§ 105.464

A seller’s property disclosure statement must be in substantially the following form:\n______________________________________________________________________________\nIf required under ORS 105.465, a seller shall deliver in substantially the following form the seller’s property disclosure statement to each buyer who makes a written offer to purchase real property in this state:\n______________________________________________________________________________\nINSTRUCTIONS TO THE SELLER\nPlease complete the following form. Do not leave any spaces blank. Please refer to the line number(s) of the question(s) when you provide your explanation(s). If you are not claiming an exclusion or refusing to provide the form under ORS 105.475 (4), you should date and sign each page of this disclosure statement and each attachment.\nEach seller of residential property described in ORS 105.465 must deliver this form to each buyer who makes a written offer to purchase. Under ORS 105.475 (4), refusal to provide this form gives the buyer the right to revoke their offer at any time prior to closing the transaction.

to each buyer who makes a written offer to purchase. Under ORS 105.475 (4), refusal to provide this form gives the buyer the right to revoke their offer at any time prior to closing the transaction. Use only the section(s) of the form that apply to the transaction for which the form is used. If you are claiming an exclusion under ORS 105.470, fill out only Section 1.\nAn exclusion may be claimed only if the seller qualifies for the exclusion under the law. If not excluded, the seller must disclose the condition of the property or the buyer may revoke their offer to purchase anytime prior to closing the transaction. Questions regarding the legal consequences of the seller’s choice should be directed to a qualified attorney.\n______________________________________________________________________________\n(\nDO NOT\nFILL OUT THIS SECTION UNLESS YOU ARE CLAIMING AN EXCLUSION UNDER ORS 105.470)\nSection 1. EXCLUSION FROM ORS 105.462 TO 105.490:\nYou may claim an exclusion under ORS 105.470 only if you qualify under the statute. If you are not claiming an exclusion, you must fill out Section 2 of this form completely.\nInitial only the exclusion you wish to claim.\n_____ This is the

470 only if you qualify under the statute. If you are not claiming an exclusion, you must fill out Section 2 of this form completely.\nInitial only the exclusion you wish to claim.\n_____ This is the first sale of a dwelling never occupied. The dwelling is constructed or installed under building or installation permit(s) #_____, issued by ________.\n_____ This sale is by a financial institution that acquired the property as custodian, agent or trustee, or by foreclosure or deed in lieu of foreclosure.\n_____ The seller is a court appointed receiver, personal representative, trustee, conservator or guardian.\n_____ This sale or transfer is by a governmental agency.\n______________________\nSignature(s) of Seller claiming exclusion\nDate ________\n______________________\nBuyer(s) to acknowledge Seller’s claim\nDate ________\n______________________________________________________________________________\nSection 2. SELLER’S PROPERTY DISCLOSURE STATEMENT\nNOTICE TO THE BUYER: THE FOLLOWING REPRESENTATIONS ARE MADE BY THE SELLER(S) CONCERNING THE CONDITION OF THE PROPERTY LOCATED AT\n_______________ ('THE PROPERTY').\nDISCLOSURES CONTAINED IN THIS FORM ARE PROVIDED BY THE SELLER ON THE

REPRESENTATIONS ARE MADE BY THE SELLER(S) CONCERNING THE CONDITION OF THE PROPERTY LOCATED AT\n_______________ ('THE PROPERTY').\nDISCLOSURES CONTAINED IN THIS FORM ARE PROVIDED BY THE SELLER ON THE BASIS OF SELLER’S ACTUAL KNOWLEDGE OF THE PROPERTY AT THE TIME OF DISCLOSURE. BUYER HAS FIVE DAYS FROM THE SELLER’S DELIVERY OF THIS SELLER’S DISCLOSURE STATEMENT TO REVOKE BUYER’S OFFER BY DELIVERING BUYER’S SEPARATE SIGNED WRITTEN STATEMENT OF REVOCATION TO THE SELLER DISAPPROVING THE SELLER’S DISCLOSURE STATEMENT, UNLESS BUYER WAIVES THIS RIGHT AT OR PRIOR TO ENTERING INTO A SALE AGREEMENT.\nFOR A MORE COMPREHENSIVE EXAMINATION OF THE SPECIFIC CONDITION OF THIS PROPERTY, BUYER IS ADVISED TO OBTAIN AND PAY FOR THE SERVICES OF A QUALIFIED SPECIALIST TO INSPECT THE PROPERTY ON BUYER’S BEHALF INCLUDING, FOR EXAMPLE, ONE OR MORE OF THE FOLLOWING: ARCHITECTS, ENGINEERS, PLUMBERS, ELECTRICIANS, ROOFERS, ENVIRONMENTAL INSPECTORS, BUILDING INSPECTORS, CERTIFIED HOME INSPECTORS, OR PEST AND DRY ROT INSPECTORS.\nSeller _____ is/ _____ is not occupying the property.\nI. SELLER’S REPRESENTATIONS:\nThe following are representations made by the seller and are not the representations of any

