Pennsylvania Code
Title 49 - PROFESSIONAL AND VOCATIONAL STANDARDS
Part I - DEPARTMENT OF STATE
Subpart A - PROFESSIONAL AND OCCUPATIONAL AFFAIRS
Chapter 35 - STATE REAL ESTATE COMMISSION
Subchapter E - STANDARDS OF CONDUCT AND PRACTICE
REAL ESTATE DOCUMENTS
Section 35.335a - Seller property disclosure statement

(i) Date roof was installed:________________ . Documented? yes ________________ no ________________ unknown

(ii) Has the roof been replaced or repaired during your ownership? yes ________________ no If "yes," were the existing shingles removed? yes ________________ no ________________ unknown

(iii) Has the roof ever leaked during your ownership?________________ yes ________________ no

(iv) Do you know of any problems with the roof, gutters or downspouts? yes ________________ no

Explain any "yes" answers that you give in this section:

________________________________________________________________________________

________________________________________________________________________________

(i) Does the property have a sump pump?________________ yes ________________ no ________________ unknown

(ii) Are you aware of any water leakage, accumulation or dampness within the basement or crawl space?__________yes ________________ no If "yes," describe in detail: ________________

________________

(iii) Do you know of any repairs or other attempts to control any water or dampness problem in the basement or crawl space?________________ yes ________________ no

If "yes," describe the location, extent, date and name of the person who did the repair or control effort:

___________________________________________________________

____________________________________________________________

(i) Are you aware of any termites/wood destroying insects, dry rot or pests affecting the property?________________ yes ________________ no

(ii) Are you aware of any damage to the property caused by termites/wood destroying insects, dry rot or pests?________________ yes ________________ no

(iii) Is your property currently under contract by a licensed pest control company?________________ yes ________________ no

(iv) Are you aware of any termite/pest control reports or treatments for the property in the last five years?________________ yes ________________ no

Explain any "yes" answers that you give in this section:

________________

________________

(i) Are you aware of any past or present water leakage in the house or other structures?________________ yes ________________ no

(ii) Are you aware of any past or present movement, shifting, deterioration or other problems with walls, foundations or other structural components?________________ yes _______________ no

(iii) Are you aware of any past or present problems with driveways, walkways, patios or retaining walls on the property? ______________ yes ________________no

Explain any "yes" answers that you give in this section:

________________

________________

When explaining efforts to control or repair, please describe the location and extent of the problem and the date and person by whom the work was done, if known:

________________

________________

(i) What is the source of your drinking water?________________ public ________________ community system ________________ well on property ________________ other

If "other," please explain: ________________________

____________________________________________

(ii) If your drinking water source is not public:__________________

When was your water last tested? ________________

What was the result of the test? ________________

Is the pumping system in working order? ________________ yes ________________ no

If "no," please explain: ________________

_____________________________________

(iii) Do you have a softener, filter or other purification system?________________ yes ________________ no

If "yes," is the system: ________________ leased ________________ owned

(iv) What is the type of sewage system?________________ public sewer ________________ private sewer ________________ septic tank ________________ cesspool ________________ other

If "other," please explain: ________________

(v) Is there a sewage pump?________________ yes ________________ no

If "yes," is it in working order? ________________ yes ________________ no

(vi) If applicable, when was the septic system or cesspool last serviced?

(vii) Is either the water or sewage system shared?________________ yes ________________ no

If "yes," please explain: ________________

(viii) Are you aware of any leaks, backups or other problems relating to any of the plumbing, water and sewage-related items?________________ yes ________________ no

If "yes," please explain: ________________

(i) Type of plumbing:_______________ copper ________________ galvanized ________________ lead ________________ PVC ________________ unknown ________________ other

If "other," please explain: ________________

(ii) Are you aware of any problems with any of your plumbing fixtures (including, but not limited to: kitchen, laundry or bathroom fixtures, wet bars, hot water heater, etc.)? _____________ yes ________________ no

If "yes," please explain: _________________________________

(i) Type of air conditioning:________________ central ________________ electric ________________ central gas ________________ wall ________________ none

(ii) List any areas of the house that are not air conditioned:____________

________________

(iii) Type of heating:________________ electric ________________ fuel ________________ oil natural gas ________________ other

If "other," please explain: ________________

(iv) List any areas of the house that are not heated:________________

________________

(v) Type of water heating:________________ electric ________________ gas ________________ solar ________________ other

If "other," please explain: ________________

(vi) Are you aware of any underground fuel tanks on the property? __________ yes ________________ no

If "yes," please describe: ________________

Are you aware of any problems with any item in this section? ________________ yes ________________ no

If "yes," please explain: ________________

(i) Are you aware of any fill or expansive soil on the property?________________ yes ________________ no

(ii) Are you aware of any sliding, settling, earth movement, upheaval, subsidence or earth stability problems that have occurred on or that affect the property?________________ yes ________________ no

NOTE TO BUYER: Some properties may be subject to mine subsidence damage. Maps of the counties and mines where mine subsidence damage may occur and mine subsidence insurance are available through the Department of Environmental Protection, Mine Subsidence Insurance Fund.

