listing information sheet listing...a frame antebellum cape cod colonial contemp french spanish...

Listing Information Sheet

Property Address:__________________________________________________MLS#_____________

Legal Description:_____________________________________________________________________

___________________________________________________________________________________

Title Company:_______________________________________________________________________

Seller:_____________________________________ Phone:_____________________________

Seller:_____________________________________ Phone:_____________________________

List date:________________________ Exp. Date:______________________ List $:_______________

Listing Company: ________________________________________________

Listing Co. Address:_________________________City:___________________State:____ Zip:_______

Listing Agent:________________________________

Phone:___________________Email:______________________________________

Commission Total:________% Other Compensation:___________________________________

LA Commission:__________%

SA Commission:__________%

*This form does not need to be handed in to Admin. Form is for auto populate use only.

ChartwellRealty

The information provided here will be available to all Heartlandsystem users now and in the future and may not be deleted.

# (System Assigned) RES RESIDENTIAL

Heartland Multiple Listing ServiceBoxed Fields and/or bolding denote required information that must be provided. Circle selections and number in order of importance.

Initial Status Type(Circle 1)

Single Family

Condo/Loft

Coop

Half Duplex

Mobile Home

Patio/Villa

Other

Townhouse

**Active

Auction

Incoming

Model**

(Circle 1)Price

$

** Low List Price

$

Area **NUMBER (Required) ST TYPE

AddressDIR STREET NAME

Unit Number

City ** County ** Zip ** Subdivision **

Legal Tax ID

-PROPERTY INFORMATION-

# Bedrooms Full Baths Half Baths** ** ** Bldg Conversion? YES

NOAge Restricted? Maint Provided? YES

NOYES

NO

Sq Ft - Total Sq Ft - Main Floor** ** Age Description(Circle 1)

Under Const 11-15 Yrs 51-75 Yrs

Never Occupied 16-20 Yrs 76-100 Yrs

2 Yrs/Less 21-30 yrs 101 Yrs +

3-5 Yrs 31-40 Yrs Model

6-10 Yrs 41-50 Yrs

** Year Built Est Completion Days(Circle 1)

0-45 91-150

46-90 150+

(Req'd if AGE=UC)

Acreage ** Basement?** Lot Size ** Central Air? ** Complex Sz YES

NO

YES

NO

Attached? YES NO

Fireplace? YES

NO# Fireplaces: ** # Garage Spaces:**Garage? YES

NOMaintenanceProvided

Bldg Exterior

HVAC

Lawn

Roof Repair

Roof Replace

Snow Removal

Street

-GENERAL INFORMATION-

Elementary School Middle School

Senior High School School District

****

**

**

ArchitectureA FRAME

ANTEBELLUM

CAPE COD

COLONIAL

CONTEMP

FRENCH

SPANISH

TRADITIONAL

TUDOR

VICTORIAN

OTHER

(Circle up to 2) Dining AreaBRKFST RM

COUNTRY

EAT IN

FORMAL

HEARTH

KIT-DR COMBO

LR-DR COMBO

OTHER

(Circle up to 4)** Utility Room

BASEMENT

MULTIPLE

SINK

BATHROOM

BEDRM LVL

HOOKUP-GAS

HOOKUP-ELE

CLOSET

GARAGE

HALL

KITCHEN

LOWER LVL

MAIN LVL

NONE

OFF KITCHEN

ROOM

SECOND LVL

(Circle up to 2)** Garage

ATTACHED

COVERED LOT

IN BUILDING

LEASED

OFF STREET

SECURED

BASEMENT

BUILT-IN

CARPORT

CONVERTED

DETACHED

FRONT ENT

REAR ENT

SHARED DR

SIDE ENT

TANDEM

OTHER

(1 Req'd if GAR# > 0; Circle up to 4)**

RoofCOMP

CONCRETE

METAL

SHAKE

SLATE

TAR & GRAV

TILE

WOOD

OTHER

Lake Description

BOATHSE

PRIV DOCK

PUB DOCK

LAKE ACC

LAKE FRONT

LAKE PRIV

LAKE RESTR

1ST TIER

2ND TIER

3RD TIER

4TH TIER

(Circle up to 3)** Floor Plan

1.5 STORY

2 STORY

3 STORY

ATR SPLIT

BUNGALOW

CAL SPLIT

EARTH CONT

F/B SPLIT

LOFT

RAISED 1.5

RANCH

REVERSE 1.5

RAISED RNCH

REVERSE 1.5

S/S SPLIT

SPLIT ENTRY

TRI-LEVEL

OTHER

(1 Req'd; Circle up to 2)** Basement

BLOCK

CELLAR

CONCRETE

CRAWL

DAYLIGHT

EGRESS WND

FINISHED

FULL

GAR ENT

INSIDE ENT

PARTIAL

RAISED

SLAB

STONE

STUBBED

WALKOUT

WALKUP

OTHER

**

FireplaceBASEMENT

CIRCULATOR

DINING RM

ELECTRIC

FAMILY RM

GAS

GAS STARTER

GREAT RM

HEARTH RM

INSERT

KITCHEN

LIVING RM

MASONRY

MASTER BR

REC RM

SEE THROUGH

STUDY

WD BURNING

WD STOVE

ZERO CLRNCE

OTHER

(Circle up to 4)** Other RoomsATRIUM

BALCONY

BR in BSMT

BRKFST

DEN/STUDY

DORMER

ENC PORCH

ENTRY

EXERCISE RM

EXP ATTIC

FR-GAR LV

FR-MAIN LV

FAMILY RM

LR-FORMAL

GREAT RM

LIBRARY

BR on MAIN

MB ON MAIN

MEDIA RM

MUD RM

OFFICE

REC RM

SAUNA

SEP QTRS

SITTING RM

SUN RM

WORKSHOP

(Circle up to 10)** ConstructionASBESTOS

BLOCK

BOARD-BAT

ALL BRICK

BRK/FRAME

BRK TRIM

BRK VENEER

CEDAR

CONCRETE

FRAME

LAP

LOG

METAL SDG

ROLLED

SHINGLE

ALL STONE

STONE/FRAME

STONE TRIM

STONE VEN

STUCCO

SYN STUCCO

STUC/FRAME

VINYL SDG

WOOD SDG

OTHER

(Circle up to 2) Lot DescriptionACREAGE

CITY

CORNER

CUL-DE-SAC

ESTATE

GOLF

GOLF FRWAY

GOLF GREEN

GREENSPACE

LAKE ON PROP

LAKE FRNT

LEVEL

POND(S)

LAND LSE

TREED

SPRING(S)

ZERO LOT

OTHER

STREAM(S)

(Circle up to 4)**

-OFFICE INFORMATION-

Agent ID 2nd Agent IDPhone

Cell- -Other Phone Type Fax

Text

Phone

Cell- -Other Phone Type Fax

Text

List Date / / (MM/DD/YYYY)

Expiration Date / / (MM/DD/YYYY)

Internet Sites ALL REALTOR.COM CO-OP WEBSITES NONE

- - Bonus / /Bonus XD(Req'd if Bonus is Entered)

Email

Earnest Deposit To SA Comp

Buyer Brk Comp Trans Brk Comp

Show InstructionsAPPT

CALL OFC

CALL SELLR

COMBO LB

CALL CO-OP

DAYSLEEPER

KEY in OFC

LA PRESENT

iBOX

LEASED

MODEL

OCCUPIED

SEC SYSTEM

VACANT

(1 Req'd; Circle up to 3)

PossessionCLOSE

EARLY

IMMED

NEGO

OTHER

SPECIFIC

TENANT

(Circle 1) Listing Type (Circle up to 3)

EXCLUSIVE AGY

EXCLUSIVE RIGHT TO SELL

LIMITED SERVICE

PROSP EXEMPT

VARIABLE RATE

List Agent CapacityDESIGNATED AGT

SELLER'S AGT

TRANS BROKER

(Circle 1)

.

(Circle up to 2)

(Req'd if Fireplace = Y)

(1 Req'd if Basement = Y; Circle up to 3)

Co-opPhone

Comp Based On

DIAGRAM

LST OFC

NOT REQ

OUT-AREA

UC

(Circle 1)

GROSS SALE PRICE

NET SALE PRICE

VOW Listing Display

VOW Allow AVM'sVOW Address Display VOW Allow Comments

YES

NO YES

NO

YES

NO

YES

NO

Photo Instructions

(Req'd if AGE=NeverOccpied or Model)

Office Extension

Printed Using Professional Computer Forms Co. On-Line Forms Software 12/09

-ADDITIONAL INFORMATION-

HeatCENT ELEC

CENT GAS

FA ELEC

FA GAS

FLOOR

GRAVITY

HEAT PUMP

HTPUMP/GAS

HOTWATER

NAT GAS

NONE

OIL

PANEL

PROPANE

RADIANT

SOLAR

SPACE

STEAM

WALL

WOOD

WOOD AUX

WOOD STOVE

ZONED

OTHER

(1 Req'd; Circle up to 2) Cooling (1 Req'd; Circle up to 2)

ATTIC FAN

CENT ELEC

CENT GAS

HEAT PUMP

NONE

SOLAR

Water (1 Req'd; Circle up to 2)

CISTERN

FEDERAL

NO CONNECT

NONE

PRIV METER

PUBLIC

Sewer (1 Req'd; Circle up to 2)

