REAL
ESTATE PURCHASE CONTRACT (RESIDENTIAL)
STATE OF ___________________
COUNTY OF ___________________
1. PARTIES: _______________________________________________________________________ (Seller) agrees to sell and convey
to __________________________________________________________________
____________________ (Purchaser), and Purchaser agrees to buy from Seller the Property described below.
2. PROPERTY: (a) Land: Address: ____________________________________________________________ [insert full
address] or more specifically described as: ______________________________________________
_________________________________________________________________________________________ _________________________________________________________________________________________, or as described
in the attached exhibit. (b) Improvements: The house, garage and all other fixtures and improvements attached to the above-described real
property, including without limitation, the following permanently installed and built-in items, if any: all equipment and appliances, valances,
screens, shutters, awnings, wall-to-wall carpeting, mirrors, ceiling fans, attic fans, mail boxes, television antennas and satellite dish system
and equipment, heating and air-conditioning units, security and fire detection equipment, wiring, plumbing and lighting fixtures, chandeliers,
water softener system, kitchen equipment, garage door openers, cleaning equipment, shrubbery, landscaping, outdoor cooking equipment, and all
other property owned by Seller and attached to the above described real property. (c) Accessories: The following described related
accessories, if any: window air conditioning units, stove, fireplace screens, curtains and rods, blinds, window shades, draperies and rods,
controls for satellite dish system, controls for garage door openers, entry gate controls, door keys, mailbox keys, above ground pool, swimming
pool equipment and maintenance accessories, and artificial fireplace logs. (d) Exclusions: The following improvements and accessories will
be retained by Seller and excluded:
_________________________________________________________________________________________
_________________________________________________________________________________________
The land, improvements and accessories are collectively referred to as the "Property".
3. PURCHASE PRICE: The Total Price shall be $___________________ payable as follows:
Earnest money:
(Receipt of which is hereby acknowledged) $___________________
Cash or certified funds due at closing:
$___________________
4. FINANCING: The portion of Sales Price not payable in cash will be paid as follows: [Check applicable items
below.]
_____ (a) Third Party
Financing: One or more third party mortgage loans in the total amount of $___________________. If the Property does not satisfy the
lenders' underwriting requirements for the loan(s), this contract will terminate and the earnest money will be refunded to
Purchaser. [Check one item only:]
_____ (1) This contract is subject to Purchaser being approved for the financing described in the attached Third Party Financing
Condition Addendum.
_____ (2) This contract is not subject to Purchaser being approved for financing and does not involve FHA or VA financing.
_____ (b) Assumption: The
assumption of the unpaid principal balance of one or more promissory notes described in the attached Loan Assumption
Addendum.
_____ (c) Seller
Financing: A promissory note from Purchaser to Seller of $___________________ bearing _______% interest per annum, secured by
[choose the appropriate instrument authorized within the state:] _____ mortgage, or
_____ vendor's and deed of trust liens, and containing the terms and conditions described in the attached Seller Financing Addendum. If
an owner policy of title insurance is furnished, Purchaser shall furnish Seller with a mortgagee policy of title insurance.
5. TITLE INSURANCE: Seller agrees to furnish to Purchaser a standard form title insurance commitment, issued by a company
qualified to insure titles in _________________________ [state], in the amount of the purchase price, insuring the mortgagee against
loss on account of any defect or encumbrance in the title, unless herein excepted; otherwise, the earnest money shall be refunded. Said property
is sold and is to be conveyed subject to any mineral and mining rights not owned by the undersigned Seller and subject to present zoning
classification.
6. PRORATIONS & HAZARD INSURANCE: The taxes, as determined on the date of closing, are to be prorated between Seller and Purchaser as of the
date of delivery of the deed. Seller shall keep in force sufficient hazard insurance on the property to protect all interests until this sale is
closed and the deed delivered. If the property is destroyed or materially damaged between the date hereof and the closing and Seller is unable or
unwilling to restore it to its previous condition prior to closing, Purchaser shall have the option of canceling the contract and receiving
back the earnest money, or accepting the property in its damaged condition, any insurance proceeds otherwise payable to Seller by reason of such
damage shall be applied to the balance of the purchase price or otherwise be payable to Purchaser.
