Connecticut Property Disclosure Statement

Property Address: [[Street Address, Unit if any]], [[City]], Connecticut [[ZIP Code]]
Seller Name(s): [[Seller Full Legal Name(s)]]
Buyer Name(s): [[Buyer Full Legal Name(s)]]
Date of This Disclosure: [[Disclosure Date]]
Year Structure Built: [[Year Built]]

Uniform Property Condition Disclosure Act, CGS § 20-327b

The seller of residential real property consisting of four dwelling units or less (including cooperatives and condominiums) is required by Connecticut General Statutes Section 20-327b to provide this Residential Property Condition Report to the prospective purchaser prior to the prospective purchaser's execution of any binder, contract to purchase, option, or lease containing a purchase option.

If the seller fails to furnish this report, the seller will be required to credit the purchaser with the sum of $500 at closing (CGS § 20-327c).

This disclosure is based on the seller's actual knowledge. It is not a warranty or guarantee of any kind. The buyer is strongly encouraged to obtain independent professional inspections.

Instructions to Seller:
1. You must answer all questions to the best of your knowledge.
2. You are required to identify and disclose any problems regarding the subject property.
3. Your real estate licensee cannot complete this form on your behalf.
4. "Yes" means the condition exists or the answer is affirmative. "No" means it does not. "UNK" means unknown to you. "N/A" means not applicable.
5. If you need additional space, attach extra pages and reference the property address, your name, and the date on each.

Seller Initials: _______ / _______ Date: [[Disclosure Date]]

A. Subject Property Information

Street Address / Municipality / ZIP: [[Full Address]]
Type of Property: [[Single-family detached / Condominium / Cooperative / Multi-family (2-4 units) / Other]]
Number of Dwelling Units on Parcel: [[Number]]
How long have you owned / occupied the property? [[Years Owned / Occupied]]
Year Built: [[Year Built]]
Approximate Square Footage (above grade): [[Sq Ft]]

Other Owners or Claims:
- Does anyone else claim to own any part of the property (including encroachments)? [[Yes / No / UNK]]
Explanation: [[Explain or "None"]]
- Does anyone other than you have or claim any right to use any part of the property (easement, right of way, etc.)? [[Yes / No / UNK]]
Explanation: [[Explain or "None"]]

Flood / Wetlands / Special Districts:
- Is the property in a flood hazard area or inland wetlands area? [[Yes / No / UNK]]
Explanation: [[Details or "N/A"]]
- Is the property located in a special tax district? [[Yes / No / UNK]]
Explanation: [[Details]]
- Is the property subject to any land use restrictions (other than standard zoning in the chain of title)? [[Yes / No / UNK]]
Explanation: [[Details]]
- Is the property in a common interest community (condo / HOA / PUD)? [[Yes / No]]
If yes, monthly/annual dues or fees: $[[Amount]], [[Frequency]]
Name of association: [[Association Name]]
Contact for further information: [[Contact Info]]

Historic / Village District:
- Is the property in a municipally designated village district, historic district, or listed on the National Register? [[Yes / No / UNK]]
Explanation: [[Details]]

Litigation / Hazardous Substances:
- Are you aware of any prior or pending litigation, government agency actions, orders, or liens on the property related to release of hazardous substances? [[Yes / No / UNK]]
Explanation: [[Details or "None"]]

Dam / Assessments:
- Are you aware of the presence of a dam on the property that is or was required to be registered with DEEP? [[Yes / No / UNK]]
- Do you have reason to believe the municipality may impose any assessment for sewer, water, sidewalks, or other improvements? [[Yes / No / UNK]]
Explanation: [[Details]]

B. Leased or Rented Equipment

Does the property include any leased or rented equipment that would require assignment or transfer of the lease, or replacement/substitution by the buyer?

