grimes road ebook

Grimes Road Home and Irrigated Acreage

For more information contact: Pam Mayo-Phillips, Principal Broker

C: 541-480-1513 [email protected] or

Brook Havens, Principal Broker C: 541-604-0788 [email protected]

www.desertvalleygroup.com ~ www.cascadesothebysrealty.com O: 541-923-1376 ~ 650 SW Bond St Suite 100 Bend, OR 97702

All Brokers are licensed in the Sate of Oregon. Each office is independently owned & operated. All information is deemed reliable, but not guaranteed by Cascade Sothebys International Realty. Purchaser shall have sole responsibility to inspect the property and inform themselves of the true condition thereof. Purchaser accepts the responsibility before submitting any offer or executing contract. Any grazing permits /leases/water rights are NOT Guaranteed by Seller or Cascade Sotheby’s International Realty, Buyer is responsible for due diligence.

Cascade Mountain Views from Grimes Road Farm Address: 110 NW Grimes Road Prineville, OR 97754 Tax Map: 141618 Tax Lot 00401 Property: Ranch Style Home on 38.5 acres with 35.9 acres of OID Irrigation Water Rights. Irrigated with 5 wheel lines and hand lines. Upper field is planted in grass hay and bottom field in a grass mixed and used for livestock grazing. Cascade Mountain Views. Property is very well maintained, fenced, gated, landscaped, & has raised bed gardens. Great Opportunity for an acreage in the country. The setting is peaceful with wonderful views minutes from town. Must see to appreciate! Improvements: •  Updated Country Home 2241 sf 3 bed, 2 bath home featuring: country kitchen, butlers

pantry, office with pellet stove, formal dining room, living room pellet fireplace insert & utility room. Radiant Floor Heat.

•  Shop 30x36 – finished workshop •  3 car detached garage 30x36 and detached one car garage •  Pole Barn with attached 36x36 machine shed & Pipe horse/livestock runs with automatic

water. •  Cattle Handling Facility-squeeze chute and alley. •  Horse Barn- 6 stall barn •  Pipe Round Pen •  Additional Home-Permitted as a Hardship Dwelling – Fuqua 2002 Manufactured Home 1320

sf 3 bedroom, 2 bath, stem wall foundation. Buyer Responsible for due diligence on Hardship Dwelling and Maintaining Hardship Status.

Irrigation: 35.9 Acres of Water Rights Ochoco Irrigation District OID – $1956. Water Delivery Schedule: Water available anytime-owner calls ahead to instruct OID on need and delivery dates. Domestic Water: Well (no well due to age) 2nd Well at Pole Barn (no well log) Utilities: Pacific Power PPL 3 meters 12 month averages: Irrigation: $282. Manufactured Home: $108 (average) Residential Service including Shop: Average $282. High $329. Low $76 Taxes: $2379. 2014 Tax Year Price: $649,500. Shown by Appointment Only ~ MLS 201408489

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SELLER’S PROPERTY DISCLOSURE STATEMENT

1

Property Address

23

4567

910

I N S T R U C T I O N S T O T H E S E L L E R

11

121314151617181920

21

22

23

24

2526

27

2829

3031323334

353637

Each seller of residential property described in ORS 105.465 must deliver this form to each buyer who makes a written offer to purchase. UnderORS 105.475 (4), refusal to provide this form gives the buyer the right to revoke their offer at any time prior to closing the transaction. Use only thesection(s) of the form that apply to the transaction for which the form is used. If you are claiming an exclusion under ORS 105.470, fill out onlySection 1.

explanation(s). If you are not claiming an exclusion or refusing to provide the form under ORS 105.475 (4), you should date and sign each page ofthis disclosure statement and each attachment.

DO NOT FILL OUT THIS SECTION UNLESS YOU ARE CLAIMING AN EXCLUSION UNDER ORS 105.470

Section 1. EXCLUSION FROM ORS 105.465 TO 105.490:

Initial only the exclusion you wish to claim.This is the first sale of a dwelling never occupied. The dwelling is constructed or installed under building or installation permit(s) #

issued by

Signature(s) of Seller(s) Claiming Exclusion

NOTICE TO THE BUYER: THE FOLLOWING REPRESENTATIONS ARE MADE BY THE SELLER(S) CONCERNING THE CONDITION OF THE

DISCLOSURE STATEMENT TO REVOKE BUYER'S OFFER BY DELIVERING BUYER'S SEPARATE SIGNED WRITTEN STATEMENT OFREVOCATION TO THE SELLER DISAPPROVING THE SELLER'S DISCLOSURE STATEMENT, UNLESS BUYER WAIVES THIS RIGHT AT ORPRIOR TO ENTERING INTO A SALE AGREEMENT.