7. CLOSING COSTS & DATE: The sale shall be closed and the deed delivered within sixty (60) days from the execution of this Agreement
by all parties, except Seller shall have a reasonable length of time within which to perfect title or cure defects in the title to the said
property. The Seller agrees to pay the cost of deed preparation and a mortgagee’s title insurance policy, all other closing costs shall be paid
by Purchaser. Purchaser agrees to allow Seller to remain in possession of said property subject to separate terms of a month to month lease
agreement to be executed at closing for a lease period not to extend beyond _________________________ [insert month/day/year].
8. CONVEYANCE: Seller agrees to convey a good merchantable title and General Warranty Deed of said property insuring that
property is free of all encumbrances, except as hereinabove set out and Seller and Purchaser agree that any encumbrances shall be paid in full at
the time of closing from sales proceeds.
9. CONDITION OF PROPERTY: (a) General Provisions and Obligations of Parties: Seller agrees to deliver the heating,
cooling, plumbing and electrical systems and any built-in appliances in operable condition at the time of closing. It shall be the responsibility
of Purchaser, at Purchaser’s expense, to satisfy himself/herself that all conditions of this contract are satisfied before closing. Said sale is
contingent upon a satisfactory inspection of the property to be completed and reported to Seller prior to or on _________________________,
20____. Said contract shall only be renegotiable upon a major defect with an individual repair cost in excess of $500.00. After closing, all
conditions of the property, as well as any aforementioned items and systems, are the responsibility of Purchaser and shall be deemed purchased
AS-IS. (b) Lender Required Repairs and Treatments: Unless otherwise agreed in writing, neither party is obligated to pay for lender
required repairs, which includes treatment for wood destroying insects. If the parties do not agree to pay for the lender required repairs or
treatments, this contract will terminate and the earnest money will be refunded to Purchaser. If the cost of lender required repairs and
treatments exceeds 5% of the Sales Price, Purchaser may terminate this contract and the earnest money will be refunded to Purchaser. (c)
Completion of Repairs and Treatments: Unless otherwise agreed in writing, Seller shall complete all agreed repairs and treatments prior to
the Closing Date. All required permits must be obtained, and repairs and treatments must be performed by persons who are licensed or otherwise
authorized by law to provide such repairs or treatments. At Purchaser's election, any transferable warranties received by Seller with respect to
the repairs and treatments will be transferred to Purchaser at Purchaser's expense. If Seller fails to complete any agreed repairs and treatments
prior to the Closing Date, Purchaser may do so and receive reimbursement from Seller at closing. The Closing Date will be extended up to 15 days,
if necessary, to complete repairs and treatments. (d) Environmental Matters: Purchaser is advised that the presence of wetlands, toxic
substances, including asbestos and wastes or other environmental hazards, or the presence of a threatened or endangered species or its habitat
may affect Purchaser's intended use of the Property. If Purchaser is concerned about these matters, an addendum required by the parties should be
used.
10. SELLER’S WARRANTIES: Seller warrants that Seller has not received notification from any lawful authority regarding any
assessments, pending public improvements, repairs, replacements or alterations to said premises that have not been satisfactorily made. These
warranties shall survive the delivery of the above deed.
11. EARNEST MONEY: The Earnest Money as paid by Purchaser as set forth in Paragraph 3 hereof shall be deposited by Seller only
upon the execution of this contract. The Earnest Money shall be nonrefundable to Purchaser except for the occurrences of Paragraphs 5, 6, or
12.
12. DEFAULT: If Purchaser fails to comply with this contract, Purchaser will be in default, and Seller may (a) enforce
specific performance, seek such other relief as may be provided by law, or both, or (b) terminate this contract and receive the earnest money as
liquidated damages, thereby releasing both parties from this contract. If, due to factors beyond Seller's control, Seller fails within the time
allowed to make any non-casualty repairs, Purchaser may (a) extend the time for performance up to 15 days and the Closing Date will be extended
as necessary or (b) terminate this contract as the sole remedy and receive the earnest money. If Seller fails to comply with this contract for
any other reason, Seller will be in default and Purchaser may (a) enforce specific performance, seek such other relief as may be provided by law,
or both, or (b) terminate this contract and receive the earnest money, thereby releasing both parties from this contract.
13. MEDIATION: Any dispute between Purchaser and Seller related to this contract that is not resolved through informal
discussion [choose one:] _____ will _____ will not be submitted to a mutually acceptable mediation service or provider.
The parties to the mediation shall bear the mediation costs equally. This paragraph does not preclude a party from seeking equitable relief from
a court of competent jurisdiction.
