Cal. Code Regs. tit. 10, § 2790.9
A. The Property has the items checked below (read across):
Range
Oven
Microwave
Dishwasher
Trash Compactor
Garbage Disposal
Washer/Dryer Hookups
Rain Gutters
Burglar Alarms
Smoke Detector(s)
Fire Alarm
TV Antenna
Satellite Dish
Intercom
Central Heating
Central Air Cndtng.
Evaporator Cooler(s)
Wall/Window Air Cndtng.
Sprinklers
Public Sewer System
Septic Tank
Sump Pump
Water Softener
Patio/Decking
Built-in Barbecue
Gazebo
Sauna
Hot Tub
Locking
Pool
Child
Spa
Locking
Safety Cover*
Resistant
Safety Cover*
Barrier*
Security Gate(s)
Automatic Garage Door Opener(s)
Number Remote Controls
Garage:
Attached
Not Attached
Carport
Pool/Spa
Heater:
Gas
Solar
Electric
Water Heater:
Gas
Water Heater: Anchored, Braced,
Private Utility or Other
or Strapped*
Water Supply:
City
Well
Gas Supple:
Utility
Bottled
Window Screen
Window Security Bars
Quick Release Mechanism on Bedroom Windows*
Exhaust Fans(s) in ____________________
220 Volt Wiring in ____________________
Fireplace(s) in ____________________
Gas Starter
Roof(s): Type:
Age: (approx.) __________
Other __________
To Seller's actual knowledge, are any of the above not in operating condition?
Yes
No. If yes, then describe.
(Attach additional sheets if necessary): ____________________
B. To Seller's actual knowledge, are there any significant defects/malfunctions in any of the following?
Yes
No. If yes, check appropriate space(s) below.
Interior Walls
Ceilings
Floors
Exterior Walls
Insulation
Roofs(s)
Windows
Doors
Foundation
Slab(s)
Driveways
Sidewalks
Walls/Fences
Electrical Systems
Plumbings/Sewers/Septics
Other Structural components
(Describe:
If any of the above is checked, explain (attach additional sheets if necessary):
* The garage door opener or child resistant pool barrier may not be in compliance with the safety standards relating to automatic reversing devices as set forth in Chapter 12.5 (commencing with Section 19890) of Part 3 of Division 13 of, or with the pool safety standards of Article 2.5 (commencing with Section 115920) of Chapter 5 of Part 10 of Division 104 of, the Health and Safety Code. The water heater may not be anchored, braced, or strapped in accordance with Section 19211 of the Health and Safety Code. Window security bars may not have quick-release mechanisms in compliance with the 1995 edition of the California Building Standards Code.
C. Does Seller have actual knowledge of any of the following:
1.
Substances, materials or products which may be an environmental hazard such as, but not limited to, asbestos, formaldehyde, radon gas, lead-based paint. mold, fuel or chemical storage tanks, and contaminated soil or water on the subject property
Yes
No
2.
Features of the property shared in common with adjoining landowners, such as walls, fences, and driveways, whose use or responsibility for maintenance may have an effect on the subject property
Yes
No
3.
Any encroachments, easements or similar matters that may affect your interest in the subject property
Yes
No
4.
Room additions, structural modifications, or other alterations or repairs made without necessary permits
Yes
No
5.
Room additions, structural modifications, or other alterations or repairs not in compliance with building codes
Yes
No
6.
Fill (compacted or otherwise) on the property or any portion thereof
Yes
No
7.
Any settling from any cause, or slippage, sliding, or other soil problems
Yes
No
8.
Flooding, drainage or grading problems
Yes
No
9.
Major damage to the property or any of the structures from fire, earthquake, floods, or landslides
Yes
No
10.
Any zoning violations, nonconforming uses, violations of “setback” requirements
Yes
No
11.
Neighborhood noise problems or other nuisances
Yes
No
12.
CC&Rs or other deed restrictions or obligations
Yes
No
13.
Homeowners' Association which has any authority over the subject property
Yes
No
14.
Any “common area” (facilities such as pools, tennis courts, walkways, or other areas co-owned in undivided interest with others)
Yes
No
15.
Any notices of abatement or citations against the property
Yes
No
16.