D DRY ROT INSPECTORS.\nSeller _____ is/ _____ is not occupying the property.\nI. SELLER’S REPRESENTATIONS:\nThe following are representations made by the seller and are not the representations of any financial institution that may have made or may make a loan pertaining to the property, or that may have or take a security interest in the property, or any real estate licensee engaged by the seller or the buyer.\n*If you mark yes on items with *, attach a copy or explain on an attached sheet.\n1. TITLE\nA. Do you have legal authority to sell the property? [ ]Yes [ ]No [ ]Unknown\n*B. Is title to the property subject to any of the\nfollowing: [ ]Yes [ ]No [ ]Unknown\n(1) First right of refusal\n(2) Option\n(3) Lease or rental agreement\n(4) Other listing\n(5) Life estate?\n*C. Is the property being transferred an\nunlawfully established unit of land? [ ]Yes [ ]No [ ]Unknown\n*D. Are there any encroachments, boundary\nagreements, boundary disputes or recent\nboundary changes? [ ]Yes [ ]No [ ]Unknown\n*E. Are there any rights of way, easements,\nlicenses, access limitations or claims that\nmay affect your interest in the property? [ ]Yes [ ]No [ ]Unknown\n*F.

dary changes? [ ]Yes [ ]No [ ]Unknown\n*E. Are there any rights of way, easements,\nlicenses, access limitations or claims that\nmay affect your interest in the property? [ ]Yes [ ]No [ ]Unknown\n*F. Are there any agreements for joint\nmaintenance of an easement or right of way? [ ]Yes [ ]No [ ]Unknown\n*G. Are there any governmental studies, designations,\nzoning overlays, surveys or notices that would\naffect the property? [ ]Yes [ ]No [ ]Unknown\n*H. Are there any pending or existing governmental\nassessments against the property? [ ]Yes [ ]No [ ]Unknown\n*I. Are there any zoning violations or\nnonconforming uses? [ ]Yes [ ]No [ ]Unknown\n*J. Is there a boundary survey for the\nproperty? [ ]Yes [ ]No [ ]Unknown\n*K. Are there any covenants, conditions,\nrestrictions or private assessments that\naffect the property? [ ]Yes [ ]No [ ]Unknown\n*L. Is the property subject to any special tax\nassessment or tax treatment that may result\nin levy of additional taxes if the property\nis sold? [ ]Yes [ ]No [ ]Unknown\n2. WATER\nA. Household water\n(1) The source of the water is (check ALL that apply):\n[ ]Public [ ]Community [ ]Private\n[ ]Other ________\n(2) Water source

roperty\nis sold? [ ]Yes [ ]No [ ]Unknown\n2. WATER\nA. Household water\n(1) The source of the water is (check ALL that apply):\n[ ]Public [ ]Community [ ]Private\n[ ]Other ________\n(2) Water source information:\n*a. Does the water source require a water permit? [ ]Yes [ ]No [ ]Unknown\nIf yes, do you have a permit? [ ]Yes [ ]No\nb. Is the water source located on the property? [ ]Yes [ ]No [ ]Unknown\n*If not, are there any written agreements for\na shared water source? [ ]Yes [ ]No [ ]Unknown [ ]NA\n*c. Is there an easement (recorded or unrecorded)\nfor your access to or maintenance of the water\nsource? [ ]Yes [ ]No [ ]Unknown\nd. If the source of water is from a well or spring,\nhave you had any of the following in the past\n12 months? [ ]Flow test [ ]Bacteria test\n[ ]Chemical contents test [ ]Yes [ ]No [ ]Unknown [ ]NA\n*e. Are there any water source plumbing problems\nor needed repairs? [ ]Yes [ ]No [ ]Unknown\n(3) Are there any water treatment systems for\nthe property? [ ]Yes [ ]No [ ]Unknown\n[ ]Leased [ ]Owned\nB. Irrigation\n(1) Are there any [ ] water rights or [ ] other\nirrigation rights for the property?

