S. 5400 2
TRANSFER OF TITLE. [IN THE EVENT A SELLER FAILS TO PERFORM THE DUTY
PRESCRIBED IN THIS ARTICLE TO DELIVER A DISCLOSURE STATEMENT PRIOR TO
THE SIGNING BY THE BUYER OF A BINDING CONTRACT OF SALE, THE BUYER SHALL
RECEIVE UPON THE TRANSFER OF TITLE A CREDIT OF FIVE HUNDRED DOLLARS
AGAINST THE AGREED UPON PURCHASE PRICE OF THE RESIDENTIAL REAL PROPER-
TY.]
"RESIDENTIAL REAL PROPERTY" MEANS REAL PROPERTY IMPROVED BY A ONE TO
FOUR FAMILY DWELLING USED OR OCCUPIED, OR INTENDED TO BE USED OR OCCU-
PIED, WHOLLY OR PARTLY, AS THE HOME OR RESIDENCE OF ONE OR MORE PERSONS,
BUT SHALL NOT REFER TO (A) UNIMPROVED REAL PROPERTY UPON WHICH SUCH
DWELLINGS ARE TO BE CONSTRUCTED OR (B) CONDOMINIUM UNITS OR COOPERATIVE
APARTMENTS OR (C) PROPERTY ON A HOMEOWNERS' ASSOCIATION THAT IS NOT
OWNED IN FEE SIMPLE BY THE SELLER.
INSTRUCTIONS TO THE SELLER:
(a) ANSWER ALL QUESTIONS BASED UPON YOUR ACTUAL KNOWLEDGE.
(b) ATTACH ADDITIONAL PAGES WITH YOUR SIGNATURE IF ADDITIONAL SPACE IS
REQUIRED.
(c) COMPLETE THIS FORM YOURSELF.
(d) IF SOME ITEMS DO NOT APPLY TO YOUR PROPERTY, CHECK "NA" (NON-AP-
PLICABLE). IF YOU DO NOT KNOW THE ANSWER CHECK "UNKN" (UNKNOWN).
SELLER'S STATEMENT: THE SELLER MAKES THE FOLLOWING REPRESENTATIONS TO
THE BUYER BASED UPON THE SELLER'S ACTUAL KNOWLEDGE AT THE TIME OF SIGN-
ING THIS DOCUMENT. THE SELLER AUTHORIZES HIS OR HER AGENT, IF ANY, TO
PROVIDE A COPY OF THIS STATEMENT TO A PROSPECTIVE BUYER OF THE RESIDEN-
TIAL REAL PROPERTY. THE FOLLOWING ARE REPRESENTATIONS MADE BY THE SELLER
AND ARE NOT THE REPRESENTATIONS OF THE SELLER'S AGENT.
GENERAL INFORMATION
1. HOW LONG HAVE YOU OWNED THE PROPERTY?
2. HOW LONG HAVE YOU OCCUPIED THE PROPERTY?
3. WHAT IS THE AGE OF THE STRUCTURE OR STRUCTURES? NOTE TO BUYER--IF
THE STRUCTURE WAS BUILT BEFORE 1978 YOU ARE ENCOURAGED TO INVESTI-
GATE FOR THE PRESENCE OF LEAD BASED PAINT.
4. DOES ANYBODY OTHER THAN YOURSELF HAVE A LEASE, EASEMENT OR ANY
OTHER RIGHT TO USE OR OCCUPY ANY PART OF YOUR PROPERTY OTHER THAN
THOSE STATED IN DOCUMENTS AVAILABLE IN THE PUBLIC RECORD, SUCH AS
RIGHTS TO USE A ROAD OR PATH OR CUT TREES OR CROPS[.]? YES NO UNKN
NA
5. DOES ANYBODY ELSE CLAIM TO OWN ANY PART OF YOUR PROPERTY? YES NO
UNKN NA (IF YES, EXPLAIN BELOW)
6. HAS ANYONE DENIED YOU ACCESS TO THE PROPERTY OR MADE A FORMAL LEGAL
CLAIM CHALLENGING YOUR TITLE TO THE PROPERTY? YES NO UNKN NA (IF
YES, EXPLAIN BELOW)
7. ARE THERE ANY FEATURES OF THE PROPERTY SHARED IN COMMON WITH
ADJOINING LAND OWNERS OR A HOMEOWNERS ASSOCIATION, SUCH AS WALLS,
FENCES OR DRIVEWAYS? YES NO UNKN NA (IF YES DESCRIBE BELOW)
8. ARE THERE ANY ELECTRIC OR GAS UTILITY SURCHARGES FOR LINE EXTEN-
SIONS, SPECIAL ASSESSMENTS OR HOMEOWNER OR OTHER ASSOCIATION FEES
THAT APPLY TO THE PROPERTY? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
9. ARE THERE CERTIFICATES OF OCCUPANCY RELATED TO THE PROPERTY? YES
NO UNKN NA (IF NO, EXPLAIN BELOW)
ENVIRONMENTAL
S. 5400 3
NOTE TO SELLER - IN THIS SECTION, YOU WILL BE ASKED QUESTIONS REGARD-
ING PETROLEUM PRODUCTS AND HAZARDOUS OR TOXIC SUBSTANCES THAT YOU KNOW
TO HAVE BEEN SPILLED, LEAKED OR OTHERWISE BEEN RELEASED ON THE PROPERTY
OR FROM THE PROPERTY ONTO ANY OTHER PROPERTY. PETROLEUM PRODUCTS MAY
INCLUDE, BUT ARE NOT LIMITED TO, GASOLINE, DIESEL FUEL, HOME HEATING
FUEL, AND LUBRICANTS. HAZARDOUS OR TOXIC SUBSTANCES ARE PRODUCTS THAT
COULD POSE SHORT- OR LONG-TERM DANGER TO PERSONAL HEALTH OR THE ENVIRON-
MENT IF THEY ARE NOT PROPERLY DISPOSED OF, APPLIED OR STORED. THESE
INCLUDE, BUT ARE NOT LIMITED TO, FERTILIZERS, PESTICIDES AND INSECTI-
CIDES, PAINT INCLUDING PAINT THINNER, VARNISH REMOVER AND WOOD PRESERVA-
TIVES, TREATED WOOD, CONSTRUCTION MATERIALS SUCH AS ASPHALT AND ROOFING
MATERIALS, ANTIFREEZE AND OTHER AUTOMOTIVE PRODUCTS, BATTERIES, CLEANING
SOLVENTS INCLUDING SEPTIC TANK CLEANERS, HOUSEHOLD CLEANERS AND POOL
CHEMICALS AND PRODUCTS CONTAINING MERCURY AND LEAD.