Please complete the following form. Do not leave any spaces blank. Please refer to the line number(s) of the question(s) when you provide your

.

The seller is a court appointed (Check only one):This sale or transfer is by a governmental agency.

Seller Date Seller Date

Signature(s) of Buyer(s) Acknowledging Seller’s Claim

Buyer Date Buyer Date

IF YOU DID NOT CLAIM AN EXCLUSION IN SECTION 1, YOU MUST FILL OUT THIS SECTION.

Section 2. SELLER'S PROPERTY DISCLOSURE STATEMENT

(NOT A WARRANTY) (ORS 105.465)

PROPERTY LOCATED AT “THE PROPERTY."

DISCLOSURES CONTAINED IN THIS FORM ARE PROVIDED BY THE SELLER ON THE BASIS OF SELLER'S ACTUAL KNOWLEDGE OF THEPROPERTY AT THE TIME OF DISCLOSURE. BUYER HAS FIVE BUSINESS DAYS FROM THE SELLER'S DELIVERY OF THIS SELLER'S

FOR A MORE COMPREHENSIVE EXAMINATION OF THE SPECIFIC CONDITION OF THIS PROPERTY, BUYER IS ADVISED TO OBTAIN ANDPAY FOR THE SERVICES OF A QUALIFIED SPECIALIST TO INSPECT THE PROPERTY ON BUYER'S BEHALF INCLUDING, FOR EXAMPLE,ONE OR MORE OF THE FOLLOWING: ARCHITECTS, ENGINEERS, PLUMBERS, ELECTRICIANS, ROOFERS, ENVIRONMENTALINSPECTORS, BUILDING INSPECTORS, CERTIFIED HOME INSPECTORS, OR PEST AND DRY ROT INSPECTORS.

Seller is is not occupying the property.

An exclusion may be claimed only if the seller qualifies for the exclusion under the law. If not excluded, the seller must disclose the condition of theproperty or the buyer may revoke their offer to purchase anytime prior to closing the transaction. Questions regarding the legal consequences ofthe seller's choice should be directed to a qualified attorney.

8

You may claim an exclusion under ORS 105.470 only if you qualify under the statute. If you are not claiming an exclusion, you must fill outSection 2 of this form completely.

38

39

SELLER Date SELLER Date

LINES WITH THIS SYMBOL REQUIRE A SIGNATURE AND DATE

Copyright Oregon Real Estate Forms, LLC 2000 - 2014 www.orefonline.com

OREF 020-1No portion may be reproduced without express permission of Oregon Real Estate Forms, LLC

Buyer Initials / Date

receiver personal representative trustee conservator guardianThis sale is by a financial institution that acquired the property as custodian, agent or trustee, or by foreclosure or deed in lieu of foreclosure.

I . S E L L E R ’ S R E P R E S E N T A T I O N S :

Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www.zipLogix.com

110 NW Grimes Rd , Prineville, OR 97754

Robert G Coates Teresa C Coates


X


This form has been licensed for use solely by Brook Havens pursuant to a Forms License Agreement with Oregon Real Estate Forms, LLC.

DocuSign Envelope ID: D161D2B0-27C1-442D-858A-20F84BC375C3

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40414243

444546474849505152535455565758

1.A. Do you have legal authority to sell the property?.................................................................

loan pertaining to the property, or that may have or take a security interest in the property, or any real estate licensee engaged by the seller or thebuyer.

The following are representations made by the seller and are not the representations of any financial institution that may have made or may make a

TITLE

*B. Is title to the property subject to any of the following:..........................................................

*C. Is the property being transferred an unlawfully established unit of land?........................*D.

recent boundary changes?....................................................................................................*E.

claims that may affect your interest in the property?.............................................................*F. Are there any agreements for joint maintenance of an easement or right of way?...............*G.

or notices that would affect the property?............................................................................*H. Are there any pending or existing governmental assessments against the property? ..........*I. Are there any zoning violations or nonconforming uses?....................................................*J. Is there a boundary survey for the property?........................................................................*K. Are there any covenants, conditions, restrictions or private assessments that affect the

*L.result in levy of additional taxes if the property is sold?.......................................................