e there any water treatment systems for\nthe property? [ ]Yes [ ]No [ ]Unknown\n[ ]Leased [ ]Owned\nB. Irrigation\n(1) Are there any [ ] water rights or [ ] other\nirrigation rights for the property? [ ]Yes [ ]No [ ]Unknown\n*(2) If any exist, has the irrigation water been\nused during the last five-year period? [ ]Yes [ ]No [ ]Unknown [ ]NA\n*(3) Is there a water rights certificate or other\nwritten evidence available? [ ]Yes [ ]No [ ]Unknown [ ]NA\nC. Outdoor sprinkler system\n(1) Is there an outdoor sprinkler system for the\nproperty? [ ]Yes [ ]No [ ]Unknown\n(2) Has a back flow valve been installed? [ ]Yes [ ]No [ ]Unknown [ ]NA\n(3) Is the outdoor sprinkler system operable? [ ]Yes [ ]No [ ]Unknown [ ]NA\n3. SEWAGE SYSTEM\nA. Is the property connected to a public or\ncommunity sewage system? [ ]Yes [ ]No [ ]Unknown\nB. Are there any new public or community sewage\nsystems proposed for the property? [ ]Yes [ ]No [ ]Unknown\nC. Is the property connected to an on-site septic\nsystem? [ ]Yes [ ]No [ ]Unknown\n(1) If yes, when was the system installed?________ [ ]Unknown [ ]NA\n(2) *If yes, was the system installed by permit?

Is the property connected to an on-site septic\nsystem? [ ]Yes [ ]No [ ]Unknown\n(1) If yes, when was the system installed?________ [ ]Unknown [ ]NA\n(2) *If yes, was the system installed by permit? [ ]Yes [ ]No [ ]Unknown [ ]NA\n(3) *Has the system been repaired or altered? [ ]Yes [ ]No [ ]Unknown\n(4) *Has the condition of the system been\nevaluated and a report issued? [ ]Yes [ ]No [ ]Unknown\n(5) Has the septic tank ever been pumped? [ ]Yes [ ]No [ ]Unknown\nIf yes, when?________ [ ]NA\n(6) Does the system have a pump? [ ]Yes [ ]No [ ]Unknown\n(7) Does the system have a treatment unit such\nas a sand filter or an aerobic unit? [ ]Yes [ ]No [ ]Unknown\n(8) *Is a service contract for routine\nmaintenance required for the system? [ ]Yes [ ]No [ ]Unknown\n(9) Are all components of the system located on\nthe property? [ ]Yes [ ]No [ ]Unknown\nD. *Are there any sewage system problems or\nneeded repairs? [ ]Yes [ ]No [ ]Unknown\nE. Does your sewage system require on-site\npumping to another level? [ ]Yes [ ]No [ ]Unknown\n4. DWELLING INSULATION\nA. Is there insulation in the:\n(1) Ceiling? [ ]Yes [ ]No [ ]Unknown\n(2) Exterior walls? [ ]Yes [ ]No [ ]Unknown\n(3) Floors?

