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.
SELLER’S DISCLOSURE STATEMENT
Form # 2091 01/20 ©ST. LOUIS REALTORS® Approved by Counsel for St. Louis REALTORS® To be used exclusively by REALTORS® Page 1 of 6 _______/_______ Initials BUYER and SELLER acknowledge they have read this page________/________ BUYER BUYER SELLER SELLER
1
2
3
4
Real estate brokers and agents
5 guarantee the accuracy of the information in this form. 6 TO SELLER: Your truthful disclosure of the condition of your property gives you the best protection against
7 that you violated your legal obligation to Buyer by concealing a material defect(s), lead-based paint, use as a site for 8 methamphetamine production or storage and/or any other disclosure required by law. Your knowledge of the property prior to 9 your ownership may be relevant. In the case of a material defect, for example, if information that you possess indicates some 10 persistent pattern of a problem not completely remedied, such information should be included in this disclosure in order to 11 achieve full and honest disclosure. Your answers or the answers you fail to provide, either way, may have legal consequences, 12 even after the closing of the sale. This questionnaire should help you meet your disclosure obligation, but it may not cover all 13 aspects of your property. If you know of or suspect some condition which would substantially lower the value of the property, 14 impair the health or safety of future occupants, or otherwise affect Buyer's decision to buy your property, then use the space at 15 the end of this form to describe that condition. 16 TO BUYER: THIS INFORMATION IS A DISCLOSURE ONLY AND IS NOT INTENDED TO BE A PART OF ANY 17 CONTRACT BETWEEN BUYER AND SELLER. If you sign a contract to purchase the property, that contract, and not this 18 disclosure statement, will provide for what is to be included in the sale. So, if you expect certain items, appliances, or equipment 19 included, you must specify them in the contract. Since these disclosures are based on the Seller's knowledge, you cannot be sure 20 that there are, in fact, no problems with the property simply because the Seller is not aware of them. The answers given by the 21 Seller are not warranties of the condition of the property. Thus, you should condition your offer on a professional inspection of 22 the property. You may also wish to obtain a home protection plan/warranty. Due to the variety of insurance, requirements, 23 products, and arrangements Buyer should contact appropriate party to determine insurance coverage needed. 24 Conditions of the property that you can see on a reasonable inspection should either be taken into account in the purchase price 25 or you should make the correction of these conditions by the Seller a requirement of the sale contract. 26 SUBDIVISION, CONDOMINIUM, VILLA, CO-OP OR OTHER SHARED COST DEVELOPMENT (if applicable) 27 (a) Development Name 28 (b) Contact Phone 29 Type of Property: (check all that apply) Single-Family Residence Multi-Family Condominium Townhome 30 Villa Co-Op 31 (c) Mandatory Assessment: #1 ________________________________ $ ______ per: month quarter half-year year 32 Mandatory Assessment: #2 ________________________________$ _________ per: month quarter half-year year 33 (d) Mandatory Assessment(s) include: 34 entrance sign/structure street maintenance common ground snow removal of common area 35 snow removal specific to this dwelling landscaping of common area landscaping specific to this dwelling 36 clubhouse pool tennis court exercise area reception facility water sewer trash removal 37 doorman cooling heating security elevator other common facility _______________________ 38 assigned parking space(s): how many _________ identified as _________ some insurance real estate taxes 39 other specific item(s): 40 Exterior Maintenance of this dwelling covered by Assessment: 41 (e) Optional Assessment(s)/Membership(s) Please explain ___________________________________________________________ 42 43 (f) Are you aware of any existing or proposed special assessments? Yes No 44 (g) Are you aware of any special taxes and/or district improvement assessments? Yes No 45 (h) Are you aware of any condition or claim which may cause an increase in assessment or fees? Yes No 46 (i) Are you aware of any material defects in any common or other shared elements? Yes No 47 (j) Are you aware of any existing indentures/restrictive covenants? Yes No 48 (k) Are you aware of any violation of the indentures/restrictions by yourself or by others? Yes No 49 (l) Is there a recorded street/road maintenance agreement? Yes No 50 (m) Please explain any "Yes" answer you gave for (e), (f), (g), (h), (i), (j) or (k) above: _____________________________________ 51 52 St. Louis Wildwood 2525 Ossenfort Rd, Wildwood, MO 63038 Created by Ted Wight with SkySlope® Forms DigiSign Verified - d2142866-92cd-4270-b4ed-c153229115ba LLZ WCZ 4 4 4 4 4 4
To be completed by SELLER concerning ___________________________________________________(Property Address) located
in the municipality of (if incorporated), County of , Missouri.
