State of Alaska
Residential Real Property Transfer Disclosure Statement
Prepared in compliance with Alaska Statute (AS) 34.70.010 - 34.70.200
General Information
AS 34.70.010 requires that before the Transferee/Buyer (hereafter referred to as Buyer) of an interest in residential real property makes a written offer, the Transferor/Seller (hereafter referred to as Seller) must deliver a completed written disclosure form. This disclosure statement is in compliance with AS 34.70.010. It concerns the residential real
property* located in the Recording District, Judicial District, State of Alaska.
Residential real property means any single family dwelling, or two single family dwelling units under one roof, or any individual unit in a multi-unit structure or common interest ownership community whose primary purpose is to provide housing. AS 34.70.200(2) and (3).
AS 34.70.020 provides that if a disclosure statement or material amendment is delivered to the transferee after the transferee has made a written offer, the transferee may terminate the offer by delivering a written notice of termination to the transferor or the transferor’s licensee within three days after the disclosure statement or amendment is delivered in person or within six days after the disclosure statement or amendment is delivered by deposit in the mail.
AS 34.70.040(b) provides that if an item that must be completed in the disclosure statement is unknown or is unavailable to the Seller, and if the Seller or Seller’s agent has made a reasonable effort to ascertain the information, the Seller may make an approximation based on the best information available to the Seller or Seller’s agent. It must be reasonable, clearly labeled as an approximation, and not used to avoid the disclosure requirements of AS 34.70.010 – AS 34.70.200.
All disclosures made in this statement are required to be made in good faith (AS 34.70.060). The Seller is required to disclose defects or other conditions in the real property or the real property interest being transferred. To comply, disclosure need not include a search of the public records, nor does it require a professional inspection of the property.
If the information supplied in this disclosure statement becomes inaccurate as a result of an act or agreement after the disclosure statement is delivered to the Buyer, the Seller is required to deliver an amendment to the disclosure statement to the Buyer. An addendum/amendment form for that purpose may be attached to this disclosure.
statement.
Upon delivery to a buyer, any inspection/reports generated by a purchase agreement of this property automatically becomes an addendum/amendment to the property disclosure.
Exemption for First Sale: Under AS 34.70.120, the first transfer of an interest in residential real property that has never been occupied is exempt from the requirement for the Seller to complete the Disclosure Statement.
Waiver by Agreement: Under AS 34.70.110, completion of this disclosure statement may be waived when transferring an interest in residential real property if the Seller and Buyer agree in writing. Signing this waiver does not affect other obligations for disclosure.
Violation or Failure to Comply: A person who negligently violates or fails to perform a duty required by AS 34.70.010 - AS 34.70.200 is liable to the Buyer for actual damages suffered by the Buyer as a result of the violation or failure. If the person willfully violates or fails to perform a duty required by AS 34.70.010 -AS 34.70.200,
the Seller is liable to the Buyer for up to three times the actual damages. In addition to the damages, a court may also award the Buyer costs and attorney fees to the extent allowed under the rules of court.
Property Features:
Check all items that are built-in and will remain with the property. Also . . .
Describe any defects or malfunctions.
Air ConditionerAttached/Detached Fire AlarmsAuto Garage Door Opener(s)BarbecueBBQ CoverCarportCeilingsCentral VacuumChimney(s)CO DetectorsCooktopCrawl SpaceDishwasherDoorsDrivewaysElectrical SystemsElectronic Air CleanerExterior WallsFences/GatesFiltrationFireplace(s)FloorsFoundationGarageGarage Floor DrainGarbage DisposalGas StarterGreenhouseHeat RecoveryHeating System(s)Hot TubHot Water HeaterHumidifierInstant Hot Water DispenserInsulationIntercomInterior WallsJetted TubMechanicalMicrowave(s)Oven(s)Paddle Fan(s)Patio/DeckingPlumbing SystemsPool CoverPrivate WalkwaysRain GuttersRefrigeratorRetaining WallsRods & BlindsRoofSatellite DishSecurity SystemSewage SystemsSkylightsSlabsSmoke Detector(s)Solar PanelsSteam Shower RoomStorage Shed(s)Swimming PoolT.V. AntennaTrash CompactorVentilator SystemVentingWasher/Dryer Hook-upsWater Filtering SystemWater SoftenerWater SupplyWind GeneratorsWindowsWindow ScreensWood Stove(s)Other
Documentation: Check the documents for the subject property that the seller has available for review:
Engineer/Property/HomeWritten Agreements withParty Wall AgreementInspection Report(s) Adjacent Property OwnersLease/Rental agreementTitle InformationEnergy Rating Certificate or PUR-101Soils TestAs-Built SurveyResale CertificateWell Log and Water TestsCertificate of Occupancy or PUR-102Water Rights CertificateHazardous Materials Test(s)Deed RestrictionsSubdivision Covenants/RestrictionsOther
Additional Information:
Supply information for the following items: Yes No
To the best of your knowledge, has the property been inspected by an engineer/home inspector in the last
5 years?………………………………………………………………………………………………………………………….. □ □
¾ Drainage:
♦ Are you aware of ever having any water in the crawl space, basement, or lower level?................................. □ □
If Yes, how has the problem been resolved?