Check all that apply and provide details:
- [ ] Propane fuel tank, [[Provider / Details]]
- [ ] Water heater, [[Details]]
- [ ] Security alarm system, [[Provider]]
- [ ] Fire alarm system
- [ ] Water treatment system
- [ ] Solar devices / panels
- [ ] Major appliances
- [ ] Satellite dish antenna
- [ ] Other: [[Describe]]

Explanation of any obligations: [[Full explanation or "None"]]

C. Mechanical / Utility Systems

Heating System
- Fuel type(s): [[Oil / Natural Gas / Propane / Electric / Other]]
- System type: [[Forced hot air / Hot water baseboard / Steam / Heat pump / Other]]
- Age of system: [[Years]]
- Are you aware of any heating system problems? [[Yes / No / UNK]]
Details: [[Describe problems or "None"]]

Hot Water Heater
- Type: [[Tank / Tankless / Other]]
- Fuel: [[Same as above]]
- Age: [[Years]]
- Any hot water problems? [[Yes / No / UNK]]
Details: [[Describe]]

Air Conditioning
- Type: [[Central / Window / Wall / None / Other]]
- Age: [[Years]]
- Any AC problems? [[Yes / No / UNK]]
Details: [[Describe]]

Electrical System
- Any known electrical problems (wiring, panels, outlets, GFCI/AFCI, aluminum wiring, service capacity)? [[Yes / No / UNK]]
Details: [[Describe]]

Plumbing System
- Any known plumbing problems (pipes, drains, water pressure, water heater, fixtures)? [[Yes / No / UNK]]
Details: [[Describe]]

Underground Storage Tanks (UST)
- Is there (or was there) an underground storage tank on the property? [[Yes / No / UNK]]
If yes: Age [[Years]], Location [[Describe]]
- Has it been removed? [[Yes / No / N/A]]
Date of removal: [[Date]] Contractor: [[Name and Address]]
Documentation attached or available? [[Yes / No]]
- Any known problems with UST or former tank? [[Yes / No / UNK]]
Details: [[Describe]]

Smoke / CO Detectors and Fire Safety
- Are carbon monoxide and smoke detectors located in the dwelling? [[Yes / No]]
Number: [[Number]] Any known problems? [[Yes / No]]
- Fire sprinkler system present? [[Yes / No]] Any problems? [[Yes / No]]

Electronic Security
- Any known problems with security system? [[Yes / No / N/A]]
Details: [[Describe]]

D. Water System

- Domestic water source: [[Public / Private well / Other]]
- If public water:
- Separate expense/fee for water usage? [[Yes / No]] Flat or metered? [[Flat / Metered]]
- Amount of fee: $[[Amount]] Any unpaid water charges? [[Yes, $Amount / No]]
- If private well:
- Has well water been tested for contaminants / VOCs? [[Yes / No]]
If yes, attach report or provide entity and results: [[Details]]
- Any problems with quantity, quality, recovery, or pressure? [[Yes / No / UNK]]
Details: [[Describe]]

E. Sewage Disposal System

- Type: [[Public sewer / Septic / Cesspool / Other]]
- If public sewer:
- Separate charge? [[Yes / No]] Flat or metered? [[Flat / Metered]]
- Amount: $[[Amount]] Any unpaid sewer charges? [[Yes, $Amount / No]]
- If private (septic/cesspool):
- Name of service company: [[Company]]
- Date last pumped: [[Date]]
- Frequency of pumping during ownership: [[Frequency]]
- Any problems with the system? [[Yes / No / UNK]]
Details: [[Describe, backups, failures, repairs, etc.]]

F. Asbestos / Lead / Environmental

Asbestos
- Are asbestos insulation or building materials present? [[Yes / No / UNK]]
Location(s): [[Describe or "N/A"]]

Lead-Based Paint (Federal Disclosure Required for Pre-1978 Housing)
- Was the dwelling built before 1978? [[Yes / No / UNK]]
- Is lead-based paint present or suspected? [[Yes / No / UNK]]
Location(s): [[Describe]]
- Is lead plumbing present? [[Yes / No / UNK]]
Location(s): [[Describe]]

Federal Lead-Based Paint Disclosure Statement (for pre-1978 target housing):
Seller represents that the property [[is / is not]] target housing built before 1978. Seller [[has / has no] knowledge of lead-based paint and/or lead-based paint hazards in the housing. Records and reports available to seller (if any) have been provided to buyer. Buyer has received the EPA pamphlet "Protect Your Family From Lead in Your Home."