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.
involved in the sale do not inspect the property for defects, and they cannot
future charges
Page 2 of 6 _______/_______ Initials BUYER and SELLER acknowledge they have read this page________/________ BUYER BUYER SELLER SELLER UTILITIES 53 Utility Current Provider 54 Gas/Propane: _____ if Propane, is tank Owned Leased 55 Electric: 56 Water: _ 57 Sewer: _ _ 58 Trash: _ 59 Recycle: 60 Internet: _ 61 Phone: _ 62 HEATING, COOLING AND VENTILATING (Seller is not agreeing that all items checked are being offered for sale.) 63 (a) Heating Equipment: Forced Air Hot Water Radiators Steam Radiators Radiant Baseboard 64 (b) Source of heating: Electric Natural Gas Propane Fuel Oil Other 65 (c) Type of air conditioning: Central Electric Central Gas Window/Wall (Number of window units ) 66 (d) Areas of house not served by central heating/cooling: _____________________________________________________ 67 (e) Additional: Humidifier Electronic Air Filter Media Filter Attic Fan Other: ___________________________ 68 (f) Are you aware of any problems or repairs needed with any item in this section? Yes No If "Yes", please explain 69 70 (g) Other details: __________________________________________________________________________________ 71 FIREPLACE(S) 72 (a) Type of fireplace: Wood Burning Vented Gas Logs Vent Free Gas Logs Wood Burning Stove Natural Gas Propane 73 (b) Type of flues/venting: 74 Functional: (properly vented for wood burning and vented gas logs) Number of fireplace(s) Location(s)________________ 75 Non-Functional: Number of fireplace(s) Location(s)______Please explain 76 (c) Are you aware of any problems or repairs needed with any item in this section? Yes No If "Yes", please explain 77 78 PLUMBING SYSTEM, FIXTURES AND EQUIPMENT; POOL/SPA/POND/LAKE/HOT TUB 79 (a) Water Heater: Electric Natural Gas Propane Tankless Other: 80 (b) Ice maker supply line: Yes No 81 (c) Jet Tub: Yes No 82 (d) Swimming Pool/Spa/Hot Tub: Yes No 83 (If Yes, attach Form #2180, Pool/Spa/Pond/Lake Addendum to Seller’s Disclosure Statement) 84 (e) Lawn Sprinkler System: Yes No If yes, date of last backflow device inspection certificate: _________________ 85 (f) Are you aware of any problems or repairs needed in the plumbing system? Yes No If "Yes", please explain ______ 86 87 WATER (If well exists, attach Form #2165, Septic/Well Addendum to Seller’s Disclosure Statement) 88 (a) What is the source of your drinking water? Public Community Well Other (explain)____________________________ 89 (b) If Public, identify the utility company: 90 (c) Do you have a softener, filter or other purification system? Yes No Owned Leased/Lease Information 91 (d) Are you aware of any problems relating to the water system including the quality or source of water or any components such as 92 the curb stop box? Yes No If "Yes”, please explain 93 SEWERAGE (If Septic or Aerator exists, attach Form #2165, Septic/Well Addendum to Seller’s Disclosure Statement) 94 (a) What is the type of sewerage system to which the house is connected? Public Private Septic Aerator Other 95 If “Other” please explain 96 (b) Is there a sewerage lift system? Yes No If "Yes", is it in good working condition? Yes No 97 (c) When was the septic/aerator system last serviced? 98 (d) Are you aware of any leaks, backups, open drain lines or other problems relating to the sewerage system? Yes No 99 If "Yes", please explain 100 APPLIANCES (Seller is not agreeing that all items checked are being offered for sale.) 101 (a) Electrical Appliances and Equipment: Electric Stove/Range/Cook top Oven Built-in Microwave Oven 102 Dishwasher Garbage Disposal Trash Compactor Wired smoke alarms Electric dryer (hook up) 103 Ceiling Fan(s) Intercom System Central Vacuum System Other 104 (b) Gas Appliances & Equipment: Natural Gas Propane 105 Oven Gas Stove/Range/Cook top Exterior Lights Barbecue Water heater Tankless Water Heater 106 Gas dryer (hook up) Other 107 (c) Other Equipment: TV Antenna Cable Wiring Phone Wiring Nework/DataWiring 108 Electric Garage Door Opener(s) Number of controls 109 Security Alarm System Owned Leased /Lease information: _________ 110 DigiSign Verified - d2142866-92cd-4270-b4ed-c153229115ba LLZ WCZ Septic 4 4 4 4 4 4 2 4 4 Newer unit in the main house 4 4 Fall 2023 4 4 4 4 4 4 Propane in detached garage System is anaerobic w/o aerator - no issues 4 4 4 4 4 4 Well Culligan Main floor 4 4 Gateway - Special service at attached garage door 4 4 4 None Amerigas - 3 tanks leased ATT-Direct TV, Spectrum available - Super Fast! 4 2012 Ground source, propane 4 4 3 door openers 4 4 Gateway 4 4 4 Ameren ATT 4 Ice makers not working - not repairable 4