14. SURVIVAL OF CONTRACT: All terms, conditions and warranties not performed at the time of delivery of the deed shall survive such
delivery.
15. COMMISSION FEES: Purchaser and Seller agree that said contract was negotiated at arms length without assistance of any real
estate agents or brokers and that no such fees shall be paid by either party in connection with this contract or sale.
16. ADDITIONAL PROVISIONS: Any additional Provisions set forth on the reverse side, initialed by all parties, are hereby made a part
of this contract and this contract states the entire agreement between the parties and merges in this agreement all statements, representations,
and covenants heretofore made, and any agreements not incorporated herein are void and of no force and effect.
17. SUCCESSORS AND ASSIGNS: This contract shall be binding upon any heirs, successors and assigns of Seller or
Purchaser.
18. REVOCATION OF OFFER BY PURCHASER: This contract has been first executed by Purchaser and if not accepted by all parties by
noon on
_________________________, 20____, this offer shall be void.
19. DISCLOSURES: _______________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
[The Seller should note any disclosures about the property that may be required under Federal or state law. Consult an attorney if uncertainty
exists as to which disclosures may be required.]
PURCHASER:
____________________
____________________________________________
Date
[purchaser's signature above/printed name below]
____________________________________________
[purchaser's signature above/printed name below]
SELLER:
____________________
____________________________________________
Date
[seller's signature above/printed name below]
____________________________________________
[seller's signature above/printed name below]
Note: This addendum is only necessary if the parties have checked the option in Paragraph 4(a)(i)
above.
THIRD PARTY FINANCING CONDITION ADDENDUM
CONCERNING THE PROPERTY AT:
___________________________________________________________________________
(Address of Property)
Purchaser shall apply promptly for all financing described below and make
every reasonable effort to obtain financing approval. Financing approval will be deemed to have been obtained when the lender determines that
Purchaser has satisfied all of lender's financial requirements (those items relating to Purchaser's assets, income and credit history). If
financing (including any financed PMI premium) approval is not obtained within ______ days after the effective date, this contract will terminate
and the earnest money will be refunded to Purchaser. Each note must be secured by an
appropriate instrument authorized within the state, typically either (1) a mortgage or (2) vendor's and deed of trust liens. (Consult an attorney
if you are unsure as to which instrument is appropriate for this transaction.)
CHECK APPLICABLE BOXES:
_____ A. CONVENTIONAL
FINANCING:
_____ (1) A first mortgage loan in the principal amount of $______________ (excluding any financed PMI premium), due in full
in _________ year(s), with interest not to exceed _________% per annum for the first _________year(s) of the loan with Loan Fees not to exceed
_________% of the loan. The loan will be [choose one:] _____ with _____ without PMI.
_____ (2) A second mortgage loan in the principal amount of $ (excluding any financed PMI premium), due in full in year(s),
with interest not to exceed % per annum for the first year(s) of the loan with Loan Fees not to exceed % of the loan. The loan will be with
without PMI.
_____ B. FHA INSURED
FINANCING: A Section _________ FHA insured loan of not less than $______________ (excluding any financed MIP), amortizable monthly for not
less than _________ years, with interest not to exceed _________% per annum for the first _________ year(s) of the loan with Loan Fees not to
exceed _________% of the loan. As required by HUD-FHA, if FHA valuation is unknown, "It is expressly agreed that, notwithstanding any other
provisions of this contract, the purchaser (Purchaser) shall not be obligated to complete the purchase of the Property described herein or to
incur any penalty by forfeiture of earnest money deposits or otherwise unless the purchaser (Purchaser) has been given in accordance with
HUD/FHA or VA requirements a written statement issue by the Federal Housing Commissioner, Department of Veterans Affairs, or a Direct
Endorsement Lender setting forth the appraised value of the Property of not less than $______________. The purchaser (Purchaser) shall have
the privilege and option of proceeding with consummation of the contract without regard to the amount of the appraised valuation. The
appraised valuation is arrived at to determine the maximum mortgage the Department of Housing and Urban Development will insure. HUD does not
warrant the value or the condition of the Property. The purchaser (Purchaser) should satisfy himself/herself that the price and the condition
of the Property are acceptable."
If the FHA appraised
value of the Property (excluding closing costs and MIP) is less than the Sales Price, Seller may reduce the Sales Price to an amount equal to
the FHA appraised value (excluding closing costs and MIP) and the sale will be closed at the lower Sales Price with proportionate adjustments
to the down payment and loan amount.
