The criteria of this chapter applies to transfers of real estate subject to Iowa Code chapter 558A. For purposes of this chapter, "transfer" means the same as Iowa Code section 558A.1(5) and "agent" means the same as Iowa Code section 558A.1(1).
RESIDENTIAL PROPERTY SELLER DISCLOSURE STATEMENT
Property address: ______________________________________________
PURPOSE:
Use this statement to disclose information as mandated by Iowa Code chapter 558A. This law obligates certain sellers of residential property that includes at least one and no more than four dwelling units to disclose information about the property to be sold. The following disclosures are made by the seller(s) and not by any agent acting on behalf of the seller(s).
INSTRUCTIONS TO SELLER(S):
Any known repairs? Yes [ ] No [ ]
If yes, date of repairs/replacement: ____/____/____
If N/A check here [ ]
Any known repairs? Yes [ ] No [ ]
If yes, date of repairs/replacement: ____/____/____
Any known water tests? Yes [ ] No [ ]
If yes, date of last report: ____/____/____
and results: ________________________________________________
If N/A check here [ ]
Location of tank: _____________________________________________
Date tank last cleaned: ____/____/____
Any known repairs? Yes [ ] No [ ]
If yes, date of repairs/replacement: ____/____/____
Any known repairs? Yes [ ] No [ ]
If yes, date of repairs/replacement: ____/____/____
Any known repairs? Yes [ ] No [ ]
If yes, date of repairs/replacement: ____/____/____
Any known repairs? Yes [ ] No [ ]
If yes, date of repairs/replacement: ____/____/____
Any known repairs? Yes [ ] No [ ]
If yes, date of repairs/replacement: ____/____/____
If yes, date(s) of treatment: ____/____/____
Any known structural damage? Yes [ ] No [ ]
If yes, date(s) of repairs/replacement: ____/____/____
If yes, explain: ______________________________________________
If yes, date of last report: ____/____/____
and results: ______________________________________________
If yes, what is the flood plain designation? ______________________________________________
If yes, what is the zoning classification? ________________________________
If yes, attach a copy or state where a true, current copy of the covenants can be obtained:
__________________________________________________
Any known "common areas" such as pools, tennis courts, walkways, or other areas co-owned with others, or a Homeowner's Association which has any authority over the property? Yes [ ] No [ ]
You need to explain any "YES" response(s) above. Use the back of this statement or additional sheets as necessary: _________________________________________________________
_____________________________________________________________
_____________________________________________________________
____________________________________________________________
SELLER(S) DISCLOSURE:
Seller(s) discloses the information regarding this property based on information known or reasonably available to the Seller(s).
The Seller(s) has owned the property since ____/____/____. The Seller(s) certifies that as of the date signed this information is true and accurate to the best of my/our knowledge.
Seller(s) acknowledges that Buyer(s) be provided with the "Iowa Radon Home-Buyers and Sellers Fact Sheet" prepared by the Iowa Department of Health and Human Services.
Seller____________________________ Seller________________________
Date ____/____/____ Date ____/____/____
BUYER(S) ACKNOWLEDGMENT:
Buyer(s) acknowledges receipt of a copy of this Real Estate Disclosure Statement. This statement is not intended to be a warranty or to substitute for any inspection Buyer(s) may wish to obtain.
Buyer(s) acknowledges receipt of the "Iowa Radon Home-Buyers and Sellers Fact Sheet" prepared by the Iowa Department of Health and Human Services.
Buyer___________________________ Buyer________________________________
Date ____/____/____ Date ____/____/____
This rule is intended to implement Iowa Code chapters 17A, 272C, 543B, and 558A.
Iowa Admin. Code r. 193E-14.1