mping to another level? [ ]Yes [ ]No [ ]Unknown\n4. DWELLING INSULATION\nA. Is there insulation in the:\n(1) Ceiling? [ ]Yes [ ]No [ ]Unknown\n(2) Exterior walls? [ ]Yes [ ]No [ ]Unknown\n(3) Floors? [ ]Yes [ ]No [ ]Unknown\nB. Are there any defective insulated doors or\nwindows? [ ]Yes [ ]No [ ]Unknown\n5. DWELLING STRUCTURE\n*A. Has the roof leaked? [ ]Yes [ ]No [ ]Unknown\nIf yes, has it been repaired? [ ]Yes [ ]No [ ]Unknown [ ]NA\nB. Are there any additions, conversions or\nremodeling? [ ]Yes [ ]No [ ]Unknown\nIf yes, was a building permit required? [ ]Yes [ ]No [ ]Unknown [ ]NA\nIf yes, was a building permit obtained? [ ]Yes [ ]No [ ]Unknown [ ]NA\nIf yes, was final inspection obtained? [ ]Yes [ ]No [ ]Unknown [ ]NA\nC. Are there smoke alarms or detectors? [ ]Yes [ ]No [ ]Unknown\nD. Are there carbon monoxide alarms? [ ]Yes [ ]No [ ]Unknown\nE. Is there a woodstove or fireplace\ninsert included in the sale? [ ]Yes [ ]No [ ]Unknown\n*If yes, what is the make? ________\n*If yes, was it installed with a permit? [ ]Yes [ ]No [ ]Unknown\n*If yes, is a certification label issued by the\nUnited States Environmental Protection\nAgency (EPA) or the Department of\nEnvironmental

yes, was it installed with a permit? [ ]Yes [ ]No [ ]Unknown\n*If yes, is a certification label issued by the\nUnited States Environmental Protection\nAgency (EPA) or the Department of\nEnvironmental Quality (DEQ) affixed to it? [ ]Yes [ ]No [ ]Unknown\n*F. Has pest and dry rot, structural or\n'whole house' inspection been done\nwithin the last three years? [ ]Yes [ ]No [ ]Unknown\n*G. Are there any moisture problems, areas of water\npenetration, mildew odors or other moisture\nconditions (especially in the basement)? [ ]Yes [ ]No [ ]Unknown\n*If yes, explain on attached sheet the frequency\nand extent of problem and any insurance claims,\nrepairs or remediation done.\nH. Is there a sump pump on the property? [ ]Yes [ ]No [ ]Unknown\nI. Are there any materials used in the\nconstruction of the structure that are or\nhave been the subject of a recall, class\naction suit, settlement or litigation? [ ]Yes [ ]No [ ]Unknown\nIf yes, what are the materials? ________\n(1) Are there problems with the materials? [ ]Yes [ ]No [ ]Unknown [ ]NA\n(2) Are the materials covered by a warranty? [ ]Yes [ ]No [ ]Unknown [ ]NA\n(3) Have the materials been inspected?

________\n(1) Are there problems with the materials? [ ]Yes [ ]No [ ]Unknown [ ]NA\n(2) Are the materials covered by a warranty? [ ]Yes [ ]No [ ]Unknown [ ]NA\n(3) Have the materials been inspected? [ ]Yes [ ]No [ ]Unknown [ ]NA\n(4) Have there ever been claims filed for these\nmaterials by you or by previous owners? [ ]Yes [ ]No [ ]Unknown [ ]NA\nIf yes, when? ________\n(5) Was money received? [ ]Yes [ ]No [ ]Unknown [ ]NA\n(6) Were any of the materials repaired or\nreplaced? [ ]Yes [ ]No [ ]Unknown [ ]NA\n6. DWELLING SYSTEMS AND FIXTURES\nIf the following systems or fixtures are included\nin the purchase price, are they in good working\norder on the date this form is signed?\nA. Electrical system, including wiring, switches,\noutlets and service [ ]Yes [ ]No [ ]Unknown\nB. Plumbing system, including pipes, faucets,\nfixtures and toilets [ ]Yes [ ]No [ ]Unknown\nC. Water heater tank [ ]Yes [ ]No [ ]Unknown\nD. Garbage disposal [ ]Yes [ ]No [ ]Unknown [ ]NA\nE. Built-in range and oven [ ]Yes [ ]No [ ]Unknown [ ]NA\nF. Built-in dishwasher [ ]Yes [ ]No [ ]Unknown [ ]NA\nG. Sump pump [ ]Yes [ ]No [ ]Unknown [ ]NA\nH. Heating and cooling systems [ ]Yes [ ]No [ ]Unknown [ ]NA\nI.

