Entry
New front door
Half bath remodel 2025
New floor, wall panels
Living room
Owner Improvements
2nd floor full bath Full remodel 2018
New vanity with marble counter, floors, tile bath surround
Exterior
New front concrete porch and walkway 2022
Updated landscaping
Backyard Cedar fence, fully enclosed 2018
Refreshed fireplace with marble tile
Gas fireplace insert w/ remote start
Cafe shutters
Kitchen Full remodel 2019
New cabinets with soft close
New appliances
New marble counters
New floors
Breakfast room Full remodel 2019
New floors
Added pantry cabinets
French doors leading to new patio
Family Room
Cafe shutters
New flooring 2019
New mini split HVAC 2018
Main bedroom full bath Full remodel 2018
New vanity with marble counter,
tile floors,
tile & marble shower
Concrete patio 2019
New hvac systems 2023
Miscellaneous
Updated 200amp electrical panel
Updated plumbing throughout, replaced stacks
Recent paint throughout
Attic pull-down access added. Flooring added for attic storage
Security system 2018
Recent tuckpointing
Newer roof 2017
Newer windows
This document has legal consequences. If you do not understand it, consult your attorney. The text of this form may not be altered in any manner without written acknowledgement of all parties.
DISCLOSURE OF INFORMATION ON LEAD-BASED PAINT AND/OR LEAD-BASED PAINT HAZARDS
Every Buyer 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
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.
(a) Presence of lead-based paint and/or lead-based paint hazards (check one below):
Seller has no knowledge of lead-based paint and/or lead-based paint hazards
in the
Known lead-based
(b) Records and
and/or lead-based paint hazards are present in the housing (explain):
(check one below):
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 all documents below):
Seller has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing.
Buyer has received copies of all information listed above (leave blank if none provided to Buyer.)
received the pamphlet Protect Your Family From Lead in Your Home.
Received a 10-day opportunity (or mutually agreed upon period) to conduct a risk assessment or inspection of the presence of
ead - b ased paint or lead
based hazards; or
Waived the opportunity to conduct a risk assessment or inspection for the presence of lead-based paint and/or lead-based paint
hazards.
or if
above and certify, to the
and is aware of his/her responsibility to ensure compliance.
of their knowledge, that the information they have provided is true
This document has legal consequences. If you do not understand it, consult your attorney. The text of this form may not be altered in any manner without written acknowledgement of all parties.
Form # 2091 01/25
Property Address :
Approved by Counsel for St. Louis
To be used exclusively by REALTOR® members of St Louis REALTORS® and those issued a use license by St Louis REALTORS®
SELLER’S DISCLOSURE STATEMENT
Note: If Seller knows or suspects some condition which might lower the value of the property being sold or adversely affect Buyer's decision to buy the property, then Seller needs to disclose it. This statement will assist Buyer in evaluating the property being considered. Real estate brokers and agents involved in the sale do not inspect the property for defects, and they cannot guarantee the accuracy of the information in this form.
TO SELLER: Your truthful disclosure of the condition of your property gives you the best protection against future charges that you violated your legal obligation to Buyer by concealing a material defect(s), lead-based paint, use as a site for methamphetamine production or storage and/or any other disclosure required by law. Your knowledge of the property prior to your ownership may be relevant. In the case of a material defect, for example, if information that you possess indicates some persistent pattern of a problem not completely remedied, such information should be included in this disclosure in order to achieve full and honest disclosure. Your answers or the answers you fail to provide, either way, may have legal consequences, even after the closing of the sale. This questionnaire should help you meet your disclosure obligation, but it may not cover all aspects of your property. If you know of or suspect some condition which would substantially lower the value of the property, impair the health or safety of future occupants, or otherwise affect Buyer's decision to buy your property, then use the space at the end of this form to describe that condition.
