Indiana Property Disclosure Statement

Indiana Code (IC) 32-21-5 mandates that the seller of certain residential real property must deliver to the buyer the Seller's Residential Real Property Disclosure Statement (SRPDS) before the buyer signs a purchase contract. The form requires disclosure of the seller's actual knowledge of material defects in specified categories. Failure to provide the required disclosure may allow the buyer to rescind or pursue damages. The buyer generally has three (3) business days after receipt of the disclosure (if not provided timely before contract) to rescind the purchase contract.

This document is a complete SRPDS-style form compliant with IC 32-21-5, incorporating all mandated categories plus the federal lead-based paint overlay (42 U.S.C. § 4852d) for pre-1978 housing. Disclosures are based solely on the seller's actual knowledge. The property is sold in its present physical condition unless otherwise agreed in writing.

All user-supplied information appears as `[[Token Name]]` placeholders. Fixed statutory requirements and standard clauses are written in full.

Property Address: [[Street Address]], [[City]], Indiana [[ZIP Code]]

Seller(s) Name(s): [[Seller Full Legal Name(s)]]

Buyer(s) Name(s): [[Buyer Full Legal Name(s)]]

Date of Disclosure: [[Disclosure Date]]

Year Built: [[Year Built]], -

1. Seller's Knowledge and Ownership

Seller has owned the property for [[Years Owned]] years.

Seller occupied the property during the last twelve (12) months: [[Yes / No]].

Seller discloses below all known material defects and conditions of which Seller has actual knowledge. "Actual knowledge" means personal knowledge, not what Seller "should have known" or learned from others after the fact. If Seller has no knowledge of a particular item, that is noted. This disclosure is not a warranty and does not substitute for buyer's independent inspections.

Seller Initials: ________ Date: [[Disclosure Date]], -

2. Roof, Attic, Gutters, and Siding

• Age and type of roof: [[Roof Age in Years / Material, e.g., 12 years, asphalt shingles]]

• Known leaks, missing shingles, damage, or repairs in the last five (5) years: [[Yes / No]]

Details: [[Roof Leak or Repair Description or "None known"]]

• Known issues with gutters, downspouts, flashing, or attic ventilation/insulation: [[Yes / No]]

Details: [[Details or "None known"]]

• Known issues with siding, exterior cladding, or trim: [[Yes / No]]

Details: [[Details or "None known"]]

• Any roof warranty transferable to buyer: [[Yes, provide details / No]], -

3. Foundation, Basement, Crawlspace, Slab, and Structural Components

• Known cracks, settling, shifting, heaving, or movement in foundation, walls, floors, or slab: [[Yes / No]]

Details and locations: [[Foundation or Structural Description or "None known"]]

• Known structural repairs, engineering reports, or retrofits: [[Yes / No]]

Details: [[Structural Repairs Description or "None"]]

• Known water intrusion, seepage, or moisture issues in basement or crawlspace: [[Yes / No]]

Details: [[Water Intrusion Details or "None known"]]

• Known sagging floors, walls out of plumb, or other structural concerns: [[Yes / No]]

Details: [[Details or "None known"]], -

4. Plumbing System

• Known defects, leaks, low pressure, slow drains, or clogs in plumbing: [[Yes / No]]

Details: [[Plumbing Defects Description or "None known"]]

• Water heater age, type, and condition: [[Water Heater Age / Type / Condition Notes]]

• Known sewer or septic system issues, backups, or failures: [[Yes / No]]

Details and last service date if known: [[Sewer or Septic Details or "None known"]]

• Water source: [[Municipal / Private Well]]

• Known water quality, pressure, or contamination issues: [[Yes / No]]

Details: [[Water Quality Details or "None known"]], -

5. Electrical System

• Known defects, inadequate service, flickering lights, or wiring issues: [[Yes / No]]

Details: [[Electrical Defects Description or "None known"]]

• Known aluminum wiring, knob-and-tube wiring, or unpermitted electrical work: [[Yes / No]]

Details: [[Electrical Wiring Notes or "None known"]]

• Electrical panel capacity and condition: [[Panel Details, e.g., 200-amp, updated 2018]]

• Known GFCI/AFCI or safety device issues: [[Yes / No]]

Details: [[Details or "None known"]], -

6. Heating, Ventilation, Air Conditioning (HVAC), and Appliances

• HVAC system type(s), age, and condition: [[HVAC Type / Age / Condition, e.g., Gas forced air, 8 years old, serviced annually]]

• Known defects, failures, or required repairs to heating, cooling, or ventilation: [[Yes / No]]

Details: [[HVAC Problems Description or "None known"]]

• Known issues with built-in appliances that convey with the property: [[Yes / No]]

Details: [[Appliance Defects or "None known"]]

• Any transferable HVAC or appliance warranties: [[Yes, list / No]], -

7. Water, Sewer, Well, and Septic Systems

• Water supply: [[Municipal / Private Well / Other]]

• Sewer disposal: [[Municipal Sewer / Private Septic / Other]]

• Known problems with well, pump, pressure tank, or septic system: [[Yes / No]]

Details and dates of last inspection/pumping: [[Details or "None known"]]

• Any private water or sewer permits or violations known: [[Yes / No]]

Details: [[Details or "None known"]], -

8. Environmental Hazards and Conditions

Seller discloses the following known conditions. This section includes both state requirements and the federal lead-based paint disclosure for target housing built before 1978.