oven [ ]Yes [ ]No [ ]Unknown [ ]NA\nF. Built-in dishwasher [ ]Yes [ ]No [ ]Unknown [ ]NA\nG. Sump pump [ ]Yes [ ]No [ ]Unknown [ ]NA\nH. Heating and cooling systems [ ]Yes [ ]No [ ]Unknown [ ]NA\nI. Security system [ ]Owned [ ]Leased [ ]Yes [ ]No [ ]Unknown [ ]NA\nJ. Are there any materials or products used in\nthe systems and fixtures that are or have\nbeen the subject of a recall, class action\nsuit settlement or litigation? [ ]Yes [ ]No [ ]Unknown\nIf yes, what product? _______________\n(1) Are there problems with the product? [ ]Yes [ ]No [ ]Unknown\n(2) Is the product covered by a warranty? [ ]Yes [ ]No [ ]Unknown\n(3) Has the product been inspected? [ ]Yes [ ]No [ ]Unknown\n(4) Have claims been filed for this product\nby you or by previous owners? [ ]Yes [ ]No [ ]Unknown\nIf yes, when? _______________\n(5) Was money received? [ ]Yes [ ]No [ ]Unknown\n(6) Were any of the materials or products repaired\nor replaced? [ ]Yes [ ]No [ ]Unknown\n7. COMMON INTEREST\nA. Is there a Home Owners’ Association\nor other governing entity? [ ]Yes [ ]No [ ]Unknown\nName of Association or Other Governing\nEntity _______________\nContact Person __________________\nAddress

nA. Is there a Home Owners’ Association\nor other governing entity? [ ]Yes [ ]No [ ]Unknown\nName of Association or Other Governing\nEntity _______________\nContact Person __________________\nAddress ______________________\nPhone Number __________________\nB. Regular periodic assessments: $_____\nper [ ]Month [ ]Year [ ]Other _____\n*C. Are there any pending or proposed special\nassessments? [ ]Yes [ ]No [ ]Unknown\nD. Are there shared 'common areas' or joint\nmaintenance agreements for facilities like\nwalls, fences, pools, tennis courts, walkways\nor other areas co-owned in undivided interest\nwith others? [ ]Yes [ ]No [ ]Unknown\nE. Is the Home Owners’ Association or other\ngoverning entity a party to pending litigation\nor subject to an unsatisfied judgment? [ ]Yes [ ]No [ ]Unknown [ ]NA\nF. Is the property in violation of recorded\ncovenants, conditions and restrictions or in\nviolation of other bylaws or governing rules,\nwhether recorded or not? [ ]Yes [ ]No [ ]Unknown [ ]NA\n8. SEISMIC\nWas the house constructed before 1974? [ ]Yes [ ]No [ ]Unknown\nIf yes, has the house been bolted to its\nfoundation? [ ]Yes [ ]No [ ]Unknown\n9. GENERAL\nA.

]Yes [ ]No [ ]Unknown [ ]NA\n8. SEISMIC\nWas the house constructed before 1974? [ ]Yes [ ]No [ ]Unknown\nIf yes, has the house been bolted to its\nfoundation? [ ]Yes [ ]No [ ]Unknown\n9. GENERAL\nA. Are there problems with settling, soil,\nstanding water or drainage on the property\nor in the immediate area? [ ]Yes [ ]No [ ]Unknown\nB. Does the property contain fill? [ ]Yes [ ]No [ ]Unknown\nC. Is there any material damage to the property or\nany of the structure(s) from fire, wind, floods,\nbeach movements, earthquake, expansive soils\nor landslides? [ ]Yes [ ]No [ ]Unknown\nD. Is the property in a designated floodplain? [ ]Yes [ ]No [ ]Unknown\nNote: Flood insurance may be required for\nhomes in a floodplain.\nE. Is the property in a designated slide or\nother geologic hazard zone? [ ]Yes [ ]No [ ]Unknown\n*F. Has any portion of the property been tested\nor treated for asbestos, formaldehyde, radon\ngas, lead-based paint, mold, fuel or chemical\nstorage tanks or contaminated soil or water? [ ]Yes [ ]No [ ]Unknown\nG. Are there any tanks or underground storage\ntanks (e.g., septic, chemical, fuel, etc.)\non the property? [ ]Yes [ ]No [ ]Unknown\nH.