TO BUYER: THIS INFORMATION IS A DISCLOSURE ONLY AND IS NOT INTENDED TO BE A PART OF ANY CONTRACT BETWEEN BUYER AND SELLER. If you sign a contract to purchase the property, that contract, and not this disclosure statement, will provide for what is to be included in the sale. So, if you expect certain items, appliances, or equipment included, you must specify them in the contract. Since these disclosures are based on the Seller's knowledge, you cannot be sure that there are, in fact, no problems with the property simply because the Seller is not aware of them The answers given by the Seller are not warranties of the condition of the property. Thus, you should condition your offer on a professional inspection of the property. You may also wish to obtain a home protection plan/warranty. Due to the variety of insurance, requirements, products, and arrangements Buyer should contact appropriate party to determine insurance coverage needed. Conditions of the property that you can see on a reasonable inspection should either be taken into account in the purchase price or you should make the correction of these conditions by the Seller a requirement of the sale contract.
STATUTORY DISCLOSURES
Note: The following information, if applicable to the property, is required by federal or state law to be disclosed to prospective buyers. Local laws and ordinances may require additional disclosures.
LEAD-BASED PAINT
1 Does the Property include a residential dwelling built prior to 1978? If “Yes,” 42 U.S.C. 4852d and EPA regulations promulgated pursuant thereto require that a completed Disclosure of Information and Acknowledgement Lead Based Paint and/or Lead-Based Paint Hazards form (Form #2049) must be signed by Seller and any involved real estate licensee(s) and given to any potential buyer.
2 Please explain any “Yes” answers you gave in this section:
The house was built prior to 1978 and likely contains lead-based paint. However, the owner has not
tested for the presence of lead-based paint and cannot identify areas with lead-based paint.
3 Are you aware if the Property is or was used as a site for methamphetamine production or the place of residence of a person convicted of a crime involving methamphetamine or a derivative controlled substance related thereto? If “Yes,” §442.606 RSMo requires you to disclose such facts in writing.
4 Please explain any “Yes” answers you gave in this section:
WASTE DISPOSAL SITE OR DEMOLITION
5 Are you aware of any permitted or unpermitted solid waste disposal site or demolition landfill on the property? If “Yes,” Section 260.213 RSMo requires Seller to disclose the location of any such site on the Property. Note: If Seller checks “Yes,” Buyer may be assuming liability to the State for any remedial action at the property.
6 Please explain any “Yes” answers you gave in this section:
7 Have you ever received a report stating affirmatively that the Property is or was previously contaminated with radioactive material or other hazardous material? If “Yes,” §442.055 RSMo requires you to disclose such knowledge in writing. Please provide such information, including a copy of such report, if available.
8 Please explain any “Yes” answers you gave in this section:
ADDITIONAL DISCLOSURES
Lead-Based Paint
9 Are you aware of the presence of any lead hazards (such as paint, water supply lines, etc.) on the property?
10 Are you aware if it has ever been covered or removed?
11 Are you aware if the property has been tested for lead?
12 Please explain any “Yes” answers you gave in this section including test date, type of test and results:
13 Are you aware if the property has been tested for radon gas?
14 Are you aware if the property has ever been mitigated for radon gas?
15 Please explain any “Yes” answers you gave in this section:
16 Are you aware of the presence of any mold on the property?
17 Are you aware of anything with mold on the property that has ever been covered or removed?
18 Are you aware if the property has ever been tested for the presence of mold?
19 Please explain any “Yes” answers you gave in this section: Asbestos Materials
20 Are you aware of the presence of asbestos materials on the property, such as roof shingles, siding, insulation, ceiling, flooring, pipe wrap, etc.?
21 Are you aware of any asbestos material that has been encapsulated or removed?
22 Are you aware if the property has been tested for the presence of asbestos?
23 Please explain any “Yes” answers you gave in this section:
24 Are you aware of any other environmental concerns that may affect the property such as polychlorinated biphenyls (PCB’s), electro-magnetic fields (EMF’s), underground fuel tanks, unused septic or storage tanks, etc.?