NOTE TO BUYER - IF CONTAMINATION OF THIS PROPERTY FROM PETROLEUM
PRODUCTS AND/OR HAZARDOUS OR TOXIC SUBSTANCES IS A CONCERN TO YOU, YOU
ARE URGED TO CONSIDER SOIL AND GROUNDWATER TESTING OF THIS PROPERTY.
10. IS ANY OR ALL OF THE PROPERTY LOCATED IN A FEDERAL EMERGENCY
MANAGEMENT AGENCY (FEMA) DESIGNATED FLOODPLAIN? YES NO UNKN NA
(IF YES, EXPLAIN BELOW)
11. IS ANY OR ALL OF THE PROPERTY LOCATED WHOLLY OR PARTIALLY IN THE
SPECIAL FLOOD HAZARD AREA ("SFHA"; "100-YEAR FLOODPLAIN") ACCORD-
ING TO THE FEDERAL EMERGENCY MANAGEMENT AGENCY'S (FEMA'S) CURRENT
FLOOD INSURANCE RATE MAPS FOR YOUR AREA? YES NO UNKN NA (IF YES,
EXPLAIN BELOW)
12. IS ANY OR ALL OF THE PROPERTY LOCATED WHOLLY OR PARTIALLY IN A
MODERATE RISK FLOOD HAZARD AREA ("500-YEAR FLOODPLAIN") ACCORDING
TO FEMA'S CURRENT FLOOD INSURANCE RATE MAPS FOR YOUR AREA? YES NO
UNKN NA (IF YES, EXPLAIN BELOW)
13. IS THE PROPERTY SUBJECT TO ANY REQUIREMENT UNDER FEDERAL LAW TO
OBTAIN AND MAINTAIN FLOOD INSURANCE ON THE PROPERTY? YES NO UNKN
NA (IF YES, EXPLAIN BELOW)
HOMES IN THE SPECIAL FLOOD HAZARD AREA, ALSO KNOWN AS HIGH RISK
FLOOD ZONES, ON FEMA'S FLOOD INSURANCE RATE MAPS WITH MORTGAGES
FROM FEDERALLY REGULATED OR INSURED LENDERS ARE REQUIRED TO OBTAIN
AND MAINTAIN FLOOD INSURANCE. EVEN WHEN NOT REQUIRED, FEMA ENCOUR-
AGES HOMEOWNERS IN HIGH RISK, MODERATE RISK, AND LOW RISK FLOOD
ZONES TO PURCHASE FLOOD INSURANCE THAT COVERS THE STRUCTURE(S) AND
THE PERSONAL PROPERTY WITHIN THE STRUCTURE(S). ALSO NOTE THAT
HOMES IN COASTAL AREAS MAY BE SUBJECT TO INCREASED RISK OF FLOOD-
ING OVER TIME DUE TO PROJECTED SEA LEVEL RISE AND INCREASED
EXTREME STORMS CAUSED BY CLIMATE CHANGE WHICH MAY NOT BE REFLECTED
IN CURRENT FLOOD INSURANCE RATE MAPS.
14. HAVE YOU EVER RECEIVED ASSISTANCE, OR ARE YOU AWARE OF ANY PREVI-
OUS OWNERS RECEIVING ASSISTANCE, FROM THE FEDERAL EMERGENCY
MANAGEMENT AGENCY (FEMA), THE U.S. SMALL BUSINESS ADMINISTRATION
(SBA), OR ANY OTHER FEDERAL DISASTER FLOOD ASSISTANCE FOR FLOOD
DAMAGE TO THE PROPERTY? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
FOR PROPERTIES THAT HAVE RECEIVED FEDERAL DISASTER ASSISTANCE, THE
REQUIREMENT TO OBTAIN FLOOD INSURANCE PASSES DOWN TO ALL FUTURE
OWNERS. FAILURE TO OBTAIN AND MAINTAIN FLOOD INSURANCE CAN RESULT
IN AN INDIVIDUAL BEING INELIGIBLE FOR FUTURE ASSISTANCE.
15. IS THERE FLOOD INSURANCE ON THE PROPERTY? YES NO UNKN NA (IF YES,
ATTACH A COPY OF THE POLICY)
S. 5400 4
A STANDARD HOMEOWNER'S INSURANCE POLICY TYPICALLY DOES NOT COVER
FLOOD DAMAGE. YOU ARE ENCOURAGED TO EXAMINE YOUR POLICY TO DETER-
MINE WHETHER YOU ARE COVERED.
16. IS THERE A FEMA ELEVATION CERTIFICATE AVAILABLE FOR THE PROPERTY?
YES NO UNKN NA (IF YES, ATTACH A COPY OF THE CERTIFICATE)
AN ELEVATION CERTIFICATE IS A FEMA FORM, COMPLETED BY A LICENSED
SURVEYOR OR ENGINEER. THE FORM PROVIDES CRITICAL INFORMATION ABOUT
THE FLOOD RISK OF THE PROPERTY AND IS USED BY FLOOD INSURANCE
PROVIDERS UNDER THE NATIONAL FLOOD INSURANCE PROGRAM (NFIP) TO
HELP DETERMINE THE APPROPRIATE FLOOD INSURANCE RATING FOR THE
PROPERTY. A BUYER MAY BE ABLE TO USE THE ELEVATION CERTIFICATE
FROM A PREVIOUS OWNER FOR THEIR FLOOD INSURANCE POLICY.