First right of refusal

Are there any encroachments, boundary agreements, boundary disputes or

Are there any rights of way, easements, licenses, access limitations or

Are there any governmental studies, designations, zoning overlays, surveys

Option Lease or rental agreement Other listing Life estate

59

2. WATER

60

A. Household water

61

(1) The source of the water is (check ALL that apply): Public Community Private Other

62

(2) Water source information:

63

*a) Does the water source require a water permit?.....................................................

64

If yes, do you have a permit?................................................................................

65

Is the water source located on the property?........................................................

66

*If not, are there any written agreements for a shared water source?...................

67

Is there an easement (recorded or unrecorded) for your access to or

68

maintenance of the water source?.........................................................................

69

If the source of water is from a well or spring, have you had any of

70

the following in the past 12 months?......................................................................

7172

Are there any water source plumbing problems or needed repairs?.....................

73

(3) Are there any water treatment systems for the property?................................................

747576

(1)

77

If any exist, has the irrigation water been used during the last five-year period?..........

78

Is there a water rights certificate or other written evidence available?..........................

79

Outdoor sprinkler system

80

Is there an outdoor sprinkler system for the property?..................................................

81

Has a back flow valve been installed?...........................................................................

82

Is the outdoor sprinkler system operable?.....................................................................

*b)

*c)

d)

*e)Flow test Bacteria test Chemical contents test

Leased OwnedB. Irrigation

water rights or other rights for the property?..............................

C.83848586

87888990919293

3. SEWAGE SYSTEMA. Is the property connected to a public or community sewage system?..................................B. Are there any new public or community sewage systems proposed for the property?.........C. Is the property connected to an on-site septic system?.......................................................

If yes, when was the system installed?............................................................................

*Has the system been repaired or altered?.....................................................................Has the condition of the system been evaluated and a report issued?............................Has the septic tank ever been pumped?.......................................................................

If yes, when?

*D. Are there any sewage system problems or needed repairs?................................................E. Does your sewage system require on-site pumping to another level?..................................


Property Address

Is the property subject to any special tax assessment or tax treatment that mayproperty?................................................................................................................................

Are there any

(1)(2)(3)

* (2)* (3)

94959697

*If you mark yes on items with *, attach a copy or explain on an attached sheet.

Yes No UnknownYes* No Unknown

Yes* No Unknown

Yes* No Unknown

Yes* No UnknownYes* No Unknown

Yes* No UnknownYes* No UnknownYes* No UnknownYes* No Unknown

Yes* No Unknown

Yes* No Unknown

Yes* No UnknownYes No Unknown NAYes* No Unknown NAYes* No Unknown NA

Yes No Unknown NA

Yes* No Unknown

Yes* No UnknownYes No Unknown

Yes No UnknownYes* No Unknown NAYes* No Unknown NA

Yes No Unknown NAYes No Unknown NA

Yes No Unknown

Yes No Unknown

Yes No UnknownYes No Unknown

Unknown NA

Yes* No Unknown NAYes No Unknown NAYes No Unknown NA

Yes* No UnknownYes No Unknown


LINES WITH THIS SYMBOL REQUIRE A SIGNATURE AND DATEBuyer Initials / Date




NA

(1)(2) *If yes, was the system installed by permit?(3)(4)(5)

(6) *Does the system have a pump? Yes* No Unknown NA(7) *Does the system have a treatment unit such as a sand filter or an aerobic unit? Yes* No Unknown NA(8) *Is a service contract for routine maintenance required for the system? Yes* No Unknown NA(9) *Are all components of the system located on the property? Yes* No Unknown NA

9899

100101102103

..................................................................... Yes* No Unknown NA


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Robert G Coates Teresa C CoatesThis form has been licensed for use solely by Brook Havens pursuant to a Forms License Agreement with Oregon Real Estate Forms, LLC.


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104105106107108109

110111112113114115116117118119120

4.

B. Are there any defective insulated doors or windows?............................................................

DWELLING INSULATION

*A. Has the roof leaked?...............................................................................................................

B. Are there any additions, conversions or remodeling?............................................................

If yes, was a building permit obtained?...................................................................................If yes, was final inspection obtained?......................................................................................

C.Are there carbon monoxide alarms?.......................................................................................

