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PROPERTY CONDITION DISCLOSURE STATEMENT

The following is a Property Condition Disclosure required by Sections 89-1-507 through 89-1-527 of the Mississippi Real Estate Brokers Act of 1954, as Amended, and made by the

 SELLER(S) concerning the condition of the RESIDENTIAL PROPERTY

located at: ____________________________________________________________________________

SELLER(S):____________________________________________________

Approximate Age of the Residence______

This Disclosure is not a warranty of any kind by the Seller or any Real Estate Agent of the Seller in this transaction and is not a substitute for any inspections or warranties the Purchaser may wish to obtain. This statement may be made available to other parties and is to be attached to the Listing Agreement and signed by the SELLER(S).

TO THE SELLER(S):

Please complete the following form, including any past history of problems, if known. If the condition or question does not apply to your property, mark with “N/A”. IF THE RESIDENCE IS NEW/PROPOSED RESIDENTIAL CONSTRUCTION, the BUILDER should complete the Property Condition Disclosure Statement and reference specific plans/specifications, materials lists and/or change orders.

DO NOT LEAVE ANY BLANK SPACES. ATTACH ADDITIONAL PAGES IF

NECESSARY. THIS FORM MAY BE DUPLICATED BUT NOT ALTERED

STRUCTURAL ITEMS:

A. BUILDING CODE:

Was the residence built in conformity with an approved building code? Yes _____ No _____ Unknown _______

If yes, was it inspected by a City/County Code Enforcement Inspector? Yes _____ No _____ Unknown _______

Has a Mississippi Licensed Home Inspector completed a Home Inspection Report? Yes _____ No_____

B. STRUCTURAL ITEMS:

Are you aware of any foundation repairs made in the past? Yes _____ No _____ Explain ____________________

Are any foundation repairs currently needed? Yes _____ No _____ Explain _____________________________

C. HISTORY OF INFESTATION, IF ANY: TERMITES, CARPENTER ANTS, ETC:

Any evidence of rot, mildew, vermin, rodents, termites, carpenter ants, or other infestation? Yes _____ No _____

Have you requested treatments for any type of infestations? Yes _____ No _____ Explain___________________

Are you aware of any Repaired Damage? Yes _____ No_____; If yes, please describe_______________________

Is there currently an outstanding termite contract? Yes _____ No _____ Who is the contractor? ______________

D. ROOF:

Has the roof been replaced or repaired during your ownership? Yes _____ No _____; If yes, when? ___________

During your ownership have there been any leaks, water back ups, or problems with the roof? Yes ____ No_____

The roof is _____ years old.

E. LAND AND SITE DATA:

Is there an engineer’s survey available? Yes _____ No _____ Date the survey was completed______________

Are you aware of the existence of any of the following, to wit:

Encroachments: Yes ___ No ___ Unknown ___ Flood Zone: Yes ___ No ___ Unknown ____

Easements: Yes ___ No ___ Unknown ___ Soil/Erosion: Yes ___ No ___ Unknown ____

Soil Problems: Yes ___ No ___ Unknown ___ Subsoil Problem: Yes___ No___ Unknown_____

Standing Water: Yes ___ No ___ Unknown ___ Land Fill: Yes___ No___ Unknown_____

Are you aware of any current zoning regulations which will cause the residence to be considered a nonconforming usage (lot size, set backs, etc) Yes ____ No ____ If Yes, please explain _________________________________

Are there any rights-of-way, easements, eminent domain proceedings or similar matters which may negatively impact your ownership interest in the residence? Yes _____ No _____ If YES, please explain ________________

FOR ANY REASON, has any portion of the residence ever suffered water damage? Yes _____ No ____ If yes, please explain in detail ______________. Is the residence currently located in a FEMA Designated Flood Hazard Zone? Yes ___ No ___ Unknown _____; Is Flood Insurance required? Yes _____ No _____ Unknown _________

Is any portion of the property designated as a

 WETLANDS AREA? Yes _____ No _____ Unknown__________

F. ADDITIONS/REMODELS:

During your period of ownership, have there been any additions, remodeling, structural changes or alterations to

the residence? Yes ____ No _____ If YES, please explain _____________________________________________

Name of the Licensed Contractor______________________. Were all work permits and approvals in compliance with the local building codes? Yes _____ No ____ Please Explain ______________________________________

G. STRUCTURE/WALLS/ WINDOWS:

Has there been any damage to the structure as a result of fire, windstorm, tornados, hurricane or any other natural disaster? Yes ___ No ___ If YES, please explain ___________________________________________________

Have you ever experienced ANY problems with walls, siding or windows? Yes ___ No ___ Explain __________