Any lawsuits by or against the Seller threatening to or affecting this real property, including any lawsuits alleging a defect or deficiency in this real property or “common areas” (facilities such as pools, tennis courts, walkways, or other areas co-owned in undivided interest with others)
Yes
No
If the answer to any of these is yes and they are not included in the preliminary title report, explain. (Attach additional sheets if necessary.)
The information herein is true and correct to the Seller's actual knowledge, as of the date signed by the Seller or Seller's representative.
Seller ____________________
Date ____________________
BUYER(S) MAY WISH TO OBTAIN PROFESSIONAL ADVICE AND/OR INSPECTIONS OF THE PROPERTY AND TO PROVIDE FOR APPROPRIATE PROVISIONS IN A CONTRACT BETWEEN BUYER(S) AND SELLER(S) WITH RESPECT TO ANY ADVICE/INSPECTION/DEFECTS.
I/WE ACKNOWLEDGE RECEIPT OF A COPY OF THIS STATEMENT.
BUYER
DATE
BUYER
DATE
The form approved by the Commissioner for the disclosure of Existing Subdivision Interest information is as follows:
EXISTING SUBDIVISION INTEREST DISCLOSURE STATEMENT
THIS EXISTING SUBDIVISION INTEREST DISCLOSURE STATEMENT (THIS “DISCLOSURE STATEMENT”) CONCERNS THE REAL PROPERTY SITUATED IN THE CITY OF____________________, COUNTY OF ____________________, STATE OF CALIFORNIA, DESCRIBED AS _________________________ (THE “EXISTING SUBDIVISION INTEREST”). THIS STATEMENT IS A DISCLOSURE OF THE CONDITION OF THE EXISTING SUBDIVISION INTEREST AS OF (date)__________, 20___, WITHIN THE SELLER'S ACTUAL KNOWLEDGE. IT IS NOT A REPRESENTATION OR WARRANTY OF ANY KIND BY THE SELLER(S) OR ANY AGENT(S) REPRESENTING ANY PRINCIPAL(S) IN THIS TRANSACTION, AND IS NOT A SUBSTITUTE FOR ANY INSPECTIONS OR WARRANTIES THE BUYER(S) MAY WISH TO OBTAIN.
I. COORDINATION WITH OTHER DISCLOSURE FORMS AND EXISTING REPORTS
All parties acknowledge that the real property being purchased is a lot, condominium unit or other interest in the Existing Subdivision Interest (the “Property”) and the Seller hereby discloses to the Buyer in this transaction that the following inspection reports, if any, regarding the Property were completed and are or have been in the possession of the Seller:
Description/type
Vendor (by)
Date on Report
1.
2.
3.
4.
5.
6.
7.
8.
Buyer may request a copy of any of the reports listed above in writing within 5 days after receipt of this Disclosure Statement.
The following disclosures and other disclosures required by law, applicable to the condition of the Property, have or will be made in connection with this real estate transfer, and shall satisfy the disclosure obligations on this form, where the subject matter is the same.
Inspection reports completed pursuant to the contract of sale or receipt for deposit.
Additional inspection reports or disclosures:
The disclosures and reports identified in this Section are collectively called the “Existing Disclosures.”
II. SELLER'S INFORMATION
The Seller discloses the following information with the knowledge that this is not a representation or warranty. Seller hereby authorizes any agent(s) representing any principal(s) 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 Property.
The information disclosed in this Disclosure Statement is limited to information which Seller actually knows, based on reasonable efforts to obtain such information. The phrases “Seller's knowledge” and “Seller's awareness” when used herein, are limited accordingly.
THE FOLLOWING ARE DISCLOSURES MADE BY THE SELLER AND ARE NOT THE DISCLOSURES OF THE AGENT(S), IF ANY. THIS INFORMATION IS A DISCLOSURE AND IS NOT PART OF ANY CONTRACT BETWEEN THE BUYER AND SELLER,
Seller or Seller's tenant
is
is not occupying the Property.
Note: Authority cited: Section 11001, Business and Professions Code. Reference: Sections 10050 and 11010, Business and Professions Code.
1. New section filed 2-14-2008; operative 3-15-2008 (Register 2008, No. 7).