e tanks or contaminated soil or water? [ ]Yes [ ]No [ ]Unknown\nG. Are there any tanks or underground storage\ntanks (e.g., septic, chemical, fuel, etc.)\non the property? [ ]Yes [ ]No [ ]Unknown\nH. Has the property ever been used as an illegal\ndrug manufacturing or distribution site? [ ]Yes [ ]No [ ]Unknown\n*If yes, was a Certificate of Fitness issued? [ ]Yes [ ]No [ ]Unknown\n*I. Has the property been classified as\nwildland-urban interface? [ ]Yes [ ]No [ ]Unknown\n10. FULL DISCLOSURE BY SELLERS\n*A. Are there any other material defects affecting\nthis property or its value that a prospective\nbuyer should know about? [ ]Yes [ ]No\n*If yes, describe the defect on attached sheet and\nexplain the frequency and extent of the problem\nand any insurance claims, repairs or remediation.\nB. Verification:\nThe foregoing answers and attached explanations (if any) are complete and correct to\nthe best of my/our knowledge and I/we have received a copy of this disclosure statement.\nI/we authorize my/our agents to deliver a copy of this disclosure statement to all\nprospective buyers of the property or their agents.\nSeller(s) signature:\nSELLER ______________________ DATE

ent.\nI/we authorize my/our agents to deliver a copy of this disclosure statement to all\nprospective buyers of the property or their agents.\nSeller(s) signature:\nSELLER ______________________ DATE _______________\nSELLER ______________________ DATE _______________\n______________________________________________________________________________\nII. BUYER’S ACKNOWLEDGMENT\nA. As buyer(s), I/we acknowledge the duty to pay diligent attention to any material defects that are known to me/us or can be known by me/us by utilizing diligent attention and observation.\nB. Each buyer acknowledges and understands that the disclosures set forth in this statement and in any amendments to this statement are made only by the seller and are not the representations of any financial institution that may have made or may make a loan pertaining to the property, or that may have or take a security interest in the property, or of any real estate licensee engaged by the seller or buyer. A financial institution or real estate licensee is not bound by and has no liability with respect to any representation, misrepresentation, omission, error or inaccuracy contained in another party’s disclosure statement

ion or real estate licensee is not bound by and has no liability with respect to any representation, misrepresentation, omission, error or inaccuracy contained in another party’s disclosure statement required by this section or any amendment to the disclosure statement.\nC. Buyer (which term includes all persons signing the 'buyer’s acknowledgment' portion of this disclosure statement below) hereby acknowledges receipt of a copy of this disclosure statement (including attachments, if any) bearing seller’s signature(s).\nDISCLOSURES, IF ANY, CONTAINED IN THIS FORM ARE PROVIDED BY THE SELLER ON THE BASIS OF SELLER’S ACTUAL KNOWLEDGE OF THE PROPERTY AT THE TIME OF DISCLOSURE. IF THE SELLER HAS FILLED OUT SECTION 2 OF THIS FORM, YOU, THE BUYER, HAVE FIVE DAYS FROM THE SELLER’S DELIVERY OF THIS DISCLOSURE STATEMENT TO REVOKE YOUR OFFER BY DELIVERING YOUR SEPARATE SIGNED WRITTEN STATEMENT OF REVOCATION TO THE SELLER DISAPPROVING THE SELLER’S DISCLOSURE UNLESS YOU WAIVE THIS RIGHT AT OR PRIOR TO ENTERING INTO A SALE AGREEMENT.\nBUYER HEREBY ACKNOWLEDGES RECEIPT OF A COPY OF THIS SELLER’S PROPERTY DISCLOSURE STATEMENT.\nBUYER ______________________ DATE _______________\nBUYER

T AT OR PRIOR TO ENTERING INTO A SALE AGREEMENT.\nBUYER HEREBY ACKNOWLEDGES RECEIPT OF A COPY OF THIS SELLER’S PROPERTY DISCLOSURE STATEMENT.\nBUYER ______________________ DATE _______________\nBUYER ______________________ DATE _______________\nAgent receiving disclosure statement on buyer’s behalf to sign and date:\n______________________ Real Estate Licensee\n______________________ Real Estate Firm\nDate received by agent ________\n______________________________________________________________________________\n[2003 c.328 §3; 2007 c.30 §13; 2007 c.866 §8; 2009 c.387 §18; 2009 c.591 §14a; 2013 c.435 §1; 2017 c.147 §1; 2019 c.584 §1; 2023 c.9 §5]