Benchmark Listing Agreement

LISTING CHECKLIST
EMAIL listing documents to PAPERLESS PIPELINE:

[email protected]
ALL LISTING PAPERWORK MUST BE COMPLETE
STREET ADDRESS __________________________________________ MLS # __________________

CITY __________________________ ZIP___________ LIST PRICE ________________________
LISTING DATE _____________________ EXPIRATION DATE _____________________
LISTING AGENT(S): __________________________________________________________________
Assistant’s Name (that you want to have access to this file): __________________________________
OFFICE: q Cool Springs-112 q Cool Springs-115 q Hendersonville q West Nashville

q Midtown q Mt. Juliet q Murfreesboro
Please submit the following:
q Printout of Active MLS Sheet (Agent Full version – not Buyer version, not a screenshot)
q Listing Agreement (RF101 or RF131)
q Confirmation of Agency Status (RF302)
q TN Residential Property Condition Disclosure (RF201)
or Property Condition Exemption (RF203) or Property Condition Disclaimer (RF204)
q Additional Required Residential Disclosures (RF205) – If client completed PC Exemption, this

new form is required. Even if client refuses to sign PC Exemption, this form is still required by
Tenn. Code Ann. 66-5-212.
q Disclaimer Notice (RF304)

q RESPA Affiliated Business Disclosure
q (If applicable) Lead-Based Paint Disclosure (pre 1978) (RF209)
q (If applicable) Subsurface Sewage Disposal System Permit Disclosure (RF208)
q (If applicable) Personal Interest Disclosure (RF305)
q (If short sale) Short Sale Listing Amendment (RF602) & Short Sale Disclosure (RF713)
q (If applicable) Referral Agreement (RF701) NOTE: Benchmark’s policy is for the closing
agency to pay all outbound referrals, at the closing table.
Notes:
If applicable, check appropriate box:
q Relist q Limited Service Listing q New Construction q Short Sale

