21 NCAC 58A .0114 RESIDENTIAL
PROPERTY AND OWNERS' ASSOCIATION DISCLOSURE STATEMENT
(a) Every owner of real property subject to a transfer of
the type governed by Chapter 47E of the General Statutes shall complete the
following Residential Property and Owners' Association Disclosure Statement and
furnish a copy of the complete statement to a purchaser in accordance with the
requirements of G.S. 47E-4. The form shall bear the seal of the North Carolina
Real Estate Commission and shall read as follows:
[N.C. REAL ESTATE COMMISSION SEAL]
STATE OF NORTH CAROLINA
RESIDENTIAL PROPERTY AND OWNERS' Association DISCLOSURE
STATEMENT
Instructions to
Property Owners
1. The Residential Property
Disclosure Act (G.S. 47E) ("Disclosure Act") requires owners of
residential real estate (single-family homes, individual condominiums,
townhouses, and the like, and buildings with up to four dwelling units) to
furnish purchasers a Residential Property and Owners' Association Disclosure
Statement ("Disclosure Statement"). This form is the only one
approved for this purpose. A disclosure statement must be furnished in
connection with the sale, exchange, option, and sale under a lease with option
to purchase where the tenant does not occupy or intend to occupy the dwelling.
A disclosure statement is not required for some transactions, including the
first sale of a dwelling which has never been inhabited and transactions of
residential property made pursuant to a lease with option to purchase where the
lessee occupies or intends to occupy the dwelling. For a complete list of
exemptions, see G.S. 47E-2.
2. You must respond to each of the
questions on the following pages of this form by filling in the requested
information or by placing a check (√) in the appropriate box. In
responding to questions, you are only obligated to disclose information about
which you have actual knowledge.
a. If you check "Yes" for
any question, you must explain your answer and either describe any problem or
attach a report from an attorney, engineer, contractor, pest control operator
or other expert or public agency describing it. If you attach a report, you will
not be liable for any inaccurate or incomplete information contained in it so
long as you were not grossly negligent in obtaining or transmitting the
information.
b. If you check "No," you
are stating that you have no actual knowledge of any problem. If you check
"No" and you know there is a problem, you may be liable for making an
intentional misstatement.
c. If you check "No
Representation," you are choosing not to disclose the conditions or
characteristics of the property, even if you have actual knowledge of them or
should have known of them.
d. If you check "Yes" or
"No" and something happens to the property to make your Disclosure
Statement incorrect or inaccurate (for example, the roof begins to leak), you
must promptly give the purchaser a corrected Disclosure Statement or correct
the problem.
3. If you are assisted in the sale of
your property by a licensed real estate broker, you are still responsible for
completing and delivering the Disclosure Statement to the purchasers; and the
broker must disclose any material facts about your property which he or she
knows or reasonably should know, regardless of your responses on the Statement.
4. You must give the completed
Disclosure Statement to the purchaser no later than the time the purchaser
makes an offer to purchase your property. If you do not, the purchaser can,
under certain conditions, cancel any resulting contract (See "Note to
Purchasers" below). You should give the purchaser a copy of the
Disclosure Statement containing your signature and keep a copy signed by the
purchaser for your records.
Note to
Purchasers
If the owner does not give you a Residential Property and
Owners' Association Disclosure Statement by the time you make your offer to
purchase the property, you may under certain conditions cancel any resulting
contract without penalty to you as the purchaser. To cancel the contract,
you must personally deliver or mail written notice of your decision to cancel
to the owner or the owner's agent within three calendar days following your
receipt of the Disclosure Statement, or three calendar days following the
date of the contract, whichever occurs first. However, in no event does the
Disclosure Act permit you to cancel a contract after settlement of the
transaction or (in the case of a sale or exchange) after you have occupied
the property, whichever occurs first.
5. In the space below, type or print
in ink the address of the property (sufficient to identify it) and your name.
Then sign and date.