17. HAVE YOU EVER FILED A CLAIM FOR FLOOD DAMAGE TO THE PROPERTY WITH
ANY INSURANCE PROVIDER, INCLUDING THE NATIONAL FLOOD INSURANCE
PROGRAM (NFIP)? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
18. IS ANY OR ALL OF THE PROPERTY LOCATED IN A DESIGNATED WETLAND?
YES NO UNKN NA (IF YES, EXPLAIN BELOW)
[12.] 19. IS THE PROPERTY LOCATED IN AN AGRICULTURAL DISTRICT? YES
NO UNKN NA (IF YES, EXPLAIN BELOW)
[13.] 20. WAS THE PROPERTY EVER THE SITE OF A LANDFILL? YES NO UNKN
NA (IF YES, EXPLAIN BELOW)
[14.] 21. ARE THERE OR HAVE THERE EVER BEEN FUEL STORAGE TANKS ABOVE
OR BELOW THE GROUND ON THE PROPERTY? YES NO UNKN NA IF YES,
ARE THEY CURRENTLY IN USE? YES NO UNKN NA LOCATION(S) ARE THEY
LEAKING OR HAVE THEY EVER LEAKED? YES NO UNKN NA (IF YES, EXPLAIN
BELOW)
[15.] 22. IS THERE ASBESTOS IN THE STRUCTURE? YES NO UNKN NA (IF YES,
STATE LOCATION OR LOCATIONS BELOW)
[16.] 23. IS LEAD PLUMBING PRESENT? YES NO UNKN NA (IF YES, STATE
LOCATION OR LOCATIONS BELOW)
[17.] 24. HAS A RADON TEST BEEN DONE? YES NO UNKN NA (IF YES, ATTACH A
COPY OF THE REPORT)
[18.] 25. HAS MOTOR FUEL, MOTOR OIL, HOME HEATING FUEL, LUBRICATING
OIL OR ANY OTHER PETROLEUM PRODUCT, METHANE GAS, OR ANY HAZARDOUS
OR TOXIC SUBSTANCE SPILLED, LEAKED OR OTHERWISE BEEN RELEASED ON
THE PROPERTY OR FROM THE PROPERTY ONTO ANY OTHER PROPERTY? YES NO
UNKN NA (IF YES, DESCRIBE BELOW)
[19.] 26. HAS THE PROPERTY BEEN TESTED FOR THE PRESENCE OF MOTOR FUEL,
MOTOR OIL, HOME HEATING FUEL, LUBRICATING OIL, OR ANY OTHER PETRO-
LEUM PRODUCT, METHANE GAS, OR ANY HAZARDOUS OR TOXIC SUBSTANCE?
YES NO UNKN NA (IF YES, ATTACH REPORT(S))
STRUCTURAL
[20.] 27. IS THERE ANY ROT OR WATER DAMAGE TO THE STRUCTURE OR STRUC-
TURES? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
[21.] 28. IS THERE ANY FIRE OR SMOKE DAMAGE TO THE STRUCTURE OR STRUC-
TURES? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
[22.] 29. IS THERE ANY TERMITE, INSECT, RODENT OR PEST INFESTATION OR
DAMAGE? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
[23.] 30. HAS THE PROPERTY BEEN TESTED FOR TERMITE, INSECT, RODENT OR
PEST INFESTATION OR DAMAGE? YES NO UNKN NA (IF YES, PLEASE ATTACH
REPORT(S))
[24.] 31. WHAT IS THE TYPE OF ROOF/ROOF COVERING (SLATE, ASPHALT,
OTHER.)? ANY KNOWN MATERIAL DEFECTS? HOW OLD IS THE ROOF? IS THERE
A TRANSFERABLE [WARRANTEE] WARRANTY ON THE ROOF IN EFFECT NOW? YES
NO UNKN NA (IF YES, EXPLAIN BELOW)
S. 5400 5
[25.] 32. ARE THERE ANY KNOWN MATERIAL DEFECTS IN ANY OF THE FOLLOWING
STRUCTURAL SYSTEMS: FOOTINGS, BEAMS, GIRDERS, LINTELS, COLUMNS OR
PARTITIONS[.]? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
MECHANICAL SYSTEMS & SERVICES
[26.] 33. WHAT IS THE WATER SOURCE (CIRCLE ALL THAT APPLY - WELL,
PRIVATE, MUNICIPAL, OTHER)? IF MUNICIPAL, IS IT METERED? YES NO
UNKN NA
[27.] 34. HAS THE WATER QUALITY AND/OR FLOW RATE BEEN TESTED? YES NO
UNKN NA (IF YES, DESCRIBE BELOW)
[28.] 35. WHAT IS THE TYPE OF SEWAGE SYSTEM (CIRCLE ALL THAT APPLY -
PUBLIC SEWER, PRIVATE SEWER, SEPTIC OR CESSPOOL)? IF SEPTIC OR
CESSPOOL, AGE? ________ DATE LAST PUMPED? ________ FREQUENCY OF
PUMPING? ________ ANY KNOWN MATERIAL DEFECTS? YES NO UNKN NA (IF
YES, EXPLAIN BELOW)
[29.] 36. WHO IS YOUR ELECTRIC SERVICE PROVIDER? ________ WHAT IS THE
AMPERAGE? ________ DOES IT HAVE CIRCUIT BREAKERS OR FUSES?
________ PRIVATE OR PUBLIC POLES? ________ ANY KNOWN MATERIAL
DEFECTS? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
[30.] 37. ARE THERE ANY FLOODING, DRAINAGE OR GRADING PROBLEMS THAT
RESULTED IN STANDING WATER ON ANY PORTION OF THE PROPERTY? YES NO
UNKN NA (IF YES, STATE LOCATIONS AND EXPLAIN BELOW)
[31. DOES THE BASEMENT HAVE SEEPAGE THAT RESULTS IN STANDING WATER?