E. Is there a woodstove or fireplace insert included in the sale?................................................*If yes, what is the make?*If yes, was it installed with a permit?......................................................................................*If yes, is a certification label issued by the United States Environmental Protection Agency

*F. Has pest and dry rot, structural or "whole house" inspection been done within the last

If yes, has it been repaired?....................................................................................................

If yes, was a building permit required?....................................................................................

Are there smoke alarms or detectors?....................................................................................

Department of Environmental Quality (DEQ) affixed to it?.................................

121122

124125126127128129130131132133134135

Are there problems with the materials?..........................................................................

136137138139

Water heater tank...................................................................................................................

140

Garbage disposal....................................................................................................................

141142

Built-in dishwasher..................................................................................................................

143

Sump pump.............................................................................................................................

144

Heating and cooling systems..................................................................................................

(1)

Leased...................................................................................Owned

A. Electrical system, including wiring, switches, outlets and service...........................................

C.145146147148149150151152153154155

D.

Are there any materials or products used in the systems and fixtures

F.

that are or have been the subject of a recall, class action settlement or other litigations?......

G.

If yes, what product?Are there problems with the product?.............................................................................Is the product covered by a warranty?............................................................................Has the product been inspected?...................................................................................Have claims been filed for this product by you or by previous owners?.........................If yes, when?

H.

Was money received?.....................................................................................................

I.

Were any of the materials or products repaired or replaced?.........................................

A. Is there insulation in the:(1) Ceiling? .............................................................................................................................(2) Exterior walls? ...................................................................................................................(3) Floors? ..............................................................................................................................

5. DWELLING STRUCTURE

D.

6. DWELLING SYSTEMS AND FIXTURES

*G. Are there any moisture problems, areas of water penetration, mildew odorsor other moisture conditions (especially in the basement)?....................................................*If yes, explain on attached sheet the frequency and extent of problem and any insurance claims, repairs or remediation done.

H. Is there a sump pump on the property?...................................................................................I. Are there any materials used in the construction of the structure that are or

have been the subject of a recall, class action suit, settlement or litigation?.........................If yes, what are the materials?

(2) Are the materials covered by a warranty?.......................................................................(3) Have the materials been inspected?...............................................................................(4) Have there ever been claims filed for these materials by you or by previous owners?..

If yes, when?(5) Was money received?.....................................................................................................(6) Were any of the materials repaired or replaced?............................................................

If the following systems or fixtures are included in the purchase price, are they in good working order on the date this form is signed?

B.

J.Security system

Plumbing system, including pipes, faucets, fixtures and toilets...............................................

Built-in range and oven...........................................................................................................

(1)(2)(3)(4)

(5)(6)


Property Address

three years?.............................................................................................................................

156157158159160


Yes No UnknownYes No UnknownYes No UnknownYes No Unknown

Yes* No UnknownYes No Unknown NAYes No UnknownYes No Unknown NAYes No Unknown NAYes No Unknown NAYes No UnknownYes No UnknownYes No Unknown

Yes* No Unknown NA

Yes* No Unknown NA

Yes* No Unknown

Yes* No Unknown

Yes No Unknown

Yes No Unknown

Yes No Unknown NAYes No Unknown NAYes No Unknown NAYes No Unknown NA

NAYes No Unknown NAYes No Unknown NA

Yes No UnknownYes No UnknownYes No UnknownYes No Unknown NAYes No Unknown NAYes No Unknown NAYes No Unknown NAYes No Unknown NAYes No Unknown NA

Yes No Unknown

Yes No Unknown NAYes No Unknown NAYes No Unknown NAYes No Unknown NA

Yes No Unknown NAYes No Unknown NA

LINES WITH THIS SYMBOL REQUIRE A SIGNATURE AND DATEBuyer Initials / Date




123 (EPA) or the

E.


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161162

163

164

165166167168169170171172173

174175176

7.

B. Regular periodic assessments: $

COMMON INTEREST

Month*C. Are there any pending or proposed special assessments?....................................................

Is the Home Owners' Association or other governing entity a party to

restrictions or in violation of other bylaws or governing rules, whether recorded or not?........

E.

Are there shared "common areas" or joint maintenance agreement for facilities like walls, fences,

A.

pools, tennis courts, walkways or other areas co-owned in undivided interest with others?...

pending litigation or subject to an unsatisfied judgment?.......................................................

Are there problems with settling, soil, standing water or drainage on

177178179180181182183184185186187188

189190

192193

194195196

197

198199200201202203204205206

207208209

A.