H. OTHER:

Are you aware of any problems which may exist with the property by virtue of prior usages such as, but not limited to, Methamphetamine Labs, Hazardous/Toxic waste disposal, the presence of asbestos components, Lead-Based Paint, Urea-Formaldehyde Insulation, Mold, Radon Gas, Underground Tanks or any past industrial uses of the premises? Yes ___ No ___ If “YES, please explain _________________________________________

SELLER’S INITIALS __________ Page 2 of 3 PURCHASER’S INITIALS __________

MECHANICAL ITEMS:

ELECTRICAL SYSTEM/PLUMBING SYSTEM:

Are you aware of any problems or conditions that affect the desirability or functionality of the Heating, Cooling, Electrical, Plumbing, or Mechanical Systems? Yes ____ No ____ If yes, please explain all known problems in complete detail _______________________________________________________________________________

WATER, SEWER, & SEPTIC ITEMS:

WATER:

The water supply is: Public _____ Private ____ On-site Well ____ Neighbor’s Well ____ Community______

If your drinking water is from a well, when was the water quality last checked for safety, what were the results of the test and who conducted the test? ______________________________________________________________

Is the water supply equipped with a water softener? Yes _____ No _____ Unknown _____

The Sewage System is: Public ____ Private ____ Septic ____ Cesspool ____ Treatment Plant ____ Other _____

Is there a sewage pump installed? Yes ____ No ____ Date of the last Septic Inspection ____________________

Are you aware of any leaks, back-ups, or other problems relating to any of the plumbing, water, sewage, or related items during your ownership? Yes ____ No ____. If yes, please explain ________________________________

OTHER MATTERS/ITEMS:

MISCELLANEOUS:

Is the residence situated on Leasehold or Sixteenth Section land? Yes _____ No _____ Explain ______________

Is there any existing or threatening legal action affecting the property? Yes ____ No ____ Explain____________

Are you aware of any violations of local/state/federal laws/regulations relating to the property? Yes ____ No ____

Are you aware of any hidden defects or needed repairs about which the purchaser should be informed

 PRIOR to their purchase? Yes ____ No ___ If yes, please explain in detail _______________________________________

What is the APPROXIMATE SQUARE FOOTAGE of the Heated and Cooled Living Area ________________

How was this approximation of square footage determined? ___________________________________________

Are there any finished wood floors beneath the floor coverings? Yes ____ No ____ Where __________________

Are there any Homeowner’s Association Fees associated with ownership? Yes ____ No ____ Amount _________

If the property is a Condominium, how much is the YEARLY Maintenance Fees $_________________________

What is the YEARLY Real Estate Tax Bill? $__________ Homestead Exemption has been filed for __________

Is the property subject to ANY special real property tax assessments Yes _____ No _____ Explain ____________

Is the property located in a Public Improvement (tax) District (PID) Yes _____ No _____ Unknown _________

What is the average YEARLY Electric Bill? $_______ What is the average YEARLY Gas Bill? $___________

If the residence is serviced by Propane (LP) Gas, what is the average YEARLY Propane Bill? $______________

The Propane Tank is: Owned ______ Leased ______ If Leased, how much is the lease payment? $__________

Is Cable Television Service available at the site? Yes ____ No ____ Service Provider ______________________

Are any items remaining with the residence financed separately from the mortgages? Yes ____ No ___

APPLIANCES/SYSTEMS REMAINING WITH RESIDENCE:

ITEM YES NO GAS/ELECTRIC AGE LIST REPAIRS COMPETED

IN LAST TWO (2) YEARS

Cook-top

Dishwasher

Garbage Disposal

Ice-maker

Microwave

Oven(s)

Trash Compactor

Vent-Fan

Other Items

MECHANICAL EQUIPMENT CONSIDERED PERSONAL PROPERTY SHOULD BE NEGOTIATED IN THE CONTRACT OF SALE OR OTHER SUCH INSTRUMENT IF THE ITEMS REMAIN WITH THE RESIDENCE.

To the extent of the Seller’s knowledge as a property owner, the Seller(s) acknowledges that the information contained above is true and accurate for those areas of the property listed. The owner(s) agree to save and hold the Broker harmless from all claims, disputes, litigation and/or judgments arising from any incorrect information supplied by the owner(s) or from any material fact known by the owner(s) which owner(s) fail to disclose except the Broker is not held harmless to theowner(s) in claims, disputes, litigation, or judgments arising from conditions of which the Broker had actual knowledge.

_______________________________________ _________________________________________

SELLER (UPON LISTING) DATE SELLER (UPON LISTING) DATE

_______________________________________ _________________________________________

SELLER (AT CLOSING) DATE SELLER (AT CLOSING) DATE

PROSPECTIVE PURCHASER’S SIGNATURE ___________________________________________________________

PURCHASER(S) ACKNOWLEDGE RECEIPT OF REPORT DATE

MREC FORM #0100 Page 3 of 3 EFFECTIVE DATE: JULY 1, 2008