Page 3 of 6 _______/_______ Initials BUYER and SELLER acknowledge they have read this page________/________ BUYER BUYER SELLER SELLER Satellite Dish Owned Leased/Lease Information: 111 Electronic Pet Fence System Number of Collars: _____________ Other: ____________________________________ 112 (d) Are you aware of any items in this section in need of repair or replacement? Yes No If "Yes", please explain 113 114 ELECTRICAL 115 Type of service panel: Fuses Circuit Breakers Other: _ 116 (a) Type of wiring: Copper Aluminum Knob and Tube Unknown 117 (b) Are you aware of any problems or repairs needed in the electrical system? Yes No If "Yes", please explain ___________ 118 119 ROOF, GUTTERS AND DOWNSPOUTS 120 (a) What is the approximate age of the roof? Years. Documented? Yes No 121 (b) Has the roof ever leaked during your ownership? Yes No If "Yes" please explain _______________ 122 123 (c) Has the roof been repaired, recovered or any portion of it replaced or recovered during your ownership? Yes No If "Yes", 124 please explain _ 125 (d) Are you aware of any problems with the roof, gutters or downspouts? Yes No If "Yes", please explain 126 127 CONSTRUCTION 128 (a) Are you aware of any problems with the footing, foundation walls, sub-floor, interior and exterior walls, roof construction, 129 decks/porches or other load bearing components? Yes No If "Yes" please describe in detail 130 131 (b) Are you aware of any repairs to any of the building elements listed in (a) above? Yes No If "Yes", please describe the 132 location, extent, date and name of the person/company who did the repair or control effort _______________________________ 133 134 (c) Are you aware that any of the work in (b) above was completed without required permits? Yes No 135 (d) List all significant additions, modifications, renovations, & alterations to the property during your ownership: 136 137 (e) Were required permits obtained for the work in (d) above? Yes No 138 BASEMENT AND CRAWL SPACE (Complete only if applicable) 139 (a) Sump pit Sump pit and pump 140 (b) Type of foundation: Concrete Stone Cinder Block Wood 141 (c) Are you aware of any dampness, water accumulation or leakage, in the basement or crawl space? Yes No If “Yes”, please 142 describe in detail __________________________________________________________________________________________________ 143 144 145
Are you aware of any repairs or other attempts to
any water or dampness problem in the basement or crawl space? 146 Yes No If "Yes", please describe the location, extent, date and name of the person/company who did the repair or control 147 effort 148 149 PESTS OR TERMITES/WOOD DESTROYING INSECTS 150 (a) Are you aware of any pests or termites/wood destroying insects impacting the property and improvements? Yes No 151 (b) Are you aware of any uncorrected damage to the property caused by pests or termites/wood destroying insects? Yes No 152 (c) Is your property currently under a warranty contract by a licensed pest/termite control company? Yes No 153 (d) Are you aware of any pest/termite control reports for the property? Yes No 154 (e) Are you aware of any pest/termite control treatments to the property? Yes No 155 (f) Please explain any "Yes" answers you gave in this section 156 157 SOIL AND DRAINAGE 158
Are you aware of any fill, expansive soil or sinkholes on the property or that may affect the property? Yes No 159 (b) Are you aware of any soil, earth movement, flood, drainage or grading problems on the property or that may affect the 160 property? Yes No 161 (c) Are you aware of any past, present or proposed mining, strip-mining, or any other excavations on the property or that may affect 162 the property? Yes No 163 (d) Are you aware of any Post-construction Stormwater Best Management Practices (BMPs) on the property? (BMPs are private 164 stormwater management facilities which include a recorded formal Maintenance Agreement with the Metropolitan Sewer District, 165 e.g. retention ponds, rain gardens, sand filters, permeable pavement) Yes No 166 (e) Please explain any “Yes” answers you gave in this section 167 168 DigiSign Verified - d2142866-92cd-4270-b4ed-c153229115ba LLZ WCZ lighting may need some bulbs replaced - detached garage 400 amp service, full backup generac 4 4 4 4 Creek on property on road easement parcel 4 4 4 4 4 4 original construction termite treatment Small area of storm damage 4 Very minor and readily flows to drain caused by overwatering and major 4 4 33 replaced decking 100% - Hillyard Painting Co 4 Direct TV 4 All baths 4 4 2014 front porch repair rain. Basement built with Owens-Corning waterproofing - drains to daylight 4 over master bath - repaired renovated, kitchen renovated, full back up power install Generac and south tip of 16.35 acre parcel 4 4 4 4 Three shingles replaced in 2012 4 4 exterior 4 4