YES NO UNKN NA (IF YES, EXPLAIN BELOW)] 38. HAS THE STRUCTURE(S)
EXPERIENCED ANY WATER PENETRATION OR DAMAGE DUE TO SEEPAGE OR A
NATURAL FLOOD EVENT, SUCH AS FROM HEAVY RAINFALL, COASTAL STORM
SURGE, TIDAL INUNDATION OR RIVER OVERFLOW? YES NO UNKN NA (IF
YES, EXPLAIN BELOW)
ARE THERE ANY KNOWN MATERIAL DEFECTS IN ANY OF THE FOLLOWING (IF YES,
EXPLAIN BELOW. USE ADDITIONAL SHEETS IF NECESSARY.):
[32.] 39. PLUMBING SYSTEM? YES NO UNKN NA
[33.] 40. SECURITY SYSTEM? YES NO UNKN NA
[34.] 41. CARBON MONOXIDE DETECTOR? YES NO UNKN NA
[35.] 42. SMOKE DETECTOR? YES NO UNKN NA
[36.] 43. FIRE SPRINKLER SYSTEM? YES NO UNKN NA
[37.] 44. SUMP PUMP? YES NO UNKN NA
[38.] 45. FOUNDATION/SLAB? YES NO UNKN NA
[39.] 46. INTERIOR WALLS/CEILINGS? YES NO UNKN NA
[40.] 47. EXTERIOR WALLS OR SIDING? YES NO UNKN NA
[41.] 48. FLOORS? YES NO UNKN NA
[42.] 49. CHIMNEY/FIREPLACE OR STOVE? YES NO UNKN NA
[43.] 50. PATIO/DECK? YES NO UNKN NA
[44.] 51. DRIVEWAY? YES NO UNKN NA
[45.] 52. AIR CONDITIONER? YES NO UNKN NA
[46.] 53. HEATING SYSTEM? YES NO UNKN NA
[47.] 54. HOT WATER HEATER? YES NO UNKN NA
[48.] 55. THE PROPERTY IS LOCATED IN THE
FOLLOWING SCHOOL DISTRICT UNKN
NOTE: BUYER IS ENCOURAGED TO CHECK PUBLIC RECORDS CONCERNING THE PROP-
ERTY (E.G. TAX RECORDS AND WETLAND AND [FLOOD PLAIN] FEMA'S CURRENT
FLOOD INSURANCE RATE MAPS AND ELEVATION CERTIFICATES)
S. 5400 6
THE SELLER SHOULD USE THIS AREA TO FURTHER EXPLAIN ANY ITEM ABOVE. IF
NECESSARY, ATTACH ADDITIONAL PAGES AND INDICATE HERE THE NUMBER OF ADDI-
TIONAL PAGES ATTACHED.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
SELLER'S CERTIFICATION: SELLER CERTIFIES THAT THE INFORMATION IN THIS
PROPERTY CONDITION DISCLOSURE STATEMENT IS TRUE AND COMPLETE TO THE
SELLER'S ACTUAL KNOWLEDGE AS OF THE DATE SIGNED BY THE SELLER. IF A
SELLER OF RESIDENTIAL REAL PROPERTY ACQUIRES KNOWLEDGE WHICH RENDERS
MATERIALLY INACCURATE A PROPERTY CONDITION DISCLOSURE STATEMENT PROVIDED
PREVIOUSLY, THE SELLER SHALL DELIVER A REVISED PROPERTY CONDITION
DISCLOSURE STATEMENT TO THE BUYER AS SOON AS PRACTICABLE. IN NO EVENT,
HOWEVER, SHALL A SELLER BE REQUIRED TO PROVIDE A REVISED PROPERTY CONDI-
TION DISCLOSURE STATEMENT AFTER THE TRANSFER OF TITLE FROM THE SELLER TO
THE BUYER OR OCCUPANCY BY THE BUYER, WHICHEVER IS EARLIER.
SELLER _______________________________________ DATE ________________
SELLER _______________________________________ DATE ________________
BUYER'S ACKNOWLEDGMENT: BUYER ACKNOWLEDGES RECEIPT OF A COPY OF THIS
STATEMENT AND BUYER UNDERSTANDS THAT THIS INFORMATION IS A STATEMENT OF
CERTAIN CONDITIONS AND INFORMATION CONCERNING THE PROPERTY KNOWN TO THE
SELLER. IT IS NOT A WARRANTY OF ANY KIND BY THE SELLER OR SELLER'S AGENT
AND IS NOT A SUBSTITUTE FOR ANY HOME, PEST, RADON OR OTHER INSPECTIONS
OR TESTING OF THE PROPERTY OR INSPECTION OF THE PUBLIC RECORDS.
BUYER _______________________________________ DATE ________________
BUYER _______________________________________ DATE ________________
§ 2. Subdivision 2 of section 462 of the real property law, as amended
by chapter 690 of the laws of 2022, is amended to read as follows:
2. The following shall be the disclosure form:
PROPERTY CONDITION DISCLOSURE STATEMENT
NAME OF SELLER OR SELLERS:
PROPERTY ADDRESS:
THE PROPERTY CONDITION DISCLOSURE ACT REQUIRES THE SELLER OF RESIDEN-
TIAL REAL PROPERTY TO CAUSE THIS DISCLOSURE STATEMENT OR A COPY THEREOF
TO BE DELIVERED TO A BUYER OR BUYER'S AGENT PRIOR TO THE SIGNING BY THE
BUYER OF A BINDING CONTRACT OF SALE.
PURPOSE OF STATEMENT: THIS IS A STATEMENT OF CERTAIN CONDITIONS AND
INFORMATION CONCERNING THE PROPERTY KNOWN TO THE SELLER. THIS DISCLOSURE
STATEMENT IS NOT A WARRANTY OF ANY KIND BY THE SELLER OR BY ANY AGENT
REPRESENTING THE SELLER IN THIS TRANSACTION. IT IS NOT A SUBSTITUTE FOR
ANY INSPECTIONS OR TESTS AND THE BUYER IS ENCOURAGED TO OBTAIN HIS OR
HER OWN INDEPENDENT PROFESSIONAL INSPECTIONS AND ENVIRONMENTAL TESTS AND
ALSO IS ENCOURAGED TO CHECK PUBLIC RECORDS PERTAINING TO THE PROPERTY.
