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Property Condition Disclosure Statement DOS-1614 - New York
| Property Condition Disclosure Statement Form. This is a New York form and can be used in Miscellaneous Title Real Estate Statewide . |
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NYS Department of State Division of Licensing Services 84 Holland Avenue Albany, NY 12208-3490 (518) 474-4429Property Condition Disclosure Statement www.dos.state.ny.usName of Seller or Sellers: Property Address: General Instructions: The Property Condi tion Disclosure Act requires the seller of residential real property to cause this disclosure statement or a copy thereof to be delivered to a buyer or buyers 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 thbuyee r is encouraged to obtain his or her own independent professional inspections and environmental tests and also is encouraged to check public reco rds pertaining to the property. A knowingly false or incomp lete statement by the seller on this form may subject the seller to claims by the buyer prio r t o o r 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 th e signing by the buyer of a binding contract of sale, the buyer seceihavle l rupon the transfer of title a credit o$500 af gainst 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 o r occupied, or intended to be used or occupied, wholly or partly, as the home or residence of one or more persons, but shall not refer to (a) unimproved real property upon which such dwllinges are to be constructed or (b) condom ini um uni ts oooper crative apartments or (c) property on a homeowners association that is not owned in fee simple by the seller. Instructions to the Seller: a. Answer all questions based upon your actual knowledge. b. Attach additional pages with your signature if aitddional 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 Unkn (Unknown). Sellers Statement: T h e seller makes the following representations to the buyer based upon the sellers actual knowledgetime at t ohef signing this document. The seller authorizes his or her agent, if any, to provide a copy of th is st at emen t to a prospective buyer of the residential real property. The following are representations made by the seller and are not the representations of the sellers agent. GENERAL INFORMATION 1. How long have you owned the proper.................................ty? 2. How long have you occupied the propert................................y? 3. What i s t he a ge o f t he s tructure o r s tructures? .............................. Note to buyer If the structure was built befo1978 yre ou are encouraged to investigate for the presence of lead based pai.nt...................................... 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 Unkn NA 5. Does anybody else claim to own any part of your propeIf Yrty?e s, explain below ....... Yes No Unkn NA DOS-1614 (1/02) PAGE 1 OF 6 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2Property Condition Disclosure Statement 6. Has anyone denied you access to the property or made a formal legal claim challenyourging title to the property?If Y es, explain belo ................................w Yes No Unkn NA 7. Are there any features of the property shared in common with adjoining landowners or a homeowners association, such as walls, fences or drivewIayf Ys?e s, describe below.... Yes No Unkn NA 8. Are there any electric or gas utility surcharges for line ex t ensions, special assessments or homeowner or other association fees that apply to the propeIf Yrty?e s, explain below.... Yes No Unkn NA 9. Are there certificates of occupancy related to the properIf Nty? o, explain below........ Yes No Unkn NA ENVIRONMENTAL Note to Seller: In this section, you will be asked questions regarding petro leum oducpr ts and hazardous or toxic substances that you know to have been sillep d, leaked or otherwise been released on the property or from the p rop ert y onto any other property. Petroleum products may include, but are notlimite d to, gasoline, diesel fuel, home heating fuel, and lubricants. Hazardous o r to xic subs tances 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 t o, fertilizers, pesticides and insecticid es, paint including paint thinner, varnish remover and wood preservatives, treated wood, construction materials such as asphalt and roofing materials, antifreeze and other automooductive pts,r batteries, cleaning solvents including sept ic t ank cleaners, household cleaners and pool chemicals and products containing mercury and lead. Note to Buyer: If contamination of this property from petroleum products and/azaror hdous or t ox ic subs tances 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 floodplIaf Yin?e s, explain belo w.... Yes No Unkn NA 11. Is any or all of the property located in a designated wetlaIf Ynd?e s, explain belo ......w Yes No Unkn NA 12. Is the property located in an agricultural distriIctf Y? es, explain belo .............w Yes No Unkn NA 13. Was the property ever the site of a landfill?If Y es, explain belo w................. Yes No Unkn NA DOS-1614 (1/02) PAGE 2 OF 6 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 3Property Condition Disclosure Statement 14. Are there or have there ever been fuel storage tanks above or below the ground on the property? ............................................................. Yes No Unkn NA If Y es, a re t hey c urrently i n u se?.................................... Yes No Unkn NA Location(s) Are they leaking or have they ever leakedIf
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