(d)
control
(a)
HAZARDOUS SUBSTANCES/OTHER ENVIRONMENTAL CONCERNS
Page 4 of 6 _______/_______ Initials BUYER and SELLER acknowledge they have read this page________/________ BUYER BUYER SELLER SELLER
169 (a) Lead: (Note: Production of lead-based paint was banned in 1978. See Disclosure of Information and Acknowledgement Lead Based 170 Paint and/or Lead-Based Paint Hazards, form #2049.) 171 (1) Are you aware of the presence of any lead hazards (such as paint, water supply lines, etc.) on the property? Yes No 172 (2) Are you aware if it has ever been covered or removed? Yes No 173 (3) Are you aware if the property has been tested for lead? Yes No If "Yes", please give date performed, type of test and test 174 results ___________________ 175 (4) Please explain any “Yes” answers you gave in this section 176 177 (b) Asbestos Materials 178 (1) Are you aware of the presence of asbestos materials on the property, such as roof shingles, siding, insulation, ceiling, flooring, 179 pipe wrap, etc.? Yes No 180 (2) Are you aware of any asbestos material that has been encapsulated or removed? Yes No 181 (3) Are you aware if the property has been tested for the presence of asbestos? Yes No If "Yes", please give date performed, 182 type of test and test results _______________________________________________________________________________ 183 (4) Please explain any “Yes” answers you gave in this section ______________________________________________________ 184 185 (c) Mold 186 (1) Are you aware of the presence of any mold on the property? Yes No 187 (2) Are you aware of anything with mold on the property that has ever been covered or removed? Yes No 188 (3) Are you aware if the property has ever been tested for the presence of mold? Yes No If "Yes", please give date performed, 189 type of test and test results __________________ 190 (4) Please explain any “Yes” answers you gave in this section 191 _ 192 (d) Radon 193 (1) Are you aware if the property has been tested for radon gas? Yes No If "Yes", please give date performed, type of test 194 and test results __ 195 (2) Are you aware if the property has ever been mitigated for radon gas? Yes No If "Yes", please provide the date and name 196 of the person/company who did the mitigation 197 (e) Methamphetamine 198 Are you aware if the property is or was used as a lab, production or storage site for methamphetamine or was the residence of 199 a person convicted of a crime related to methamphetamine or a derivative controlled substance related thereto? 200 Yes No If "Yes", Section 442.606 RSMo requires you to disclose such facts in writing, please explain 201 202 (f) Waste Disposal Site or Demolition Landfill (permitted or unpermitted) 203 Are you aware of any permitted or unpermitted solid waste disposal site or demolition landfill on the property? Yes No 204 If "Yes", Section 260.213 RSMo requires you to disclose the location of any such site on the property. Please provide such 205 information. 206 207 Note: If Seller checks “Yes”, Buyer may be assuming liability to the State for any remedial action at the property. 208 (g) Radioactive or Hazardous Materials 209 Have you ever received a report stating affirmatively that the property is or was previously contaminated with radioactive 210 material or other hazardous material? Yes No If "Yes", Section 442.055 RSMo requires you to disclose such knowledge 211 in writing. Please provide such information, including a copy of such report, if available. 212 213 (h) Other Environmental Concerns 214 Are you aware of any other environmental concerns that may affect the property such as polychlorinated biphenyls (PCB’s), 215 electro-magnetic fields (EMF’s), underground fuel tanks, unused septic or storage tanks, etc.? Yes No If "Yes", please 216 explain 217 218 SURVEY AND ZONING 219 (a) Are you aware of any shared or common features with adjoining properties? Yes No 220 (b) Are you aware of any rights of way, unrecorded easements, or encroachments, which affect the property? Yes No 221 (c) Is any portion of the property located within the 100-year flood hazard area (flood plain)? Yes No 222 (d) Do you have a survey of the property? Yes No (If “Yes”, please attach) Does it include all existing improvements on the 223 property? Yes No 224 (e) Are you aware of any violations of local, state, or federal laws/regulations, including zoning, relating to the property? Yes No 225 (f) Please explain any “Yes” answers you gave in this section 226 _ 227 DigiSign Verified - d2142866-92cd-4270-b4ed-c153229115ba LLZ WCZ 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 damp from power washing. Mold bleached/painted 4 4 4 Heater closet in detached garage got 4 4
