[ ] is old law to be omitted.
                                                            LBD01848-02-9
 A. 10895                            2
 
 BUT  SHALL  NOT  REFER  TO  (A) UNIMPROVED REAL PROPERTY UPON WHICH SUCH
 DWELLINGS ARE TO BE CONSTRUCTED OR (B) CONDOMINIUM UNITS OR  COOPERATIVE
 APARTMENTS  OR  (C)  PROPERTY  ON  A HOMEOWNERS' ASSOCIATION THAT IS NOT
 OWNED IN FEE SIMPLE BY THE SELLER.
 
 INSTRUCTIONS TO THE SELLER:
   (a) ANSWER ALL QUESTIONS BASED UPON YOUR ACTUAL KNOWLEDGE.
   (b) ATTACH ADDITIONAL PAGES WITH YOUR SIGNATURE IF ADDITIONAL SPACE IS
 REQUIRED.
   (c) COMPLETE THIS FORM YOURSELF.
   (d)  IF  SOME ITEMS DO NOT APPLY TO YOUR PROPERTY, CHECK "NA" (NON-AP-
 PLICABLE). IF YOU DO NOT KNOW THE ANSWER CHECK "UNKN" (UNKNOWN).
 
   SELLER'S STATEMENT: THE SELLER MAKES THE FOLLOWING REPRESENTATIONS  TO
 THE  BUYER BASED UPON THE SELLER'S ACTUAL KNOWLEDGE AT THE TIME OF SIGN-
 ING THIS DOCUMENT. THE SELLER AUTHORIZES HIS OR HER AGENT,  IF  ANY,  TO
 PROVIDE  A COPY OF THIS STATEMENT TO A PROSPECTIVE BUYER OF THE RESIDEN-
 TIAL REAL PROPERTY. THE FOLLOWING ARE REPRESENTATIONS MADE BY THE SELLER
 AND ARE NOT THE REPRESENTATIONS OF THE SELLER'S AGENT.
 GENERAL INFORMATION
   1. HOW LONG HAVE YOU OWNED THE PROPERTY?
   2. HOW LONG HAVE YOU OCCUPIED THE PROPERTY?
   3. WHAT IS THE AGE OF THE STRUCTURE OR STRUCTURES? NOTE  TO  BUYER--IF
      THE  STRUCTURE WAS BUILT BEFORE 1978 YOU ARE ENCOURAGED TO INVESTI-
      GATE FOR THE PRESENCE OF LEAD BASED PAINT.
   4. DOES ANYBODY OTHER THAN YOURSELF HAVE  A  LEASE,  EASEMENT  OR  ANY
      OTHER  RIGHT  TO USE OR OCCUPY ANY PART OF YOUR PROPERTY OTHER THAN
      THOSE STATED IN DOCUMENTS AVAILABLE IN THE PUBLIC RECORD,  SUCH  AS
      RIGHTS TO USE A ROAD OR PATH OR CUT TREES OR CROPS. YES NO UNKN NA
   5. DOES  ANYBODY  ELSE CLAIM TO OWN ANY PART OF YOUR PROPERTY?  YES NO
      UNKN NA (IF YES, EXPLAIN BELOW)
   6. HAS ANYONE DENIED YOU ACCESS TO THE PROPERTY OR MADE A FORMAL LEGAL
      CLAIM CHALLENGING YOUR TITLE TO THE PROPERTY? YES NO  UNKN  NA  (IF
      YES, EXPLAIN BELOW)
   7. ARE  THERE  ANY  FEATURES  OF  THE  PROPERTY  SHARED IN COMMON WITH
      ADJOINING LAND OWNERS OR A HOMEOWNERS ASSOCIATION, SUCH  AS  WALLS,
      FENCES OR DRIVEWAYS? YES NO UNKN NA (IF YES DESCRIBE BELOW)
   8. ARE  THERE  ANY  ELECTRIC OR GAS UTILITY SURCHARGES FOR LINE EXTEN-
      SIONS, SPECIAL ASSESSMENTS OR HOMEOWNER OR OTHER  ASSOCIATION  FEES
      THAT APPLY TO THE PROPERTY? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
   9. ARE  THERE  CERTIFICATES OF OCCUPANCY RELATED TO THE PROPERTY?  YES
      NO UNKN NA (IF NO, EXPLAIN BELOW)
 