_____ C. VA GUARANTEED
FINANCING: A VA guaranteed loan of not less than $______________ (excluding any financed Funding Fee), amortizable monthly for not less than
_______ years, with interest not to exceed _______% per annum for the first _______ year(s) of the loan with Loan Fees not to exceed _______%
of the loan.
VA NOTICE TO PURCHASER:
"It is expressly agreed that, notwithstanding any other provisions of this contract, the Purchaser shall not incur any penalty by
forfeiture of earnest money or otherwise or be obligated to complete the purchase of the Property described herein, if the contract purchase
price or cost exceeds the reasonable value of the Property established by the Department of Veterans Affairs. The Purchaser shall, however,
have the privilege and option of proceeding with the consummation of this contract without regard to the amount of the reasonable value
established by the Department of Veterans Affairs."
If Purchaser elects to
complete the purchase at an amount in excess of the reasonable value established by VA, Purchaser shall pay such excess amount in cash from a
source which Purchaser agrees to disclose to the VA and which Purchaser represents will not be from borrowed funds except as approved by VA.
If VA reasonable value of the Property is less than the Sales Price, Seller may reduce the Sales Price to an amount equal to the VA reasonable
value and the sale will be closed at the lower Sales Price with proportionate adjustments to the down payment and the loan amount.
PURCHASER:
____________________
____________________________________________
Date
[purchaser's signature above/printed name below]
____________________________________________
[purchaser's signature above/printed name below]
SELLER:
____________________
____________________________________________
Date
[seller's signature above/printed name below]
____________________________________________
[seller's signature above/printed name below]
Note: This addendum is only necessary if the parties have checked the option in Paragraph 4(b) above.
LOAN ASSUMPTION ADDENDUM
TO CONTRACT CONCERNING THE PROPERTY AT:
___________________________________________________________________________
(Address of Property)
A. CREDIT DOCUMENTATION: Within _____ days after the effective date of this contract, Purchaser shall deliver to Seller the
following: [check all applicable items:] _____credit report _____verification of employment, including salary
_____verification of funds on deposit in financial institutions ____current financial statement to establish Purchaser's
creditworthiness. Purchaser hereby authorizes any credit reporting agency to furnish to Seller at Purchaser's sole expense copies of
Purchaser's credit reports.
B. CREDIT APPROVAL: If Purchaser's documentation is not delivered within the specified time, Seller may terminate this
contract by notice to Purchaser within 7 days after expiration of the time for delivery, and the earnest money will be paid to Seller. If the
documentation is timely delivered, and Seller determines in Seller's sole discretion that Purchaser's credit is unacceptable, Seller may
terminate this contract by notice to Purchaser within 7 days after expiration of the time for delivery and the earnest money will be refunded to
Purchaser. If Seller does not terminate this contract, Seller will be deemed to have accepted Purchaser's credit.
C. ASSUMPTION:
_____ (1) The unpaid principal
balance of a first lien promissory note payable to which unpaid balance at closing will be $________________. The total current monthly
payment including principal, interest and any reserve deposits is $________________. Purchaser’s initial payment will be the first payment due
after closing.
_____ (2) The unpaid principal
balance of a second lien promissory note payable to which unpaid balance at closing will be $________________. The total current monthly
payment including principal, interest and any reserve deposits is $________________. Purchaser’s initial payment will be the first payment due
after closing.
Purchaser’s assumption of an existing note includes all obligations
imposed by the deed of trust securing the note. If the unpaid principal balance(s) of any assumed loan(s) as of the Closing Date varies from the
loan balance(s) stated above, the [check only one:]
_____cash payable at closing _____Sales Price will be adjusted by the
amount of any variance; provided, if the total principal balance of all assumed loans varies in an amount greater than $350.00 at closing, either
party may terminate this contract and the earnest money will be refunded to Purchaser unless the other party elects to eliminate the excess in
the variance by an appropriate adjustment at closing. Purchaser may terminate this contract and the earnest money will be refunded to Purchaser
if the noteholder requires (a) payment of an assumption fee in excess of $________________ in (1) above or $________________ in (2) above and
Seller declines to pay such excess, (b) an increase in the interest rate to more than ________% in (1) above, or ________% in (2) above, (c) any
other modification of the loan documents, or (d) consent to the assumption of the loan and fails to consent. An appropriate instrument authorized
within the state, typically either (1) a mortgage or (2) vendor's and deed of trust liens, to secure the assumption will be required, and it will
automatically be released on execution and delivery of a release by noteholder. If Seller is released from liability on any assumed note, the
instrument securing the assumption will not be required. If noteholder maintains an escrow account, the escrow account must be transferred to
Purchaser without any deficiency. Purchaser shall reimburse Seller for the amount in the transferred accounts.