AERATION

GRINDER

NO CONNECT

JET

LAGOON

NONE

PRIVATE

Interior FeaturesALL CARPET

ALL W-COV

CEDAR CLST

FIXER-UP

HOT TUB

INDOOR POOL

ISLAND-KIT

PANTRY

PRT CARPET

PRT W-COV

SAUNA

SKYLIGHT

SUMPPUMP

V-CEILING

WLK-IN CLST

WETBAR

WHEELCHAIR

WHRLPOOL

WOOD FLOOR

(Circle up to 8)Exterior Features (Circle up to 8)

BARN

DECK

DECK-COV

FIXERUP

FNC METAL

FNC OTHER

FNC PARTIAL

FNC PRIVACY

FNC WOOD

GAZEBO

GREENHSE

HORSE FACIL

HOT TUB

OUT BLDG(s)

PATIO

PATIO-COV

POOL-ABOVE

POOL-INGRD

PORCH

PORCH-SCR

SAT ALLOWED

SPRINKLER

STORM DR

STORM WNDW

STORM PRT

STOR SHED

TENNIS

THERM WNDW

WHEELCHAIR

WOOD WNDW

EquipmentAIR-CLEANER

BACKFLOW

BIDET

CEIL FAN

CENTRAL VAC

DISHWASHER

DISPOSAL

DOUBLE OVEN

DOWNDRAFT

DRYER

FIRE ALARM

FRPL-EQUIP

FRPL-SCRN

GARG DR OPN

HOOD-FAN

HUMIDIFIER

INTERCOM

MICROWAVE

RNGE-Built In

RNGE-Elec

RNGE-Free Std

RNGE-Gas

REFRIG

SAT DISH

SEC SYSTEM

SMOKE DET

TRASH COMP

UNDER CAB

WASHER

WATER PUR

WATER SOFT

OTHER

(Circle up to 16)HOA Dues IncludesAMNT-ALL

CABLE

RESERVES

AMNT-NO

AMNT-PART

BLD MAINT

CLUBHOUSE

COM CENTR

DAYCARE

ELECTRICITY

EX-ROOM

EX-TRAIL

(Circle up to 16)

Available AmenitiesBOAT DOCK

BLDG MAINT

CLUBHOUSE

COM CENTR

COM LNDRY

RECYCLE

DAYCARE

EQUESTRIAN

EX-ROOM

GOLF

HANDBALL

HOBBY RM

LWN MAINT

PARTY RM

PLAY AREA

PUTT GREEN

SAUNA

SEC SYSTEM

SNOW REMV

POOL

TENNIS

TRAILS

TRASH PICK

OTHER

(Circle up to 16)

Warranty10 YEAR

BUILDER-1 YR

BUILDER

BUYER

PRIVATESELLER

OTHER

(Circle up to 2)

In Flood Plain?

OwnershipBANK

RELO (Corp)

ESTATE

INVEST

LOCAL

PRIVATE

PROBATE

REO

RTC

OTHER

Exclude from Inspections

Req'd if AGED is NEW or UCCeiling R Factor Wall R Factor

-FINANCIAL INFORMATION-

(Circle 1)

Will Sell Terms ASSUMABLE

AUCTION

BOND

CASH

CFD

CONV

EXCHANGE

EXCH-ONLY

VA

WRAP

OTHER(Circle up to 5)

HOA Fees $ HOA Fee Per MO SA

QT YR(Req'd if HOA>0) Taxes $ Special Taxes $

-MOBILE HOME INFORMATION- MAKE MODEL

ROOM DIMENSIONS

X

LEVEL SQUARE FT ROOM FEATURES

, , ,X , , ,X , , ,

Enter up to 4 from list above.

X , ,X , , ,X , , ,X , , ,X , , ,X , , ,X , ,X , , ,X , , ,X , , ,

(Circle1)Other R Factor

Req'd if AGED is NEW or UC

Warranty Company

Warranty Cost Warranty Deductible

WINDO

W

ZONED

OTHER

RURAL

WELL

OTHER

PUBLIC

SEPTIC

OTHER

GAS

GOLF

HANDBALL

HOBBY RM

INSURANCE

LWN MAINT

MAINT FREE

MANAGMENT

PARKING

PARTY RM

PLAY AREA

POOL

PUTT GREEN

REC FACIL

RECYCLE

SAUNA

SECURITY

SNOW REMV

STORAGE

TAXES

TENNIS

TRASH PICK

WATER

OTHER

Tax Notation

-ROOM INFORMATION-

YES NO

UNKNOWN

X , , ,

** **

**

****

** ****

**

FHA

FmHA

LEASE OPT

LEASE PURCH

Tax Abatement? YES

NOSpecial Doc Req'd?

FEATURES: CEDAR CLSTCEIL FANDBL VANITY

LEVELS: B= BASEMENT 3= LEVEL 3 L =LOWER 4= LEVEL 4 1= LEVEL 1 5= LEVEL 5 2= LEVEL 2

ATRATTBALBR2BR3BR4BR5

ATRIUMATTICBALCONY2nd BDRM3rd BDRM4th BDRM5th BDRM

BRKBTFBTHBF2BF3BF4

BRKFST RMFULL BTHHALF BTH2nd FULL3rd FULL4th FULL

BH6DENDINDN2DOREXR

6th HALFDEN/STUDYDINING RM2nd DIN RMDORMEREXERCISE RM

FAMFM2GRTHRTKITKT2

RAMILY RM2nd FAM RMGREAT RMHEARTH RMKITCHEN2nd KITCHEN

MBRMS2MEDOFFPORREC

MASTER BR2nd MST BRMEDIA RMOFFICEENCL PORCHREC RM

ROOMS: BF5BF6BH2BH3BH4BH5

5th FULL6th FULL2nd HALF3rd HALF4th HALF5th HALF

LAULIBLIVLV2MBTMB2

LAUNDRYLIBRARYLIVING RM2nd LIV RMMASTER BTH2nd MST BTH

RR2SAUSITSUNWRKOTH

2nd REC RMSAUNASITTING RMSUN RMWORKSHOPOTHER

BRICK FLBUILT INSCARPET

FIREPLACEHARDWDKIT ISLELAMINATE

LINEOLEUMMARBLEPANTRYPARQUET

RESERVEDRUG(S)SAUNA

SHADES-BLSKYLIGHTS&T

TILE FLVAUL CEILVINYL FL

WETBARWHIRLPOOLWLK CLST

WNDW COVWOOD FLOTHER

S-TSHWRTUB

YES

NO

InspectionExclusions?

YES

NO

TelecomCABLE-AV

HI SPEED INT-AV

METRO FREE

METRO PAID

TOLL

Builder Plan

OPTION

OWNER

OWNER 2nd

PRIVATE

Green Features (Circle up to 16)

ACTIVE SOLAR

AM LUNG ASSOC RTG

BROWNFIELDS

ECOBROKER CERT

EFF APPLIANCES

EFF LIGHTS

EFF MORTGAGE

EFF TAX INCENTIVE

ENERGY STAR

ENERGY STAR MTG

FIBER CEMENT

FOREST STW CNCL

GEOTHERMAL

GREEN ROOF

HI EFF HOT WTR

INDOOR AIR QUAL

INFILL LOT

INS CONC FORMS

INS - BLOWN

INS - FOAM IN PLACE

LOW EMIT DR/WND

LOW FLOW TOILET

LOW VOL ORGANIC

MODULAR/PREFAB

NAHB/GBI VERIFIED

PASSIVE SOLAR

RADIANT BARRIER

RADIANT FL-AIR

RADIANT FL-ELE

RADIANT FL-HYD

RAIN GARDEN

RCY COMPONENTS

SET BACK THERM

SOLAR ASST WATER

STRAW BALE

TANKLESS HWH

WIND POWER

Req'd if Inspection Exclusions is Yes Req'd if Warranty is Seller Provides

Req'd if Warranty is Seller Provides Req'd if Warranty is Seller Provides

Req'd if Age is UC, New or Model

-REMARKS & DIRECTIONS-

REMARKS - 350 Characters

ADDITIONAL REMARKS - 300 Characters - Will appear on the full detail (2 page) report on the agent only matrix.heartlandmls.com

DIRECTIONS - 350 Characters

ADDITIONAL DIRECTIONS - 300 Characters - Will appear on the full detail (2 page) report on the agent only matrix.heartlandmls.com

Fields marked with double asterisk (**) are displayed on the Realtor.com website.

SHOWING AGENT INFORMATION - 350 Characters

PRINT PUBLICATION TEXT - 144 Characters

VIRTUAL TOUR LINK - 225 Characters Branded?Required if Virtual Tour Link Exists

YES NO


Showing Instructions Form MLS #: __________Address: __________________________________________

__________________________________________ Status: ______________

Listing Agent: __________________________________________ Date: ______________

Contact InformationHome, Work, Mobile Phone Number

Any Day, Evenings & Weekends, Weekdays, WeekendsSeller(s)

Person to Call

Person to Call

Person to Call

Person to Call

Person to Call

Person to Call

Scheduling RulesAppointment Rule Must Get Approval From Seller Notify Seller (Leave Message) Occupancy: Occupied Vacant

Show Without Calling Agent must call Listing Agent Notice Required

Special Instructions

Temporary Instructions

Instructions to the Showing AgentPets

Other

Lockbox/Access Information

Lockbox Type/ Access Method

Combination IBox IBox w/CBS Code Garage Keypad

Key at Listing Office Listing Agent will Provide Occupant will Provide Other

Lockbox/Keypad Location

Combination/CBS/Key Code Gate Code

Security System Information

System None Inactive Active Code to Disarm Code to Rearm

Instructions

Control Location

Notifications

Send a text message notification to the listing agent's pager

Seller E-Mail 1 Showing Notifications Showing Feedback



Feedback OptionsFeedback form to use for Showings of this listing

Feedback form to use for Previews of this listing

Feedback must be reviewed by the listing agent or office staff before releasing to seller(s)

Feedback Message This message will be included in the feedback request e-mail sent to the showing agent, and will also be displayed on the feedback form for this listing.