INSURANCE
Are you aware of any claims that have been filed for damages to the property? Yes No If “Yes”, please provide the following
information: date of claim, description of claim,
Page 5 of 6 _______/_______ Initials BUYER and SELLER acknowledge they have read this page________/________ BUYER BUYER SELLER SELLER
228
229
and/or
completed ______________________________________ 230 231 232 233
234
The approximate
235 (b) Has the property been continuously
Yes N If
explain _______ 236 237
238
explain 239 240
Is the property located in an area that requires any specific disclosure(s) from the city or county? Yes No If "Yes", please 241 explain 242 (e) Is the property designated as a historical home or located in a historic district? Yes No If "Yes", please explain 243 244
Is property tax abated? Yes No Expiration date _________________________ Attach documentation from taxing authority. 245 (g) Are you aware of any pets having been kept in or on the property? Yes No If "Yes" please explain 246 247 (h) Is the Buyer being offered a protection plan/home warranty at closing at Seller's expense? Yes No (If “Yes”, please attach) 248 (i) Are you aware of any inoperable windows or doors, broken thermal seals, or cracked/broken glass? Yes No 249 (j) Are you aware if carpet has been laid over a damaged wood floor? Yes No 250 (k) Are you aware of any existing or threatened legal action affecting the property? Yes No 251 (l) Are you aware of any consent required of anyone other than the signer(s)of this form to convey title to the property? Yes No 252 (m) Please explain any "Yes" answers you gave for (i), (j), (k), or (l) above_______________________________________________ 253 254 Additional Comments: 255 256 257 258 259 260 Seller attaches the following document(s): 261 DigiSign Verified - d2142866-92cd-4270-b4ed-c153229115ba LLZ WCZ Dogs. One 4 present 4 4 goldendoodle. Barn cats never in residence. Cabin on Wildwood Historic Registry - no restrictions 4 33 repaired 2024. New gate opener 2019. Natural eastern cedar fencing on roadway, 4 4 4 repaired but not operable. 4 2,500 feet of asphalt driveway replaced in 2017. Foundation stone veneer 4 One casement window upstairsproperty line new 2017-2019 - all done by Chesterfield Fence. 1991 4 4 4
repairs
replacements
MISCELLANEOUS
(a)
age of the residence is ________ years. The Seller has occupied the property from ___________ to _____ ____.
occupied during the last twelve months?
"No", please
(c) Is the property located in an area that requires any compliance inspection(s) including municipality, conservation, fire district or
any other required governmental authority? Yes No If "Yes", please
(d)
(f)
Page 6 of 6 SELLER’S ACKNOWLEDGEMENT: 262 Seller acknowledges that he has carefully examined this statement and that it is complete and accurate to the best of Seller's knowledge. 263 Seller agrees to immediately notify listing broker in writing of any changes in the property condition. Seller authorizes all brokers and 264 their licensees to furnish a copy of this statement to prospective Buyers. 265 266 SELLER SIGNATURE DATE SELLER SIGNATURE DATE 267 268 Seller Printed Name Seller Printed Name 269 BUYER’S ACKNOWLEDGEMENT: 270 Buyer acknowledges having received and read this Seller's Disclosure Statement. Buyer understands that the information in this Seller’s 271 Disclosure Statement is limited to information of which Seller has actual knowledge. Buyer should verify the information contained in 272 this Seller’s Disclosure Statement, and any other important information provided by either Seller or broker (including any information 273 obtained through the Multiple Listing Service) by an independent, professional investigation of his own. Buyer acknowledges that broker 274 is not an expert at detecting or repairing physical defects in property. 275 276 BUYER SIGNATURE DATE BUYER SIGNATURE DATE 277 278 Buyer Printed Name Buyer Printed Name 279 William C Zschoche Lita L Zschoche DigiSign Verified - d2142866-92cd-4270-b4ed-c153229115ba 03/31/2024 Lita L Zschoche 03/31/2024 William C Zschoche
Thisdocumenthaslegalconsequences.
Ifyoudonotunderstandit,consultyourattorney.
Thetextofthisformmaynotbealteredin anymanner withoutwrittenacknowledgementofallparties.
