OWNER PROPERTY DISCLOSURE
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1 OWNER PROPERTY DISCLOSURE GENERAL INFORMATION Rental Property Address Owner s Name (First, MI, Last) Nickname Home # Business # Extension address Mobile # Pager # Address City State Zip code Name of spouse/co-owner Spouse nickname Is spouse a co-owner? (yes) (no) Spouse/co-owner work # Extension Spouse/co-owner Mobile # Spouse/co-owner Emergency name Emergency contact numbers Emergency relationship (example, son) HOME OWNER ASSOCIATION INFORMATION (HOA) 1
2 HOA name HOA address HOA phone number HOA Contact person INSURANCE - PLEASE FILL OUT INSURANCE AUTHORIZATION FORM Property Insurance company Insurance policy number Insurance agent name Insurance agent s telephone PROPERTY DETAILS Is there a security System Name of security company Code to turn off system Security alarm instructions Is there a home warranty please attach copy of warranty Warranty company Warranty company telephone Warranty contact name Is there a basement? Has basement ever flooded? Has basement ever had mold? List other basement problems If yes, is it finished? Please explain Please explain Is there a sump pump? What type of parking Is there an attic fan or smart vent? garage carport street parking other # of parking spaces Parking unit # Is there a storage unit? Is there a garage door opener Location # of openers 2
3 Location of mail box Mailbox information Keyed Combination Other Location of breaker box Location of main water shutoff Location of sprinkler shutoff Is there attic access? Is their crawl space access? Location of water heater Water heater age Type of heating unit Age of heater Last heating unit service Air-conditioning Type wall central A/C age Last A/C service Evaporative cooling unit Last cooling unit service Is there a water softener Type of TV connection Cable Satellite Dish Are additional TV connections at tenant s expense? Instructions What is the type of roofing What is the age of the roof? Are there any roof problems? comp shingle other years If roof problems, please explain What is the gutter condition? What is the water source? city septic If any water problems, explain Have there been any mold issues in the property If yes, please list below Are there working smoke alarms If so, how many and what locations 3
4 Are there CO detectors If so, how many and what locations Is there an irrigation system? Age of irrigation system Irrigation system instructions What type: Is there a monthly gardening service? Will you supply gardening service? List special gardening services you will supply Is there a swimming pool? Swimming pool service company Do you have a hot tub? provided by owner provided by HOA Pool service telephone Is there a hot tub service If so, list information below Are there any plumbing issues? If yes, please list below Are there any electrical issues? If yes, please list below Are there ceiling fans? If yes, how many Is there a fireplace or wood If yes, is it a gas fireplace? burning stove in the rental home? Detail the last chimney service Do we have your permission to have the chimney(s) cleaned annually at your expense? When was the gas fireplace service Is there a humidifier? When was the last humidifier service 4
5 Are there heated floors Do you have a pest control service? Pest control Company Pest control telephone Utilities: Company Phone # Tenant, Owner, or HOA Responsibility. Electric Gas Water Sewer Garbage Other Gas Shut Off Location: Water Shut Off Location: Additional Information Have you ever experienced drug problems in the property? If no, explain Have you ever had a meth lab? If no, explain Have you ever had lead-based paintwork? If no, explain Have you ever had asbestos work done? If no, explain Are windows and door operating properly If no, explain 5
6 Do doors have deadbolts? Are there any cracked windows or glass doors? If no, explain Is the property clean? If yes, please list below List any personal property left in the unit, such as lawn mowers, garden tools, Property Specific Information Do all doors have the same key? How many? List details if no Remote controls for garage door opener Remote controls for ceiling fan Remote for removable A/C unit How many? How many? How many? Schools Elementary Middle High School Advertising/Marketing Information Are pets allowed If pets allowed, be specific Will you permit a sign? Owner Signature and Date 6
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