A KNOWINGLY FALSE OR INCOMPLETE STATEMENT BY THE SELLER ON THIS FORM
MAY SUBJECT THE SELLER TO CLAIMS BY THE BUYER PRIOR TO OR AFTER THE
TRANSFER OF TITLE. [IN THE EVENT A SELLER FAILS TO PERFORM THE DUTY
PRESCRIBED IN THIS ARTICLE TO DELIVER A DISCLOSURE STATEMENT PRIOR TO
THE SIGNING BY THE BUYER OF A BINDING CONTRACT OF SALE, THE BUYER SHALL
RECEIVE UPON THE TRANSFER OF TITLE A CREDIT OF FIVE HUNDRED DOLLARS
S. 5400 7
AGAINST THE AGREED UPON PURCHASE PRICE OF THE RESIDENTIAL REAL PROPER-
TY.]
"RESIDENTIAL REAL PROPERTY" MEANS REAL PROPERTY IMPROVED BY A ONE TO
FOUR FAMILY DWELLING USED OR OCCUPIED, OR INTENDED TO BE USED OR OCCU-
PIED, WHOLLY OR PARTLY, AS THE HOME OR RESIDENCE OF ONE OR MORE PERSONS,
BUT SHALL NOT REFER TO (A) UNIMPROVED REAL PROPERTY UPON WHICH SUCH
DWELLINGS ARE TO BE CONSTRUCTED OR (B) CONDOMINIUM UNITS OR COOPERATIVE
APARTMENTS OR (C) PROPERTY ON A HOMEOWNERS' ASSOCIATION THAT IS NOT
OWNED IN FEE SIMPLE BY THE SELLER.
INSTRUCTIONS TO THE SELLER:
(a) ANSWER ALL QUESTIONS BASED UPON YOUR ACTUAL KNOWLEDGE.
(b) ATTACH ADDITIONAL PAGES WITH YOUR SIGNATURE IF ADDITIONAL SPACE IS
REQUIRED.
(c) COMPLETE THIS FORM YOURSELF.
(d) IF SOME ITEMS DO NOT APPLY TO YOUR PROPERTY, CHECK "NA" (NON-AP-
PLICABLE). IF YOU DO NOT KNOW THE ANSWER CHECK "UNKN" (UNKNOWN).
SELLER'S STATEMENT: THE SELLER MAKES THE FOLLOWING REPRESENTATIONS TO
THE BUYER BASED UPON THE SELLER'S ACTUAL KNOWLEDGE AT THE TIME OF SIGN-
ING THIS DOCUMENT. THE SELLER AUTHORIZES HIS OR HER AGENT, IF ANY, TO
PROVIDE A COPY OF THIS STATEMENT TO A PROSPECTIVE BUYER OF THE RESIDEN-
TIAL REAL PROPERTY. THE FOLLOWING ARE REPRESENTATIONS MADE BY THE SELLER
AND ARE NOT THE REPRESENTATIONS OF THE SELLER'S AGENT.
GENERAL INFORMATION
1. HOW LONG HAVE YOU OWNED THE PROPERTY?
2. HOW LONG HAVE YOU OCCUPIED THE PROPERTY?
3. WHAT IS THE AGE OF THE STRUCTURE OR STRUCTURES? NOTE TO BUYER--IF
THE STRUCTURE WAS BUILT BEFORE 1978 YOU ARE ENCOURAGED TO INVESTI-
GATE FOR THE PRESENCE OF LEAD BASED PAINT.
4. DOES ANYBODY OTHER THAN YOURSELF HAVE A LEASE, EASEMENT OR ANY
OTHER RIGHT TO USE OR OCCUPY ANY PART OF YOUR PROPERTY OTHER THAN
THOSE STATED IN DOCUMENTS AVAILABLE IN THE PUBLIC RECORD, SUCH AS
RIGHTS TO USE A ROAD OR PATH OR CUT TREES OR CROPS. YES NO UNKN NA
5. DOES ANYBODY ELSE CLAIM TO OWN ANY PART OF YOUR PROPERTY? YES NO
UNKN NA (IF YES, EXPLAIN BELOW)
6. HAS ANYONE DENIED YOU ACCESS TO THE PROPERTY OR MADE A FORMAL LEGAL
CLAIM CHALLENGING YOUR TITLE TO THE PROPERTY? YES NO UNKN NA (IF
YES, EXPLAIN BELOW)
7. ARE THERE ANY FEATURES OF THE PROPERTY SHARED IN COMMON WITH
ADJOINING LAND OWNERS OR A HOMEOWNERS ASSOCIATION, SUCH AS WALLS,
FENCES OR DRIVEWAYS? YES NO UNKN NA (IF YES DESCRIBE BELOW)
8. ARE THERE ANY ELECTRIC OR GAS UTILITY SURCHARGES FOR LINE EXTEN-
SIONS, SPECIAL ASSESSMENTS OR HOMEOWNER OR OTHER ASSOCIATION FEES
THAT APPLY TO THE PROPERTY? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
9. ARE THERE CERTIFICATES OF OCCUPANCY RELATED TO THE PROPERTY? YES
NO UNKN NA (IF NO, EXPLAIN BELOW)
ENVIRONMENTAL
NOTE TO SELLER - IN THIS SECTION, YOU WILL BE ASKED QUESTIONS REGARD-
ING PETROLEUM PRODUCTS AND HAZARDOUS OR TOXIC SUBSTANCES THAT YOU KNOW
TO HAVE BEEN SPILLED, LEAKED OR OTHERWISE BEEN RELEASED ON THE PROPERTY
OR FROM THE PROPERTY ONTO ANY OTHER PROPERTY. PETROLEUM PRODUCTS MAY
INCLUDE, BUT ARE NOT LIMITED TO, GASOLINE, DIESEL FUEL, HOME HEATING
FUEL, AND LUBRICANTS. HAZARDOUS OR TOXIC SUBSTANCES ARE PRODUCTS OR
OTHER MATERIAL THAT COULD POSE SHORT- OR LONG-TERM DANGER TO PERSONAL
S. 5400 8
HEALTH OR THE ENVIRONMENT IF THEY ARE NOT PROPERLY DISPOSED OF, APPLIED
OR STORED. THESE INCLUDE, BUT ARE NOT LIMITED TO, FERTILIZERS, PESTI-
CIDES AND INSECTICIDES, PAINT INCLUDING PAINT THINNER, VARNISH REMOVER
AND WOOD PRESERVATIVES, TREATED WOOD, CONSTRUCTION MATERIALS SUCH AS
ASPHALT AND ROOFING MATERIALS, ANTIFREEZE AND OTHER AUTOMOTIVE PRODUCTS,
BATTERIES, CLEANING SOLVENTS INCLUDING SEPTIC TANK CLEANERS, HOUSEHOLD
CLEANERS, POOL CHEMICALS, PRODUCTS CONTAINING MERCURY AND LEAD AND
INDOOR MOLD.