 ENVIRONMENTAL
   NOTE TO SELLER - IN THIS SECTION, YOU WILL BE ASKED QUESTIONS  REGARD-
 ING  PETROLEUM  PRODUCTS AND HAZARDOUS OR TOXIC SUBSTANCES THAT YOU KNOW
 TO HAVE BEEN SPILLED, LEAKED OR OTHERWISE BEEN RELEASED ON THE  PROPERTY
 OR  FROM  THE  PROPERTY  ONTO ANY OTHER PROPERTY. PETROLEUM PRODUCTS MAY
 INCLUDE, BUT ARE NOT LIMITED TO, GASOLINE,  DIESEL  FUEL,  HOME  HEATING
 FUEL,  AND  LUBRICANTS.  HAZARDOUS  OR  TOXIC SUBSTANCES ARE PRODUCTS OR
 OTHER MATERIAL THAT COULD POSE SHORT- OR LONG-TERM  DANGER  TO  PERSONAL
 HEALTH  OR THE ENVIRONMENT IF THEY ARE NOT PROPERLY DISPOSED OF, APPLIED
 OR STORED.  THESE INCLUDE, BUT ARE NOT LIMITED TO,  FERTILIZERS,  PESTI-
 CIDES  AND  INSECTICIDES, PAINT INCLUDING PAINT THINNER, VARNISH REMOVER
 AND WOOD PRESERVATIVES, TREATED WOOD,  CONSTRUCTION  MATERIALS  SUCH  AS
 ASPHALT AND ROOFING MATERIALS, ANTIFREEZE AND OTHER AUTOMOTIVE PRODUCTS,
 A. 10895                            3
 
 BATTERIES,  CLEANING  SOLVENTS INCLUDING SEPTIC TANK CLEANERS, HOUSEHOLD
 CLEANERS [AND], POOL CHEMICALS [AND], PRODUCTS  CONTAINING  MERCURY  AND
 LEAD AND INDOOR MOLD.
 
   NOTE  TO  BUYER  -  IF  CONTAMINATION  OF THIS PROPERTY FROM PETROLEUM
 PRODUCTS AND/OR HAZARDOUS OR TOXIC SUBSTANCES IS A CONCERN TO  YOU,  YOU
 ARE URGED TO CONSIDER SOIL AND GROUNDWATER TESTING OF THIS PROPERTY.
   10. IS  ANY OR ALL OF THE PROPERTY LOCATED IN A DESIGNATED FLOODPLAIN?
       YES  NO  UNKN  NA (IF YES, EXPLAIN BELOW)
   11. IS ANY OR ALL OF THE PROPERTY LOCATED  IN  A  DESIGNATED  WETLAND?
       YES  NO  UNKN  NA (IF YES, EXPLAIN BELOW)
   12. IS  THE  PROPERTY  LOCATED  IN AN AGRICULTURAL DISTRICT?   YES  NO
       UNKN  NA (IF YES, EXPLAIN BELOW)
   13. WAS THE PROPERTY EVER THE SITE OF A LANDFILL?  YES  NO   UNKN   NA
       (IF YES, EXPLAIN BELOW)
   14. ARE  THERE  OR  HAVE  THERE  EVER BEEN FUEL STORAGE TANKS ABOVE OR
       BELOW THE GROUND ON THE PROPERTY?  YES  NO  UNKN  NA  IF YES,  ARE
       THEY CURRENTLY IN USE? YES NO UNKN NA LOCATION(S) ARE THEY LEAKING
       OR HAVE THEY EVER LEAKED? YES NO UNKN NA (IF YES, EXPLAIN BELOW)
   15. IS  THERE ASBESTOS IN THE STRUCTURE? YES NO UNKN NA (IF YES, STATE
       LOCATION OR LOCATIONS BELOW)
   16. IS LEAD PLUMBING PRESENT? YES NO UNKN NA (IF YES,  STATE  LOCATION
       OR LOCATIONS BELOW)
   17. HAS  A RADON TEST BEEN DONE? YES NO UNKN NA (IF YES, ATTACH A COPY
       OF THE REPORT)
   18. HAS MOTOR FUEL, MOTOR OIL, HOME HEATING FUEL, LUBRICATING  OIL  OR
       ANY  OTHER  PETROLEUM  PRODUCT,  METHANE  GAS, OR ANY HAZARDOUS OR
       TOXIC SUBSTANCE SPILLED, LEAKED OR OTHERWISE BEEN RELEASED ON  THE
       PROPERTY  OR  FROM  THE  PROPERTY ONTO ANY OTHER PROPERTY?  YES NO
       UNKN NA (IF YES, DESCRIBE BELOW)
   19. HAS THE PROPERTY BEEN TESTED FOR THE PRESENCE OF MOTOR FUEL, MOTOR
       OIL, HOME HEATING FUEL, LUBRICATING OIL, OR  ANY  OTHER  PETROLEUM
       PRODUCT,  METHANE GAS, OR ANY HAZARDOUS OR TOXIC SUBSTANCE? YES NO
       UNKN NA (IF YES, ATTACH REPORT(S))
   19-A.  HAS THE PROPERTY BEEN TESTED FOR INDOOR MOLD? YES NO  UNKN  (IF
       YES, ATTACH A COPY OF THE REPORT)
 
