Seller's Real Property Disclosure Statement FLORIDA ASSOCIATION OF REALTORS® j* PER y IS THE PROPERTY CURRENTLY LEASED? NO ES 0 TERMINATION DATE OF LEASE: DOES THE PROPERTY CURRENTLY HAVE HOMESTEAD EXEMPTION? NOQ’YES 0); YEAR GENERAL INFORMATION ABOUT PROPERTY: PROPERTY ADDRESS: LEGAL DESCRIPTION: NOTICE TO BUYER AND SELLER: In Florida, a Seller is obligated to disclose to a Buyer all known facts that materially affect the value of the property being sold and that are not readily observable. This disclosure statement is designed to assist Seller in complying with the disclosure requirements under Florida law and to assist the Buyer in evaluating the property being considered. This disclosure statement concerns the condition of the real property located at above address. It is not a warranty of any kind by the Seller or any Licensee in this transaction. It is not a substitute for any inspections or warranties the parties may wish to obtain. It is based only upon Seller's knowledge of the property condition. This disclosure is not intended to be a part of any contract for sale and purchase. All parties may refer to this information when they evaluate, market, or present Seller's property to prospective Buyers. The following representations are made by the Seller(s) and are not the representations of any real estate licensees. 1. CLAIMS & ASSESSMENTS a. Are you aware of existing, pending, or proposed legal actions, claims, special assessments, municipal service taxing or benefit unit charges or unpaid assessments (including homeowners’ association maintenance fees or proposed increases in assessments and/or maintenance fees) affecting the property? NORYES 6 if yes, expiain: b. Have any local, state, or federal authorities notified you that repairs, alterations or corrections of the property are required? NO §}-YES (1 If yes, explain: 2, DEED/HOMEOWNERS' ASSOCIATION RESTRICTIONS Are You Aware: a. of any deed or homeowner restrictions? NO ( YES 2 y YEeso b. of any proposed changes to any of the restrictions? c. of any resale restrictions? NO 1} YES d, of any restrictions on leasing the property? NOO) YES e. If any answer to questions 2a-2e is yes, please explain: f. Are access roads privale) public 0) ? If private, describe the terms and conditions of the maintenance agreement: _ g. If there is a homeowner association, is membership mandatory? NO 1) YES Sand are fees charged by the homeowner association? NO) YES yes, explain: 3. PROPERTY-RELATED ITEMS Are You Aware: a. if you have ever had the property surveyed? NO & YES 0 Date: b. if the property was surveyed, did you receive an elevation certificale? NO O YES Dale: c. of any walls, driveways, fences or other features shared in common with adjoining landowners or any encroachments, boundary line disputes, setback violations, or eesements affecting the property? NOW YES O d. of any portion of the property that is fenced? NOO YES a If any answer to questions 3a-3d is yes, please explain: ) acknowledge receipt of a copy of this page, which is Page 1 of 5 Pages. ion of REALTORS® = All Rights Reserved Buyer ( )(__) and Seiler SRPD-¢ Rev.5/09 ©2006 Florida Form generated by: TrueForms™ 800-499-9512 | 4908227199 ulerspjos ®et-OL OL 82390 EFTA00305915

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4, THE LAND: Are You Aware: a. of any past or present settling, soil movement, or sinkhole problems on the property or on adjacent properties? Ni YEeso . Of any sinkhole insurance claim that has been made on subject property? NO YES 9 li. if claim made, was claim paid? NOG YES iii. was the full amount of [he insurance proceeds used to repair the sinkhole damage? NOO YES © b. of any past or present drainage or flood problems affecting the property or adjacent properties? NO & YES J c. of any past or present problems with driveways, walkways, patios, seawalls, or retaining walls on the property or adjacent properties due to drainage, flooding, or soil movements? NO 29 YES 0 If any answer to questions 4a-4c is yes, please explain: 5. ENVIRONMENT: Was the property built before 19787 NO O YES AX Are You Aware: a. of any substances, materials, or products which may be an environmental hazard, such as, but not limited to, asbestos, urea formaldehyde, radon gas, mold, lead-based paint, Chinese/defective drywall, fue], propane or chemical storage tanks (active or abandoned), or contaminated scil or water on the property? NO (YES O ifyes,explain: i. of any damage to the structures logated on the property due to any of the substances, materials or products listed in subsection (a) above? YES 0 ff yes, explain: ii. of any corrosion to air conditioner or refrigerator coils, copper tubing, electrical wiring, computer wiring or other household items that have been damaged by sulfur or methane gas emitted from Chinese/defective drywall? YES 0 ifyes,explain; ii. of any clean up, repairs, or remediation of the property due to any of the substances, materials or products listed in subsection (a) above? NO YES 0 Hf yes, explain: b. of any condition or proposed change in the vicinity of the property that does or will materially effect the value of the property, such as, but not limited to, proposed development or proposed roadways? NO ¢ YES 0) wetlands, mangroves, archeological sites, or other environmentally sensitive areas located on the property? oYveso if any answer to questions 5a-5c is yes, please explain: 6. ZONING: Are You Aware: m Lith) a. of the zoning classification of the property? NO 0) YESf'If yes, identify the zoning classification Ras ‘ b. of any zoning violations or nonconforming uses? NO SXYES O c. if the property is zoned for its current use? NO 7) YES. d. of any zoning —— L pene | additions, improvements or replacement of the property? NO QrYES o e. if there are any zoni or administrative regulations which are in conflict with the existing or intended use of the property? NO Buyer ( nt ) and Seller ( )¢ ) acknowledge receipt of 2 copy of this page, which is Page 2 of 5 Pages. SRPO-4 Rev. 5/08 € 2006 Fi on of REALTORS® = All Rights Reserved Form generated by: True Forms™ 800-489-9612 ed 290822195 Ule}SPjOS ©6101 OL 82190 EFTA00305916

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f. of any restricted otne than association and flood area requirements affecting improvements or replacement of the property? N YEso If any answer to questions 6a-6f is yes, please explain: 7. FLOOD: Are You Aware: a. if any portion of the property is in a special flood hazard area? Now YES b. does the property require flood insurance? NOE YES O c, whether any improvements including additions, are located below the base flood elevation? NO @rrYESO d. whether such improvements have been constructed in violation of applicable local flood guidelines? NO RLYES oa e. if any portion of the property is seaward of the coastal construction control line? NOYES 0 if any answer to questions 7a-7e is yes, please explain: 8. TERMITES, DRY ROT, PESTS, WOOD DESTROYING ORGANISMS: a. Do you have any knowledge of termites, dry rot, pests or wood destroying organisms on or affecting any improvements located on the property or any structural damage to the property by them? NO g YES 0 if yes. explain: b. Have you ever had the property inspected for termites, dry rot, pest or wood destroying organism? NO (J YES Date of inspection _2OOG _ If so, whal was the outcome of the inspection? ogeks we c. Has the property been treated for termites, dry rot, pest or wood destroying organisms? yo O YESO Date eee and type of treatment , Company name: 9. STRUCTURE-RELATED ITEMS: Are You Aware: a. of any structural damage which may have resulted from events including, but not limited to, fire, wind, flood, hail, landslide, or blasting, and which materially affect the value of the property? N@T7 YES O b. of any structural condition or, in the case of a homeowner association, any condition in the common elements that materially affects the value of the property? NO (YES 0 c. of any improvements or additions to the property, whether by you or by others, that have been constructed in violation of building codes or without necessary permits? NO @ YES 0 d. of any active permits on the property which have not been closed by a final inspection? NOZ YES O any answer to questions 9a-Sd is yes, please explain: 410. ROOF-RELATED ITEMS: Are You Aware: a. of any roof or overhang defects? noG YESo b. if the roof has leaked since you owned the property? noG YES Wf c. if anything was done to correct the ?7NO 0 YES d, if the roof has been replaced? NO @ YES ©) if yes, nN: e. if there is a warranty on the roof? NO YES © If yes, is it transferable? NO 0 YES f. If the roof has been inspected within the /ast twelve months? NO YES 9 id answer to questions 10a-10f is yes ; nt ) and Seller, ne ) acknowledge receipt of a copy of this page, which is Page 3 of 5 Pages SRPO-4 Rev. 5/09 ©2006 Fiori tion of REALTORS® = Ali Rights Reserved Buyer { Form goneraied by TrueForms™ www.TrueFerms.com 800-459-9872 6d 4908227 19S UlS}SP/CH ®6L01 OL 82390 EFTA00305917

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11. PLUMBING-RELATED ITEMS: a. What is your drinking water source? Public if Private Well (J) Other Source. If your drinking water is from a well or other source, when was your water last checkec for safety and what was the result of the test? b. Do you have a water conditioning system? Ni SO if yes, type: What is the balance owed orf the system? c. Do you have a sewer (Kor septic system 0)? If septic system describe the location of each system: Owned CJ Leased O cd. Are you aware of any septic tanks or wells on the property which are not currently being used? NO ESO Ifyes, explain; e. Are you aware of any plumbing leaks since you have owned the property? NOY] YES © If yes, explain: f. Are you aware of any conditions that materially affect the value of the Property relating to the septic tank/drain field, sewer lines, or any other plumbing related items? NO 6 YES (0 ff yes, explain: 12. POOLS/HOT TUBS/SPAS: a. Does the property have a swimming pool? NO 0) YES 28 Hot tub? NO.SF'YES 0 Spa? NO 4] YES b. If you answered yes to any part of 12a, was the certificate of completion received after Oct, 1, 2000 for the pool? NO G’YES CJ For the spa? NO &’YES © For the hat tub? NO YES c. Check the pool safety features (as defined by Section 515.27, Florida Statutes) your swimming pool, hot tub or spa has: Enclosure that meets the pool barrier requirements §Approved safety pool cover 9 Required door and window exit alarms () Required door locks Ol none d. Are aware of any conditions regarding these items that materially affect the value of the property? N YES © If yes, explain: 13, MAJOR APPLIANCES: Indicate existing equipment: Range SJ Oven EX Microwa' Dishwasher £4 Garbage Disposai a Trash Compaclor 9) Refrigerator.’ Freezer] Washer &f Orjér 0) Are any of these appliances leased? Ney YES © Are any of these gas appliances? NO 0 YES = Is the water heater: owned &f leased (; Is the water heater: electric 0 gas 0 Are you aware of any problems with these appliances, including whether any of the appliances have leaked or overflowed, since you have owned the property? N&f YES 0 ff yes, explain: 14, ELECTRICAL SYSTEM: Are You Aware: a. of any Camaged or malfunctioning switches, receptacles, or wiring? NOY Yeso b. of any conditions that materially affect the value or operating capacity of the electrical system? NO (YES O !f answers to questions 14a or 14b is yes, please explain: 15, HEATING AND AIR CONDITIONING: Indicate existing equipment: 32 we Air conditioning: Heating: Central R[ Window/Wall “J Number of units Electric Fuel Oli Gas Other g Solar Heating: Owned F) Leased 9 Wood-burning stove: NO RL YES 9) Fireplace: NO24 YES (J Describe fireplace equipment: Are you aware of any defects, maifunctioning or condensation problems regarding these items, since you have owned the property? NO 1) YES () If yes, explain: Tf } acknowledge receipt of a copy of this page, which is Page 4 of 5 Pages. bon of REALTORS® All Rights Reserved Buyer ( )(__) ang Seller ( SRPD-4 Rev. 509 ©2006 Fiori Form generated by: TrueForms” 600-499-9612 ord 2490822199 ule}spjoS ®0Z:01 OL 82190 EFTA00305918

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16. OTHER EQUIPMENT: indicate existing equipment: Security System: NO 0 YES © Leased J Owned 2) Connected to Central Monitor () Monthly Fee $ Smoke Detectors: NO 1) YES (, Number of smoke detectors? Lawn Sprinkler System: NO ©) YES ©) Sprinkler water source: If well is source, is there an iron filter? NO O YES (1 Is there a timer? NO 0 YES © Is the timer automatic? NO O YES O Garage door openers? NO CJ YES ©, Number of transmilters? , Humidistat? NO O YES O Humidifier? NO O YES © Electric air filters? NO YES © Vent fans? NOG YESO Paddle fans? NO 0) YES (0, Number of paddle fans? 17. OTHER MATTERS: Is there anything else that materially affects the value of the property? NO 0 YES 4 If yes, explain: ACKNOWLEDGEMENT OF SELLER The undersigned Seller represents that the information set forth in the above disciosure statement is accurate and complete to the best of the Seller's knowledge on the date signed below. Seller does not intend for this disclosure statement to be a warranty or guaranty of any kind. Seller hereby authorizes disclosure of the information contained in this ; prpspective Buyers of the property. Seller understands and agrees that Seller will notify the Buyer in writing gess days after Seller becomes aware that any information set forth in this disclosure statement has beco 6r incorrect in any way during the term of tne pending purchase by the Buyer. Seller: ! E. ULAeot Date:_ 7 ot ‘Lh 3 { (print) Seller: v ! Date: (signature) (print) RECEIPT AND ACKNOWLEDGMENT OF BUYER Seller is using this form to disclose Seller's knowledge of the condition of the real property and improvements located on the property as of the dale signed by Seller. This disclosure form is not a warranty of any kind. The information contained in the disclosure ‘s limited to information to which the seller has knowledge. It is not intended to be a substitute for any inspections or professional advice the Buyer may wish to obtain. An independent professional inspection is encouraged and may be helpful to verify the condition of the properly and to determine the cost of repairs, if any. Buyer understands these representations are not made by any real estate licensee. Buyer hereby acknowledges having received a copy of this disclosure statement. Buyer Date: (signaiu’e) (print) Buyer: ! Date: (sgnature) (print) Buyer (__)(___) and Seller (____} (____) acknowledge receipt of a copy of this page. which is Page 5 of 5 Pages. SRPD-4 Rev. 5/09 ©2006 Florida Association ofREALTORS® Ail Rights Reservec Form generated by. TrueForms” www.TrueForms.com 800-499-9612 bed 2908227195 UlS}SP|OS BLZ-OL OL 82190 EFTA00305919