Form#2180 01/20 ©ST.LOUISREALTORS ApprovedbyCounselforSt.LouisREALTORS TobeusedexclusivelybyREALTORS Page1of2
shouldbeunderstoodthat
TobecompletedbySELLER concerning__________________________________________________________(PropertyAddress) 1 Note: Potentialbuyersshould be aware that the currentownermaynot usethe pool/spa/pond/lake toitsfull capacity, ifat all. 2 If one of these is being underutilized, it may falsely appear to be problem free. If it is more heavily utilized, problems may 3 surface that were previously now known or detectable. These problems may not be discovered by a pool/spa/pond/lake 4 inspection. 5 POOL 6 (A)GeneralInformation:(Giveclosestapproximationthatisknown) 7 (1)Age______(2)Shape_______(3)Size(lengthxwidth)________(4)Depth_______(5)Volume(gallons)_____________ 8 (6) Type: 9 Aboveground(pleasecheckthefollowingthatapply) Vinylliner Other_____________________________________ 10 Inground(pleasecheckthefollowingthatapply) Concrete Stainless Gunite Fiberglass Vinylliner 11 Other__________________________________________________________________________________________ 12 (7) PoolBuilder_______________________________________________________________________________________ 13 (8) Typeofchemicalsanitizer Chlorine Copper/Silver Ionizer Bacquacil Ozonator Saltwater 14 Other__________________________________________________________________________________________ 15 (9) Poolserviceprovider___________________________________Lastserviced_____________________________(date) 16 (10)Lastopenedby_______________________________________Lastclosedby_________________________________ 17 (11)Ageofheater___________________Heatingsource____________________(12)Ageofpump___________________ 18 (13)Ageoffilter____________________Typeoffilter Sand DE Other____________________________________ 19 Additionalcomments/information: 20 21 22 ____________________________________________________________________________________________________________ 23 (B)VisualComponents: Specifyifanyrepairshavebeenperformedduringyourownershiponthevisualcomponents(including, 24 butnotlimitedtothefollowing): 25 Tileandgrouting,coping,interiorfinish,caulking/expansionjointsanddeck 26 27 28 ____________________________________________________________________________________________________________ 29 (C) Deck Equipment: Specify if any repairs have been performed during your ownership on the deck equipment (including, 30 butnotlimitedtothefollowing): 31 Skimmer(s),ladder(s),handrails,maindecksurface,anchors,inlets/fittings,lights/GFI,ropes,divingboardandcovers 32 33 34 ____________________________________________________________________________________________________________ 35 (D)MechanicalEquipment: Specifyifanyrepairshavebeenperformedduringyourownershiponthemechanical 36 equipment(including,butnotlimitedtothefollowing): 37 38 39 ____________________________________________________________________________________________________________ 40 (E)Leaksand/orDefects: 41 (1) Areyouawareofanyleaksin thepoolorpoolcomponents Yes No 42 (2) Areyouawareofanydefectsrelatingtothepoolortoanyofthepoolcomponents Yes No 43 Explainany“Yes”answersinthissection: 44 45 46 ____________________________________________________________________________________________________________ 47 ____________________________________________________________________________________________________________ 48 Created by Ted Wight with SkySlope® Forms 2525 Ossenfort Rd, Wildwood, MO 63038 DigiSign Verified - d2142866-92cd-4270-b4ed-c153229115ba 33 Pebble Tech / Saltwater Skimmers have been resealed 2023. Pumps and filter have been replaced as needed. All equipment in working Pool deck coated 2019, pebble tech 2008. New coping and tile 2023. Pool Irr. Coping and tile complete renovation 2023 Westport 4 20x40 Westport 4 4'-12' Fencing replaced 2016 - eastern red cedar Westport Custom cover 2019 - stored at Westport. 4 N/A 3/19/2024 2 built in 1991 by Westport. Saltwater conversaion in 2008. 30,000+ Westport 4 4 order as of 3/19/2024.
POOL/SPA/POND/LAKEADDENDUMTOSELLER’SDISCLOSURESTATEMENT (It
thepreambletotheSeller’sDisclosureappliestothisAddendum)
Page2of2 SPA 49 GeneralInformation:(Giveclosestapproximationthat isknown) 50 (1)Age______(2)Volume(gallons)______(3)Manufacturer_________________(4)Construction___________________ 51 (5)Typeofchemicalsanitizer Chlorine Copper/SilverIonizer Bacquacil Ozonator Other__________________ 52 (6)Spaserviceprovider_______________________________Lastserviced__________________________________(date) 53 (7)Ageofheater______________HeatSource______________________________________________________________ 54 (8)Ageofpump_______________________(9)Ageoffilter__________________(10)Numberofjets________________ 55 (11) Specify if any repairs have been performed during your ownership on spa equipment (including, but not limited to the 56 itemsabove)__________________________________________________________________________________________ 57 58 ____________________________________________________________________________________________________ 59 (12)Areyouawareofanydefects