Revised: 02/09/2018
EXCLUSIVE RIGHT TO SELL LISTING AGREEMENT
(Designated Agency)
1 BROKER (listing company): ___________________________________________________________________________
Benchmark Realty, LLC
2 ADDRESS OF COMPANY: ____________________________________________________________________________
2500 21st Ave South No. 102 Nashville TN 37212
3 OWNER/SELLER (“Seller” or “Client”): ________________________________________________________________
4 ADDRESS OF OWNER/SELLER: ______________________________________________________________________
5 In consideration of Broker’s Agreement to find a ready, willing, and able Buyer and other valuable consideration, the receipt
6 and sufficiency of which is hereby acknowledged, the undersigned Seller hereby grants Broker the Exclusive Right to Sell
7 the hereinafter described Property in accordance with the following terms and conditions:
8 1. PROPERTY ADDRESS/LEGAL DESCRIPTION:
9 ________________________________________________________________________________________ (Address)
10 _________________________________________________ (City), Tennessee, _______________ (Zip), as recorded in
11 ________________________________________ County Register of Deeds Office, _________ deed book(s), ________
12 pages(s), _________________ and/or instrument no. and further described as:
13 ________________________________________________________________________________________________
14 together with all fixtures, landscaping, improvements, and appurtenances, all being hereinafter collectively referred to as
15 the “Property”.
16 A. Included as part of the Property (if present): all attached light fixtures and bulbs including ceiling fans; permanently
17 attached plate-glass mirrors; heating, cooling, and plumbing fixtures and equipment; all doors, storm doors and
18 windows; all window treatments (e.g. shutters, blinds, shades, curtains, draperies) and hardware; all wall-to-wall
19 carpet; range; all built-in kitchen appliances; all bathroom fixtures and bathroom mirrors; all gas logs, fireplace
20 doors and attached screens; all security system components and controls; garage door opener and all (at least ___)
21 remote controls; an entry key; swimming pool and its equipment; awnings; permanently installed outdoor cooking
22 grills; all landscaping and all outdoor lighting; mailbox(es); attached basketball goals and backboards; TV mounting
23 brackets (but excluding flat screen TVs); antennae and satellite dishes (excluding components); and central vacuum
24 systems and attachments.
25 B. Other items that remain with the Property at no additional cost to Buyer:
26
27
28 C. Items that will NOT remain with the Property:
29
30
31 D. Leased Items: Leased items that remain with the Property are (e.g. security systems, water softener systems, etc.):
32
33
34 If leases are not assumable, it will be Seller’s responsibility to pay balance.
35 2. THE LISTING PRICE: $______________ (____________________________________________________Dollars)
36 3. TERM: LISTING DATE: ____________________ LISTING EXPIRATION DATE: _______________________
37 If a contract to purchase, exchange, or lease is signed before this Agreement expires, the term hereof shall continue until
38 final disposition of Purchase and Sales Agreement, exchange agreement, or lease agreement.
39 Carry-Over Clause. Should the Seller contract to sell or exchange, or contract to lease the Property within ________
40 days after the expiration of this Agreement to any Buyer/Tenant (or anyone acting on Buyer’s/Tenant’s behalf) who has
41 been introduced to the Property, directly or indirectly, during the term hereof, as extended, the Seller agrees to pay the
42 compensation as set forth below. This includes but is not limited to any introduction or exposure to Property by
43 advertisements or postings appearing in any medium which originated as a result of listing the Property with Broker.
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Unauthorized use of the
Una t form may result in legal sanctions being brought against the user and should be reported to the Tennessee Association of Realtors at (615) 321-1477.
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Copyright 2015 © Tennessee Realtors Version 01/01/2018
RF101 – Exclusive Right to Sell Listing Agreement (Designated Agency), Page 1 of 7
44 This carry-over clause shall not apply if the Property is listed with another licensed real estate broker at the time of such
45 contract.
46 4. POSSESSION OF PROPERTY to be delivered: _______________________________________________________
47 5. TERMS of sale acceptable to Seller (such as FHA, VA, Conventional, etc.):
48 _________________________________________________________________________________________________
49 6. COMPENSATION:
50 A total of $________________________________, or ________% compensation based on the total sales price which
51 shall be paid by Seller to Broker in readily available funds on the date of closing of Property as evidenced by delivery of
52 warranty deed and payment of purchase price which includes, but is not limited to, payment of purchase price in full,
53 execution of a 1031 exchange, execution of a deed of trust, or execution of a promissory note (the “Closing”). In any
54 exchange of the Property, Seller consents to Broker receiving compensation from both parties based upon the value of
55 both properties.
56 In the event that the Property is leased under the terms of this Agreement, Seller agrees to pay a total of
57 $______________________________________ , or __________% compensation based upon the monthly rental amount
58 which shall be paid by Seller to Broker in readily available funds within five business days of rent being due under the
59 terms of said lease. Said compensation shall be paid by Seller to Broker and shall continue for the duration of the lease
60 agreement with compensation being paid to Broker within five business days of rent being due under the terms of the
61 lease. This obligation to pay said compensation shall survive the natural termination of this Agreement. In the event that
62 the Property is sold during the term of any lease agreement reached under this Agreement or any carry-over period
