Connecticut Real Estate Disclosure

RESIDENTIAL PROPERTY CONDITION DISCLOSURE REPORT

Seller’s Name: ________________________________

Property Address:  ________________________________________

The Uniform Property Condition Disclosure Act (Public Act No. 95-311) requires the seller of residential property to provide this disclosure to the prospective purchaser prior to the prospective purchaser’s execution of any binder, contract to purchase, option or lease containing a purchase option.  These provisions apply to the transfer of residential real property of four dwelling units or less made with or without the assistance of a licensed broker or salesperson. The seller will be required to credit the purchaser with the sum of $300.00 at closing if the seller fails to furnish this report as required by this act.

Please note that Connecticut law requires the owner of any dwelling in which children under the age of 6 reside to abate or manage materials containing toxic levels of lead.

I. SELLERS’ CERTIFICATION

Pursuant to the Uniform Property Condition Disclosure Act, the seller is obligated to disclose here any knowledge of any problem regarding the following:

 

I. GENERAL INFORMATION
1. How long have you occupied the property?             Age of structure
2. Does anybody other than yourself have any right to use any part of your property, or does anybody else claim to own any part of your property? Yes No Unknown
If yes, explain
3. Is the property in a flood plain area or an area containing wetlands? Yes No Unknown
II. SYSTEM/UTILITIES
4. Heating system problems? Yes No Unknown
If yes, explain
a. Heating System and Fuel Type
b. Is there an underground fuel tank? Yes No Unknown
If yes, location and age
5. Hot water heater problems? Yes No Unknown
If yes, explain
Type of hot water heater
Age
6. Plumbing system problems? Yes No Unknown
If yes, explain
7. Sewage system problems? Yes No Unknown
If yes, explain
a. Type of sewage disposal system (central sewer, septic, cesspool, etc.)
b. If private:

(a)     Name of service company

(b)     Date last pumped frequency

8. Air conditioning problems? Yes No Unknown
If yes, explain
Air Conditioning Type Central Window Other
9. Electrical system problems? Yes No Unknown
If yes, explain
10. Drinking water problems? Yes No Unknown
If yes, quality or quantity?Explain
11. Electronic Security System Problems? Yes No Unknown
If yes, explain
12. Carbon monoxide or smoke detector problems? Yes No Unknown
If yes, explain
13. Fire sprinkler system problems? Yes No Unknown
If yes, explain
III. BUILDING/STRUCTURE/IMPROVEMENTS
14. Foundations/slab problems/settling? Yes No Unknown
If yes, explain
15. Basement Water/Seepage/Damage? Yes No Unknown
If yes explain:(a)     Amount

(b)     Frequency

(c)     Location

16. Sump Pump Problems? Yes No Unknown
If yes, explain
17. Roof leaks, problems? Yes No Unknown
If yes:(a)     Roof type

(b)     Age

18. Interior walls/ceiling problems? Yes No Unknown
If yes, explain
19. Exterior siding problems? Yes No Unknown
If yes, explain
20. Floor problems? Yes No Unknown
If yes, explain
21. Chimney/fireplace/wood or coal stove problems? Yes No Unknown
If yes, explain
22. Any knowledge of fire/smoke damage? Yes No Unknown
If yes, explain
If made of wood, is wood treated or untreated?
23. Patio/deck problems? Yes No Unknown
If yes, explain
24. Driveway problems? Yes No Unknown
If yes, explain
25. Termite/insect/rodent/pest infestation problems? Yes No Unknown
If yes, explain
26. Is house insulated? Yes No Unknown
If yes:(a)     Type

(b)     Location

27. Rot and water damage problems? Yes No Unknown
If yes, explain
28. Water drainage problems? Yes No Unknown
If yes, explain
29. Are asbestos containing insulation or building materials present? Yes No Unknown
If yes, location
30. Is lead paint present? Yes No Unknown
If yes, explain
31. Is lead plumbing present? Yes No Unknown
If yes, location
32. Has test for radon been done? Yes No Unknown
If yes, attach copy.
State whether a radon control system is in place Yes No Unknown

The Seller should use this area to further explain any item above. Attach additional pages if necessary and indicate here the number of additional pages attached.

_______________________________________________________

_______________________________________________________

I. Seller’s Certification

 

To the extent of the Seller(s) knowledge as a property owner, the Seller acknowledges that the information contained above is true and accurate for those areas of the property listed. In the event a real estate broker or salesperson is utilized, the Seller authorizes the brokers or salespersons to provide the above information to prospective buyers, selling agents or buyer’s agents.

DATE  ____________________

SELLER_________________           SELLER  _____________________

Signature (Type or Print) _________________________________

DATE  ____________________

SELLER_________________          SELLER  _____________________

Signature (Type or Print)  _________________________________

II. Responsibilities of Real Estate Brokers

This report in no way relieves a real estate broker of his or her obligation under the provisions of Section 20-328-5a of the Regulations of Connecticut State Agencies to disclose any material facts.  Failure to do so could result in punitive action taken against the broker, such as fines, suspension or revocation of license.

 

III. Statements Not to Constitute a Warranty

 

Any representations made by the seller on this report shall not constitute a warranty to the buyer.

 

IV. Nature of Disclosure Report

 

This residential disclosure report is not a substitute for inspections, tests, and other methods of determining the physical condition of the property.

 

V. Buyer’s Certification

 

The Buyer is urged to carefully inspect the property and, if desired, to have the property inspected by an expert. The Buyer understands that there are areas of the property for which the Seller has no knowledge and this disclosure statement does not encompass those areas. The Buyer also acknowledges that the Buyer has read and received a signed copy of this statement from the Seller or Seller’s agent.

 

DATE ____________________

BUYER____________________    BUYER ______________________

Signature (Type or Print)  __________________________________

DATE ________________________

BUYER_____________________   BUYER _____________________

Signature (Type or Print)  __________________________________

State Specific Real Estate Forms

–For State Specific Real Estate Forms you can download in Word format, go to http://www.uslegalforms.com/realestate/


Inside Connecticut Real Estate Disclosure