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Property Condition Disclosure Statement www.dos.state.ny

NYS Department of State Division of Licensing Services Box 22001. Albany, NY 12201-2001. Property Condition Disclosure Statement (518) 474-4429. Name of Seller or Sellers: Property Address: General Instructions: The Property Condition Disclosure Act requires the seller of residential real Property to cause this Disclosure Statement or a copy thereof to be delivered to a buyer or buyer's agent prior to the signing by the buyer of a binding contract of sale. Purpose of Statement : This is a Statement of certain conditions and information concerning the Property known to the seller. This Disclosure Statement is not a warranty of any kind by the seller or by any agent representing the seller in this transaction.

DOS-1614 (Rev. 8/06) PAGE 1 OF 6 NYS Department of State Division of Licensing Services P.O. Box 22001 Albany, NY 12201-2001 (518) 474-4429 Property Condition Disclosure Statement www.dos.state.ny.us

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