 STRUCTURAL
   20. IS  THERE  ANY ROT OR WATER DAMAGE TO THE STRUCTURE OR STRUCTURES?
       YES NO UNKN NA (IF YES, EXPLAIN BELOW)
   21. IS THERE ANY FIRE OR SMOKE DAMAGE TO THE STRUCTURE OR  STRUCTURES?
       YES NO UNKN NA (IF YES, EXPLAIN BELOW)
   22. IS  THERE  ANY  TERMITE,  INSECT,  RODENT  OR  PEST INFESTATION OR
       DAMAGE?  YES NO UNKN NA (IF YES, EXPLAIN BELOW)
   23. HAS THE PROPERTY BEEN TESTED FOR TERMITE, INSECT, RODENT  OR  PEST
       INFESTATION  OR  DAMAGE?  YES  NO  UNKN  NA (IF YES, PLEASE ATTACH
       REPORT(S))
   24. WHAT IS THE TYPE OF ROOF/ROOF COVERING (SLATE,  ASPHALT,  OTHER.)?
       ANY KNOWN MATERIAL DEFECTS? HOW OLD IS THE ROOF? IS THERE A TRANS-
       FERABLE  WARRANTEE  ON  THE ROOF IN EFFECT NOW? YES NO UNKN NA (IF
       YES, EXPLAIN BELOW)
   25. ARE THERE ANY KNOWN MATERIAL  DEFECTS  IN  ANY  OF  THE  FOLLOWING
       STRUCTURAL  SYSTEMS: FOOTINGS, BEAMS, GIRDERS, LINTELS, COLUMNS OR
       PARTITIONS. YES NO UNKN NA (IF YES, EXPLAIN BELOW)
 A. 10895                            4
 