• Lead-based paint or hazards (pre-1978 housing): [[Yes, describe known locations / No / Housing built 1978 or later / Unknown]]

Details: [[Lead Paint Locations and Details or "N/A"]]

• Seller has provided the EPA pamphlet "Protect Your Family From Lead in Your Home": [[Yes / No / N/A]]

• Asbestos-containing materials: [[Yes / No / Unknown]]

Details and locations: [[Asbestos Details or "None known"]]

• Radon: [[Yes, test results or mitigation / No / Unknown]]

Details: [[Radon Details or "None known"]]

• Mold or water-damage-related mold (beyond ordinary bathroom surfaces): [[Yes / No]]

Details and remediation: [[Mold Details or "None known"]]

• Underground storage tanks (fuel oil, propane, septic, etc.): [[Yes / No / Unknown]]

Details: [[UST Details or "None known"]]

• Hazardous chemicals, solvents, waste, or prior manufacturing use: [[Yes / No / Unknown]]

Details: [[Hazardous Materials Details or "None known"]]

• Soil contamination, fill material, or landfill on site: [[Yes / No / Unknown]]

Details: [[Soil or Fill Details or "None known"]]

• Other known environmental conditions: [[Yes / No]]

Details: [[Other Environmental Details or "None known"]], -

9. Natural Hazards, Flooding, and Drainage

• Property located in a FEMA-designated flood zone or Special Flood Hazard Area: [[Yes / No / Unknown]]

• Known history of flooding, water standing, or poor drainage: [[Yes / No]]

Details and dates: [[Flood or Drainage History or "None known"]]

• Flood insurance ever required or purchased: [[Yes / No]]

• Known landslide, erosion, subsidence, or soil movement risk: [[Yes / No]]

Details: [[Land Movement Details or "None known"]]

• Other natural hazards (e.g., karst, sinkhole in Indiana context): [[Yes / No]]

Details: [[Other Hazards or "None known"]], -

10. Structural Additions, Alterations, and Permits

• Any additions, renovations, or structural work performed without required permits: [[Yes / No]]

Description: [[Unpermitted Work Description or "None known"]]

• Any permitted work that has not received final inspection/approval: [[Yes / No]]

Details: [[Permit Status Details or "None known"]]

• Known building code violations or stop-work orders: [[Yes / No]]

Details: [[Violations Details or "None known"]], -

11. Homeowners Association, Assessments, and Common Interest

• Property subject to HOA, condominium, or property owners association: [[Yes / No]]

• Association name: [[HOA Name or "N/A"]]

• Current regular assessments/dues: [[HOA Dues Amount and Frequency or "N/A"]]

• Any special assessments levied or proposed: [[Yes, amount and purpose / No]]

Details: [[Special Assessment Details or "None"]]

• Known association defects, litigation, or unpaid assessments affecting the property: [[Yes / No]]

Details: [[HOA Issues Details or "None known"]]

• HOA documents (bylaws, declarations, financials, meeting minutes) available: [[Yes / No]], -

12. Legal Issues, Title, and Other Disclosures

• Known title defects, liens, encumbrances, or easements not of record: [[Yes / No]]

Details: [[Title Issues Details or "None known"]]

• Any pending or threatened litigation, claims, or disputes affecting the property: [[Yes / No]]

Details: [[Litigation Details or "None known"]]

• Any known violation of zoning, building, or other laws: [[Yes / No]]

Details: [[Legal Violation Details or "None known"]]

• Any death or other stigmatizing event on the premises within the last three years that Seller believes a reasonable buyer would consider material: [[Yes / No / Unknown]]

Details: [[Stigma Details or "None known"]]

• Any other material facts or conditions not disclosed above that affect the value or desirability of the property: [[Yes, describe / No]]

Details: [[Other Material Facts or "None"]], -

13. Buyer Inspection and Rescission Advisory

This disclosure is based solely on Seller's actual knowledge and is not a substitute for professional inspection. Buyer is strongly advised to:

1. Obtain a whole-house professional inspection by a qualified inspector.

2. Obtain separate inspections for roof, foundation, HVAC, electrical, plumbing, septic/well, radon, mold, and wood-destroying insects as desired.

3. Review title commitment, survey, flood determinations, and all HOA documents.

4. Conduct all due diligence within contract deadlines.

Under IC 32-21-5, if the required disclosure statement is not provided before the buyer signs the purchase contract, the buyer may rescind the contract within three (3) business days after receiving the disclosure.

Buyer acknowledges receipt of this disclosure statement.

Buyer Initials: _______ Date: _______, -

14. Seller Certification and Signature

Seller certifies that the information in this disclosure is true and complete to the best of Seller's actual knowledge as of the date signed. Seller will supplement this disclosure if any material change occurs before closing.

Seller Signature: ________________________________ Date: [[Disclosure Date]]

Printed Name: [[Seller Full Legal Name(s)]]

Seller Signature: ________________________________ Date: [[Disclosure Date]]

Printed Name: [[Seller Full Legal Name(s)]], -

15. Buyer Acknowledgment of Receipt

Buyer acknowledges receipt of this completed Seller's Residential Real Property Disclosure Statement and the opportunity to conduct inspections.

Buyer Signature: _______________________________ Date: _______

Printed Name: [[Buyer Full Legal Name(s)]]

Buyer Signature: _______________________________ Date: _______

Printed Name: [[Buyer Full Legal Name(s)]], -

Template example, not professional (legal/financial/medical) advice. This form is modeled on the requirements of Indiana Code IC 32-21-5 and the federal lead-based paint disclosure rules. Figures, deadlines, and required disclosures must be verified against current primary sources for the transaction date and jurisdiction. Consult qualified Indiana legal counsel and perform independent due diligence. Sources: IC 32-21-5 (as of 2026); 42 U.S.C. § 4852d.

> ⚠️ Template example, not professional (legal/financial/medical) advice. Figures and clauses must be verified for the applicable jurisdiction and kept current.