63 described herein, Seller agrees to pay Broker at the time of Closing any remaining compensation based upon future
64 rental payments and/or any compensation that may be due under the terms of this Listing Agreement.
65 In the event a Buyer is found for said Property during the period above set out, on the terms and at the price specified
66 herein, or for a price and upon terms agreeable to Seller, Seller further agrees to convey said Property by warranty deed
67 to such Buyer, free from all assessments, liens and encumbrances, but subject to all restrictions of record, if any. The
68 compensation payable for the sale of Property is not set in any manner other than between Broker and Seller. Property is
69 offered without regard to race, color, religion, sex, handicap, familial status or national origin. A request from Seller to
70 observe discriminatory requirements in the sale or lease of the Property will not be granted since it is a violation of the
71 law.
72 In the event that a ready, willing, and able Buyer (or Tenant) is produced and a contract results, the Seller is obligated to
73 compensate Broker in the event that Seller unlawfully fails to close or to fulfill lease terms by Seller’s breach of the
74 Purchase and Sale Agreement or lease agreement. In the event this occurs, Seller agrees to compensate Broker in an
75 amount equal to the compensation which would have been due and owing Broker had the transaction closed or the lease
76 been fulfilled. Such compensation will be payable without demand. Should the Broker consent to release the Listing
77 prior to the expiration of the term of this Agreement or any extensions, Seller agrees to pay all costs incurred by Broker
78 to market Property or other amount as agreed to by the parties as a cancellation fee, in addition to any other sums that
79 may be due to Broker. Seller agrees to pay all reasonable attorney’s fees together with any court costs and expenses
80 which real estate firm incurs in enforcing any of Seller’s obligations to pay compensation under this Listing Agreement.
81 The parties hereby agree that all remedies are fair and equitable and neither party will assert the lack of mutuality of
82 remedies as a defense in the event of a dispute.
83 7. RESPONSIBILITIES AND RIGHTS OF THE PARTIES.
84 Broker is hereby granted the authority to advertise this listing on the Internet. Broker is additionally permitted to file this
85 listing with any Multiple Listing Service (MLS) or similar service(s) of which Broker is a member. Seller understands
86 and agrees that by placing the listing on the MLS or these similar services, the listing may be included in a searchable
87 database provided by the MLS or similar service which can be viewed on other agents’ websites. Seller also agrees that
88 the listing may also appear on publicly accessible websites sponsored by and/or affiliated with the MLS, the local
89 association of Realtors®, or similar listing services and those who lawfully receive listing information from said entities.
90 Broker shall provide timely notice to MLS of status changes, shall use best efforts to produce a Buyer, and may divide
91 compensation with other real estate licensees for cooperation in connection with the sale or lease of the Property. Broker
92 shall offer a cooperative compensation to any agent who is a member participant of any MLS(es) in which Property is
93 listed in the amount of ________% of Selling Price/monthly rental amount or $_______________________________ to
94 a Selling Agent or Facilitator (an agent who is representing the interests of and/or is working with the Buyer/Tenant)
95 who is the procuring cause of the transaction. Broker may offer a cooperative compensation to an agent who is not a
96 member participant of the MLS(es) in which the Property is listed. In the event that Broker elects to offer a cooperating
97 compensation to an agent who is not a member participant in the MLS(es) in which the Property is listed, it will be in the
98 amount of _______% of Selling Price/monthly rental amount or $_____________________ to a Selling Agent or
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99 Facilitator (an agent who is representing the interests of and/or is working with the Buyer/Tenant) who is the procuring
100 cause of the transaction. In this event, Broker shall notify Seller in writing that a cooperative compensation is being
101 offered to that nonmember participant agent. Seller will assist Broker in any reasonable way in selling Property and will
102 refer to Broker all inquiries regarding this Property during the term of the Agreement, and any extensions or renewals
103 thereof, and authorizes Broker to provide final sales information to the MLS for the purpose of compiling comparable
104 sales data reports.
105 Broker is authorized to place a real estate sign and lock box on the Property and to remove all other real estate signs; to
106 disseminate the Tennessee Residential Property Condition Disclosure, Disclaimer or Exemption form and the Multiple
107 Listing Profile Sheet as well as the Lead-Based Paint Disclosure form and the Additional Required Residential
108 Disclosures form (RF 205) (if either is required by law and if such information is not otherwise disseminated); to exhibit
109 said Property to any prospective Buyer; and to have interior/exterior photographs/videos taken, and/or audio recorded for
110 the creation of any advertising materials of said Property to be used and distributed in promoting the sale and to use same
111 to advertise the Property on the Internet or other broadcast media; and to do such advertising as Broker deems
112 appropriate. In the event that Seller provides photographs, videos or other copyrightable materials to Broker, Seller
113 grants Brokers a nonrevocable license to such material and the authority to grant license to Broker’s MLS for storage;
114 reproduction, compiling and distribution of said material. Seller shall allow the Property to be shown at all reasonable
115 hours and otherwise cooperate with Broker.
116 Seller agrees that Broker is authorized to receive on behalf of Seller all notices, offers, and other documents incidental to
117 the offering and sale of the Property which is covered by this Agreement. Seller agrees that such receipt by Broker may