□ Sump Pump(s) □ Curtain Drain □ Rain Gutter/Extension □ Other ____________________
When was problem resolved? ___________________________________________________________
Location of each sump pump: ___________________________________________________________
♥ To where does the water drain after it leaves the sump pump? _________________________________
If gutters, where do downspouts discharge? ________________________________________________
♦ Is there a floor drain in the structure, including garage?……………………………………………………….…. □□
If Yes, where is it located and where does it drain to? ________________________________________
¾ Roof or Other Leakage:
Type: □ Asphalt/Composition Shingle □ Cedar Shake □ Built-up □ Metal □ Other __________ Age: years. Location of attic access? ____________________________________
♦ Are you aware of any ice damming on the roof? ………………………………………………………………….. □ □
If Yes, provide location. ________________________________________________________________
♦ Are you aware of any water leaking into the home? i.e., windows, lights, fireplace, etc. ……………………..□ □
If Yes, provide location. ________________________________________________________________
¾ Fireplace and/or Woodstove: Date chimney(s) last cleaned? Who cleaned? _______________
¾ Heating System(s):
Mark all types that apply: □ Hot Water Baseboard □ Forced Air □ Radiant Heat □ Electrical Heat
□ Wood Stove □ Other ___________________________________
Age: years. Last Cleaned: Last Inspected: _________________
Source: □Natural Gas □ Electric □ Propane Tank leased or owned? □ Wood □ Coal
□ Oil with gallon storage which is □ Buried □ Above Ground □ Other ____________
Age of Tank? years.
¾ Hot Water Heater:
Age: years. Capacity: gallons. Type: □ Gas □ Electric □ Other ________
¾ Water Supply:
Type: □ Public □ Private □ Community □ Cistern/Water Tank If Cistern/Water Tank: Size
□ Other
If Private: Well Depth: feet. Flow Rate: gallons per minute. Date Tested: .
♦ Have you had any problems with your water supply?...................................................................................... □ □
♦ Has the water supply been tested in the past 12 months?.............................................................................. □ □
If Yes, attach all documentation from all tests.
♦ Are you aware of any contaminants in your water supply, to include but not limited to E-coli, nitrates,
heavy metals, arsenic or other contaminants? ……………………………………………………………........... .□ □
♦ Has the well failed while you have owned the property?................................................................................ .□ □
♦ Have you ever had a well pump problem or failure?........................................................................................□ □
♦ Do you supply water to, or receive water from others?....................................................................................□ □
If Yes, is there a recorded agreement?............................................................................................................□ □ ♥ Do you have a water rights certificate for this property?…………………………………………………………. .□ □
/ / / /
Seller’s Initials Date Property Address Buyer’s Initials Date
08-4229 (Rev. 7/08) -4-
Additional Information (Continued):
¾ Sewer System: Yes No
Type: □ Public □ Private □ Community □ Other ______________________________
♦ Does your sewer system have a lift station/lift pump?.....................................................................................□ □
If Private: □ Septic Tank □ Holding Tank □ Other: ____________________________________
Drainfield System: □ Bed □ Trench □ Mound □ Pit □ Crib □ Other _______________
Innovative Sewer System: □ Intermittent Sand Filter □ Biocycle □ Recirculating Upflow Filter
□ Secondary sewer treatment plant □ Other __________________
♦ Has the sewer system failed while you owned the property? ..........................................................................□ □
If Yes, explain: _______________________________________________________________________
Age of sewer system: ________ Location: _________________________________________________
♦ Have you had any work maintenance or inspections done on the sewer system during your ownership? .....□ □
If Yes, explain: _______________________________________________________________________
Approval/Certification source (and date if known): ____________________________________________
♦ Are you aware of any abandoned sewer systems, leachfields, cribs, etc. on the property?............................□ □
¾ Freeze-ups:
♦ Have you had any frozen water lines, sewer lines, drains, or heating systems?..............................................□ □
If yes, please explain. __________________________________________________________________
♦ Are there any heat tapes, heat lamps, or other freeze prevention devices? ….……………………………...... □ □
Location, and explain use. _______________________________________________________________
¾ Average Annual Utility Costs:
Gas $ Company/Source: _________________________________
Electric $ Company/Source: _________________________________
Oil $ /Gallons: Company/Source: _________________________________
Propane $ Company/Source: _________________________________
Wood $ Company/Source: _________________________________
Coal $ Company/Source: _________________________________
Water $ Company/Source: _________________________________
Sewer $ Company/Source: _________________________________
Refuse $ Company/Source: _________________________________
Other $ Company/Source: _________________________________
To the best of your knowledge, are you aware of any of the following conditions with respect to the subject property? If answer is
“Yes,” indicate the relevant item number and explain the condition on the Addendum/Amendment(s) to the Disclosure Statement.
