"Property Disclosure Statement Form" - Kansas

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Kansas Property Disclosure Statement
_________________________________
_________________________________
Seller’s Name
Buyer’s Name
_______________________________________________________________________
Property Address
Notice to Seller: ​ T his Property Disclosure Statement (hereinafter referred to as the “Disclosure”)
allows a seller of residential property to disclose to a potential buyer all known facts that
materially and adversely affect the value of the subject property that is not readily observable.
This Disclosure is designed to assist the seller with informing a potential buyer in evaluating the
property for purchase. The listing real estate agent, the selling real estate agent, and their
respective agents will also rely upon this information when marketing and presenting the
property to prospective buyers. The completion of this Disclosure should be done in accordance
with State law.
Notice to Buyer: ​ T he information provided is the representation is of the seller's best knowledge
as of the date noted. Disclosure by the seller is not a substitute for an inspection and you may
wish to obtain such an independent home inspection company. The information contained in this
statement is not a warranty by the seller as to the condition of the property, of which the seller is
required to disclose any known latent (hidden, concealed, or unseen) defects to any potential
Buyer.
1. Ownership. ​ _ __________________________________________________________
Property Type (i.e., Single Family, Condo, etc.)
_________________________________
_________________________________
Year Built
Ownership Length
Accurate survey of the property?
☐ Yes
☐ No
☐ N/A
_________________________________
_________________________________
Lived in Since
Lived in Until
Other Comments: ​
_ _______________________________________________________
© ​
T EMPLATEROLLER.COM
Kansas Property Disclosure Statement
_________________________________
_________________________________
Seller’s Name
Buyer’s Name
_______________________________________________________________________
Property Address
Notice to Seller: ​ T his Property Disclosure Statement (hereinafter referred to as the “Disclosure”)
allows a seller of residential property to disclose to a potential buyer all known facts that
materially and adversely affect the value of the subject property that is not readily observable.
This Disclosure is designed to assist the seller with informing a potential buyer in evaluating the
property for purchase. The listing real estate agent, the selling real estate agent, and their
respective agents will also rely upon this information when marketing and presenting the
property to prospective buyers. The completion of this Disclosure should be done in accordance
with State law.
Notice to Buyer: ​ T he information provided is the representation is of the seller's best knowledge
as of the date noted. Disclosure by the seller is not a substitute for an inspection and you may
wish to obtain such an independent home inspection company. The information contained in this
statement is not a warranty by the seller as to the condition of the property, of which the seller is
required to disclose any known latent (hidden, concealed, or unseen) defects to any potential
Buyer.
1. Ownership. ​ _ __________________________________________________________
Property Type (i.e., Single Family, Condo, etc.)
_________________________________
_________________________________
Year Built
Ownership Length
Accurate survey of the property?
☐ Yes
☐ No
☐ N/A
_________________________________
_________________________________
Lived in Since
Lived in Until
Other Comments: ​
_ _______________________________________________________
© ​
T EMPLATEROLLER.COM
_______________________________________________________________________
_______________________________________________________________________
2. Water Supply.​ ________________________________________________________
Type (i.e., Public, Well, etc.)
_______________________________________________________________________
Issues with Water Supply
_______________________________________________________________________
Water Treatment Systems
_______________________________________________________________________
Fire Sprinkler Systems
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
3. Sewage Disposal.​ ______________________________________________________
Type (i.e., Public, Septic, etc.)
How many bedrooms is the sewage disposal approved for? _______________________
Is the septic system functioning properly?​
_____________________________________
When was the last time the septic system was pumped? __________________________
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
4. Heating.​ _____________________________________________________________
Type (i.e., Oil, Natural Gas, Electric, Propane, etc.)
Is heat supplied to all finished rooms? ________________________________________
Are the systems in operating condition? _______________________________________
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
© ​
T EMPLATEROLLER.COM
_______________________________________________________________________
5. Air Conditioning.​
_ _____________________________________________________
Type (i.e., Oil, Natural Gas, Electric, Propane, etc.)
Is air conditioning supplied to all finished rooms? _______________________________
Is the air conditioning system in operating condition? ____________________________
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
6. Hot Water.​ ___________________________________________________________
Type (i.e., Oil, Natural Gas, Electric, etc.) and Age
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
7. Foundation. ​ _ _________________________________________________________
Settlement or Other Problems
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
8. Basements and Cellars. ​ ________________________________________________
Leaks or Excessive Moisture
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
9. Roof. ​ _ _______________________________________________________________
Leaks or Evidence of Moisture
_______________________________________________________________________
Existing Fire-Retardant Treated Plywood
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T EMPLATEROLLER.COM
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
10. Plumbing System. ​ ____________________________________________________
Type and Age
Is the plumbing system in operating condition? _________________________________
Are there any known issues with the plumbing system?​
__________________________
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
11. Electric Systems.​
_____________________________________________________
Issues with the Electrical System
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
12. Insulation. ​ _ _________________________________________________________
Insulation in Exterior Walls
_______________________________________________________________________
Insulation in Floor
_______________________________________________________________________
Insulation in Other Areas
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
13. Exterior Drainage. ​ _ __________________________________________________
Condition of Gutters and Downspouts
Other Comments: ​
_ _______________________________________________________
© ​
T EMPLATEROLLER.COM
_______________________________________________________________________
_______________________________________________________________________
14. Wood-Destroying Insects.​
_ _____________________________________________
Known Infestations or Damage
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
15. Carbon Monoxide Alarm. ​ I s there a carbon monoxide alarm on the property?
_______________________________________________________________________
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
16. Hazardous Materials. Are there any hazardous or regulated materials located on the
property, including, but not limited to, mold, asbestos, radon gas, lead-based paint,
licensed landfills, methamphetamine labs, underground storage tanks, any mining
operations, or other past contamination?
_______________________________________________________________________
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
17. Fire.​ _______________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Number and Condition of Fireplaces, Wood Stoves, or Chimneys
Other Comments: ​
_ _______________________________________________________
_______________________________________________________________________
© ​
T EMPLATEROLLER.COM
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