Yes NoIfYes,pleaseexplain___________________________________________ 60 ____________________________________________________________________________________________________ 61 ____________________________________________________________________________________________________ 62 PONDSandLAKES 63 GeneralInformation:(Givetheclosestapproximationthatisknown) 64 (1)NumberofPonds/Lakes_______(2)Age_______(3)Depth_________(4)Size(e.g.gallons,acreage)______________ 65 (5) Type Natural Artificial 66 (6)Construction Concrete Plastic Other_____________________________________________________________ 67 (7)Watersource_______________________________________________________________________________________ 68 (8) DoesanysewagerunintothePond/Lake Yes No 69 (9) IsthePond/Lakeshared Yes No 70 (10)IsthePond/Lakestocked Yes No 71 (11)Pondserviceprovider____________________________________Lastserviced___________________________(date) 72 (12)Ifheated,ageofheater_________________HeatSource___________________________________________________ 73 (13)Isthereapump Yes No Ageofpump ____________ 74 (14)Haveanychemicalsbeenadded Yes No 75 (15)Isthereafiltrationsystem Yes No Ageoffilter____________ 76 (16)Isthereanoverflowsystem Yes No 77 (17)Ifthereisanoverflowsystem,doesoverflowrun ontoadjoiningproperties Yes No 78 (18)Arethereanyleaks Yes No 79 (19)Isthereafountain(s) Yes No 80 (20)HaveanyrepairsbeenperformedduringyourownershiponthePond/LakeoranycomponentofthePond/Lake 81 Yes No 82 (21)Areyouawareofanydefects Yes No 83 Explanationofany“Yes”answers(8-10,14-18,20and21above): 84 85 86 ____________________________________________________________________________________________________________ 87 SELLER’SACKNOWLEDGEMENT Seller acknowledgesthathe hascarefully examined this statementandthatit is complete and 88 accurate to the best of Seller’sknowledge. Seller agreesto immediately notify listing broker in writing of any changesin theproperty 89 condition. Sellerauthorizesallbrokersandtheirlicenseestofurnishacopyofthisstatementtoprospectivebuyers. 90 __________________________________________________ ____________________________________________________ 91 SELLERSIGNATURE DATE SELLERSIGNATURE DATE 92 __________________________________________________ ____________________________________________________ 93 SellerPrintedName SellerPrintedName 94 BUYER’SACKNOWLEDGEMENT BuyeracknowledgeshavingreceivedandreadthisPool/Spa/Pond/LakeAddendumtoSeller’s 95 Disclosure Statement. Buyer understands that the information in this addendum is limited to information of which Seller has actual 96 knowledge. BuyershouldverifytheinformationcontainedinthisPool/Spa/Pond/LakeAddendumtoSeller’sDisclosureStatementand 97 any other important information provided by either Seller or Broker (including any information obtained through the Multiple Listing 98 Service) by an independent, professional investigation of his own. Buyer acknowledges that broker is not an expert at detecting or 99 repairingphysicaldefectsinproperty. 100 __________________________________________________ ____________________________________________________ 101 BUYERSIGNATURE DATE BUYERSIGNATURE DATE 102 __________________________________________________ ____________________________________________________ 103 BuyerPrintedName BuyerPrintedName 104 William C Zschoche Lita L Zschoche DigiSign Verified - d2142866-92cd-4270-b4ed-c153229115ba Lita L Zschoche 03/31/2024 William C Zschoche 03/31/2024 33 ~.4 acres 4 N/A run off 4 as a wildlife habitat. 4 N/A 4 Clay bottom, earth dam, steel pipe discharge N/A 4 4 4 18' 4 4 4 4 1 4 4 Renovated in 1991 - was existing stock pond. Pond was renovated strictly 4
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.
SEPTIC/WELL ADDENDUM TO SELLER’S DISCLOSURE STATEMENT
Form # 2165 01/20 ©ST. LOUIS REALTORS® Approved by Counsel for St. Louis REALTORS® To be used exclusively by REALTORS® Page 1 of 2
PROPERTY ADDRESS: ___________________ DATE: 1 SEPTIC (Explain any “Yes” answers): 2 Note: Potential buyers should be aware that the current owner may not use the septic system to its full capacity. If the system 3 is being underutilized, it may falsely appear to be problem free. If the system is more heavily utilized, problems may surface 4 that were previously not known or detectable. These problems may not be discovered by a septic inspection. 