NOTE TO BUYER - IF CONTAMINATION OF THIS PROPERTY FROM PETROLEUM
PRODUCTS AND/OR HAZARDOUS OR TOXIC SUBSTANCES IS A CONCERN TO YOU, YOU
ARE URGED TO CONSIDER SOIL AND GROUNDWATER TESTING OF THIS PROPERTY.
10. IS ANY OR ALL OF THE PROPERTY LOCATED IN A FEDERAL EMERGENCY
MANAGEMENT AGENCY (FEMA) DESIGNATED FLOODPLAIN? YES NO UNKN NA
(IF YES, EXPLAIN BELOW)
11. IS ANY OR ALL OF THE PROPERTY LOCATED WHOLLY OR PARTIALLY IN THE
SPECIAL FLOOD HAZARD AREA ("SFHA"; "100-YEAR FLOODPLAIN") ACCORD-
ING TO THE FEDERAL EMERGENCY MANAGEMENT AGENCY'S (FEMA'S) CURRENT
FLOOD INSURANCE RATE MAPS FOR YOUR AREA? YES NO UNKN NA (IF YES,
EXPLAIN BELOW)
12. IS ANY OR ALL OF THE PROPERTY LOCATED WHOLLY OR PARTIALLY IN A
MODERATE RISK FLOOD HAZARD AREA ("500-YEAR FLOODPLAIN") ACCORDING
TO FEMA'S CURRENT FLOOD INSURANCE RATE MAPS FOR YOUR AREA? YES NO
UNKN NA (IF YES, EXPLAIN BELOW)
13. IS THE PROPERTY SUBJECT TO ANY REQUIREMENT UNDER FEDERAL LAW TO
OBTAIN AND MAINTAIN FLOOD INSURANCE ON THE PROPERTY? YES NO UNKN
NA (IF YES, EXPLAIN BELOW)
HOMES IN THE SPECIAL FLOOD HAZARD AREA, ALSO KNOWN AS HIGH RISK
FLOOD ZONES, ON FEMA'S FLOOD INSURANCE RATE MAPS WITH MORTGAGES
FROM FEDERALLY REGULATED OR INSURED LENDERS ARE REQUIRED TO OBTAIN
AND MAINTAIN FLOOD INSURANCE. EVEN WHEN NOT REQUIRED, FEMA ENCOUR-
AGES HOMEOWNERS IN HIGH RISK, MODERATE RISK, AND LOW RISK FLOOD
ZONES TO PURCHASE FLOOD INSURANCE THAT COVERS THE STRUCTURE(S) AND
THE PERSONAL PROPERTY WITHIN THE STRUCTURE(S). ALSO NOTE THAT
HOMES IN COASTAL AREAS MAY BE SUBJECT TO INCREASED RISK OF FLOOD-
ING OVER TIME DUE TO PROJECTED SEA LEVEL RISE AND INCREASED
EXTREME STORMS CAUSED BY CLIMATE CHANGE WHICH MAY NOT BE REFLECTED
IN CURRENT FLOOD INSURANCE RATE MAPS.
14. HAVE YOU EVER RECEIVED ASSISTANCE, OR ARE YOU AWARE OF ANY PREVI-
OUS OWNERS RECEIVING ASSISTANCE, FROM THE FEDERAL EMERGENCY
MANAGEMENT AGENCY (FEMA), THE U.S. SMALL BUSINESS ADMINISTRATION
(SBA), OR ANY OTHER FEDERAL DISASTER FLOOD ASSISTANCE FOR FLOOD
DAMAGE TO THE PROPERTY? YES NO UNKN NA (IF YES, EXPLAIN BELOW) FOR
PROPERTIES THAT HAVE RECEIVED FEDERAL DISASTER ASSISTANCE, THE
REQUIREMENT TO OBTAIN FLOOD INSURANCE PASSES DOWN TO ALL FUTURE
OWNERS. FAILURE TO OBTAIN AND MAINTAIN FLOOD INSURANCE CAN RESULT
IN AN INDIVIDUAL BEING INELIGIBLE FOR FUTURE ASSISTANCE.
15. IS THERE FLOOD INSURANCE ON THE PROPERTY? YES NO UNKN NA (IF YES,
ATTACH A COPY OF THE POLICY)
A STANDARD HOMEOWNER'S INSURANCE POLICY TYPICALLY DOES NOT COVER
FLOOD DAMAGE. YOU ARE ENCOURAGED TO EXAMINE YOUR POLICY TO DETER-
MINE WHETHER YOU ARE COVERED.
16. IS THERE A FEMA ELEVATION CERTIFICATE AVAILABLE FOR THE PROPERTY?
YES NO UNKN NA (IF YES, ATTACH A COPY OF THE CERTIFICATE)
S. 5400 9
AN ELEVATION CERTIFICATE IS A FEMA FORM, COMPLETED BY A LICENSED
SURVEYOR OR ENGINEER. THE FORM PROVIDES CRITICAL INFORMATION ABOUT
THE FLOOD RISK OF THE PROPERTY AND IS USED BY FLOOD INSURANCE
PROVIDERS UNDER THE NATIONAL FLOOD INSURANCE PROGRAM (NFIP) TO
HELP DETERMINE THE APPROPRIATE FLOOD INSURANCE RATING FOR THE
PROPERTY. A BUYER MAY BE ABLE TO USE THE ELEVATION CERTIFICATE
FROM A PREVIOUS OWNER FOR THEIR FLOOD INSURANCE POLICY.
