Tennessee Residential Property
Condition Disclosure
The Tennessee Residential Property Disclosure Act states that anyone transferring title to residential real property must provide information about the condition of the property. This completed form constitutes that disclosure by the Seller. This is not a warranty, or a substitute for any professional inspections or warranties that the purchasers may wish to obtain.
Instructions to the Seller:
Complete this form yourself and answer each question to the best of your knowledge. If an answer is an estimate, clearly label it as such. The Seller hereby authorizes any agent(s) representing any party in this transaction to provide a copy of this statement to any person or entity in connection with any actual or anticipated sale of the subject property.
Property Address __________________________________________City _______________
Seller's Name(s) ______________________________________________________________
Property Age __________
Date Seller Acquired the Property _____________________________________________
Do You Occupy the Property? __________
If Not Owner-Occupied, How Long Has It Been Since the Seller Occupied the Property? __________
A. The Subject Property Includes the Items Checked Below:
____ Range
____ Oven
____ Microwave
____ Dishwasher
____ Garbage Disposal
____ Trash Compactor
____ Water Softener
____ 220 Volt Wiring
____ Washer/Dryer Hookups
____ Central Heating
____ Heat Pump
____ Central Air Conditioning
____ Wall/Window Air Conditioning
____ Window Screens
____ Rain Gutters
____ Fireplace(s) (Number ___)
____ Gas Starter for Fireplace
____ Smoke Detector/Fire Alarm
____ Burglar Alarm
____ Patio/Decking/Gazebo
____ Irrigation System
____ Sump Pump
____ Garage Door Opener(s) (Number of Openers ___)
____ Intercom
____ TV Antenna/Satellite Dish
____ Pool
____ Spa/Whirlpool Tub
____ Hot Tub
____ Sauna
____ Current Termite Contract
____ Access to Public Streets
____ Other ___________________________________________________________
____ Other ___________________________________________________________
Garage: __ Attached __ Not Attached __ Carport
Water Heater: __Gas __ Solar __ Electric
Water Supply: __ City __ Well __ Private
__ Utility __ Other
Waste Disposal: __ City Sewer __ Septic Tank __ Other
Gas Supply: __ Utility __ Bottled __ Other ____
Roof(s): Type _______________ Age (approx.) __________________
Other Items: _________________________________________________
To the best of your knowledge, are any of the above NOT in operating condition?
___YES ___NO
If YES, then describe (Attach additional sheets if necessary): ______
B. Are You (Seller) Aware of Any Significant Defects/Malfunctions in Any of the Following?
Interior Walls YES NO UNKNOWN
Ceilings YES NO UNKNOWN
Floors YES NO UNKNOWN
Windows YES NO UNKNOWN
Doors YES NO UNKNOWN
Insulation YES NO UNKNOWN
Plumbing YES NO UNKNOWN
Sewer/Septic YES NO UNKNOWN
Electrical System YES NO UNKNOWN
Exterior Walls YES NO UNKNOWN
Roof YES NO UNKNOWN
Basement YES NO UNKNOWN
Foundation YES NO UNKNOWN
Slab YES NO UNKNOWN
Driveway YES NO UNKNOWN
Sidewalks YES NO UNKNOWN
Central Heating YES NO UNKNOWN
Heat Pump YES NO UNKNOWN
Central Air Conditioning YES NO UNKNOWN
If any of the above is/are marked YES, please explain: ___
C. Are You (Seller) Aware of Any of the Following?
1. Substances, materials or products which may be an environmental hazard such as, but not limited to: asbestos, radon gas, lead-based paint, fuel or chemical storage tanks and/or contaminated soil or water on the subject property?
YES NO UNKNOWN
2. Features shared in common with adjoining landowners, such as walls, but not limited to, fences and driveways, with joint rights and obligations for use and maintenance?
YES NO UNKNOWN
3. Any authorized changes in roads, drainage or utilities affecting the property, or contiguous to the property?
YES NO UNKNOWN
4. Any changes since the most recent survey of this property was done?
YES NO UNKNOWN
Most recent survey of the property: __________(check here if unknown.)__________
5. Any encroachments, easements, or similar items that may affect your ownership interest in the subject property?
YES NO UNKNOWN
6. Room additions, structural modifications or other alterations or repairs made without necessary permits?
YES NO UNKNOWN
7. Room additions, structural modifications or other alterations or repairs not in compliance with building codes?
YES NO UNKNOWN
8. Landfill (compacted or otherwise) on the property or any portion thereof?
YES NO UNKNOWN
9. Any settling from any cause, or slippage, sliding or other soil problems?
YES NO UNKNOWN
10. Flooding, drainage or grading problems?
YES NO UNKNOWN
11. Any requirement that flood insurance be maintained on the property?
YES NO UNKNOWN
12. Property or structural damage from fire, earthquake, floods or landslides?
YES NO UNKNOWN
13. Any zoning violations, nonconforming uses and/or violations of "setback" requirements?
YES NO UNKNOWN
14. Neighborhood noise problems or other nuisances?
YES NO UNKNOWN
15. Subdivision and/or deed restrictions or obligations?
YES NO UNKNOWN
16. A Homeowners Association (HOA) which has any authority over the subject property?
YES NO UNKNOWN
Name of HOA: __________
HOA Address: __________
Monthly Dues: __________ Special Assessments: __________
17. Any "common area" (facilities such as pools, tennis courts, walkways, or other areas co-owned in undivided interest with others)?
YES NO UNKNOWN
18. Any notices of abatement or citations against the property?
YES NO UNKNOWN
19. Any lawsuit(s) against the seller threatening to or affecting this real property?
YES NO UNKNOWN
If the answer to any of the above is YES, please explain: ______
20. Is any system, equipment or part of the property being leased?
YES NO UNKNOWN
21. Any exterior wall covering of the structure(s) covered with exterior insulation and finish systems (EIFS), also known as "synthetic stucco"?
YES NO UNKNOWN
If yes, has there been a recent inspection to determine whether the structure has excessive moisture accumulation and/or moisture related damages? (The Tennessee Real Estate Commission urges any buyer or seller who encounters this product to have a qualified professional inspect the structure in question for the preceding concern and provide a written report of the professional’s finding.)
YES NO UNKNOWN
If yes, please explain. If necessary, please attach an additional sheet. _____________________
_____________________________________________________________________________
_____________________________________________________________________________
D. Certification: I/we certify that the information herein, concerning the real property located at _____________________________, is true and correct to the best of my/our knowledge as of the date signed. Should any of these conditions change prior to conveyance of title to this property, these changes will be disclosed in addenda to this document.
___________________________________ ___________________________________
Transferor (Seller) Date
___________________________________ ___________________________________
Transferor (Seller) Date
Parties may wish to obtain professional advice and/or inspections of the property and to negotiate appropriate provisions in the purchase agreement regarding advice, inspections or defects.
Transferee/Buyer's Acknowledgement:
I/we understand that this disclosure statement is not intended as a substitute for any inspection, and that I/we have a responsibility to pay diligent attention to and inquire about those material defects which are evident by careful observation.
I/we acknowledge receipt of a copy of this disclosure.
___________________________________ ___________________________________
Transferee (Buyer) Date
___________________________________ ___________________________________
Transferee (Buyer) Date
James H. Forsythe
Attorney at Law
6410 Poplar Avenue, Suite 130
Memphis, Tennessee 38119-4839
Phone: (901) 767-0057
Fax: (901) 767-0927
E-mail: forsythe@bellsouth.net