(iii) Are you aware of any existing or proposed mining, strip mining or any other excavations that might affect this property?________________ yes ________________ no

(iv) To your knowledge, is this property or part of it located in a flood zone or wetlands area?________________ yes ________________ no

(v) Do you know of any past or present drainage or flooding problems affecting the property?________________ yes ________________ no

(vi) Do you know of any encroachments, boundary line disputes or easements?________________ yes ________________ no

NOTE TO BUYER: Most properties have easements running across them for utility services and other reasons. In many cases, the easements do not restrict the ordinary use of the property, and the seller may not be readily aware of them. Buyers may wish to determine the existence of easements and restrictions by examining the property and ordering an abstract of title or searching the records in the Office of the Recorder of Deeds for the county before entering into an agreement of sale.

(vii) Are you aware of any shared or common areas (for example, driveways, bridges, docks, walls, etc.) or maintenance agreements? ________ yes ________________ no

(viii) Are you aware of any sinkholes that have developed on the property? _________ yes ________________ no

Explain any "yes" answers that you give in this section:

________________

________________

(i) Are you aware of any underground tanks or hazardous substances present on the property (structure or soil), including, but not limited to, asbestos, polychlorinated byphenyls (PCBs), radon, lead paint, urea-formaldehyde foam insulation (UFFI), etc? _______yes ________________ no

(ii) To your knowledge, has the property been tested for any hazardous substances?________________ yes ________________ no

(iii) Do you know of any other environmental concerns that might impact upon the property?________________ yes ________________ no

Explain any "yes" answers that you give in this section:

________________

________________

________________

(i) Do you know the location and condition of any basin, pond, ditch, drain, swale, culvert, pipe or other manmade feature of land that temporarily or permanently conveys or manages storm water for the property?________________ yes ________________ no ________________ unknown

(ii) If the answer to (i) is yes, is the owner of this property responsible for the ongoing maintenance of the storm water facility? ________________ yes ________________ no ________________ unknown

Explain any "yes" answers that you give in this section:

________________

________________

________________

(i) Are you aware of any existing or threatened legal action affecting the property? _______ yes _________ no

(ii) Do you know of any violations of Federal, State or local laws or regulations relating to this property?________________ yes ________________ no

(iii) Are you aware of any public improvement, condominium or homeowner association assessments against the property that remain unpaid or of any violations of zoning, housing, building safety or fire ordinances that remain uncorrected?________________ yes ________________ no

(iv) Are you aware of any judgment, encumbrance, lien (for example, comaker or equity loan) or other debt against this property that cannot be satisfied by the proceeds of this sale?________________ yes ________________ no

(v) Are you aware of any reason, including a defect in title, that would prevent you from giving a warranty deed or conveying title to the property?________________ yes ________________ no

(vi) Are you aware of any material defects to the property, dwelling or fixtures which are not disclosed elsewhere on this form?________________ yes ________________ no

A material defect is a problem with the property or any portion of it that would have a significant adverse impact on the value of the residential real property or that involves an unreasonable risk to people on the land.

Explain any "yes" answers that you give in this section:

___________________________________________________

___________________________________________________

The undersigned seller represents that the information set forth in this disclosure statement is accurate and complete to the best of the seller's knowledge. The seller hereby authorizes any agent for the seller to provide this information to prospective buyers of the property and to other real estate agents. The seller alone is responsible for the accuracy of the information contained in this statement. The seller shall cause the buyer to be notified in writing of any information supplied on this form that is rendered inaccurate by a change in the condition of the property following the completion of this form.

EXECUTOR, ADMINISTRATOR, TRUSTEE

The undersigned has never occupied the property and lacks the personal knowledge necessary to complete this disclosure statement.

_______________________________________________

________________ DATE__________________________

RECEIPT AND ACKNOWLEDGMENT BY BUYER

The undersigned buyer acknowledges receipt of this disclosure statement. The buyer acknowledges that this statement is not a warranty and that, unless stated otherwise in the sales contract, the buyer is purchasing this property in its present condition. It is the buyer's responsibility to satisfy himself or herself as to the condition of the property. The buyer may request that the property be inspected, at the buyer's expense and by qualified professionals, to determine the condition of the structure or its components.