Form 17 |
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SELLER DISCLOSURE STATEMENT |
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©Copyright 2019 |
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Seller Disclosure Statement |
IMPROVED PROPERTY |
Northwest Multiple Listing Service |
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Rev. 7/19 |
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ALL RIGHTS RESERVED |
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Page 4 of 6 |
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(Continued) |
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YES |
NO |
DON’T |
N/A |
149 |
5. SYSTEMS AND FIXTURES |
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KNOW |
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150 |
*A. If any of the following systems or fixtures are included with the transfer, are there any defects? |
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151 |
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If yes, please explain: ____________________________________________________ |
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152 |
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Electrical system, including wiring, switches, outlets, and service |
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153 |
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Plumbing system, including pipes, faucets, fixtures, and toilets |
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154 |
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Hot water tank |
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155 |
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Garbage disposal |
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156 |
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Appliances |
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157 |
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Sump pump |
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158 |
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Heating and cooling systems |
.................................................................................................... |
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159 |
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Security system: Owned |
Leased |
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160 |
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Other_____________________________________________________________________________________________ |
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161 |
*B. |
If any of the following fixtures or property is included with the transfer, are they leased? |
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162 |
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(If yes, please attach copy of lease.) |
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163 |
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Security System: _______________________________________________________________________________ |
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164 |
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Tanks (type): ___________________________________________________________________________________ |
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165 |
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Satellite dish: ___________________________________________________________________________________ |
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166 |
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Other: ___________________________________________________________________________________________ |
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167 |
*C. Are any of the following kinds of wood burning appliances present at the property? |
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168 |
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(1) Woodstove? |
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169 |
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(2) |
Fireplace insert? |
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170 |
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(3) |
Pellet stove? |
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171 |
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(4) |
Fireplace? |
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172 |
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If yes, are all of the (1) woodstoves or (2) fireplace inserts certified by the U.S. Environmental |
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173 |
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Protection Agency as clean burning appliances to improve air quality and public health? |
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174 |
D. |
Is the property located within a city, county, or district or within a department of natural |
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175 |
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resources fire protection zone that provides fire protection services? |
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176 |
E. |
Is the property equipped with carbon monoxide alarms? (Note: Pursuant to RCW 19.27.530, Seller |
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177 |
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must equip the residence with carbon monoxide alarms as required by the state building code.) |
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178 |
F. Is the property equipped with smoke detection devices? |
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179 |
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(Note: Pursuant to RCW 43.44.110, if the property is not equipped with at least one smoke |
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180 |
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detection device, at least one must be provided by the seller.) |
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181 |
6. HOMEOWNERS’ ASSOCIATION/COMMON INTERESTS |
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182 |
A. |
Is there a Homeowners’ Association? |
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183 |
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Name of Association and contact information for an officer, director, employee, or other authorized |
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184 |
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agent, if any, who may provide the association's financial statements, minutes, bylaws, fining policy, |
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185 |
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and other information that is not publicly available: ______________________________ |
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186 |
B. |
Are there regular periodic assessments? |
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187 |
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$ ______________ per month year |
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188 |
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Other: _______________________________________________________________ |
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189 |
*C. Are there any pending special assessments? |
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190 |
*D. Are there any shared “common areas” or any joint maintenance agreements (facilities |
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191 |
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such as walls, fences, landscaping, pools, tennis courts, walkways, or other areas |
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192 |
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co-owned in undivided interest with others)? |
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193 |
7. ENVIRONMENTAL |
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194 |
*A. Have there been any flooding, standing water, or drainage problems on the property |
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195 |
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that affect the property or access to the property? |
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196 |
*B. |
Does any part of the property contain fill dirt, waste, or other fill material? |
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197 |
*C. Is there any material damage to the property from fire, wind, floods, beach movements, |
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198 |
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earthquake, expansive soils, or landslides? |
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199 |
D. |
Are there any shorelines, wetlands, floodplains, or critical areas on the property? |
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*E. Are there any substances, materials, or products in or on the property that may be environmental |
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201 |
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concerns, such as asbestos, formaldehyde, radon gas, lead-based paint, fuel or chemical |
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202 |
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storage tanks, or contaminated soil or water? |
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203 |
*F. Has the property been used for commercial or industrial purposes? |
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204 |
________________________________ |
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