Exclusive Right to Sell Contract 2010Page 1 of 7

THIS CONTRACT is made between ________________________________________________________ 1(“SELLER”) and _________________________________________________________ (“BROKER”) for 2the Property known as: _______________________________________________________________3and legally described as below, or as described in the attached Legal Description Addendum:___________ 4_____________________________________________________________________________________5_____________________________________________________________________________________6(the “Property”) is EXCLUSIVE for a period beginning _____________________ and ending at 11:59 p.m. 7on ______________________ inclusive unless terminated by BROKER. The Property is offered for sale 8for the Purchase Price of $ _____________________ on terms agreeable to SELLER. SELLER hereby 9warrants to BROKER that this is the one and only Right to Sell Contract in effect regarding the 10Property and SELLER has the capacity to convey merchantable title to the Property. BROKER and11licensee(s) are licensed under the laws of the state in which the Property is located.12

131. LISTING SERVICES. SELLER authorizes BROKER to:14

(a) Cooperate and share the commission payable under this Contract with other brokers including 15brokers who have been employed as Buyer agents, sub-agents, disclosed dual agents (Missouri only),16transaction brokers, or designated agents, subject, where applicable, to authorization as otherwise 17provided in this Contract.18(b) Submit pertinent information, including virtual tours and images when applicable, concerning the 19Property to any listing service to which BROKER subscribes and to abide by the rules of the listing 20service.21(c) Provide to listing services for dissemination to others, including the county appraiser if required by 22law, timely notice of status changes affecting the Property, sales information, including price, and other 23information concerning the Property for use of the members of such services, to compile reliable 24statistics, and to establish market value for other properties. Report sales information about the 25Property, including the price at which the Property sold, to the MLS for dissemination to MLS 26participants, subscribers, and other licensees or users of the MLS database compilation.27(d) Obtain information on SELLER’S mortgage(s) and/or home equity loan(s):28

Loan #1______________________ held by _______________________________________,29Phone #: __________________.30



(e) Disseminate data about the Property and other information relating to the Property supplied by, or 35on behalf of SELLER, including creative works depicting the Property, such as virtual tours, images, and 36any textual descriptions of the Property (collectively referred to as “Content”), to MLS participants, 37subscribers and other licensees or users of the MLS database compilation, or any other MLS in which 38BROKER participates, and to further disseminate, or permit MLS or other MLS participants to 39disseminate such Content to potential purchasers through websites on the Internet. Further, the 40BROKER is authorized to otherwise advertise the Property in any manner deemed appropriate by the 41BROKER, including but not limited to advertising on the Internet, virtual tours, websites, trade journals 42and any other medium, and communications via e-mail and facsimile. Notwithstanding, any of the 43above, SELLER reserves the right to opt-out of internet advertising and advertising on other BROKERS’ 44websites by completing a separate “Opt-Out” form.45(f) Grant to the BROKER an irrevocable, perpetual, non-exclusive and fully sub-licensable and 46assignable right (through multiple tiers) to use, reproduce, modify, adapt, publish, create derivative 47works from, distribute, perform, and display any photographs, floor plans, architectural drawings, video 48images, sounds, or other copyrightable material related to the Property ("Works"), and to incorporate 49any such Works (in whole or in part) into other Works in any form, media, or technology now known or 50later developed.51

52

EXCLUSIVE RIGHT TO SELL CONTRACT


(g) This non-exclusive license shall survive the termination of this Agreement for any reason whatsoever. 53SELLER represents and warrants to BROKER that the license granted to BROKER for this Content, does 54not violate or infringe upon the rights, including any copyright rights, of any person or entity. SELLER55acknowledges and agrees that all listing content is owned exclusively by BROKER, and SELLER has no 56right, title or interest in Content.57

582. SELLER AGREES TO:59

(a) Refer any offer or inquiry regarding the Property that is received by SELLER during the term of this 60Contract to BROKER.61(b) Permit BROKER to place a “For Sale” sign on the Property and to remove all other signs during the 62term of this Contract.63(c) Allow BROKER to enter the Property at reasonable times for the purpose of inspection, preview, or 64to show the Property to prospective purchasers or other brokers.65(d) Furnish BROKER with a key to the Property, authorize the use of a “Lock Box” during the term of 66this Contract and to hold BROKER, his agents, employees, cooperating brokers, their agents and 67employees, the Heartland Multiple Listing Service, the Kansas City Regional Association of Realtors® 68free and harmless from any loss or damage that might result from the use of such.69(e) Allow BROKER to accept a deposit to be applied against the Purchase Price and to place that 70deposit into the escrow account maintained by BROKER or other escrow agent until the Closing of the 71sale of the Property. If the deposit is forfeited by the Buyer, ______% of the deposit shall be retained by 72BROKER, provided, however, that the amount retained shall not exceed the amount to which BROKER 73would be entitled as a commission if the transaction had been consummated, and the balance of the 74deposit shall be paid to SELLER.75(f) Leave all utilities on at the Property during the term of this Contract or until Possession, whichever is 76later, unless provided for otherwise in the Contract.77(g) Maintain adequate homeowner’s property insurance during the term of this Contract or until 78Possession, whichever is later, and contact their insurance company regarding the adequacy of said 79insurance.80

813. BROKER AGREES TO:82

(a) Market the Property at BROKER’S cost and expense unless otherwise specifically agreed upon 83elsewhere in this contract.84(b) Perform the terms of this Contract, exercise reasonable skill and care for SELLER, and promote the 85interests of SELLER with the utmost good faith, loyalty and fidelity unless acting as a Transaction 86BROKER, or as a Disclosed Dual agent (Missouri only).87(c) Seek a price and terms acceptable to SELLER.88(d) Provide, at a minimum, the following services:89

(1) Accept delivery of and present to SELLER all offers and counter offers to sell Property;90(2) Assist SELLER in developing, communicating, negotiating, and presenting offers, counter91offers, and notices that relate to the offers and the counter offers until a purchase agreement is 92signed and all contingencies are satisfied or waived; and 93(3) Answer SELLER’S questions relating to the offers, counter offers, notices, and contingencies.94

(e) Disclose to SELLER all adverse material facts actually known (or should have known, in Missouri)95by Broker about Buyer.96(f) Disclose to SELLER any facts known by BROKER which are omitted from or contradict any 97information included in a written report prepared by a qualified third party.98(g) Comply with all applicable federal, state, and local laws, rules and regulations, and ordinances, 99including fair housing and civil rights statutes and rules and regulations.100(h) Keep all information about SELLER confidential unless: disclosure is authorized under this Contract;101disclosure is required by statute, rule or regulation; failure to disclose would constitute a fraudulent 102misrepresentation; or disclosure is necessary under Missouri law to defend the affiliated licensee 103against an action of wrongful conduct in an administrative or judicial proceeding or before a professional 104committee.105

106


(i) Disclose to all prospective Buyers all adverse material facts actually known by the BROKER,107including but not limited to:108

(1) Any environmental hazards affecting the Property which are required by law to be disclosed; 109(2) The physical condition of the Property;110(3) Any material defects in the Property;111(4) Any material defects in the title to the Property; 112(5) Any material limitation on SELLER'S ability to perform under the terms of the contract.113

(j) Assist with the closing of the sale of the Property.114(k) Account in a timely manner for all money and property received.115BROKER shall not be obligated to continue to market the Property or present subsequent offers after an 116offer has been accepted by SELLER unless the sales Contract permits SELLER to continue to market 117the Property and consider other offers until Closing. Notwithstanding the above, if the Property is in 118Missouri, all written offers MUST be presented regardless of whether the Property is subject to a 119sales contract.120

1214. SELLER’S DISCLOSURE AND CONDITION OF PROPERTY ADDENDUM (“Seller’s Disclosure”).122SELLER understands that the law requires disclosure of any material defects in the Property to prospective 123Buyers and that failure to do so may result in civil liability for damages. SELLER agrees to complete the 124Seller’s Disclosure Statement to be provided to prospective Buyers and to update the disclosure statement 125at the request of BROKER, or in the event of a material change in the condition of the Property.126SELLER will provide all inspection reports, if any, and authorizes Licensee to disclose such reports127and warrants that there are no known defects in the Property except as will be indicated on the Seller’s 128Disclosure Statement. SELLER agrees to hold BROKER, its affiliated licensees and employees, and all 129cooperating Brokers and their agents and employees harmless for any damages or civil or criminal actions, 130and all claims, demands, suits, losses or expenses (including reasonable attorney’s fees) arising out of any 131misrepresentation, nondisclosure, or concealment by SELLER in connection with the sale of the Property 132including, without limitation, the inaccuracy of information provided by SELLER for the preparation of the 133listing data, contained in the Seller’s Disclosure Statement, or otherwise provided or omitted in connection 134with the sale of the Property. SELLER agrees to thoroughly review the listing information prepared by 135BROKER and advise BROKER immediately of any errors or omissions, including but not limited to the age 136of the Property and size of the lot. SELLER agrees that SELLER will personally assume all responsibility 137for any claims made by a Buyer before or after possession with respect to any errors or omissions 138contained in the information provided to BROKER and the Buyer, and that BROKER shall not be 139responsible in any manner for any errors or omissions.140

