INFORMATION FOR MAKING AN OFFER (OPTIONAL) This form does not constitute a disclosure or offer and SHALL NOT become part of any Residential Sales Contract. This information is provided for the sole purpose of assisting Cooperating agent(s) in preparing offers. Seller makes no representations or warranties regarding the accuracy of the information contained in this Information Sheet. SELLER’S INFORMATION Seller Name(s): Jean Jaques Engelbrecht & Carol Alyssa Engelbrecht Preferred Delivery: Mailing Address OR Fax OR Email (check all that apply): FIRPTA: Seller IS OR IS NOT a “Foreign Person,” as defined by the Foreign Investment in Real Property Tax Act (FIRPTA). 1031 Exchange – Seller is selling Property as part of a 1031 Exchange: Yes OR No Real Estate Licensed/Related Parties: Seller is an active OR inactive licensed real estate agent in Virginia and/or Other . Listing Broker/Agent is related to Seller. PROPERTY INFORMATION Tax Map/ID # 0781 10 0136 Legal Description: Lot(s) 136 Section Subdivision or Condominium Greenfield Farm Parking Space(s) # 136 County/Municipality Deed Book/Liber # Page/Folio # Street Address 5454 Crossrail Drive Unit # City Burke ZIP Code 22015 Mailbox Number: 6 Storage Unit Number(s): Property Subject to: Condominium Association Cooperative Association Property Owners Association Association Name: Greenfield Farm Phone #: Management Company: Phone #: Lead-Based Paint: Residential dwellings at Property were OR were not constructed before 1978. Other: UTILITIES INFORMATION Water Supply: Public Private Well Community Well Hot Water: Oil Gas Elec. Other: Air Conditioning: Oil Gas Elec. Heat Pump Other Zones Heating: Oil Gas Elec. Heat Pump Other Zones Sewage Disposal: Public Septic for # BR Community Septic Alternative Septic for # BR: Other: (If applicable) Association Fee Includes Following Utilities:
Utility Companies/Name: Electric: Dominion Water: Fairfax
NVAR – K1385 – 01/22
Gas/Oil: NO Trash: HOA
Pick-up Day(s):
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