17. HAVE YOU EVER FILED A CLAIM FOR FLOOD DAMAGE TO THE PROPERTY WITH
ANY INSURANCE PROVIDER, INCLUDING THE NATIONAL FLOOD INSURANCE
PROGRAM (NFIP)? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
18. IS ANY OR ALL OF THE PROPERTY LOCATED IN A DESIGNATED WETLAND?
YES NO UNKN NA (IF YES, EXPLAIN BELOW)
[12.] 19. IS THE PROPERTY LOCATED IN AN AGRICULTURAL DISTRICT? YES
NO UNKN NA (IF YES, EXPLAIN BELOW)
[13.] 20. WAS THE PROPERTY EVER THE SITE OF A LANDFILL? YES NO UNKN
NA (IF YES, EXPLAIN BELOW)
[14.] 21. ARE THERE OR HAVE THERE EVER BEEN FUEL STORAGE TANKS ABOVE
OR BELOW THE GROUND ON THE PROPERTY? YES NO UNKN NA IF YES,
ARE THEY CURRENTLY IN USE? YES NO UNKN NA LOCATION(S) ARE THEY
LEAKING OR HAVE THEY EVER LEAKED? YES NO UNKN NA (IF YES,
EXPLAIN BELOW)
[15.] 22. IS THERE ASBESTOS IN THE STRUCTURE? YES NO UNKN NA (IF YES,
STATE LOCATION OR LOCATIONS BELOW)
[16.] 23. IS LEAD PLUMBING PRESENT? YES NO UNKN NA (IF YES, STATE
LOCATION OR LOCATIONS BELOW)
[17.] 24. HAS A RADON TEST BEEN DONE? YES NO UNKN NA (IF YES, ATTACH A
COPY OF THE REPORT)
[18.] 25. HAS MOTOR FUEL, MOTOR OIL, HOME HEATING FUEL, LUBRICATING
OIL OR ANY OTHER PETROLEUM PRODUCT, METHANE GAS, OR ANY HAZARD-
OUS OR TOXIC SUBSTANCE SPILLED, LEAKED OR OTHERWISE BEEN
RELEASED ON THE PROPERTY OR FROM THE PROPERTY ONTO ANY OTHER
PROPERTY? YES NO UNKN NA (IF YES, DESCRIBE BELOW)
[19.] 26. HAS THE PROPERTY BEEN TESTED FOR THE PRESENCE OF MOTOR
FUEL, MOTOR OIL, HOME HEATING FUEL, LUBRICATING OIL, OR ANY
OTHER PETROLEUM PRODUCT, METHANE GAS, OR ANY HAZARDOUS OR TOXIC
SUBSTANCE? YES NO UNKN NA (IF YES, ATTACH REPORT(S))
[19-a.] 27. HAS THE PROPERTY BEEN TESTED FOR INDOOR MOLD? YES NO UNKN
(IF YES, ATTACH A COPY OF THE REPORT)
STRUCTURAL
[20.] 28. IS THERE ANY ROT OR WATER DAMAGE TO THE STRUCTURE OR STRUC-
TURES? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
[21.] 29. IS THERE ANY FIRE OR SMOKE DAMAGE TO THE STRUCTURE OR STRUC-
TURES? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
[22.] 30. IS THERE ANY TERMITE, INSECT, RODENT OR PEST INFESTATION OR
DAMAGE? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
[23.] 31. HAS THE PROPERTY BEEN TESTED FOR TERMITE, INSECT, RODENT OR
PEST INFESTATION OR DAMAGE? YES NO UNKN NA (IF YES, PLEASE ATTACH
REPORT(S))
[24.] 32. WHAT IS THE TYPE OF ROOF/ROOF COVERING (SLATE, ASPHALT,
OTHER.)? ANY KNOWN MATERIAL DEFECTS? HOW OLD IS THE ROOF? IS THERE
A TRANSFERABLE [WARRANTEE] WARRANTY ON THE ROOF IN EFFECT NOW? YES
NO UNKN NA (IF YES, EXPLAIN BELOW)
[25.] 33. ARE THERE ANY KNOWN MATERIAL DEFECTS IN ANY OF THE FOLLOWING
STRUCTURAL SYSTEMS: FOOTINGS, BEAMS, GIRDERS, LINTELS, COLUMNS OR
PARTITIONS[.]? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
S. 5400 10
MECHANICAL SYSTEMS & SERVICES
[26.] 34. WHAT IS THE WATER SOURCE (CIRCLE ALL THAT APPLY - WELL,
PRIVATE, MUNICIPAL, OTHER)? IF MUNICIPAL, IS IT METERED? YES NO
UNKN NA
[27.] 35. HAS THE WATER QUALITY AND/OR FLOW RATE BEEN TESTED? YES NO
UNKN NA (IF YES, DESCRIBE BELOW)
[28.] 36. WHAT IS THE TYPE OF SEWAGE SYSTEM (CIRCLE ALL THAT APPLY -
PUBLIC SEWER, PRIVATE SEWER, SEPTIC OR CESSPOOL)? IF SEPTIC OR
CESSPOOL, AGE? ________ DATE LAST PUMPED? ________ FREQUENCY OF
PUMPING? ________ ANY KNOWN MATERIAL DEFECTS? YES NO UNKN NA (IF
YES, EXPLAIN BELOW)
[29.] 37. WHO IS YOUR ELECTRIC SERVICE PROVIDER? ________ WHAT IS THE
AMPERAGE? ________ DOES IT HAVE CIRCUIT BREAKERS OR FUSES?
________ PRIVATE OR PUBLIC POLES? ________ ANY KNOWN MATERIAL
DEFECTS? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
[30.] 38. ARE THERE ANY FLOODING, DRAINAGE OR GRADING PROBLEMS THAT
RESULTED IN STANDING WATER ON ANY PORTION OF THE PROPERTY? YES NO
UNKN NA (IF YES, STATE LOCATIONS AND EXPLAIN BELOW)
[31. DOES THE BASEMENT HAVE SEEPAGE THAT RESULTS IN STANDING WATER?