 MECHANICAL SYSTEMS & SERVICES
   26. WHAT  IS  THE WATER SOURCE (CIRCLE ALL THAT APPLY - WELL, PRIVATE,
       MUNICIPAL, OTHER)? IF MUNICIPAL, IS IT METERED? YES NO UNKN NA
   27. HAS THE WATER QUALITY AND/OR FLOW RATE BEEN TESTED? YES NO UNKN NA
       (IF YES, DESCRIBE BELOW)
   28. WHAT IS THE TYPE OF SEWAGE SYSTEM (CIRCLE ALL THAT APPLY -  PUBLIC
       SEWER, PRIVATE SEWER, SEPTIC OR CESSPOOL)?  IF SEPTIC OR CESSPOOL,
       AGE?  ________  DATE  LAST  PUMPED? ________ FREQUENCY OF PUMPING?
       ________ ANY KNOWN MATERIAL DEFECTS?   YES NO  UNKN  NA  (IF  YES,
       EXPLAIN BELOW)
   29. WHO IS YOUR ELECTRIC SERVICE PROVIDER? ________ WHAT IS THE AMPER-
       AGE?  ________  DOES  IT  HAVE CIRCUIT BREAKERS OR FUSES? ________
       PRIVATE OR PUBLIC POLES? ________ ANY KNOWN MATERIAL DEFECTS?  YES
       NO UNKN NA (IF YES, EXPLAIN BELOW)
   30. ARE THERE ANY FLOODING, DRAINAGE OR GRADING PROBLEMS THAT RESULTED
       IN  STANDING  WATER ON ANY PORTION OF THE PROPERTY? YES NO UNKN NA
       (IF YES, STATE LOCATIONS AND EXPLAIN BELOW)
   31. DOES THE BASEMENT HAVE SEEPAGE THAT RESULTS IN STANDING WATER? YES
       NO UNKN NA (IF YES, EXPLAIN BELOW)
       ARE THERE ANY KNOWN MATERIAL DEFECTS IN ANY OF THE  FOLLOWING  (IF
       YES, EXPLAIN BELOW. USE ADDITIONAL SHEETS IF NECESSARY.):
   32. PLUMBING SYSTEM?            YES NO UNKN NA
   33. SECURITY SYSTEM?            YES NO UNKN NA
   34. CARBON MONOXIDE DETECTOR?   YES NO UNKN NA
   35. SMOKE DETECTOR?             YES NO UNKN NA
   36. FIRE SPRINKLER SYSTEM?      YES NO UNKN NA
   37. SUMP PUMP?                  YES NO UNKN NA
   38. FOUNDATION/SLAB?            YES NO UNKN NA
   39. INTERIOR WALLS/CEILINGS?    YES NO UNKN NA
   40. EXTERIOR WALLS OR SIDING?   YES NO UNKN NA
   41. FLOORS?                     YES NO UNKN NA
   42. CHIMNEY/FIREPLACE OR STOVE? YES NO UNKN NA
   43. PATIO/DECK?                 YES NO UNKN NA
   44. DRIVEWAY?                   YES NO UNKN NA
   45. AIR CONDITIONER?            YES NO UNKN NA
   46. HEATING SYSTEM?             YES NO UNKN NA
   47. HOT WATER HEATER?           YES NO UNKN NA
   48. THE  PROPERTY  IS LOCATED IN THE FOLLOWING SCHOOL DISTRICT    UNKN
      NOTE: BUYER IS ENCOURAGED TO CHECK PUBLIC  RECORDS  CONCERNING  THE
      PROPERTY (E.G. TAX RECORDS AND WETLAND AND FLOOD PLAIN MAPS)
   THE  SELLER SHOULD USE THIS AREA TO FURTHER EXPLAIN ANY ITEM ABOVE. IF
 NECESSARY, ATTACH ADDITIONAL PAGES AND INDICATE HERE THE NUMBER OF ADDI-
 TIONAL PAGES ATTACHED.
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________
   SELLER'S CERTIFICATION: SELLER CERTIFIES THAT THE INFORMATION IN  THIS
 PROPERTY  CONDITION  DISCLOSURE  STATEMENT  IS  TRUE AND COMPLETE TO THE
 SELLER'S ACTUAL KNOWLEDGE AS OF THE DATE SIGNED  BY  THE  SELLER.  IF  A
 SELLER  OF  RESIDENTIAL  REAL  PROPERTY ACQUIRES KNOWLEDGE WHICH RENDERS
 MATERIALLY INACCURATE A PROPERTY CONDITION DISCLOSURE STATEMENT PROVIDED
 PREVIOUSLY, THE  SELLER  SHALL  DELIVER  A  REVISED  PROPERTY  CONDITION
 DISCLOSURE  STATEMENT  TO THE BUYER AS SOON AS PRACTICABLE. IN NO EVENT,
 HOWEVER, SHALL A SELLER BE REQUIRED TO PROVIDE A REVISED PROPERTY CONDI-
 A. 10895                            5
 
 TION DISCLOSURE STATEMENT AFTER THE TRANSFER OF TITLE FROM THE SELLER TO
 THE BUYER OR OCCUPANCY BY THE BUYER, WHICHEVER IS EARLIER.
   SELLER__________ DATE___________
   SELLER__________ DATE___________
   BUYER'S  ACKNOWLEDGMENT:  BUYER ACKNOWLEDGES RECEIPT OF A COPY OF THIS
 STATEMENT AND BUYER UNDERSTANDS THAT THIS INFORMATION IS A STATEMENT  OF
 CERTAIN  CONDITIONS AND INFORMATION CONCERNING THE PROPERTY KNOWN TO THE
 SELLER. IT IS NOT A WARRANTY OF ANY KIND BY THE SELLER OR SELLER'S AGENT
 AND IS NOT A SUBSTITUTE FOR ANY HOME, PEST, RADON OR  OTHER  INSPECTIONS
 OR TESTING OF THE PROPERTY OR INSPECTION OF THE PUBLIC RECORDS.
   BUYER__________ DATE__________
   BUYER__________ DATE _________
   §  2.    This  act  shall take effect on the one hundred eightieth day
 after it shall have become a law; provided, however, that this act shall
 apply to contracts of sale for real property entered into  on  or  after
 such effective date.