Residential Property Disclosure Statement

Notice to Seller and Purchaser

The North Carolina residential Property Disclosure Act requires the owner of residential real property consisting of 1-4 units, whenever the property is to be sold, exchanged, optioned, or purchased pursuant to a lease with option to purchae, to furnish to the purchaser a RESIDENTIAL PROPERTY DISCLOSURE STATEMENT disclosing certain conditions of the property. Certain transfer of residential property are excluded from this requirement by G.S. 47E-2, including transfers of residential property made pursuant to a lease with an option to purchase where the lessee occupies or intends to occupy the dwelling. Guidelines

Property Address/Description: ___________________________________________________________________________________________
__________________________________________________________________________________________________________________

The undersigned owner(s) of the real property described above disclose the following present conditions of the real property of which the owner(s) has actual knowledge with regard to:

1. Any Abnormality or malfunctioning of the water supply or sanitary sewage disposal system:
   Yes None Known No Representations
   If yes, please describe ____________________________________________________________________________________________
   _____________________________________________________________________________________________________________
2. Any damage to or abnormality of the roof, chimneys, floors, foundation, basement, or load-bearing walls, or any leak in the roof or basement:
   Yes None Known No Representations
   If yes, please describe ____________________________________________________________________________________________
   _____________________________________________________________________________________________________________
3. Any abnormality or malfunctioning of the plumbling, electrical, heating, or cooling systems:
   Yes None Known No Representations
   If yes, please describe ____________________________________________________________________________________________
   _____________________________________________________________________________________________________________
4. Present infestation of wood-destroying insects or organisms or past infestation the damage for which has not been repaired:
   Yes None Known No Representations
   If yes, please describe ____________________________________________________________________________________________
   _____________________________________________________________________________________________________________
5. The real property's violation of zoning laws, restrictive covenants or building codes; any encroachment of the real property from or to adjacent real property; or notices from any governmental agency affecting this real property:
   Yes None Known No Representations
   If yes, please describe ____________________________________________________________________________________________
   _____________________________________________________________________________________________________________
6. Presence of lead-based paint, asbestos, radon gas, methane gas, underground storage tank, hazardous material or toxic material (whether buried or covered):
   Yes None Known No Representations
   If yes, please describe ____________________________________________________________________________________________
   _____________________________________________________________________________________________________________

The purchaser and owner may wish to obtain professional advice about, or inspection of, the real property. The owner has a duty to disclose any material inaccuracy in this statement or any material change in the real property which is discovered between the date of this statement and the closing of the transaction. The owner(s) acknowledge having examined this statement before signing below:

___________________________________ ______________ ___________________________________ __________________
Owner                               Date           Owner                               Date

The purchaser(s) acknowledge receipt of a copy of this disclosure statement and further acknowledge that they have examined it before signing below:

___________________________________ ______________ ___________________________________ __________________
Purchaser                           Date           Purchaser                           Date

REC 1-/95