1415. LEGAL AND PROFESSIONAL ADVICE. BROKER suggests SELLER seek legal, tax, and other 142professional advice relative to any real estate transaction. BROKER makes no representation or warranty 143respecting the advisability of any transaction. BROKER is not an expert in matters relating to law, tax, 144financing, surveying, structural or mechanical condition, hazardous material, engineering, or other 145specialized topics. SELLER is encouraged to seek expert help in such areas. BROKER will cooperate 146with experts engaged by SELLER, but BROKER shall have no liability to SELLER pertaining to such 147matters.148

1496. LIABILITIES. SELLER agrees to indemnify BROKER against and hold BROKER harmless from any 150liability for vandalism, theft or damage of any nature whatsoever to the Property, or for personal injury to 151persons on the Property. In consideration of BROKER’S arranging for any inspections at SELLER’S 152request, SELLER hereby agrees to indemnify and hold harmless BROKER, and BROKER’S affiliated 153licensees, agents and employees from any liability, costs or expenses resulting from or in connection with 154those inspections.155

1567. BROKERAGE RELATIONSHIP DISCLOSURE. SELLER acknowledges receiving (a) the Broker 157Disclosure Form (in Missouri) on or before the signing of the Seller’s Agency Agreement, or upon158the licensee obtaining any personal or financial information, whichever occurs first; OR, (b) the 159Real Estate Brokerage Relationships Brochure (in Kansas) at the first practical opportunity. The 160

161


Missouri “Form”, or Kansas “Brochure” needs to be read by all consumers. SELLER understands 162and agrees that BROKER can show the Property and obtain offers from all prospective Buyers, including 163Buyers with whom BROKER has a brokerage relationship. BROKER shall notify SELLER and Buyer of 164BROKER’S intention to represent both of them (Disclosed Dual Agency is available only in Missouri),165to represent neither but to assist both the Buyer and SELLER (Transaction Brokerage is available in 166both Kansas and Missouri), or designate an agent for the Buyer and another to represent SELLER 167(Designated Agency is available in both Kansas and Missouri). SELLER also understands and agrees 168that as part of the marketing of the Property, BROKER will be showing Buyers properties other than the 169Property and providing Buyers with information on selling prices in the area. SELLER understands that 170BROKER may show alternative properties not owned by SELLER to prospects and may list competing 171properties for sale without breaching any duty or obligation to SELLER.172 p

Seller Agency. A SELLER’S agent represents SELLER only, so the Buyer may be either unrepre-173sented or represented by another agent. The SELLER’S agent is responsible for performing the follow-174ing duties: promoting the interests of SELLER with the utmost good faith, loyalty, and fidelity; protecting 175SELLER’S confidences, unless disclosure is required; presenting all offers in a timely manner; advising 176SELLER to obtain expert advice; accounting for all money and property received; disclosing to SEL-177LER all adverse material facts about the Buyer that the agent knows; environmental hazards affecting 178the Property that are required to be disclosed; the physical condition of the Property or any material 179defects in the Property or in the title to the Property; any material limitation on SELLER’S ability to 180complete the contract. The SELLER’S agent has no duty to conduct an independent inspection of the 181Property for the benefit of the Buyer or to independently verify the accuracy or completeness of any 182statement by SELLER or any qualified third party.183Transaction Broker. (Kansas and Missouri). SELLER acknowledges that BROKER may have Buy-184er clients who have retained BROKER to represent them in the acquisition of property. If one of these 185clients becomes interested in making an offer on the Property, BROKER would be in the position of 186representing the Buyer and SELLER in the same transaction. Unless designated agents have been 187appointed as provided below, this representation would constitute a dual agency (Missouri only). With 188the informed consent of both SELLER and the Buyer, BROKER may act as a Transaction Broker. As a 189Transaction Broker, BROKER would assist the parties with the real estate transaction without being an 190agent or advocate for the interests of either party. A Transaction Broker has the duty to perform the 191terms of any written or oral agreement made with any party to the transaction; to exercise reasonable 192skill, care and diligence as a Transaction Broker, including but not limited to: presenting all offers and 193counter offers in a timely manner regardless of whether the Property is subject to a Contract for sale or 194lease or a letter of intent; keeping the parties fully informed regarding the transaction and suggesting 195that such parties obtain expert advice as to material matters about which the Transaction Broker knows 196but the specifics of which are beyond the expertise of such broker; accounting in a timely manner for all 197money and property received; disclosing to each party to the transaction any adverse material facts of 198which the Transaction Broker has actual notice or knowledge; and assisting the parties in complying 199with the terms and conditions of any Contract. The parties to a transaction brokerage transaction shall 200not be liable for any acts of the Transaction Broker. The following information shall not be disclosed by 201a Transaction Broker without the informed consent of the party or parties disclosing such information to 202the BROKER: that a Buyer is willing to pay more than the Purchase Price offered for the Property; that 203SELLER is willing to accept less than the asking price for the Property; what the motivating factors are 204for any party buying, selling or leasing the Property; that SELLER or a Buyer will agree to financing 205terms other than those offered or any confidential information about the other party, unless disclosure 206of such information is required by law, statute, rules or regulations or failure to disclose such informa-207tion would constitute fraud or dishonest dealing. (A separate Transaction Broker Addendum must208be signed by all parties when this arrangement is used.)209Sub-Agency. A Sub-Agent is the agent of an agent. A Sub-Agent owes the same obligations and 210responsibilities as the agent.211Disclosed Dual Agency. (Missouri only). BROKER may have Buyer clients who have retained 212BROKER to represent them in connection with the acquisition of property. If a Buyer represented by 213BROKER becomes interested in making an offer on the Property, BROKER is in the position of 214


representing both SELLER and the Buyer in that transaction. This representation, known as dual 215agency, can create inherent conflicts of interest. The same is true if the listing agent is also the selling 216agent. A Dual Agent shall be a limited agent for both SELLER and a Buyer and shall have the duties of 217SELLER’S or a Buyer’s agent except that a Dual Agent may disclose any information to one client that 218the licensee gains from the other client if the information: (1) is material to the transaction unless it is 219confidential information that has not been made public or, (2) becomes public by the words or conduct 220of the client to whom the information pertains or; (3) is obtained from a source other than the licensee. 221A Dual Agent may not disclose, without the consent of the client to whom the information pertains: that 222a Buyer is willing to pay more than the Purchase Price offered for the Property; that SELLER is willing 223to accept less than the asking price for the Property; what the motivating factors are for any client, 224buying or selling the Property or that a client will agree to financing terms other than those offered 225and/or the terms of any prior offers or counter offers made by any party. A Dual Agent shall not 226disclose to one client any confidential information about the other client unless the disclosure is 227required by statute, rule or regulation or failure to disclose the information would constitute a 228misrepresentation or unless disclosure is necessary to defend the affiliate licensee against an action of 229wrongful conduct in any administrative or judicial proceeding or before a professional committee. (A230separate Disclosed Dual Agency Amendment must be signed by SELLER and the Buyer when 231this form of agency is used.)232Designated Agency. A Designated Agent is a licensee affiliated with BROKER who has been 233designated by BROKER, or BROKER’S authorized representative, to act as the agent of a Buyer234represented by BROKER or a SELLER represented by BROKER to the exclusion of all other affiliated235licensees of BROKER. The use of a Designated Agent is an alternative to a Disclosed Dual Agency in 236Missouri or a Transaction Broker in Kansas or Missouri. A Designated SELLER’S Agent will perform all 237of the duties of a SELLER’S Agent.238

If a Designated Agent is appointed to represent SELLER, SELLER understands and agrees 239that:240

(1) The Designated Agent will perform all of the duties of a SELLER’S Agent and will be241SELLER’S legal agent to the exclusion of all other licensees affiliated with BROKER.242

(2) Another licensee with the BROKER may act as a Designated Agent for a Buyer in the sale243of the Property.244

(3) The supervising broker (or branch broker, if applicable) will act as a Transaction Broker and 245will not advocate for the interests of either party and will not, without prior consent of both 246parties, disclose any information or personal confidences about a party which might place the 247other party at an advantage. The supervising broker (or branch broker, if applicable) may 248appoint an affiliated licensee to act in the transaction as a Transaction Broker.249(4) If the Designated Agent for SELLER is also the Designated Agent of a Buyer who is 250interested in purchasing the Property, the Designated Agent cannot represent both SELLER 251and Buyer. With the informed consent of both SELLER and Buyer, the Designated Agent may 252act as a Transaction Broker and assist the parties with the real estate transaction without being 253an agent or advocate for the interests of either party.254(5) If a Buyer who is represented by a Designated Agent of BROKER wants to see a property 255which was personally listed by the supervising broker, the supervising broker, with the written 256consent of SELLER, may specifically designate an affiliated licensee who will act as the 257Designated Agent for SELLER.258

2598. BROKERAGE RELATIONSHIPS CONFIRMATION: Unless otherwise provided herein, the SELLER 260authorizes the designated broker to cooperate with and compensate other designated brokers.261

