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BURNET <br />REALTY' <br />REAL ESTATE TRANSFER <br />DISCLOSURE STATEMENT <br />66. Address _______________________ <br />67. Page 2 <br />6d <br />69. <br />70. <br />71. <br />72. <br />Unused Weil: Is there a well on the oroperty which is no longer in use? DYes ENo <br />II yes. has it been sealed according to State Regulations MSA 1S6A7 DYes GNo <br />Comments; ________________________________________________________________ <br />Contaminated Well: Is there a well on the property containing contaminated water? Yes. <br />Date well water last tested for contaminants:___________ Comments:______________ <br />73. D. LAND USE AND PROPERTY CONDITION; <br />74. Are you aware of any of the following existing: <br />Encroachments? Yta___ Soil problems? Yss_ <br />Diseased frees? Yes___ No Rodent infestation? Yes. <br />Resinct»ns or Reservations on the use of the propeny? Yes______ <br />75. <br />76. <br />77. <br />7a <br />79. <br />80. <br />NoJdT <br />N0_ie^ <br />No_L <br />Insect Ini t? Mss.NofedGI <br />Easemeras other than utilih/ or dramaga aasamants which do not interfate with prasart imprcMmeriU? <br />Is lha property located in a designated flood plain? Mn________ No <br />Comments: ______________________________________________ <br />82. <br />eaE. INSULATION DISCLOSURE: <br />84. Does the tnsuiaoon m the property contain urea lormaidehyda foam? Yea <br />85. Date insulation installed: ___________________ Type: _____ <br />8a Comments: ____________________________________________ <br />Unlmown <br />Company; <br />87. F. OTHER KNOWN DEFECTS: <br />8a Are there ^ny other known defects in or on the property? <br />89 ______________________________________________ <br />If yes, explain below: <br />51. <br />9Z <br />9i G. SELLER’S STATEMENT (To be signed a* time of listing) <br />94. We/I. ownerfs) of the property at <br />9Si acknowledge the above Real Transfer Disclosure SUMmenl and give permission to Listing Broker to disclose <br />9a this info^atiop^ the prospe^n^rbuyers. <br />97. ^ <br />b ini9 <br />98. H. BUYER'S ACKNOWLEDGEMENT: (To be signed at hme of purchase agreement) <br />99. We/I. the Buyer(s) of the property at_________________________________________ <br />too. do acknowledge receipt of the Reai Estate Transfer Disclosure Statement artd agree that no representations <br />101. regarding the condition of the property have been made, of*'or than those made above. LISTING BROKER ANO <br />102. AGENTS MAKE NO REPRESENTATIONS ANO ARE NOT RESPONSIBLE FOR ANY CONOfTIONS EXISTING IN <br />103. THE PROPERTY. <br />105 I, SELLER'S ACKNOWLEDGEMENT: (To be signed at time of purchase agreement) <br />106 -»S OF THE DATE OF THE ACCEPTANCE OF THE PURCHASE AGREEMENT. WeA. the Seilens) of ihe above <br />propeny agree that the conoition of the prooerty is :he same aa noted above and will be m proper wcrxing order107 <br />108. on date of dosing, eiceoi for 'he changes indicated above and dated: <br />109 ___________________________________ -- -___ _________ <br />110 MN etiros iseat onicinal ccev to umNO enoxER-. comas to saixiR. surtJt. silunc snoNaii <br />L. <br />! <br />I