Name of Association or Other Governing Entity

Is there a Home Owners' Association or other governing entity?...........................................

Address Phone Number

D.

Contact Person

per Year Other

F. Is the property in violation of recorded covenants, conditions and

8. GENERAL

the property or in the immediate area?....................................................................................B. Does the property contain fill?.................................................................................................C. Is there any material damage to the property or any of the structure(s)

from fire, wind, floods, beach movements, earthquake, expansive soils or landslides?.........D. Is the property in a designated floodplain?.............................................................................E. Is the property in a designated slide or other geologic hazard zone?.....................................

*F. Has any portion of the property been tested or treated for asbestos, formaldehyde, radon, gas,lead-based paint, mold, fuel or chemical storage tanks or contaminated soil or water?.........

G. Are there any tanks or underground storage tanks (e.g., septic, chemical, fuel, etc.)

H. Has the property ever been used as an illegal drug manufacturing or distribution site?........*If yes, was a Certificate of Fitness issued?...........................................................................

I. Has the property been classified as forestland-urban interface?............................................

*A. Are there any other material defects affecting this property or its value thatYes* No

9. FULL DISCLOSURE BY SELLER(S)

If yes, describe the defect on attached sheet and explain the frequency and extent of the problem and any insurance claims, repairs orremediation?

The foregoing answers and attached explanations (if any) are complete and correct to the best of my/our knowledge and I/we have received a copyof this disclosure statement. I/we authorize my/our agents to deliver a copy of this disclosure statement to all prospective buyers of the property or

V E R I F I C A T I O N

SELLER’S PROPERTY DISCLOSURE STATEMENTProperty Address

on the property?.....................................................................................................................

their agents.

210211

212

213

214

215

216

Yes No Unknown

Yes No UnknownYes No Unknown

Yes* No Unknown

Yes No Unknown NA

Yes No Unknown

Yes No UnknownYes No UnknownYes No Unknown

Yes* No Unknown

Yes No Unknown

Yes No Unknown NA

Yes No UnknownYes No UnknownYes* No Unknown NA

Seller DateSeller Date

I I . B U Y E R ’ S A C K N O W L E D G M E N T :

A. As buyer(s), I/we acknowledge the duty to pay diligent attention to any material defects that are known to me/us or can be known by me/us byutilizing diligent attention and observation.

B. Each buyer acknowledges and understands that the disclosures set forth in this statement and in any amendments to this statement are madeonly by the seller and are not the representations of any financial institution that may have made or may make a loan pertaining to theproperty, or that may have or take a security interest in the property, or of any real estate licensee engaged by the seller or buyer. A financialinstitution or real estate licensee is not bound by and has no liability with respect to any representation, misrepresentation, omission, error orinaccuracy contained in another party's disclosure statement required by this section or any amendment to the disclosure statement.

C. Buyer (which term includes all persons signing the "Buyer's Acknowledgment" portion of this disclosure statement below) herebyacknowledges receipt of a copy of this disclosure statement (including attachments, if any) bearing seller's signature(s).

DISCLOSURES, IF ANY, CONTAINED IN THIS FORM ARE PROVIDED BY THE SELLER ON THE BASIS OF SELLER'S ACTUAL KNOWLEDGEOF THE PROPERTY AT THE TIME OF DISCLOSURE. IF THE SELLER HAS FILLED OUT SECTION 2 OF THIS FORM, YOU, THE BUYER,HAVE FIVE BUSINESS DAYS FROM THE SELLER'S DELIVERY OF THIS DISCLOSURE STATEMENT TO REVOKE YOUR OFFER BYDELIVERING YOUR SEPARATE SIGNED WRITTEN STATEMENT OF REVOCATION TO THE SELLER DISAPPROVING THE SELLER'SDISCLOSURE UNLESS YOU WAIVE THIS RIGHT AT OR PRIOR TO ENTERING INTO A SALE AGREEMENT.

BUYER HEREBY ACKNOWLEDGES RECEIPT OF A COPY OF THIS SELLER'S PROPERTY DISCLOSURE STATEMENT.