5 (a) How many people occupy the property? ______ 6 (b) Has the property been vacant over any period during the last 12 months? Yes No 7 (c) Does any other property owner share this system? Yes No 8 (d) Is any part of your system located on a neighbor’s property? Yes No 9 (e) Is there a well within 50 feet of the septic tank? Yes No 10 (f) Does the system have an aerator? Yes No 11 (g) Of what is the bottom of the tank constructed? gravel concrete unknown 12 (h) Are any laundry, sinks, tubs and/or showers dispersing outside of the septic system? Yes No 13 (i) Do any of the pipes flow into ditches, creeks, ravines or a lagoon? Yes No 14 (j) Are any of the pipes exposed? Yes No 15 (k) Is there any seepage or surface discharge (effluence) from the septic system? Yes No 16 If “Yes”, is there any from your system onto your neighbor’s property? Yes No 17 (l) Is there any seepage or surface discharge from a neighbor’s system onto your property? Yes No 18 (m) Have you noticed any noxious, offensive or unusual odors from the system? Yes No 19 (n) Have you experienced slow drainage or drain backups? Yes No 20 (o) Is there a current maintenance service agreement covering your system? Yes No 21 If “Yes”, what is the annual cost and who is the current provider? _____________________________________ 22 (p) Does any government authority require a maintenance service agreement for the 23 new homeowner? Yes No 24 (q) Have you ever been notified/cited by any governmental authority on problems 25 related to the system? Yes No 26 (r) Has a service company ever recommended any work to be done to the system? Yes No 27 (s) Are you aware of any defects? Yes No 28 (t) Have you expanded, updated or modified the septic system? Yes No 29 (u) Have you cleaned or pumped the system during your ownership of the property? Yes No 30 If “Yes”, when was it done and who did the work? __________________________ 31 WELLS (Explain any “Yes” answers): 32 (a) Is any part of the well located on a neighbor’s property? Yes No 33 (b) Is the well shared with any other properties? Yes No 34 If “Yes”, is there a recorded well agreement? Yes No 35 (c) Are you aware of any problems relating to the quality or source of drinking water? Yes No 36 (d) Have you ever been notified/cited by any governmental authority on problems 37 related to the system? Yes No 38 (e) Has a service company ever recommended any work be done to the system? Yes No 39 (f) Are you aware of any defects? Yes No 40 (g) Are you aware of any plans to bring public water to this property? Yes No 41 Explanation of any “Yes” answers and additional comments for either of the above sections: 42 43 44 45 46 47 48 49 50 04/01/2024 Created by Ted Wight with SkySlope® Forms 2525 Ossenfort Rd, Wildwood, MO 63038 DigiSign Verified - d2142866-92cd-4270-b4ed-c153229115ba 4 4 4 4 4 Pumped 3x since 1991 - Septic Services Co. 4 4 4 4 in 2019 (estiamte). 4 4 4 4 4 2 4 4 4 Well pump replaced winter 2014 - new wire. 4 4 4 4 4 Piping repair ~2020. System has a booster pump for pool and 15 sprinkler zones. Aerator not used per Septic Services Inc recommendation. System is therefore 4 anaerobic. 4 4 1996 detached garage/office with lift pump to existing system last serviced 4 4 4 4
Page 2 of 2 SELLER’S ACKNOWLEDGEMENT: Seller acknowledges that he has carefully examined this statement and that it is complete and 51 accurate to the best of Seller’s knowledge. Seller agrees to immediately notify listing broker in writing of any changes in the property 52 condition. Seller authorizes all brokers and their licensees to furnish a copy of this statement to prospective buyers. 53 54 SELLER SIGNATURE DATE SELLER SIGNATURE DATE 55 56 Seller Printed Name Seller Printed Name 57 BUYER’S ACKNOWLEDGEMENT: Buyer acknowledges having received and read this Septic/Well Addendum to Sellers 58 Disclosure Statement. Buyer understands that the information in this Addendum is limited to information of which Seller has actual 59 knowledge. Buyer should verify the information contained in this Septic/Well Addendum to Sellers Disclosure Statement and any other 60 important information provided by either Seller or broker (including any information obtained through the Multiple Listing Service) by 61 an independent, professional investigation of his own. Buyer acknowledges that broker is not an expert at detecting or repairing physical 62 defects in property. 63 64 BUYER SIGNATURE DATE BUYER SIGNATURE DATE 65 66 Buyer Printed Name Buyer Printed Name 67 William C Zschoche Lita L Zschoche DigiSign Verified - d2142866-92cd-4270-b4ed-c153229115ba 03/31/2024 Lita L Zschoche 03/31/2024 William C Zschoche
Expenditures 1. 2,500 feet of new asphalt roadway 2. 1,250 feet of new Eastern Red Cedar three rail horse fencing with an estimated 40+ year life 3. Newer pump and wiring for well 4. Complete new iron gate controls/closer 5. Approximately 1,700 square feet of refinished hardwood flooring 6. Newer ground sourced 2 stage main heat pump, geothermal with four 250-foot-deep wells for 2,000 total feet of heat exchanging piping in the yard adjacent to the rear of the house 7. Newer conventional heat pump for second floor 8. Detached ofce/garage HVAC serviced recently... standard AC unit with propane furnace (two dedicated 75-gallon-tanks) 9. Rebuilt the Davey booster pump for well tank (supporters 15 zones of irrigation) 10. Newer main cellulose (or DE) pool filtration system 11. Newer salt cell for pool chlorine generator 12. Recently re-sodded the front yard 13. Pool deck resurfaced with “Cool Feel” coating 14. Newer coping and tile in pool (2023) 15. Detached wooden deck recoated with pigmented deck stain 16. Deluxe tub/shower enclosures on upper and lower-level baths 17. Green granite countertop added in lower-level TV area 18. Master bath has been completely renovate
2525 Ossenfort Road Glencoe, Missouri 63038 Recent