NOTICE TO PURCHASER: The monthly payments, interest rates or other terms of some loans may be adjusted by the noteholder at or
after closing. If you are concerned about the possibility of future adjustments, do not sign the contract without examining the notes and the
instrument securing the note.
NOTICE TO SELLER: Your liability to pay the note assumed by Purchaser will continue unless you obtain a release of liability
from the noteholder. If you are concerned about future liability, you should use the a Release of Liability Addendum.
PURCHASER:
____________________
____________________________________________
Date
[purchaser's signature above/printed name below]
____________________________________________
[purchaser's signature above/printed name below]
SELLER:
____________________
____________________________________________
Date
[seller's signature above/printed name below]
____________________________________________
[seller's signature above/printed name below]
Note: This addendum is only necessary if the parties have checked the option in Paragraph 4(c) above.
SELLER FINANCING ADDENDUM
TO CONTRACT CONCERNING THE PROPERTY AT:
___________________________________________________________________________
(Address of Property)
A. CREDIT DOCUMENTATION: Within _____ days after the effective date of this contract, Purchaser shall deliver to Seller:
[check all applicable items:] _____credit report _____verification of employment, including salary
_____verification of funds on deposit in financial institutions _____current financial statement to establish Purchaser's
creditworthiness. Purchaser hereby authorizes any credit reporting agency to furnish to Seller at Purchaser's sole expense copies of
Purchaser's credit reports.
B. CREDIT APPROVAL: If Purchaser's documentation is not delivered within the specified time, Seller may terminate this
contract by notice to Purchaser within 7 days after expiration of the time for delivery, and the earnest money will be paid to Seller. If the
documentation is timely delivered, and Seller determines in Seller's sole discretion that Purchaser's credit is unacceptable, Seller may
terminate this contract by notice to Purchaser within 7 days after expiration of the time for delivery and the earnest money will be refunded to
Purchaser. If Seller does not terminate this contract, Seller will be deemed to have accepted Purchaser's credit.
C. PROMISSORY NOTE: The promissory note (Note) described in Paragraph 4 of this contract payable by Purchaser to the
order of Seller will be payable at the place designated by Seller. Purchaser may prepay the Note in whole or in part at any time without penalty.
Any prepayments are to be applied to the payment of the installments of principal last maturing and interest will immediately cease on the
prepaid principal. The Note will contain a provision for payment of a late fee of 5% of any installment not paid within 10 days of the due date.
The Note will be payable as follows:
_____ (1) In one payment due ____________________ after the
date of the Note with interest payable ___________________.
_____ (2) In
____________________ installments of $____________________, [check all applicable items:] _____including interest _____plus interest beginning
____________________ after the date of the Note and continuing at ____________________ intervals thereafter for ____________________ when the
balance of the Note will be due and payable.
_____ (3) Interest only in
____________________ installments for the first ____________________ month(s) and thereafter in installments of $____________________, [check
all applicable items:] _____including interest _____plus interest beginning ____________________ after the date of the Note and continuing at
____________________ intervals thereafter for when the balance of the Note will be due and payable.
D. SECURING INSTRUMENT: [Choose the appropriate instrument authorized within the state:] A _____ mortgage, or _____
deed of trust lien, will provide for the following:
(1) PROPERTY TRANSFERS: [check only
one:]
_____ (a) Consent Not Required:
The Property may be sold, conveyed or leased without the consent of Seller, provided any subsequent Purchaser assumes the Note.
_____ (b) Consent Required: If all or any part of the Property is sold, conveyed, leased for a period longer
than 3 years, leased with an option to purchase, or otherwise sold, without the prior written consent of Seller, Seller may declare the
balance of the Note, to be immediately due and payable. The creation of a subordinate lien, any conveyance under threat or order of
condemnation, any deed solely between Purchasers, the passage of title by reason of the death of a Purchaser or by operation of law will not
entitle Seller to exercise the remedies provided in this paragraph.