Property Address: _____________________________________________________________________
Owner's Name(s): _____________________________________________________________________
Owner(s) acknowledge(s) having examined this Disclosure
Statement before signing and that all information is true and correct as of
the date signed.
Owner
Signature:__________________________________________________ Date _________,
____
Owner
Signature:__________________________________________________ Date _________,
____
Purchasers acknowledge receipt of a copy of this
Disclosure Statement; that they have examined it before signing; that they
understand that this is not a warranty by owners or owners' agents; that it
is not a substitute for any inspections they may wish to obtain; and that the
representations are made by the owners and not the owners' agents or
subagents. Purchasers are strongly encouraged to obtain their own
inspections from a licensed home inspector or other professional. As used
herein, words in the plural include the singular, as appropriate.
Purchaser
Signature:________________________________________________ Date ________,
____
Purchaser
Signature:________________________________________________ Date ________,
____
Property Address/Description:__________________________________________________________________
___________________________________________________________________________________________
The following questions address the characteristics and
condition of the property identified above about which the owner has actual
knowledge. Where the question refers to "dwelling," it is
intended to refer to the dwelling unit, or units if more than one, to be
conveyed with the property. The term "dwelling unit" refers to any structure
intended for human habitation.
No Repre-
Yes No sentation
1. In what year was the dwelling
constructed? ________________
Explain if necessary:
_____________________________________________________
□
2. Is there any problem, malfunction or
defect with the dwelling's foundation, slab, fireplaces/chimneys, floors,
windows (including storm windows and screens), doors, ceilings, interior and
exterior walls, attached garage, patio, deck or other structural components
including any modifications to them?
□
□
□
3. The dwelling's exterior walls are made
of what type of material? □ Brick Veneer □ Wood □
Stone □ Vinyl □ Synthetic Stucco □
Composition/Hardboard □ Concrete □ Fiber Cement □ Aluminum
□ Asbestos □ Other __________________________
(Check all that apply)
□
4. In what year was the dwelling's roof
covering installed? _______________
(Approximate if no records are
available.) Explain if necessary: ________________________________________________________________________
□
5. Is there any leakage or other problem
with the dwelling's roof?
□
□
□
6. Is there any water seepage, leakage,
dampness or standing water in the dwelling's basement, crawl space, or slab?
□
□
□
7. Is there any problem, malfunction or
defect with the dwelling's electrical system (outlets, wiring, panel,
switches, fixtures, generator, etc.)?
□
□
□
8. Is there any problem, malfunction or
defect with the dwelling's plumbing system (pipes, fixtures, water heater,
etc.)?
□
□
□
9. Is there any problem, malfunction or
defect with the dwelling's heating and/or air conditioning?
□
□
□
10. What is the dwelling's heat source?
□ Furnace □ Heat Pump □ Baseboard
□ Other________________________
(Check all that apply)
Age of system: ________________
□
11. What is the dwelling's cooling source?
□ Central Forced Air □ Wall/Window Unit(s)
□ Other________________________
(Check all that apply)
Age of system: ________________
□
12. What is the dwelling's fuel sources?
□ Electricity □ Natural Gas □ Propane □ Oil
□ Other________________________
(Check all that apply)
If the fuel source is stored in a tank,
identify whether the tank is □ above ground or □ below ground,
and whether the tank is □ leased by seller or □ owned by
seller.
(Check all that apply)
□
13. What is the dwelling's water supply
source? □ City/County □ Community System
□ Private Well □ Shared
Well □ Other_______________________
(Check all that apply)
□
14. The dwelling's water pipes are made of
what type of material? □ Copper □ Galvanized
□ Plastic □ Polybutylene
□ Other________________________
(Check all that apply)
□
15. Is there any problem, malfunction or
defect with the dwelling's water supply (including water quality, quantity or
water pressure)?