Seller initials: ___ Buyer initials (acknowledgment): ___ Date: [[Date]]

Other Environmental
- Radon: Has the property been tested for radon? [[Yes / No]] Results: [[pCi/L or "N/A"]] Mitigation system present? [[Yes / No]]
- Any known environmental hazards (methane, hazardous waste, etc.)? [[Yes / No / UNK]]
Details: [[Describe]]

Crumbling Foundations / Pyrrhotite
- Do you have knowledge of any testing or inspection related to foundation condition or pyrrhotite? [[Yes / No / UNK]]
Details: [[Describe or "None"]]
- Any foundation repairs performed? [[Yes / No]]
Description and dates: [[Details]]

G. Building / Structure / Improvements

Foundation
- Foundation type/material: [[Full basement / Crawl / Slab / Other]], [[Concrete / Other]]
- Foundation or slab problems or settling? [[Yes / No / UNK]]
Details: [[Describe]]
- Basement water seepage / dampness? [[Yes / No / UNK]]
Amount, frequency, location: [[Describe]]
- Sump pump present and functional? [[Yes / No / N/A]] Any problems? [[Yes / No]]

Roof
- Roof type: [[Asphalt shingle / Metal / Slate / Tile / Other]]
- Approximate age: [[Years]]
- Roof leaks? [[Yes / No / UNK]]
Details: [[Describe or "None"]]
- Any roof repairs or replacements in last 5 years? [[Yes / No]]
Details: [[Describe]]

Exterior
- Exterior siding problems? [[Yes / No / UNK]]
Details: [[Describe]]
- Chimney, fireplace, wood/coal stove problems? [[Yes / No / UNK]]
Details: [[Describe]]
- Patio / deck problems? [[Yes / No / UNK]]
Details: [[Describe]] Wood treated or untreated? [[Treated / Untreated / N/A]]
- Driveway problems? [[Yes / No / UNK]]
Details: [[Describe]]
- Water drainage problems around foundation or yard? [[Yes / No / UNK]]
Details: [[Describe]]

Interior
- Interior floor, wall, or ceiling problems? [[Yes / No / UNK]]
Details: [[Describe]]
- Fire or smoke damage? [[Yes / No / UNK]]
Details: [[Describe]]
- Termite, insect, rodent, or pest infestation problems? [[Yes / No / UNK]]
Details: [[Describe or "None"]]

Other Known Defects
List any other known material defects not disclosed above that affect the property's condition, value, or use:
[[Describe in detail or state "None known to seller"]]

H. Additional Disclosures and Acknowledgments

Known Latent Defects
Seller discloses all known latent (hidden) defects of which Seller has actual knowledge that could affect the health, safety, or structural integrity of the property.

Seller Statement
I/we, the undersigned seller(s), state that the information provided in this disclosure is true and correct to the best of my/our knowledge as of the date signed. I/we understand that this disclosure does not constitute a warranty and that the buyer is advised to conduct independent inspections.

Seller Signature(s):

__________________________________________
[[Seller Full Name(s)]] Date: [[Date]]

__________________________________________
[[Seller Full Name(s)]] Date: [[Date]]

Buyer Acknowledgment
I/we acknowledge receipt of this completed Residential Property Condition Report and the EPA lead pamphlet (if applicable) prior to signing any contract. I/we understand that this is not a substitute for professional inspections.

Buyer Signature(s):

__________________________________________
[[Buyer Full Name(s)]] Date: [[Date]]

__________________________________________
[[Buyer Full Name(s)]] Date: [[Date]]

Sources and Notes

• Primary authority: Connecticut General Statutes § 20-327b (Uniform Property Condition Disclosure Act) and § 20-327c ($500 credit).
• Form based on the Residential Property Condition Report published by the Connecticut Department of Consumer Protection (current as of 2025, 2026 revisions).
• Federal lead-based paint disclosure: 42 U.S.C. § 4852d and implementing regulations (required for target housing built before 1978).
• Crumbling foundations / pyrrhotite: Properties in affected areas may have additional disclosure obligations under specific legislation.
• "As of" date for this template: June 2026.

Disclaimer: This is a template example based on Connecticut statutory requirements and the standard disclosure form. It is not legal advice and does not replace the official state form or professional legal or inspection services. Complete all sections accurately with your actual knowledge. Buyers should obtain home inspections, radon testing, well/septic evaluations, and other due diligence. Laws and forms may be updated; verify current requirements before use. All user-supplied information appears as [[Token Name]].

All numbered and lettered items are on their own lines with appropriate spacing. Tables have no more than six columns.