Buyer DateBuyer Date

Licensee receiving disclosure statement on buyer's behalf to sign and date:

Real Estate Licensee

Real Estate Firm

Date received by Licensee

LINES WITH THIS SYMBOL REQUIRE A SIGNATURE AND DATE Buyer Initials / DateCopyright Oregon Real Estate Forms, LLC 2000 - 2014



a prospective buyer should know about?................................................................................191

(complete even if zero) Number of pages of explanations are attached.

www.orefonline.com


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Sale Agreement #

Addendum

LEAD-BASED PAINT DISCLOSURE ADDENDUM

1 This Addendum must be part of every Real Estate Sale Agreement for the sale of a home built prior to 1978. A copy of the completed

2 Addendum may be treated as an original.

3 LEAD WARNING STATEMENT

4 Every purchaser of any interest in residential real property on which a residential dwelling was built prior to 1978 is notified that

5 such property may present exposure to lead from lead-based paint that may place young children at risk of developing lead

6 poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities,

7 reduced intelligence quotient, behavioral problems and impaired memory. Lead poisoning also poses a particular risk to

8 pregnant women. The seller of any interest in residential real property is required to provide the buyer with any information on

9 lead-based paint hazards from risk assessments or inspections in the seller's possession and notify the buyer of any known

10 lead-based paint hazards. A risk assessment or inspection for possible lead-based paint hazards is recommended prior to

12 PROPERTY ADDRESS

13 ADDENDUM TO REAL ESTATE SALE AGREEMENT NO.


14 SELLER'S DISCLOSURE

15 1. Presence of lead-based paint and/or lead-based paint hazards (check either (a) or (b) below):

16 (a) Seller has knowledge of lead-based paint and/or lead-based paint hazards in the housing (explain).

17

1819 (b) Seller has no knowledge of lead-based paint and/or lead-based paint hazards in the housing.

20 2. Records and reports available to the Seller (check either (a) or (b) below):

21 (a) Seller has provided the Buyer with all available records and reports pertaining to lead-based paint and/or lead-

based paint hazards in the housing (list documents below):22

23

24

25 (b) Seller has no records or reports pertaining to lead-based paint and/or lead-based paint hazards in the housing.

.

.

26 BUYER'S ACKNOWLEDGMENT (Initial below):

27 1. Buyer has received copies of all information listed at 2(a) above.

28 2. Buyer has received the pamphlet Protect Your Family from Lead in Your Home.

29 3. Buyer has (check either (a) or (b) below):

30 (a) Pursuant to the provisions contained in the "Lead Based Paint Inspection" section of the Real Estate Sale

31 Agreement, received a 10-day opportunity (or mutually agreed upon period) to conduct a risk assessment or inspection for32 the presence of lead-based paint and/or lead-based paint hazards; or

33 (b) Waived the opportunity to conduct a risk assessment or inspection for the presence of lead-based paint and/or

34 lead-based paint hazards.

35 LISTING LICENSEE'S ACKNOWLEDGMENT (Initial below):

36 Licensee has informed the seller of the seller's obligations under 42 USC 4852d and is aware of his/her responsibility to

38 RIGHT OF CANCELLATION WITHIN LEAD-BASED PAINT CONTINGENCY PERIOD

39 If this Lead-Based Paint Disclosure Addendum (hereinafter this "Disclosure Addendum") is delivered to Buyer after Buyer’s offer is

40 accepted by Seller unless waived pursuant to Section 3, Buyer’s Acknowledgment of this Disclosure Addendum, Buyer shall have the right

41 to cancel the Real Estate Sale Agreement within ten (10) calendar days which shall commence when Buyer and Seller sign this Disclosure

42 Addendum, by Buyer giving written notice of cancellation to Seller or Seller’s agent. Upon such cancellation, all earnest money deposit(s)

43 shall be promptly refunded to Buyer and this transaction shall be terminated.

44 CERTIFICATION OF ACCURACY45 The following parties have reviewed the information above and certify, to the best of their knowledge, that the information they46 have provided is true and accurate.

47 Buyer

48 Buyer

49 Selling Licensee

50 Selling Firm

Date

Date

Seller Date

Seller Date

Listing Licensee

Listing Firm

11 purchase.

37 ensure compliance.

LINES WITH THIS SYMBOL REQUIRE A SIGNATURE AND DATE

Copyright Oregon Real Estate Forms, LLC 2000 – 2014 www.orefonline.com

No portion may be reproduced without express permission of Oregon Real Estate Forms, LLCOREF 021

lead


X

X

Robert G Coates

Teresa C Coates

Pam Mayo-Phillips,Brook Havens

Cascade Sothebys International RealtyThis form has been licensed for use solely by Brook Havens pursuant to a Forms License Agreement with Oregon Real Estate Forms, LLC.


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