YES NO UNKN NA (IF YES, EXPLAIN BELOW)] 39. HAS THE STRUCTURE(S)
EXPERIENCED ANY WATER PENETRATION OR DAMAGE DUE TO SEEPAGE OR A
NATURAL FLOOD EVENT, SUCH AS FROM HEAVY RAINFALL, COASTAL STORM
SURGE, TIDAL INUNDATION OR RIVER OVERFLOW? YES NO UNKN NA (IF
YES, EXPLAIN BELOW)
ARE THERE ANY KNOWN MATERIAL DEFECTS IN ANY OF THE FOLLOWING (IF YES,
EXPLAIN BELOW. USE ADDITIONAL SHEETS IF NECESSARY.):
[32.] 40. PLUMBING SYSTEM? YES NO UNKN NA
[33.] 41. SECURITY SYSTEM? YES NO UNKN NA
[34.] 42. CARBON MONOXIDE DETECTOR? YES NO UNKN NA
[35.] 43. SMOKE DETECTOR? YES NO UNKN NA
[36.] 44. FIRE SPRINKLER SYSTEM? YES NO UNKN NA
[37.] 45. SUMP PUMP? YES NO UNKN NA
[38.] 46. FOUNDATION/SLAB? YES NO UNKN NA
[39.] 47. INTERIOR WALLS/CEILINGS? YES NO UNKN NA
[40.] 48. EXTERIOR WALLS OR SIDING? YES NO UNKN NA
[41.] 49. FLOORS? YES NO UNKN NA
[42.] 50. CHIMNEY/FIREPLACE OR STOVE? YES NO UNKN NA
[43.] 51. PATIO/DECK? YES NO UNKN NA
[44.] 52. DRIVEWAY? YES NO UNKN NA
[45.] 53. AIR CONDITIONER? YES NO UNKN NA
[46.] 54. HEATING SYSTEM? YES NO UNKN NA
[47.] 55. HOT WATER HEATER? YES NO UNKN NA
[48.] 56. THE PROPERTY IS LOCATED IN THE FOLLOWING SCHOOL DISTRICT
UNKN NOTE: BUYER IS ENCOURAGED TO CHECK PUBLIC RECORDS CONCERNING
THE PROPERTY (E.G. TAX RECORDS AND WETLAND AND [FLOOD PLAIN] FEMA'S
CURRENT FLOOD INSURANCE RATE MAPS AND ELEVATION CERTIFICATES)
THE SELLER SHOULD USE THIS AREA TO FURTHER EXPLAIN ANY ITEM ABOVE. IF
NECESSARY, ATTACH ADDITIONAL PAGES AND INDICATE HERE THE NUMBER OF ADDI-
TIONAL PAGES ATTACHED.
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
SELLER'S CERTIFICATION: SELLER CERTIFIES THAT THE INFORMATION IN THIS
PROPERTY CONDITION DISCLOSURE STATEMENT IS TRUE AND COMPLETE TO THE
SELLER'S ACTUAL KNOWLEDGE AS OF THE DATE SIGNED BY THE SELLER. IF A
S. 5400 11
SELLER OF RESIDENTIAL REAL PROPERTY ACQUIRES KNOWLEDGE WHICH RENDERS
MATERIALLY INACCURATE A PROPERTY CONDITION DISCLOSURE STATEMENT PROVIDED
PREVIOUSLY, THE SELLER SHALL DELIVER A REVISED PROPERTY CONDITION
DISCLOSURE STATEMENT TO THE BUYER AS SOON AS PRACTICABLE. IN NO EVENT,
HOWEVER, SHALL A SELLER BE REQUIRED TO PROVIDE A REVISED PROPERTY CONDI-
TION DISCLOSURE STATEMENT AFTER THE TRANSFER OF TITLE FROM THE SELLER TO
THE BUYER OR OCCUPANCY BY THE BUYER, WHICHEVER IS EARLIER.
SELLER__________ DATE___________
SELLER__________ DATE___________
BUYER'S ACKNOWLEDGMENT: BUYER ACKNOWLEDGES RECEIPT OF A COPY OF THIS
STATEMENT AND BUYER UNDERSTANDS THAT THIS INFORMATION IS A STATEMENT OF
CERTAIN CONDITIONS AND INFORMATION CONCERNING THE PROPERTY KNOWN TO THE
SELLER. IT IS NOT A WARRANTY OF ANY KIND BY THE SELLER OR SELLER'S AGENT
AND IS NOT A SUBSTITUTE FOR ANY HOME, PEST, RADON OR OTHER INSPECTIONS
OR TESTING OF THE PROPERTY OR INSPECTION OF THE PUBLIC RECORDS.
BUYER__________ DATE__________
BUYER__________ DATE _________
§ 3. Section 465 of the real property law, as added by chapter 456 of
the laws of 2001, is amended to read as follows:
§ 465. [Remedy] LIABILITY. 1. [In the event a seller fails to perform
the duty prescribed in this article to deliver a disclosure statement
prior to the signing by the buyer of a binding contract of sale, the
buyer shall receive upon the transfer of title a credit of five hundred
dollars against the agreed upon purchase price of the residential real
property.] NOTHING CONTAINED IN THIS ARTICLE SHALL BE CONSTRUED AS
LIMITING ANY EXISTING LEGAL CAUSE OF ACTION OR REMEDY AT LAW, IN STATUTE
OR IN EQUITY.
2. Any seller who provides a property condition disclosure statement
or provides or fails to provide a revised property condition disclosure
statement shall be liable only for a willful failure to perform the
requirements of this article. For such a willful failure, the seller
shall be liable for the actual damages suffered by the buyer in addition
to any other existing equitable or statutory remedy.
§ 4. Section 467 of the real property law is REPEALED.
§ 5. This act shall take effect on the one hundred eightieth day after
it shall have become a law. Effective immediately the addition, amend-
ment and/or repeal of any rule or regulation necessary for the implemen-
tation of this act on its effective date are authorized to be made and
completed on or before such date.
