Damian, Deneed'Td2- zzo4 f.
SELLER'S RESIDENTIAL REAL ESTATE SALES DISCLOSURE Date
State Form 46234 (R/1293)
(month, day. year)
Seller states that the information contained in this Disclosure is correct to the best of Seller's CURRENT ACTUAL KNOWLEDGE as of the above
date The prospective buyer and the owner may wish to obtain professional advice or inspections of the property and provide for appropriate
provisions in a contract between them concerning any advice, inspections, defects, or Warranties obtained on the property. The representations in
this form are the representations of the owner and are not the representations of the agent. if any. This information is for disclosure only and is
not intended to be a part of any contract between the buyer and the owner. Indiana law (IC 24-4.6-2) generally requires sellers of 1-4 unit
residential property to complete this form regarding the known physicel condition of the property. An owner must Complete and sign the disclosure
form and submit the form to a prospective buyer before an offer is accepted for the sale of the real estate.
Property address (number and street, d~y, state, ZiP code)
I"/Z7 E. lib ''~ ~ r' r_,,~'~Ex., /H
1. The following are in the conditions indicated:
: !:
A. APPLIANCES } ha:luded = 1[3efsc~,~ Net
Know ' : : :: : : w
· , Kr~
Built-in Vacuum System /~ Air Purifier
Clothes Dryer X Burglar alarm
Clothes Washer X Ceiling Fan(s)
Dishwasher /V~ _Garage Door Opener / Controls
Disposal X Inside Telephone Widng and
Freezer ,~ Blocks / Jacks
Gas Grill X Intercom
Hood X Light Fixtures
Microwave Oven X Sauna
Oven ~ Smoke / Fire Alarm(s)
Range X Switches and Outlets
Refrigerator Y~ Vent Fan(s)
Room Air Conditioner(s) /~ 60 / 100 / 200 Amp Service
Trash Compactor X (Circle one)
TV Antenna/Dish
;NO TEi !!Defecf':~l~s ~!c~)~10n that woUki have a significant adverse
~ct on: jh~Val~ ~ :the:!pr(~c~erty that would significantly impall the
haajth or aafe~'y ~f future occupa~tts of the property, or that if not repaired,
rernuved o~ telfailed would significantly Shorten or adversely affect the
Approved by and restricted to use by Members of the Indiana Association of REALTORS®, Inc. IAR 1999 #3 I
(office use only)
Page I of 4
Cistern
Septic Field / Bed
Hot Tub
Plumbing
Aerator System
Sump Pump
Irrigation Systems
Water Heater I Electdc
Water Heater / Gas
Water Heater / Solar
Water Pud~er
Water Scttener
Well
Other Sewer System
Are the improvements connected to a pubIic water system?
Are the improvements connected to a public sewer system?
Are the improvements connected to a
private/community water system?
Are the improvements connected to a
private/community sewer system?
Do Not
Yes No Know
X
D, .EATING &!C0OLING ~e.e~let Oef.~e i!N0t Do
:SYSTEM:; ~ln~l,ded:: Odecave Net
KnoY.,
Attic Fan y%
Central Air Conditioning )(,.
Hot Water Heat /~
Furnace Heat / Gas 7%
Furnace Heat / Electric /~
Solar House-Heating /X,
Woodburning Stove /~
Fireplace ~
Fireplace Insert /~
Air Cleaner ~
Humidifier y,,
Propane Tank ~
2, ROOF
Age. if known: Yeara.
Does the roof leak?
Is there present damage to the roof?
:! :::::~? :;: !:: ;::i !~;: ::~;!~: i:!:i ~:~: .ow::::: :::::::::::::::::::::::::::::::::::
Are there any existing hazardous oondi-
~. tions on the properb/, such as methane
gas. lead paint. ladon gas in house or
well. radioactive material, landfill,
(. mineshaft, expansive soil, toxic materi-
als, asbestos insulation or PCB'S?
there rnofe than one roof on the house?
.so, how many? roofs.
YES No
Do
Not
Know
(office use only)
Page 2 of 4
Do improvements have aluminum wiring?
Are there any foundation
problems with the improvements?
Are there any encroachmonte?
Are there any violations of zoning.
building cedes or re~dctive cevenanta?
Is the present use a non-conforming
use? Explain:
Have you received any notices by any
governmental or quasi-governmental
agencies affecting this property?
Are there any structural problems with
the buildings?
Have any substantial additions or
alterations been made without a required
building permit?
Are there moisture and/or water
problems in the basement or crawl space
area?
Is there any damage due to wind, flood,
termites or rodents?
Are the furnace/woodstove/chimney/~ue
all in working order? >/%
Is the property in a flood plain? /X,
Do you currently pay flood insurance? ~/~
Does the property contain
underground storage tank(s)?
Is the seller a licensed reel
estate salesperson or broker?
Is there any threatened or existing
litigation regarding the property?
Is the property subject to convenants,
conditions and/or restrictions of a
homeownerS association?
Is the property located within one (1)
mile of an airport?
mole ra,~E LSm ~)1
Da S c. rn e. n .l.
(office use only)
Page 3 of 4
E. ADDITIONAL COMMENTS AND/OR EXPLANATIONS: (Use addl~onal pages if necessary.)
The information contained in this Disclosure has been furnished by the Seller. who certifies to the truth thereof, based on the Sellers CURRENT
ACTUAL KNO%NLEDGE. A disclosure form is not a warranty by the owner or the owners agent, if any, and the disclosure form may not be used
as a substitute for any inspections or warranties that the prospective buyer or owner may later obtain. At or before settlement, the owner is
required to disclose any material change in the physical condition of the property or certify to the purchaser at settlement that the condition of the
property is substantially the same as it was when the disclosure form was provided, Seller and Purchaser hereby acknowledge receipt of this
Disclosure by signing below:
Signature of Seller Date n re,~B~r~ Date
Signature of Seller Date of Buyer'
Date
Signature of Sefier Date Signature of Seller Date
(office use only)
Page4of4
(indiana Real Estate Commission; 876 IAC 1-4-2, 17 IR 2352)
REV, 12/95
iN WITNESS WHEREOF, the parties hereto have made and executed this Agreement as follows:
CITY OF CARMEL, iNDIANA
by and through its Board of Public
Works and Safety
//~/~th _
Jaainard, Presiding Officer
Date: / '/~~
Ma ! a~,uSk_e, ~.~_~r~ber
B alker, Member
Date: ~'L>/' f~
ATTU~
Diana Cordray, .~AM , Cl~--Treasurer
November 3 2000
Mr. Denee M. Damian
1411 East 116th Street
Cannel, IN 46032
RE: Seller's Residential Real Estate Sales Disclosure
Dear Mr. Damian:
On November 1, 2000, the Board of Public Works and Safety approved the above
disclosure regarding the residence at 1427 East 116th Street in Carrnel, Indiana. An
original, fully executed copy of that disclosure is enclosed for your records.
If you have any questions or concerns, please do not hesitate to contact me at
317.571.2413.
Sincerely,
COPY
Carde A. Groce
Deputy Clerk-Treasurer
Enclosure
cc: Joseph C. Staehler
Department of Administration