262SELLER consents to the following (Check applicable boxes):263

Yes No SELLER consents to Seller Agency.264Yes No SELLER consents to a Transaction Broker and agrees, if applicable, to sign a 265

Transaction Broker Addendum. 266Yes No SELLER consents to Sub-Agency.267

268


Yes No SELLER consents to Dual Agency and agrees, if applicable, to sign a Disclosed Dual 269Agency Amendment. (Missouri only)270

Yes No SELLER consents to Designated Agency. (In Kansas, Supervising Broker acts as a 271Transaction Broker)272

Yes No SELLER consents to the appointment of a Designated Agent for a Buyer in sale of the 273SELLER’S Property. (In Kansas, Supervising Broker acts as a Transaction Broker)274

2759. TITLE INSURANCE. SELLER has been informed of SELLER’S responsibility to provide the Buyers of 276the Property with evidence of clear title as required by the sales Contract. SELLER authorizes BROKER to 277order title evidence through ________________________________. Title to the Property is vested in the 278name(s) of: ___________________________________________________________________________279_____________________________________________________________________________________ 280____________________________________________________________________________________.281

28210. COMPENSATION.283

(a) SELLER agrees to pay BROKER a commission which shall be: _____________________________. 284The Commission is due and payable if BROKER or anyone else produces or finds a purchaser ready, 285willing, and able to purchase the Property at the price and terms offered now or at the price and terms 286acceptable to SELLER at a later date. The Commission shall be split _____% listing side and _____% 287selling side.288Other Compensation: ________________________________________________________________. 289SELLER authorizes the party handling the Closing to pay the Commission and Other 290Compensation to BROKER from SELLER’S proceeds at the Closing. SELLER understands and 291agrees that BROKER may be compensated by more than one party in the transaction.292(b) If compensation to selling BROKER differs from what is stated in this Contract for any reason, such 293must be disclosed in writing to SELLER by BROKER. BROKER’S offer of compensation is only 294applicable to brokers who are participants in Heartland Multiple Listing System, unless otherwise agreed 295upon in writing.296(c) If the Property is not sold during the term of this Contract but a sale is made directly or indirectly 297within ___________ days after this Contract terminates to anyone to whom the Property was shown or 298submitted during the term of this Contract and whose name BROKER has submitted to SELLER in 299writing prior to the expiration of this Contract, the Commission and Other Compensation is due and 300payable to BROKER. However, SELLER shall not be obligated to pay the Commission and Other 301Compensation if a valid Exclusive Right To Sell Contract is entered into during such period with another 302licensed real estate broker and the sale of the Property is made during such period, unless said 303exclusions have been added to a subsequent Exclusive Right To Sell Contract. The terms 304“purchase” and “sale” as used herein shall include any agreement to transfer all or a substantial part of 305SELLER’S interest in the Property, including a Contract for deed, a Contract for sale, a lease, a 306lease/option Contract, and a shared equity Contract.307

30811. LIMITED HOME WARRANTY (RESALE ONLY). It is suggested that SELLER consider the purchase 309of a home protection plan for the Property which may increase the Property’s marketability and reduce 310SELLER’S risk. The program was explained to SELLER and SELLER (Check one) agrees does not 311agree to participate in the program. If SELLER agrees to participate in this program, a separate application 312defining the coverage of the program may be signed at the time this listing is executed and Licensee may 313receive a fee from the warranty company to cover processing and administration of the plan.314

31512. NOTICE TO SELLERS WHO ARE FOREIGN PERSONS. A SELLER who is a foreign person should 316consult an attorney or accountant familiar with the Foreign Investment in Real Property Tax Act (FIRPTA) 317before entering into negotiations or contracts for the sale of property.318

319


13. ADDITIONAL TERMS AND CONDITIONS:_______________________________________________ 320_____________________________________________________________________________________321_____________________________________________________________________________________322_____________________________________________________________________________________323_____________________________________________________________________________________324

325CAREFULLY READ THE TERMS HEREOF BEFORE SIGNING. WHEN SIGNED BY ALL PARTIES, 326

THIS DOCUMENT BECOMES PART OF A LEGALLY BINDING CONTRACT.327IF NOT UNDERSTOOD, CONSULT AN ATTORNEY BEFORE SIGNING.328

329All parties agree that this transaction can be conducted by electronic means, including email, 330

according to the Uniform Electronic Transaction Act as adopted in Kansas and Missouri.331332

_________________________________________ _________________________________________333BROKERAGE SELLER DATE334

_________________________________________ _________________________________________335LICENSEE ASSISTING SELLER DATE SELLER DATE336

_________________________________________337 SELLER ADDRESS338 _________________________________________339 SELLER CITY, STATE, ZIP340 _________________________________________341 SELLER PHONE # SELLER FAX #342 _________________________________________343 SELLER EMAIL344

345

Approved by Legal Counsel of the Kansas City Regional Association of REALTORS® for exclusive use by its REALTOR® members. No warranty is made or implied as to the legal validity or adequacy of this Contract, or that it complies in every respect with the law or that its use is appropriate for all situations. Local law, customs and practices, and differing circumstances in each transaction may dictate that amendments to this Contract be made. Copyright January 2010. Last revised 10/09. All previous versions of this document may no longer be valid.

Appointment of Designated Agent(s): BROKER or BROKER’S authorized representative hereby designates: ________________________________________________________________________________________________________________________________________________________________________________________ to act as a Designated Agent(s) on SELLER’S behalf. SELLER consents to the above named Designated Agent(s) acting as SELLER’S Designated Agent (or as a Transaction Broker, or Disclosed Dual Agent in Missouri if such Designated Agent is also the Designated Agent for the buyer), subject to both SELLER and Buyer signing a Transaction Broker Addendum or Disclosed Dual Agency Amendment (Missouri only) with BROKER, which shall be signed by the Buyer prior to writing the offer and by SELLER prior to signing the Contract.

_________________________________________________________________BROKER’S Signature (required in Missouri)

Seller’s Disclosure and Condition of Property Addendum 2010Page 1 of 8

SELLER: ___________________________________________________________________________1

PROPERTY: ________________________________________________________________________23

1. NOTICE TO SELLER.4Be as complete and accurate as possible when answering the questions in this disclosure. Attach 5additional sheets if space is insufficient for all applicable comments. SELLER agrees to disclose to 6BUYER all material defects, conditions and facts KNOWN TO SELLER which may materially affect the 7value of the Property. Non-occupant SELLERS are not relieved of this obligation. This disclosure 8statement is designed to assist SELLER in making these disclosures. Licensee(s), prospective buyers 9and buyers will rely on this information.10

112. NOTICE TO BUYER.12This is a disclosure of SELLER’S knowledge of the Property as of the date signed by SELLER and is not 13a substitute for any inspections or warranties that BUYER may wish to obtain. It is not a warranty of any 14kind by SELLER or a warranty or representation by the Broker(s) or their licensees.15

163. OCCUPANCY.17Approximate age of Property? ___________________ How long have you owned? ________________18Does SELLER currently occupy the Property? ................................................................. Yes No19If “No”, how long has it been since SELLER occupied the Property? _____________ years/months20

214. LAND (SOILS, DRAINAGE AND BOUNDARIES). (IF RURAL OR VACANT LAND, ATTACH 22SELLER’S LAND DISCLOSURE ALSO.) ARE YOU AWARE OF:23

(a) Any fill or expansive soil on the Property? ..................................................... Yes No24(b) Any sliding, settling, earth movement, upheaval or earth stability problems25

on the Property? ............................................................................................ Yes No26(c) The Property or any portion thereof being located in a flood zone, wetlands 27

area or proposed to be located in such as designated by FEMA which 28requires flood insurance? .............................................................................. Yes No29

(d) Any drainage or flood problems on the Property or adjacent properties? ...... Yes No30(e) Any flood insurance premiums that you pay? ................................................ Yes No31(f) Any need for flood insurance on the Property? .............................................. Yes No32(g) Any boundaries of the Property being marked in any way? ........................... Yes No33(h) The Property having had a stake survey? If ”Yes”, attach copy. ................... Yes No34(i) Any encroachments, boundary line disputes, or non-utility easements 35

affecting the Property? .................................................................................. Yes No36(j) Any fencing on the Property? ........................................................................ Yes No37

If “Yes”, does fencing belong to the Property? ....................................... N/A Yes No38(k) Any diseased, dead, or damaged trees or shrubs on the Property? .............. Yes No39(l) Any gas/oil wells, lines or storage facilities on Property or adjacent40

property? ....................................................................................................... Yes No41If any of the answers in this section are “Yes” (except h), explain in detail (attach other 42documentation):_____________________________________________________________________43___________________________________________________________________________________44___________________________________________________________________________________45___________________________________________________________________________________46

SELLER’S DISCLOSURE ANDCONDITION OF PROPERTY ADDENDUM

(Residential)


5. ROOF.47(a) Approximate Age: ______years Unknown Type: _____________________________48(b) Have there been any problems with the roof, flashing or rain gutters? .......... Yes No49

If “Yes”, what was the date of the occurrence? ______________________50(c) Have there been any repairs to the roof, flashing or rain gutters? ................. Yes No51

Date of and company performing such repairs___________/__________________________ 52(d) Has there been any roof replacement? ......................................................... Yes No53

If “Yes”, was it: Complete or Partial 54(e) What is the number of layers currently in place? _________layers or Unknown. 55

If any of the answers in this section are “Yes”, explain in detail (attach all warranty information 56and other documentation):____________________________________________________________57___________________________________________________________________________________58___________________________________________________________________________________59___________________________________________________________________________________60