□
□
□
16. What is the dwelling's sewage disposal
system? □ Septic Tank □ Septic Tank with Pump
□ Community System □
Connected to City/County System □ City/County System available
□ Straight pipe (wastewater does
not go into a septic or other sewer system [note: use of this type of system
violates State law]) □ Other_________________________
(Check all that apply)
□
17. If the dwelling is serviced by a septic
system, do you know how many bedrooms are allowed by the septic system
permit? If your answer is "Yes," how many bedrooms are allowed?
____________ □ No records available.
□
□
□
18. Is there any problem, malfunction or
defect with the dwelling's sewer and/or septic system?
□
□
□
19. Is there any problem, malfunction or
defect with the dwelling's central vacuum, pool, hot tub, spa, attic fan,
exhaust fan, ceiling fans, sump pump, irrigation system, TV cable wiring or
satellite dish, garage door openers, gas logs, or other systems?
□
□
□
20. Is there any problem, malfunction or
defect with any appliances that may be included in the conveyance
(range/oven, attached microwave, hood/fan, dishwasher, disposal, etc.)?
□
□
□
21. Is there any problem with present
infestation of the dwelling, or damage from past infestation of wood
destroying insects or organisms which has not been repaired?
□
□
□
22. Is there any problem, malfunction or
defect with the drainage, grading or soil stability of the property?
□
□
□
23. Are there any structural additions or
other structural or mechanical changes to the dwelling(s) to be conveyed with
the property?
□
□
□
24. Is the property to be conveyed in
violation of any local zoning ordinances, restrictive covenants, or other
land-use restrictions, or building codes (including the failure to obtain
proper permits for room additions or other changes/improvements)?
□
□
□
25. Are there any hazardous or toxic
substances, materials, or products (such as asbestos, formaldehyde, radon
gas, methane gas, lead-based paint) which exceed government safety standards,
any debris (whether buried or covered) or underground storage tanks, or any
environmentally hazardous conditions (such as contaminated soil or water, or
other environmental contamination) which affect the property?
□
□
□
26. Is there any noise, odor, smoke, etc. from
commercial, industrial or military sources which affects the property?
□
□
□
27. Is the property subject to any utility or
other easements, shared driveways, party walls or encroachments from or on
adjacent property?
□
□
□
28. Is the property subject to any lawsuits,
foreclosures, bankruptcy, leases or rental agreements, judgments, tax liens,
proposed assessments, mechanics' liens, materialmens' liens, or notices from
any governmental agency that could affect title to the property?
□
□
□
29. Is the property subject to a flood hazard
or is the property located in a federally-designated flood hazard area?
□
□
□
30. Does the property abut or adjoin any
private road(s) or street(s)?
□
□
□
31. If there is a private road or street
adjoining the property, is there in existence any owners' association or
maintenance agreements dealing with the maintenance of the road or street?
□
□
□
If you answered "yes" to any of the questions
listed above (1-31) please explain (attach additional sheets if necessary):
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
In lieu of providing a written explanation, you may attach a
written report to this Disclosure Statement by a public agency, or by an
attorney, engineer, land surveyor, geologist, pest control operator,
contractor, home inspector, or other expert, dealing with matters within the
scope of that public agency's functions or the expert's license or expertise.
The following questions pertain to the property
identified above, including the lot to be conveyed and any dwelling unit(s), sheds,
detached garages, or other buildings located thereon.
No Repre-
Yes No sentation
32. To your knowledge, is the property subject
to regulation by one or more owners' association(s) or governing documents
which impose various mandatory covenants, conditions, and restrictions upon
the lot, including, but not limited to obligations to pay regular assessment
or dues and special assessments? If your answer is "yes," please
provide the information requested below as to each owners' association to
which the property is subject [insert N/A into any blank that does not
apply]:
(specify name)
___________________________________________ whose regular assessments
("dues") are $ ________________ per ____________. The name,
address and telephone number of the president of the owners' association or
the association manager are
____________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
(specify name)
___________________________________________ whose regular assessments
("dues") are $ ________________ per ____________. The name,
address and telephone number of the president of the owners' association or
the association manager are
____________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
□
□
□
* If you answered "Yes" to question 32 above,
you must complete the remainder of this Disclosure Statement. If you answered
"No" or "No Representation" to question 32 above, you do
not need to answer the remaining questions on this Disclosure Statement. Skip
to the bottom of the last page and initial and date the page.