¾ Title: Yes No
1. Do you know of any existing, pending, or potential legal action(s) concerning the property? .........................□ □
2. Do you know of any street or utility improvements planned that will affect the property?................................□ □
3. Road maintenance provided by? __________________________________________________________
4. Is the property currently rented or leased? ......................................................................................................□ □
If Yes, expiration date: / /
5. Is there a homeowner’s association (HOA) for the property?......................................................................... □ □
If Yes, HOA name: HOA Telephone: ____________________
□ Mandatory □ Voluntary □ Inactive Monthly Dues Amount: $ per ____________
Are there any levied or pending assessments?.............................................................................................. □□
Who is responsible for issuing the resale certificate?
Name: Telephone:______________________________________
¾ Setbacks/Restrictions:
6. Have you been notified of any proposed zoning changes for the property?....................................................□ □
7. Are you aware of features of the property shared in common with adjoining property owners, such as
walls, fences, and driveways, whose use or responsibility for maintenance may affect the property?............□ □
8. Are there subdivision conditions, covenants, or restrictions? ..........................................................................□ □
9. Are you aware of any violations of building codes, zoning, setback requirements, subdivision covenants,
borough, or city restrictions on this property? ..................................................................................................□ □
10. Are you aware of any nonconforming uses of this property?...........................................................................□ □
/ / / /
Seller’s Initials Date Property Address Buyer’s Initials Date
08-4229 (Rev. 7/08) -5-
Additional Information (Continued):
Yes No
11. Are you aware of any deed, or other private restrictions on the use of the property?......................................□ □
12. Are you aware of any variances being applied for, or granted, on this property?............................................□ □
13. Are you aware of any easements on the property? .........................................................................................□ □
¾ Encroachments:
14. Does anything on your property encroach (extend) onto your neighbor’s property? .......................................□ □
15. Does anything on your neighbor’s property encroach onto your property? .....................................................□ □
¾ Environmental Concerns:
16. Are you aware of any substances, materials, or products that may be an environmental hazard such as
asbestos, formaldehyde, radon gas, lead-based paint, fuel or chemical storage tanks, contaminated soil,
water or by-products from the production of methamphetamines on the subject property? ............................□ □ 16a. Are you aware of any mildew or mold issues affecting this property? .............................................................□ □
17. Are you aware of any underground storage tanks on this property, other than previously referenced fuel
or septic tanks? Number of tanks: _________............................................................................................... □ □
18. Are you aware if the property is in an avalanche zone/mudslide area?...........................................................□ □
19. Are you aware if the property has flooded? ....................................................................................................□ □
Flood zone designation:__________________________________________________________________
20. Are you aware of any erosion/erosion zone or accretion affecting this property?........................................... □ □
21. Are you aware of any damage to the property or any of the structures from flood, landslide, avalanche,
high winds, fire, earthquake, or other natural causes? ....................................................................................□ □
22. Have you ever filed an insurance claim for any environmental damage to the property? ...............................□ □
23. Are you aware of a waste disposal site or a gravel pit within a one-mile radius of the property?....................□ □
¾ Soil Stability:
24. Are you aware of any debris burial or filling on any portion of the property?.................................................. ..□ □
25. Are you aware of any permafrost or other soil problems which have caused settling, slippage, sliding,
or heaving that affect the improvements of the property?..………………………………………………………. □ □
26. Are you aware of any drainage, or grading problems that affect this property?............................................... □ □
¾ Construction, Improvements/Remodel:
27. Have you remodeled, made any room additions, structural modifications, or improvements?........................□ □
If Yes, please describe. Was the work performed with necessary permits in compliance with building
codes? .............................................................................................................................................................□ □
Was a final inspection performed, if applicable?..............................................................................................□ □
28. Has a fire ever occurred in the structure?........................................................................................................□ □
¾ Pest Control or Wood Destroying Organisms:
29. Are you aware of any termites, ants, insects, squirrels, vermin, rodents, etc. in the structure? ......................□ □
a. If Yes, what type?
b. If Yes, where?
30. Has there been damage in the past resulting from termites, ants, insects, squirrels, rodents, etc. in the
structure?......................................................................................................................................................... □ □
a. If Yes, when?
b. If Yes, what type?
c. If Yes, where?
d. If Yes, describe what was done to resolve the problem:
¾ Other:
31. Are you aware of any murder or suicide having occurred on the property within the preceding 3 years?...... □ □
32. Are you aware of any human burial sites on the property?............................................................................. □ □
/ / / /
Seller’s Initials Date Property Address Buyer’s Initials Date
08-4229 (Rev. 7/08) -6-
Additional Information (Continued): Yes No
33. Noise
a. Are you aware of any noise sources that may affect the property, including airplanes, trains, dogs,
traffic, race tracks, neighbors, etc? ..........................................................................................................□ □
b. If Yes, explain:
34. Pets
a. Have there been any pets/animals in the house? .....................................................................................□ □
b. If Yes, what kind?