(2) TAX AND INSURANCE ESCROW: [check only
one:]
_____ (a) Escrow Not Required:
Purchaser shall furnish Seller annually, before the taxes become delinquent, evidence that all taxes on the Property have been paid. Purchaser
shall furnish Seller annually evidence of paid-up casualty insurance naming Seller as an additional loss payee.
_____ (b) Escrow Required: With each installment Purchaser shall deposit with Seller in escrow a pro rata part
of the estimated annual ad valorem taxes and casualty insurance premiums for the Property. Purchaser shall pay any deficiency within 30 days
after notice from Seller. Purchaser's failure to pay the deficiency constitutes a default under the securing instrument. Purchaser is not
required to deposit any escrow payments for taxes and insurance that are deposited with a superior lienholder. The casualty insurance must
name Seller as an additional loss payee.
(3) PRIOR LIENS: Any default under any lien superior to the lien securing
the Note constitutes default under the deed of trust securing the Note.
PURCHASER:
____________________
____________________________________________
Date
[purchaser's signature above/printed name below]
____________________________________________
[purchaser's signature above/printed name below]
SELLER:
____________________
____________________________________________
Date
[seller's signature above/printed name below]
____________________________________________
[seller's signature above/printed name below]
Note About the Following Pages: The following lead disclosure must be included if the property was built prior to 1978.
LEAD-BASED PAINT DISCLOSURE (SALES)
___________________________________________________________________
Street Address
City State
Zip
WARNING! LEAD FROM PAINT, DUST, AND SOIL CAN BE DANGEROUS IF NOT MANAGED
PROPERLY
Disclosure of Information on Lead-Based Paint and/or Lead-Based Paint
Hazards
Lead Warning Statement
Every purchaser of any interest in residential real property on which a
residential dwelling was built prior to 1978 is notified that such property may present exposure to lead from lead-based paint that may place
young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including
learning disabilities, reduced intelligence quotient, behavioral problems, and impaired memory. Lead poisoning also poses a particular risk to
pregnant women. The Seller of any interest in residential real property is required to provide the buyer with any information on lead-based paint
hazards from risk assessments or inspections in the Seller's possession and notify the buyer of any known lead-based paint hazards. A risk
assessment or inspection for possible lead-based paint hazards is recommended prior to purchase.
Seller's Disclosure
(a) Presence of lead-based paint and/or lead-based paint hazards (check
(i) or (ii) below):
(i) ______ Known lead-based paint and/or lead-based paint hazards are present in the housing (explain).
__________________________________________________________________________ __________________________________________________________________________
(ii) ______ Seller has no knowledge of lead-based paint and/or lead-based paint hazards in the
housing.
(b) Records and reports available to the seller (check (i) or (ii)
below):
(i) ______ Seller has provided the purchaser with all available records and reports pertaining to lead-based
paint and/or lead-based paint hazards in the housing (list documents below). __________________________________________________________________________ __________________________________________________________________________
(ii) _____ Seller has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in
the housing.
Purchaser's Acknowledgment (initial)
(c) ______ Purchaser has received copies of all information listed
above.
(d) ______ Purchaser has received the pamphlet Protect Your Family from
Lead in Your Home.
(e) Purchaser has (check (i) or (ii) below):
(i) ______ received a 10-day opportunity (or mutually agreed upon period) to conduct a risk assessment or
inspection for the presence of lead-based paint and/or lead-based paint hazards; or
(ii) ______ waived the opportunity to conduct a risk assessment or inspection for the presence of lead-based
paint and/or lead-based paint hazards.
Agent's Acknowledgment (initial)
(f) ______ Agent has informed the seller of the seller' obligations under
42 U.S.C. 4852(d) and is aware of his/her responsibility to ensure compliance.
Seller Initials: ______ ______ Buyer
Initials: ______ ______ Agent Initials: ______ ______
Certification of Accuracy
The following parties have reviewed the information above and certify, to
the best of their knowledge, that the information they have provided is true and accurate. Penalties for failure to comply with Federal
Lead-Based Paint Disclosure Laws include treble (3 times) damages, attorney fees, costs, and a penalty up to $10,000 for each
violation.
PURCHASER:
____________________
____________________________________________
Date
[purchaser's signature above/printed name below]
____________________________________________
[purchaser's signature above/printed name below]
SELLER:
____________________
____________________________________________
Date
[seller's signature above/printed name below]
____________________________________________
[seller's signature above/printed name below]
AGENT:
____________________
____________________________________________
Date
[agent's signature above/printed name below]
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