No Repre-
Yes No sentation
33. Are any fees charged by the association or
by the association's management company in connection with the conveyance or
transfer of the lot or property to a new owner? If your answer is
"yes," please state the amount of the fees:
_____________________________________________________________________
______________________________________________________________________
□
□
□
34. As of the date this Disclosure Statement
is signed, are there any dues, fees or special assessment which have been
duly approved as required by the applicable declaration or by-laws, and that
are payable to an association to which the lot is subject? If your answer is
"yes," please state the nature and amount of the dues, fees or
special assessments to which the property is subject:
_____________________________________________________________________
_____________________________________________________________________
______________________________________________________________________
□
□
□
35. As of the date this Disclosure Statement
is signed, are there any unsatisfied judgments against or pending lawsuits
involving the property or lot to be conveyed? If your answer is
"yes," please state the nature of each pending lawsuit and the
amount of each unsatisfied judgment:
_____________________________________________________________
______________________________________________________________________
_______________________________________________________________________
□
□
□
36. As of the date this Disclosure Statement
is signed, are there any unsatisfied judgments against or pending lawsuits
involving the planned community or the association to which the property and
lot are subject, with the exception of any action filed by the association
for the collection of delinquent assessments on lots other than the property
and lot to be conveyed? If your answer is "yes," please state the
nature of each pending lawsuit and the amount of each unsatisfied judgment:
_______________________________________
_______________________________________________________________________
_______________________________________________________________________
□
□
□
37. Which of
the following services and amenities are paid for by the owners' association(s)
identified above out of the association's regular assessments
("dues")? (Check all that apply.)
No Repre-
Yes No sentation
Management Fees
□
□
□
Exterior Building Maintenance of Property to be
Conveyed
□
□
□
Exterior Yard/Landscaping Maintenance of Lot to
be Conveyed
□
□
□
Common Areas Maintenance
□
□
□
Trash Removal
□
□
□
Recreational Amenity Maintenance (specify
amenities covered) _______________________
___________________________________________________________________________
□
□
□
Pest Treatment/Extermination
□
□
□
Street Lights
□
□
□
Water
□
□
□
Sewer
□
□
□
Storm Water Management/Drainage/Ponds
□
□
□
Internet Service
□
□
□
Cable
□
□
□
Private Road Maintenance
□
□
□
Parking Area Maintenance
□
□
□
Gate and/or Security
□
□
□
Other: (specify)
______________________________________________________________________
______________________________________________________________________
□
□
□
Owner Initials and Date
________________________ Owner Initials and Date
_______________________
Purchaser Initials and
Date ______________________ Purchaser Initials and Date
_____________________
(b) The form described in Paragraph (a) of this Rule may be
reproduced, but the text of the form shall not be altered or amended in any
way.
(c) The form described in Paragraph (a) of this Rule as
amended effective July 1, 2014 applies to all properties placed on the market
on or after July 1, 2014. The form described in Paragraph (a) of this Rule as amended
effective January 1, 2013, applies to all properties placed on the market prior
to July 1, 2014. If a corrected disclosure statement required by G.S. 47E-7 is
prepared on or after July 1, 2014, for a property placed on the market prior to
July 1, 2014, the form described in Paragraph (a) of this Rule as amended
effective July 1, 2014, shall be used.
History Note: Authority G.S. 47E-4(b); 47E-4(b1);
93A-3(c); 93A-6;
Eff. October 1, 1998;
Amended Eff. July 1, 2014; January 1, 2013; January 1,
2012; July 1, 2010; July 1, 2009; January 1, 2008; July 1, 2006; September 1,
2002; July 1, 2000.