616. INFESTATION. ARE YOU AWARE OF:62

(a) Any termites, wood destroying insects, or other pests on the Property? ....... Yes No63(b) Any damage to the Property by termites, wood destroying insects or other64

pests? ........................................................................................................... Yes No65(c) Any termite, wood destroying insects or other pest control treatments on the 66

Property in the last five years? ...................................................................... Yes No67If “Yes”, list company, when and where treated ______________________68

(d) Any current warranty, bait stations or other treatment coverage by a licensed 69pest control company on the Property? ......................................................... Yes No70If “Yes”, the annual cost of service renewal is $___________ and the time 71remaining on the service contract is _________________.) (Check one) The treatment72system stays with the Property or the treatment system is subject to removal by the 73treatment company if annual service fee is not paid.74

If any of the answers in this section are “Yes”, explain in detail (attach all warranty information 75and other documentation): ____________________________________________________________76___________________________________________________________________________________77___________________________________________________________________________________78___________________________________________________________________________________79

807. STRUCTURAL, BASEMENT AND CRAWL SPACE ITEMS. ARE YOU AWARE OF:81

(a) Any movement, shifting, deterioration, or other problems with walls, 82foundations, crawl space or slab? ................................................................. Yes No83

(b) Any cracks or flaws in the walls, ceilings, foundations, concrete slab, 84crawl space, basement floor or garage? ....................................................... Yes No85

(c) Any corrective action taken including, but not limited to piering or bracing? .. Yes No86(d) Any water leakage or dampness in the house, crawl space or basement? .... Yes No87(e) Any dry rot, wood rot or similar conditions on the wood of the Property? ...... Yes No88(f) Any problems with driveways, patios, decks, fences or retaining walls on 89

the Property? ................................................................................................. Yes No90(g) Any problems with fireplace and/or chimney? ............................................... Yes No91

Date of last cleaning? _________________92(h) Does the Property have a sump pump? ........................................................ Yes No93

If “Yes”, location: _________________________________________________94(i) Any repairs or other attempts to control the cause or effect of any problem 95

described above? .......................................................................................... Yes No96


If any of the answers in this section are “Yes” (except h), explain in detail (attach all warranty 97information and other documentation): _________________________________________________98___________________________________________________________________________________99___________________________________________________________________________________100___________________________________________________________________________________101

1028. ADDITIONS AND/OR REMODELING.103

(a) Are you aware of any additions, structural changes, or other material 104alterations to the Property? ........................................................................... Yes No105If “Yes”, explain in detail: ______________________________________________________106__________________________________________________________________________107

(b) If “Yes”, were all necessary permits and approvals obtained, and was all 108work in compliance with building codes?............................................. N/A Yes No109If “No”, explain in detail: ______________________________________________________110__________________________________________________________________________111

1129. PLUMBING RELATED ITEMS.113

(a) What is the drinking water source? Public Private Well Cistern114If well water, state type __________________ depth_____________ 115diameter ___________ age_________116

(b) If the drinking water source is a well, when was the water last checked for 117safety and what was the result of the test?___________________________118

(c) Is there a water softener on the Property? .................................................... Yes No119If “Yes”, is it: Leased Owned?120

(d) Is there a water purifier system? ................................................................... Yes No121If “Yes”, is it: Leased Owned?122

(e) What type of sewage system serves the Property? Public Sewer Private Sewer 123Septic System Cesspool Lagoon Other _____________________124

(f) The location of the sewer line clean out trap is: ___________________________125(g) Is there a sewage pump on the septic system?.........................................N/A Yes No126(h) Is there a grinder pump system? ................................................................... Yes No127(i) If there is a privately owned system, when was the septic tank, cesspool, or sewage 128

system last serviced?_________ By whom? ___________________________129(j) Is there a sprinkler system? .......................................................................... Yes No130

Does sprinkler system cover full yard and landscaped areas? ................N/A Yes No131If “No”, explain in detail: __________________________________________132

(k) Are you aware of any leaks, backups, or other problems relating to any of the, 133plumbing, water, and sewage related systems? ............................................ Yes No134

(l) Type of plumbing material currently used in the Property: 135Copper Galvanized Other ____________________________________________136

The location of the main water shut-off is: ________________________________________137(m) Is there a back flow prevention device on the lawn sprinkling system, 138

sewer or pool? .................................................................................... N/A Yes No139If your answer to (k) in this section is “Yes”, explain in detail (attach available 140documentation):_____________________________________________________________________141___________________________________________________________________________________142___________________________________________________________________________________143___________________________________________________________________________________144


10. HEATING AND AIR CONDITIONING.145(a) Does the Property have air conditioning? ...................................................... Yes No146

Central Electric Central Gas Heat Pump Window Unit(s)147Unit Age of Unit Leased Owned Location __Last Date Serviced/By Whom?1481.________________________________________________________________________1492.________________________________________________________________________150

(b) Does the Property have heating systems? .................................................... Yes No151Electric Fuel Oil Natural Gas Heat Pump Propane152Fuel Tank Other_______________153

Unit Age of Unit Leased Owned Location __Last Date Serviced/By Whom?1541.________________________________________________________________________1552.________________________________________________________________________156

(c) Are there rooms without heat or air conditioning? ......................................... Yes No157If “Yes”, which room(s)? ______________________________________________________158

(d) Does the Property have a water heater? ....................................................... Yes No159Electric Gas Solar 160

Unit Age of Unit Leased Owned Location Capacity__Last Date Serviced/By Whom?_1611.________________________________________________________________________1622.________________________________________________________________________163

(e) Are you aware of any problems regarding these items? ................................ Yes No164If “Yes”, explain in detail: _____________________________________________________165__________________________________________________________________________166__________________________________________________________________________167__________________________________________________________________________168

16911. ELECTRICAL SYSTEM.170

(a) Type of material used: Copper Aluminum Unknown171(b) Type of electrical panel(s): Breaker Fuse172

Location of electrical panel(s): _________________________________________________173Size of electrical panel (total amps), if known: _____________________________________174

(c) Are you aware of any problem with the electrical system? ............................ Yes No175If “Yes”, explain in detail: ______________________________________________________176__________________________________________________________________________177__________________________________________________________________________178

17912. HAZARDOUS CONDITIONS. ARE YOU AWARE OF:180

(a) Any underground tanks on the Property? ...................................................... Yes No181(b) Any landfill on the Property? .......................................................................... Yes No182(c) Any toxic substances on the Property, (e.g. tires, batteries, etc.)? ................ Yes No183(d) Any testing for any of the above-listed items on the Property? ...................... Yes No184(e) Any radon on the Property? ........................................................................... Yes No185(f) Any testing for radon on the Property? .......................................................... Yes No186(g) Any testing for mold on the Property? ........................................................... Yes No187(h) Any other environmental issues? ................................................................... Yes No188(i) Any methamphetamine or controlled substances ever being189

used or manufactured on the Property? ........................................................ Yes No190(In Missouri, a separate disclosure is required if methamphetamine or 191other controlled substances have been present on or in the Property.)192


If any of the answers in this section are “Yes”, explain in detail (attach test results and other 193documentation): ____________________________________________________________________194___________________________________________________________________________________195___________________________________________________________________________________196___________________________________________________________________________________197

19813. NEIGHBORHOOD INFORMATION & HOMEOWNER’S ASSOCIATION. ARE YOU AWARE OF:199

(a) Any current/pending bonds, assessments, or special taxes that 200apply to Property? .............................................................................................. Yes No201If “Yes”, what is the amount? $______________________202

(b) Any condition or proposed change in your neighborhood or surrounding 203area or having received any notice of such? ................................................. Yes No204

(c) The Property being subject to covenants, conditions, and restrictions of a 205Homeowner’s Association or subdivision restrictions? ................................... Yes No206

(d) Any violations of such covenants and restrictions? ..................................N/A Yes No207(e) The Homeowner’s Association imposing its own transfer fee when the208

Property is sold? ......................................................................................N/A Yes No209If “Yes”, what is the amount? $____________________210

(f) Any defect, damage, proposed change or problem with any 211common elements or common areas? .......................................................... Yes No212

(g) Any condition or claim which may result in any change to 213assessments or fees? ................................................................................... Yes No214

(h) Any streets that are privately owned? ............................................................ Yes No215(i) The Property being in a historic, conservation or special review district that 216

requires any alterations or improvements to the Property be approved by a 217board or commission? ................................................................................... Yes No218

(j) The Property being subject to tax abatement? ............................................... Yes No219(k) The Property being subject to a right of first refusal? ..................................... Yes No220

If any of the answers in this section are “Yes” (except c and e), explain in detail (attach other 221documentation):_____________________________________________________________________222___________________________________________________________________________________223_________________________________________________________________________________224

225Homeowner’s Association dues are paid in full until _______________ in the amount of $____________226payable yearly monthly quarterly, sent to _________________________________________and227such includes:________________________________________________________________________228Homeowner’s Association contact name, phone number, website, or email address: ________________229___________________________________________________________________________________230___________________________________________________________________________________231

23214. PRE-INSPECTION (INSPECTION DONE IN PREPARATION OF LISTING THE PROPERTY).233

(a) Has Property been pre-inspected? .............................................................. Yes No234If “Yes”, attach copy of inspection report consisting of ______number of pages.235