25 Please explain any “Yes” answers you gave in this section: SUBDIVISION,
OR OTHER SHARED COST DEVELOPMENT
32 Are you aware of any existing or proposed special assessments?
33 Are you aware of any special taxes and/or district improvement assessments?
34 Are you aware of any condition or claim which may cause an increase in assessment or fees?
35 Are you aware of any material defects in any common or other shared elements?
36 Are you aware of any existing indentures/restrictive covenants?
37 Are you aware of any violation of the indentures/restrictions by yourself or by others?
38 Is there a recorded shared driveway/street/road maintenance agreement?
39 Is there a driveway/street/road that is not maintained by city or county? If so, please explain in description
40 Please explain any “Yes” answers you gave in this section:
UTILITIES
46
HEATING, VENTILATION AND COOLING ("HVAC") SYSTEMS
50
52 Zone
53 Zone 2:
Type of Air Conditioner:
54 Zone 1: Age _____ Brand
55 Zone 2: Age _____ Brand _________________
56 Are you aware of any problems or issues with any part of the HVAC system?
57 Do you have any existing maintenance agreements in place?
58 Are any areas of the home not covered by central heating /cooling?
59 With respect to the last service/repair made to the HVAC system, please describe in detail the scope of work, date, name of person/company who did the work and cost:
60 Please explain any “Yes” or “Other” answers you gave in this section: FIREPLACE(S)
61 Location 1:
62 Location 2: Room: _______________________
63 Location 3: Room: _______________________
64 Are you aware of any problems or repairs needed with any item in this section?
65 Please explain any “Yes” or “No” answers you gave in this section:
69 Does the property have an ice-maker supply line?
70 Is property equipped with a Lawn Irrigation System? If yes, please provide date of last backflow device inspection certificate.
71 Are you aware of any problems or repairs needed in the plumbing system?
72 Does property have a Swimming Pool/Spa/Hot Tub? (If “Yes,” attach Form #2180, Pool/Spa/Pond/Lake Addendum to Seller’s Disclosure Statement.)
73 Please explain any “Yes” or “Other” answers you gave in this section:
WATER (If well exists, attach Form #2165, Septic/Well Addendum to Seller’s Disclosure Statement)
74 What is the source of your drinking water? Public Community Well Other ______________________________
75 If well, when was the water last tested? __________ Is test documented? Yes or No. If yes, please provide documentation.
76 Do you have a water softener? Yes or No. If yes, is it Owned or Leased. If leased, provide lessor and cost below. YES NO UNK
77 Are you aware of any problems relating to the water system including the quality or source of water or any components such as the curb stop box?
78 Please explain any “Yes” answers you gave in this section and water softener lease information if applicable :
SEWERAGE (If Septic or Aerator exists, attach Form #2165, Septic/Well Addendum to Seller’s Disclosure Statement)
79 What is the type of sewerage system to which the house is connected? Public Private Septic Aerator Other If Other, please explain:
80 If septic/aerator, when was system last serviced?
81 Is there a sewerage lift system?
82 Is there a sewerage grinder system?
83 Are you aware of any leaks, backups, open drain lines or other problems relating to the sewerage system?
84 Please explain any “Yes” answers you gave in this section:
ELECTRICAL (Note: Certain types of electrical panels have been subject to recall)
Type of Service Panel(s):
85 Panel 1: Amps _______ Brand
86 Panel 2: Amps _______ Brand __________________
87 Panel 3: Amps _______ Brand __________________
Type of Wiring:
88 Panel 1:
89 Panel 2:
90 Panel 3:
91 Are you aware of any problems or repairs needed in the electrical system?
92 Are you aware of any of the panels in services in the property being subject to recall or otherwise out of date?
93 Please explain any “Yes” answers you gave in this section:
CONSTRUCTION
94 The property was originally constructed in: . Seller has occupied property from to .
95 List all significant additions, modifications, renovations, & alterations to the property during your ownership below:
96 Were required permits obtained for the work described above?
97 Please explain any “No” answers you gave in this section: