The printed portions of this form, except differentiated additions, have been approved by the Colorado Real Estate Commission. (LC 38-5-04) THIS FORM HAS IMPORTANT LEGAL CONSEQUENCES AND THE PARTIES SHOULD CONSULT LEGAL AND TAX OR OTHER COUNSEL BEFORE SIGNING. SELLER'S PROPERTY DISCLOSURE (VACANT LAND) THIS DISCLOSURE SHOULD BE COMPLETED BY SELLER, NOT BY BROKER. If the Property Includes A Residence, attach Seller’s Property Disclosure (Residential) (LC-18-05-04). Seller states that the information contained in this Disclosure is correct to the best of Seller's CURRENT ACTUAL KNOWLEDGE as of this Date. Broker may deliver a copy of this Disclosure to prospective buyers. Date: Property Address: Seller: A. USE AND ACCESS Yes No Do Not Know COMMENTS/EXPLANATION 1 Current use of the Property 2 Describe any access problems 3 Roads, driveways, trails or paths through the Property used by others 4 Public highway or county road border the Property 5 Encroachments, boundary disputes, unrecorded easements 6 Notice of zoning action related to the Property 7 Zoning violations, variances, conditional use or nonconforming use 8 Crops being grown on the Property 9 Seller owns all crops 10 Livestock on the Property 11 Any land leased from others State BLM Federal Private Other 12 Any part of the Property leased to others (written or oral) 13 Conservation Easement 14 15 LC-38-5-04 SELLER'S PROPERTY DISCLOSURE (VACANT LAND) Page 1 of 4 American LegalNet, Inc. www.USCourtForms.com B. WATER AND SEWER Yes No Do Not Know 1 Type of water supply: Public Community Well Shared Well Cistern None Other If the Property is served by a well, supply to Buyer a copy of the well permit. Well Permit # __________________________________________ Water Company Name: 2 Water tap fees paid 3 Water rights COMMENTS/EXPLANATION If yes, identify: 4 Type of sanitary sewer service: Public Community Septic System None Other Tank Leach Lagoon 5 Sewer tap fees paid 6 7 C. ENVIRONMENTAL CONDITIONS To Seller's current actual knowledge, do any of the following conditions now exist or have they ever existed: 1 Hazardous materials on the Property, such as radioactive materials, toxic materials, asbestos, pesticides, wastewater and other sludge, radon, methane, or oil 2 Underground or above ground storage tanks 3 Underground transmission lines 4 Governmentally designated geological hazard or sensitive area 5 Environmental assessments, studies or reports done involving the physical condition of the Property 6 Sliding, settling, upheaval, movement or instability of earth, or expansive soil of the Property 7 Property used as, situated on, or adjacent to, a dump, land fill, or municipal solid waste land fill 8 Within governmentally designated Flood Plain area 9 Received any notice that a portion of the Property is a governmentally designated wetland area 10 Property used for any mining, gravelling, or other natural resource extraction operations such as oil and gas wells LC-38-5-04 Yes No SELLER'S PROPERTY DISCLOSURE (VACANT LAND) Do Not Know COMMENTS/EXPLANATION Page 2 of 4 American LegalNet, Inc. www.USCourtForms.com 11 Diseased or infested trees or shrubs 12 Endangered species on the Property 13 Archeological features, fossils or artifacts on the Property 14 Mine shafts, tunnels or abandoned wells on the Property 15 16 D. NOXIOUS WEEDS The Colorado Weed Management Act became law on January 1, 1992. The law requires that every county or municipality in Colorado adopt a weed management plan, outlining the rules governing identification and method of eradication. The State of Colorado has identified PURPLE LOOSESTRIFE, SPOTTED KNAPWEED, MUSK THISTLE, LEAFY SPURGE, CANADIAN THISTLE, DIFFUSE KNAPWEED, RUSSIAN KNAPWEED, DALMATION TOADFLAX and YELLOW TOADFLAX, among others, as noxious weeds. To Seller's current actual knowledge, have any of the Yes No Do Not Know COMMENTS/EXPLANATION Yes No Do Not Know COMMENTS/EXPLANATION following occurred to the Property within the last 3 years: 1 Identification of noxious weeds 2 Subject to written weed control plan 3 Herbicides applied 4 Biological agents or insects released on any of the noxious weeds 5 6 E. OTHER DISCLOSURES To Seller’s current actual knowledge, do any of the following conditions now exist: 1 Special assessments or increases in regular assessments approved by owners' association but not yet implemented 2 Notice or threat of condemnation proceedings 3 Other legal action related to the Property 4 Governmental special improvements approved but not yet installed, which may become a lien against the Property 5 Any part of the Property enrolled in any governmental programs such as Conservation Reserve Program (CRP), Wetlands Reserve Program (WRP), etc. LC-38-5-04 SELLER'S PROPERTY DISCLOSURE (VACANT LAND) Page 3 of 4 American LegalNet, Inc. www.USCourtForms.com 6 7 Seller and Buyer understand that the real estate brokers do not warrant or guarantee the above information on the Property. Property inspection services may be purchased. This form is not intended as a substitute for an inspection of the Property. ADVISORY TO SELLER: • Failure to disclose a known material defect may result in legal liability. The information contained in this Disclosure has been furnished by Seller, who certifies to the truth thereof based on Seller's CURRENT ACTUAL KNOWLEDGE. Any changes will be disclosed by Seller to Buyer promptly after discovery. Seller hereby receipts for a copy of this Disclosure. Date: Date: Seller Seller ADVISORY TO BUYER: • Even though Seller has answered the above questions to the best of Seller's current actual knowledge, Buyer should obtain expert assistance to accurately and fully evaluate the Property regarding use and access, water, sewer, other utilities, environmental and geological conditions, noxious weeds and other matters which may affect Buyer's use of the Property. Valuable information may be obtained from various local/state/federal agencies, and other experts may perform more specific evaluations of the Property. • Boundaries, location and ownership of fences, driveways, hedges, and similar items may become matters of dispute. A survey may be used to determine such matters. Buyer acknowledges that Seller does not warrant that the Property is fit for Buyer’s intended purposes or use of the Property. Buyer hereby receipts for a copy of this Disclosure. Date: Date: Buyer Buyer LC-38-5-04 SELLER'S PROPERTY DISCLOSURE (VACANT LAND) Page 4 of 4 American LegalNet, Inc. www.USCourtForms.com