23615. OTHER MATTERS. ARE YOU AWARE OF:237

(a) Any of the following?238Party walls Common areas Easement Driveways ............................. Yes No239

(b) Any fire damage to the Property? .................................................................. Yes No240(c) Any liens, other than mortgage(s)/deeds of trust currently on the Property? . Yes No241(d) Any violations of laws or regulations affecting the Property?.......................... Yes No242(e) Any other conditions that may materially affect the value 243

or desirability of the Property? ....................................................................... Yes No244


(f) Any other condition, including but not limited to financial, that may prevent 245you from completing the sale of the Property? .............................................. Yes No246

(g) Any general stains or pet stains to the carpet, the flooring or sub-flooring? .. Yes No247(h) Having keys for all exterior doors, including garage doors to the Property? .. Yes No248

List locks without keys __________________________________________249(i) Any violations of zoning, setbacks or restrictions, or non-conforming uses? . Yes No250(j) Any unrecorded interests affecting the Property? .......................................... Yes No251(k) Anything that would interfere with giving clear title to the BUYER? .............. Yes No252(l) Any existing or threatened legal action pertaining to the Property? ............... Yes No253(m) Any litigation or settlement pertaining to the Property? .................................. Yes No254(n) Any added insulation since you have owned the Property? ........................... Yes No255(o) Having replaced any appliances that remain with the Property in the 256

past five years? ............................................................................................. Yes No257(p) Any transferable warranties on the Property or any of its 258

components?............................................................................................ Yes No259(q) Having made any insurance or other claims pertaining to the Property260

in the past 5 years? ....................................................................................... Yes No261If “Yes”, were repairs from claim(s) completed? ....................................... N/A Yes No262

(r) Any use of synthetic stucco on the Property? ................................................ Yes No263If any of the answers in this section are “Yes” (except h), explain in detail: __________________264___________________________________________________________________________________265___________________________________________________________________________________266___________________________________________________________________________________267___________________________________________________________________________________268___________________________________________________________________________________269

27016. UTILITIES. Identify the name and phone number for utilities listed below.271

Electric Company Name: __________________________ Phone #______________________272Gas Company Name: ___________________________ Phone #______________________273Water Company Name: ___________________________ Phone #______________________274

27517. FIXTURES, EQUIPMENT AND APPLIANCES (FILL IN ALL BLANKS).276

The Residential Real Estate Sale Contract, including this paragraph of the residential Seller’s 277Disclosure and Condition of Property Addendum (“Seller’s Disclosure”), not the MLS, or other 278promotional material, provides for what is included in the sale of the Property. Items listed in the 279“Additional Inclusions” or “Exclusions” in Subparagraphs 1a and 1b of the Contract supersede the 280Seller’s Disclosure and the printed list in Paragraph 1 of the Contract. If there are no “Additional 281Inclusions” or “Exclusions” listed, the Seller’s Disclosure and the printed list govern what is or is not 282included in this sale. If there are differences between the Seller’s Disclosure and the Paragraph 1 283list, the Seller’s Disclosure governs. Unless modified by the Seller’s Disclosure and/or the “Additional 284Inclusions” and/or the “Exclusions” in Paragraph 1a and/or 1b, all existing improvements on the 285Property (if any) and appurtenances, fixtures and equipment (which seller agrees to own free and 286clear), whether buried, nailed, bolted, screwed, glued or otherwise permanently attached to Property287are expected to remain with Property.288

289


290“OS” = Operating and Staying with the Property (any item that is performing its intended 291

function).292“EX” = Staying with the Property but Excluded from Mechanical Repairs; cannot be an 293

Unacceptable Condition.294“NA” = Not applicable (any item not present). 295“NS” = Not staying with the Property (item should be identified as “NS” below and296

addressed as an exclusion in the Contract).297298

___Air Conditioning Window Units, #___ ___Garage Door Transmitter(s), #___ ___Sprinkler System___299___Air Conditioning Central System ___Gas Grill ___Sprinkler System Back Flow Valve300___Attached Audio/Visual Equipment ___Gas Yard Light ___Sprinkler System Auto Timer301___Attic Fan ___Humidifier ___Statuary/Yard Art302___Ceiling Fans, #___ ___Intercom ___Stove, __Elec. __Gas303___Central Vac and Attachments ___Laundry – Washer ___Stove Downdraft Cooktop304___Dishwasher ___Laundry – Dryer ___Stove/Oven __Elec. __Gas305___Disposal ___Microwave Oven ___Stove/Oven – Convection306___Doorbell ___Propane Tank ___Stove/Oven Clock Timer307___Electric Air Cleaner or Purifier __Owned __Leased ___Stove Vent Hood308___Exhaust Fan(s) – Baths ___Refrigerator ___Sump Pump 309___Fireplace Heat Re-circulator Location of Refrigerator_______ ___Swimming Pool310___Fireplace Insert ___Security System ___Swimming Pool Heater 311___Fireplace Gas Logs __Owned __Leased ___Swimming Pool Equipment312___Fireplace Gas Starter ___Smoke Detector(s), #___ ___Trash Compactor 313___Fireplace – Wood Burning Stove ___Spa/Hot Tub ___TV Antenna/Receiver/Satellite Dish314___Fountain(s) ___Spa/Sauna __Owned __Leased315___Furnace/heat Pump/other Htg System ___Spa Equipment ___Water Softener and/or purifier316___Garage Door Opener(s) ___Other _________________________ __Owned __Leased317___Other _________________________ ___Other _________________________ ___Other ________________________318___Other _________________________ ___Other _________________________ ___Other ________________________319

320Disclose any material information and describe any significant repairs, improvements or alterations to the321Property not fully revealed above. If applicable, state who did the work. Attach to this disclosure any 322repair estimates, reports, invoices, notices or other documents describing or referring to the matters 323revealed herein: ______________________________________________________________________324___________________________________________________________________________________325___________________________________________________________________________________326

327The undersigned SELLER represents, to the best of their knowledge, the information set forth in the 328foregoing Disclosure Statement is accurate and complete. SELLER does not intend this Disclosure 329Statement to be a warranty or guarantee of any kind. SELLER hereby authorizes the Licensee assisting330SELLER to provide this information to prospective BUYER of the Property and to real estate brokers and 331salespeople. SELLER will promptly notify Licensee assisting the SELLER, in writing, if any 332information in this disclosure changes prior to Closing, and Licensee assisting the SELLER will 333promptly notify Licensee assisting the BUYER, in writing, of such changes. (SELLER and BUYER 334initial and date any changes and/or attach a list of additional changes. If attached, #_____ of 335pages).336

337CAREFULLY READ THE TERMS HEREOF BEFORE SIGNING. WHEN SIGNED BY ALL PARTIES,338

THIS DOCUMENT BECOMES PART OF A LEGALLY BINDING CONTRACT.339IF NOT UNDERSTOOD, CONSULT AN ATTORNEY BEFORE SIGNING.340

341342

________________________________________ ________________________________________343SELLER DATE SELLER DATE344

345


BUYER ACKNOWLEDGEMENT AND AGREEMENT346347

1. I understand and agree the information in this form is limited to information of which SELLER has 348actual knowledge and SELLER need only make an honest effort at fully revealing the information 349requested.350

2. This Property is being sold to me without warranties or guaranties of any kind by SELLER, Broker(s)351or agents concerning the condition or value of the Property.352

3. I agree to verify any of the above information, and any other important information provided by 353SELLER or Broker (including any information obtained through the Multiple Listing Service) by an 354independent investigation of my own. I have been specifically advised to have Property examined by 355professional inspectors.356

4. I acknowledge neither SELLER nor Broker is an expert at detecting or repairing physical defects in 357Property.358

5. I specifically represent there are no important representations concerning the condition or value of 359Property made by SELLER or Broker on which I am relying except as may be fully set forth in writing 360and signed by them.361

362363

________________________________________ ________________________________________364BUYER DATE BUYER DATE365


Legal Description Addendum 2010

SELLER: _____________________________________________________________________________ 12

BUYER: _____________________________________________________________________________ 34

PROPERTY: __________________________________________________________________________ 56

PROPERTY LEGAL DESCRIPTION: 7_____________________________________________________________________________________8_____________________________________________________________________________________9_____________________________________________________________________________________10_____________________________________________________________________________________11_____________________________________________________________________________________12_____________________________________________________________________________________13_____________________________________________________________________________________14_____________________________________________________________________________________15_____________________________________________________________________________________16_____________________________________________________________________________________17_____________________________________________________________________________________18_____________________________________________________________________________________19_____________________________________________________________________________________20_____________________________________________________________________________________21_____________________________________________________________________________________22

23(INFORMATION DEEMED RELIABLE BUT NOT GUARANTEED) 24

25CAREFULLY READ THE TERMS HEREOF BEFORE SIGNING. WHEN SIGNED BY ALL PARTIES, 26

THIS DOCUMENT BECOMES PART OF A LEGALLY BINDING CONTRACT. 27IF NOT UNDERSTOOD, CONSULT AN ATTORNEY BEFORE SIGNING. 28

29__________________________________________ _________________________________________ 30SELLER DATE BUYER DATE 31

32__________________________________________ _________________________________________ 33SELLER DATE BUYER DATE 34

LEGAL DESCRIPTION ADDENDUM


LEAD BASED PAINT DISCLOSURE ADDENDUM Disclosure of Information on Lead-Based Paint and/or

Lead-Based Paint Hazards

SELLER: ____________________________________________________________________ 123456789

101112131415161718

20

PROPERTY: _________________________________________________________________

Lead Warning Statement:Every purchaser of any interest in residential real property on which a residential dwelling was built prior to 1978 is notified that such property may present exposure to lead from lead-based paint that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence quotient, behavioral problems, and impaired memory. Lead poisoning also poses a particular risk to pregnant women. The seller of any interest in residential real property is required to provide the buyer with any information on lead-based paint hazards from risk assessments or inspections in the seller's possession and notify the buyer of any known lead-based paint hazards. A risk assessment or inspection for possible lead-based paint hazards is recommended prior to purchase.

