[N.c. Real Estate Commission Seal]

Link to law: http://reports.oah.state.nc.us/ncac/title 21 - occupational licensing boards and commissions/chapter 58 - real estate commission/subchapter a/21 ncac 58a .0114.html
Published: 2015

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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.