2021 Tennessee Code
Title 66 - Property
Chapter 5 - Conveyances of Property
Part 2 - Residential Property Disclosures
§ 66-5-210. Disclosure Form

Following is the form prescribed by the general assembly which is necessary to comply with this part. The form used does not have to be the one included in this section, but it is the intent of the general assembly that any such form includes all items contained in the form below with all acknowledgement provisions of such form:

Tennessee Residential Property Condition Disclosure The Tennessee Residential Property Disclosure Act states that anyone transferring title to residential real property must provide information about the condition of the property. This completed form constitutes that disclosure by the seller. This is not a warranty, or a substitute for any professional inspections or warranties that the purchasers may wish to obtain.  Buyers and sellers should be aware that any sales agreement executed between the parties will supersede this form as to any obligations on the part of the seller to repair items identified below and/or the obligation of the buyer to accept such items “as is.” Instructions to the Seller: Complete this form yourself and answer each question to the best of your knowledge. If an answer is an estimate, clearly label it as such. The seller hereby authorizes any agent representing any party in this transaction to provide a copy of this statement to any person or entity in connection with any actual or anticipated sale of the subject property. Property Address  City  Seller's Name(s)  Property Age  Date Seller Acquired the Property  Do You Occupy the Property?  If Not Owner-Occupied, How Long Has It Been Since the Seller Occupied the Property?  The property is a   site-built home   nonsite built-home (Check the one that applies) A. The Subject Property Includes the Items Checked Below:  Range  Oven  Microwave  Dishwasher  Garbage Disposal  Trash Compactor  Water Softener  220 Volt Wiring  Washer/Dryer Hookups  Central Heating  Heat Pump  Central Air Conditioning  Wall/Window Air Conditioning  Window Screens  Rain Gutters  Fireplace(s) (Number  )  Gas Starter for Fireplace  Smoke Detector/Fire Alarm  Burglar Alarm  Patio/Decking/Gazebo  Irrigation System  Sump Pump  Garage Door Opener(s) (Number of openers   )  Intercom  TV Antenna/Satellite Dish  Pool  Spa/Whirlpool Tub  Hot Tub  Sauna  Current Termite Contract  Access to Public Streets  Other   Other  Garage: Attached Not Attached Carport Water Heater:  Gas Solar Electric Water Supply: City Well Private Utility Other Waste Disposal: City Sewer Septic Tank Other Gas Supply: Utility Bottled Other Roof(s): Type   Age (approx.)  Other Items:  To the best of your knowledge, are any of the above NOT in operating condition?  YES  NO If YES, then describe (attach additional sheets if necessary): B. Are You (Seller) Aware of Any Defects/Malfunctions in Any of the Following? Interior Walls YES NO UNKNOWN Ceilings YES NO UNKNOWN Floors YES NO UNKNOWN Windows YES NO UNKNOWN Doors YES NO UNKNOWN Insulation YES NO UNKNOWN Plumbing YES NO UNKNOWN Sewer/Septic YES NO UNKNOWN Electrical System YES NO UNKNOWN Exterior Walls YES NO UNKNOWN Roof YES NO UNKNOWN Basement YES NO UNKNOWN Foundation YES NO UNKNOWN Slab YES NO UNKNOWN Driveway YES NO UNKNOWN Sidewalks YES NO UNKNOWN Central heating YES NO UNKNOWN Heat pump YES NO UNKNOWN Central air conditioning YES NO UNKNOWN If any of the above is/are marked YES, please explain:    C. Are You (Seller) Aware of Any of the Following? 1. Substances, materials or products which may be an environmental hazard such as, but not limited to: asbestos, radon gas, lead-based paint, fuel or chemical storage tanks and/or contaminated soil or water on the subject property? YES NO UNKNOWN 2. Features shared in common with adjoining land owners, such as walls, but not limited to, fences, and/or driveways, with joint rights and obligations for use and maintenance? YES NO UNKNOWN 3. Any authorized changes in roads, drainage or utilities affecting the property, or contiguous to the property? YES NO UNKNOWN 4. Any changes since the most recent survey of the property was done? YES NO UNKNOWN Most recent survey of the property:   (check here if unknown.)  5. Any encroachments, easements, or similar items that may affect your ownership interest in the property? YES NO UNKNOWN 6. Room additions, structural modifications or other alterations or repairs made without necessary permits? YES NO UNKNOWN 7. Room additions, structural modifications or other alterations or repairs not in compliance with building codes? YES NO UNKNOWN 8. Landfill (compacted or otherwise) on the property or any portion thereof? YES NO UNKNOWN 9. Any settling from any cause, or slippage, sliding or other soil problems? YES NO UNKNOWN 10. Flooding, drainage or grading problems? YES NO UNKNOWN 11. Any requirement that flood insurance be maintained on the property? YES NO UNKNOWN 12. Property or structural damage from fire, earthquake, floods or landslides? YES NO UNKNOWN If yes, has such damage been repaired?  13. Any zoning violations, nonconforming uses and/or violations of “setback” requirements? YES NO UNKNOWN 14. Neighborhood noise problems or other nuisances? YES NO UNKNOWN 15. Subdivision and/or deed restrictions or obligations? YES NO UNKNOWN 16. A Homeowners Association (HOA) which has any authority over the subject property? YES NO UNKNOWN Name of HOA:  HOA Address:  Monthly Dues:   Special Assessments:  17. Any “common area” (facilities such as, but not limited to, pools, tennis courts, walkways, or other areas co-owned in undivided interest with others)? YES NO UNKNOWN 18. Any notices of abatement or citations against the property? YES NO UNKNOWN 19. Any lawsuits or proposed lawsuits by or against the seller which affects or will affect the property? YES NO UNKNOWN 20. Is any system, equipment or part of the property being leased? YES NO UNKNOWN If yes, please explain, and include a written statement regarding payment information.  21. Any exterior wall covering of the structures covered with exterior insulation and finish systems (EIFS), also known as “synthetic stucco”? YES NO UNKNOWN If yes, has there been a recent inspection to determine whether the structure has excessive moisture accumulation and/or moisture related damage? (The Tennessee Real Estate Commission urges any buyer or seller who encounters this product to have a qualified professional inspect the structure in question for the preceding concern and provide a written report of the professional's finding.) YES NO UNKNOWN If yes, please explain. If necessary, please attach an additional sheet.    D. Certification: I/We certify that the information herein, concerning the real property located at  , is true and correct to the best of my/our knowledge as of the date signed. Should any of these conditions change prior to conveyance of title to this property, these changes will be disclosed in addendum to this document. Transferor (Buyer) Date Transferor (Buyer) Date Parties may wish to obtain professional advice and/or inspections of the property and to negotiate appropriate provisions in the purchase agreement regarding advice, inspections or defects. Transferee/Buyer's Acknowledgement: I/We understand that this disclosure statement is not intended as a substitute for any inspection, and that I/we have a responsibility to pay diligent attention to and inquire about those material defects which are evident by careful observation. I/We acknowledge receipt of a copy of this disclosure. Transferee (Buyer) Date Transferee (Buyer) Date  If the property being purchased is a condominium, the transferee/buyer is hereby given notice that the transferee/buyer is entitled, upon request, to receive certain information regarding the administration of the condominium from the developer or the condominium association, as applicable, pursuant to Tennessee Code Annotated, § 66-27-502.

Click to view form.