Seller's Disclosure (Initial applicable lines) a) ________ ________ PRESENCE OF LEAD-BASED PAINT AND/OR LEAD-BASED 19 PAINT HAZARDS: (check one below) Known lead-based paint and/or lead-based paint hazards are present in the housing 21

22

23

(explain).

___________________________________________________________________.

Seller has no knowledge of lead-based paint and/or lead-based paint hazards in the 242526

28

housing.

b) ________ ________ RECORDS AND REPORTS AVAILABLE TO THE SELLER: 27 (check one below)

29303132

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). ___________________________________________________________________,

333435363738

4041

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

Buyer’s Acknowledgment (Initial applicable lines)c) ________ ________ BUYER HAS RECEIVED COPIES OF ALL INFORMATION LISTED ABOVE d) ________ ________ BUYER HAS RECEIVED THE PAMPHLET 39 “Protect Your Family from Lead in Your Home”e) ________ ________ BUYER HAS: (Check one below) Received a 10-day opportunity (or mutually agreed upon period) to conduct a risk 42

4344

assessment or inspection for the presence of lead-based paint or lead-based paint hazards; or Waived the opportunity to conduct a risk assessment or inspection for the presence 45

46 of lead-based paint and/or lead-based paint hazards.

Lead Based Paint Disclosure Addendum 2010 Page 1 of 2

Lead Based Paint Disclosure Addendum 2010 Page 2 of 2

474849

505152535455565758596061626364656667

Licensee's Acknowledgment: (initial)f) ________ Licensee has informed the Seller of the Seller's obligations under 42 U.S.C.

4852d and is aware of his/her responsibility to ensure compliance.

Certification of AccuracyThe following parties have reviewed the information above and certify, to the best of their knowledge, the information they have provided is true and accurate.

CAREFULLY READ THE TERMS HEREOF BEFORE SIGNING. WHEN SIGNED BY ALL PARTIES, THIS DOCUMENT BECOMES PART OF A LEGALLY BINDING CONTRACT.

IF NOT UNDERSTOOD, CONSULT AN ATTORNEY BEFORE SIGNING.

_____________________________________ _____________________________________ SELLER DATE BUYER DATE

_____________________________________ _____________________________________ SELLER DATE BUYER DATE

_____________________________________ _____________________________________ LICENSEE ASSISTING SELLER DATE LICENSEE ASSISTING BUYER DATE


COMPANY DISCLOSURE ADDENDUM

SELLER: ____________________________________________________ BUYER: _____________________________________________________ PROPERTY: __________________________________________________

COMPANY DISCLOSURE STATEMENTS

Chartwell Realty LLC is an independent real estate sales brokerage company organized under the laws of the State of Missouri and is solely responsible for its own debts and liabilities. Seller and Buyer are informed and understand that Chartwell Realty LLC has a shared interest in or may earn a financial benefit from First Federal Bank, Pulaski Bank, Chicago Title Company, Chartwell Insurance Services and/or Elliot Insurance Agency and may be recommending one or more of these companies for settlement, closing or escrow services, title insurance or loan origination sales or service. Seller and Buyer are informed and agree that Chartwell Realty LLC may also recommend one of these or other companies for services such as home inspections, engineering services, pest control, electrical, mechanical or other contractors, from which Chartwell Realty LLC may or may not receive a financial benefit, as provided by law. Seller and Buyer are further informed and understand that Chartwell Realty LLC may earn financial benefits from other companies such as HSA Home Warranty Company, AB May, Old Republic Home Protection, American Home Shield, HMS Home Warranty or other warranty companies. Seller and Buyer are informed and agree that they are not required to use any particular provider of such services and may select their own provider if they so choose and have had sufficient opportunity to choose companies for the provision of necessary services related to the sale and purchase of a home. Seller and Buyer are informed and agree that the selection of such providers described herein is an important decision and that they have considered such options and have decided to use the services of these or any other company after such careful deliberation. CAREFULLY READ THE TERMS AND STATEMENTS CONTAINED HEREIN BEFORE SIGNING. WHEN SIGNED BY ALL PARTIES, THIS DOCUMENT BECOMES PART OF A LEGALLY BINDING CONTACT. IF NOT UNDERSTOOD, CONSULT AN ATTORNEY BEFORE SIGNING. ____________________________________ ____________________________________ Seller Date Buyer Date ____________________________________ ____________________________________ Seller Date Buyer Date

MISSOURI BROKER DISCLOSURE FORMOther Agency Relationships

This disclosure is to enable you, a prospective buyer, seller, tenant orlandlord of real estate, to make an informed choice BEFORE workingwith a real estate licensee.

Missouri law allows licensees to work for the interest of one or both ofthe parties to the transaction. The law also allows the licensee to workin a neutral position. How the licensee works depends on the type ofbrokerage service agreements involved. Since the sale or lease of realestate can involve several licensees, it is important that you understandwhat options are available to you regarding representation and to under-stand the relationships among the parties to any transaction in whichyou are involved.

Missouri laws require that if you want representation, you must enterinto a written agreement. This may or may not require you to pay acommission. You do not need to enter into a written agreement with atransaction broker unless you intend to compensate this licensee. Theseagreements vary and you may also want to consider an exclusive ornonexclusive type of relationship.

If you choose not to be represented by an agent, the licensee workingwith you may be working for the other party to the transaction.

Prescribed by the Missouri Real Estate Commission as of January, 2005

Missouri law does not prohibit written agency agreements which provide for dutiesexceeding that of a limited agent described in this pamphlet.

This brokerage authorizes the following relationships:

Seller’s Limited AgentLandlord’s Limited AgentBuyer’s Limited AgentTenant’s Limited AgentSub-AgentDisclosed Dual AgentDesignated AgentTransaction BrokerOther Agency Relationship

Broker or Entity Name and Address__________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________________________

Chartwell Realty783 NE Anderson LaneLee's Summit, MO 64064

Chartwell Realty4546 Main StreetKansas City, MO 64064

CHOICES AVAILABLE TO YOU IN MISSOURI

Designated AgentSeller’s or Landlord’s Limited AgentDuty to perform the terms of the written agreement made with the seller or landlord,to exercise reasonable skill and care for the seller or landlord, and to promote theinterests of the seller or landlord with the utmost good faith, loyalty and fidelity in thesale, lease, or management of property.

Information given by the buyer/tenant to a licensee acting as a Seller’s or Landlord’sLimited Agent will be disclosed to the seller/landlord.

Buyer’s or Tenant’sLimited Agent

Duty to perform the terms of the written agreement made with the buyer or tenant, toexercise reasonable skill and care for the buyer or tenant and to promote the inter-ests of the buyer or tenant with the utmost good faith, loyalty and fidelity in the pur-chase or lease of property.

Information given by the seller/landlord to a licensee acting as a Buyer’s or Tenant’sLimited Agent will be disclosed to the buyer/tenant.

Sub-Agent(Agent of the Agent)

Owes the same obligations and responsibilites as the Seller’s or Landlord’s LimitedAgent, or Buyer’s or Tenant’s Limited Agent.

Disclosed Dual AgentWith the written consent of all parties, represents both the seller and the buyer or thelandlord and the tenant.

A Disclosed Dual Agent may disclose any information to either party that the licens-ee gains that is material to the transaction.

A dual agent may not disclose information that is considered confidential, such as:Buyer/Tenant will pay more than the purchase price or lease rateSeller/Landlord will accept less than the asking price or lease rateEither party will agree to financing terms other than those offeredMotivating factors for any person buying, selling or leasing the propertyTerms of any prior offers or counter offers made by any party.

��

Acts as your specific agent, whether you are a buyer or tenant, or seller or landlord.When the broker makes this appointment, the other real estate licensees in the compa-ny do not represent you.

There are two exceptions with both resulting in dual agency:1. The agent representing you as a buyer or tenant is also the agent who listed the

property you may want to buy or lease.2. The supervising broker of two designated agents becomes involved in the transac-

tion.

Does not represent either party, therefore, does not advocate the interest of either party.

A transaction broker is responsible for performing the following:Protect the confidences of both partiesExercise reasonable skill and carePresent all written offers in a timely mannerKeep the parties fully informedAccount for all money and property receivedAssist the parties in complying with the terms and conditions of the contractDisclose to each party of the transaction any adverse material facts known by thelicenseeSuggest that the parties obtain expert advice.

A transaction broker shall not disclose:Buyer/Tenant will pay more than the purchase or lease priceSeller/Landlord will accept less than the asking or lease priceMotivating factors of the partiesSeller/Buyer will accept financing terms other than those offered.

A transaction broker has no duty to:conduct an independent inspection of, or discover any defects in, the property forthe benefit of either partyconduct an independent investigation of the buyer’s financial condition.

Transaction Broker

��

�

��

�

�


listing information sheet listing...a frame antebellum cape cod colonial contemp french spanish...

Documents