….. Yes No Unknown NA
STRUCTURAL
20. Is there any rot or water damage to the structure or structures? If yes, explain below …………….. Yes No Unknown NA
21. Is there any fire or smoke damage to the structure or structures? If yes, explain below ……………
Yes No Unknown NA
22. Is there any termite, insect, rodent or pest infestation or dama
ge? If yes, explain below ………….. Yes No Unknown NA
23. Has the property
been tested for termite, insect, rodent or pest infestation or damage? ………… .. Yes No Unknown NA
If yes, please attached report(s)
24. What is the type of roof/roof covering (slate, asphalt, other)? ………………………………………….
● Any known material defects? ………………………………………………………………………… ..
● How old is the roof? ………………………………………………………………………………………
● Is there a transferable warrantee on the roof in effect now? If yes, explain below ……………….
DOS-1614-f (Rev. 10/15) Page 3 of 6
Property Condition Disclosure Statement
25. Are there any known material defects in any of the following structural systems: footings, beams,
girders, lintels, columns or partitions? …………………………………………………………………… Yes No Unknown NA
MECHANICAL SYSTEMS AND SERVICES
26. What is the water source? (Check all that apply) ………………………………………………………
Well Private Municipal
Other:
● If municipal, is it metered? ………………………………………………………………………………. Yes No Unknown NA
27. Has the water quality and/or flow rate been tested? ……………………………………………………
Yes No Unknown NA
28. What is the type of sewage system? (Check all that apply) ……………………………………………
Public Sewer Private Sewer
Septic Cesspool
● If septic or cesspool, age? ……………………………………………………………………………...
● Date last pumped? ……………………………………………………………………………………...
● Frequency of pumping? ………………………………………………………………………………...
● Any known material defects? If yes, explain below ………………………………………………… Yes No Unknown NA
29. Who is your electric service provider? ……………………………………………………………………
● What is the amperage? ………………………………………………………………………………....
● Does it have circuit breakers or fuses? ……………………………………………………………….
● Private or public poles? ………………………………………………………………………………..
● Any known material defects? If yes, explain below …………………………………………………
Yes No Unknown NA
30. Are there any flooding, drainage or grading pr
oblems that resulted in standing water on any
portion of the property? If yes, state locations and explain below ………………………………….....
Yes No Unknown NA
31. Does the basement have seepage that results in standing w
ater? If yes, explain below ………… Yes No Unknown NA
DOS-1614-f (Rev. 10/15) Page 4 of 6
Property Condition Disclosure Statement
Are there any known material defects in any of the following? If yes, explain below. Use additional
Sheets if necessary ……………………………………………………………………………………………….
32. Plumbing system? …………………………………………………………………………………………..
Yes No Unknown NA
33. Security system? …………………………………………………………………………………………….
Yes No Unknown NA
34. Carbon monoxide detector? ………………………………………………………………………………. Yes No Unknown NA
35. Smoke detector? ……………………………………………………………………………………………
Yes No Unknown NA
36. Fire sprinkler system? ………………………………………………………………………………………
Yes No Unknown NA
37. Sump pump? ……………………………………………………………………………………………….. Yes No Unknown NA
38. Foundation/slab? ……………………………………………………………………………………………
Yes No Unknown NA
39. Interior walls/ceilings? ………………………………………………………………………………………
Yes No Unknown NA
40. Exterior walls or siding? …………………………………………………………………………………… Yes No Unknown NA
41. Floors? ……………………………………………………………………………………………………….
Yes No Unknown NA
42. Chimney/fireplace or stove? ………………………………………………………………………………
Yes No Unknown NA
43. Patio/deck? ………………………………………………………………………………………………….
Yes No Unknown NA
44. Driveway? …………………………………………………………………………………………………… Yes No Unknown NA
45. Air conditioner? ……………………………………………………………………………………………..
Yes No Unknown NA
46. Heating system? ……………………………………………………………………………………………
Yes No Unknown NA
47. Hot water heater? ………………………………………………………………………………………….. Yes No Unknown NA
48. The property is located in the following school district
Note: Buyer is encouraged to check public records concerning the property (e.g. tax records and wetland and floodplain maps).
The seller should use this area to further explain any item above. If necessary, attach additional pages and indicate here the number of
additional pages attached.
DOS-1614-f (Rev. 10/15) Page 5 of 6
Property Condition Disclosure Statement
SELLER’S CERTIFICATION:
Seller certifies that the information in this Property Condition Disclosure Statement is true and complete to the seller’s actual knowledge
as of the date signed by the seller. I f a seller of residential real property acquires knowledge which renders materially inaccurate a Property
Condition Disclosure Statement provided previously, the seller shall deliver a revised Property Condition Disclosure Statement to the buyer as
soon as practicable. In no event, however, shall a seller be required to provide a revised Property Condition Disclosure Statement after the
transfer of title from the seller to the buyer or occupancy by the buyer, whichever is earlier.
Seller’s Signature
X Date
Seller’s Signature
X Date
BUYER’S ACKNOWLEDGMENT:
Buyer acknowledges receipt of a copy of this statement and buyer understands that this information is a statement of certain conditions and information
concerning the property known to the seller. It is not a warranty of any kind by the seller or seller’s agent and is not a substitute for any home, pest, radon or
other inspections or testing of the property or inspection of the public records.
Buyer’s Signature
X Date
Buyer’s Signature
X Date
DOS-1614-f (Rev. 10/15) Page 6 of 6
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Sellers Mandatory Property Condition Disclosure

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Completed 31 January 2022

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