118 be deemed to be receipt by Seller if such documents so provide or if the law so requires. Seller agrees to keep Broker
119 informed of Seller’s whereabouts in order for Broker to promptly forward all such notices, offers and other information
120 to Seller.
121 8. FOREIGN INVESTMENT IN REAL PROPERTY TAX ACT (“FIRPTA”) DISCLOSURE.
122 Seller is hereby notified to consult with his/her own closing attorney and tax professional concerning the applicability
123 of the Foreign Investment in Real Property Tax Act (“FIRPTA”) which may require tax withholding to be collected
124 from Seller at the Closing of any sale of the Property. Examples of this may include if Seller can be classified as one
125 of the following:
126 Non United States citizen;
127 Non resident alien; or
128 Foreign corporation, partnership, trust, or estate
129 It is Seller’s Responsibility to seek independent tax advice prior to any Closing Date regarding such tax matters.
130 9. HOLD HARMLESS AND LIMITATIONS ON BROKER’S AUTHORITY AND RESPONSIBILITY.
131 Seller agrees to carefully review the information on the Multiple Listing Profile Sheet and to complete either the
132 Tennessee Residential Property Condition Disclosure, Disclaimer, or Exemption form and to sign said documents.
133 Seller also agrees to complete the Lead-Based Paint Disclosure and the Additional Required Residential Disclosures
134 form (RF 205) if required by law and said information has not otherwise been disclosed in writing. Seller has not
135 advised Broker and/or his affiliated Licensees (hereinafter “Agents”) of any defects in the Property or the improvements
136 located thereon, except as shall be noted on the Multiple Listing Profile Sheet and the Tennessee Residential Property
137 Condition Disclosure, Disclaimer, or Exemption form signed by the Seller. Seller is not aware of any other defect or
138 environmental factor which would affect the value of or structural integrity of improvements on the Property or the
139 health of future occupants. Seller agrees that Seller shall be solely responsible for any misrepresentations or mistakes on
140 the listing data wherein Seller has supplied such information on the attached Multiple Listing Profile Sheet, Tennessee
141 Residential Property Condition Disclosure, Disclaimer, or Exemption form; the Lead-Based Paint Disclosure (if required
142 by law); and/or the Additional Required Residential Disclosures form (RF 205) (if required by law). Seller further
143 agrees to hold Agents and firm harmless and indemnify them from any claim, demand, action, liability or proceedings
144 resulting from any omission, alleged omission or misrepresentation by Seller on said forms and/or for any material fact
145 that is known or should be known by Seller concerning the Property and that is not disclosed to Agents and to provide
146 for defense costs including reasonable attorney’s fee for Agents and firm in such an event. Seller is not aware of any
147 other defect, environmental factors or adverse facts (as defined in Tenn. Code Ann § 62-13-102) concerning the
148 Property.
149 Seller authorizes Broker and/or his affiliated Licensees to conduct showings or “Open Houses” of the Property. Seller
150 additionally authorizes Broker and/or his affiliated Licensees and any duly authorized key holder key entry access to the
151 Property. Seller also authorizes Broker and/or his affiliated Licensees to place a lock box on said Property for the
152 purpose of conducting or allowing cooperating brokers to conduct key-entry showings of this Property. Seller represents
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153 that adequate insurance will be kept in force to protect Seller in the event of any damage, losses or claims arising from
154 entry to Property by persons through the above use of the key and agrees to hold Broker, its licensees, salespersons and
155 employees harmless from any loss, theft, or damage incurred as a result of showings, Open Houses or other authorized
156 entry thereof.
157 Seller acknowledges and agrees that Broker:
158 A. May show other properties to prospective buyers who are interested in Seller’s Property;
159 B. Is not an expert with regard to matters that could be revealed through a survey, title search, or inspection; for the
160 condition of the Property, any portion thereof, or any item therein; for any geological issues present on the
161 Property; for the necessity or cost of any repairs to Property; hazardous or toxic materials; square footage;
162 acreage; the availability and cost of utilities, septic, or community amenities; conditions existing off the
163 Property that may affect the Property; uses and zoning of Property, whether permitted or proposed; for
164 applicable boundaries of school districts or other school information; proposed or pending condemnation
165 actions involving the Property; the appraised or future value of the Property; termites and wood destroying
166 organisms; building products and construction techniques; the tax or legal consequences of a contemplated
167 transaction; or matters relating to financing, etc. Seller acknowledges that Broker is not an expert with respect
168 to the above matters and is hereby advised to seek independent expert advice on any of these matters which are
169 of concern to Seller;
170 C. Shall owe no duties to Seller nor have any authority to act on behalf of Seller other than what is set forth in this
171 Agreement and the duties contained in the Tennessee Real Estate License Act of 1973, as amended, and the
172 Tennessee Real Estate Commission Rules; and
173 D. May make all disclosures required by law and/or the National Association of Realtors® Code of Ethics.
174 10. EXPERT ASSISTANCE
175 While Broker has considerable general knowledge of the real estate industry and real estate practices, Broker is not an
176 expert in the matters of law, square footage, acreage, home inspections, geological issues, wood destroying organisms,
177 taxation, financing, surveying, structural conditions, hazardous materials, engineering, etc. Client acknowledges
178 Broker’s advice to seek professional assistance and advice as needed in these and other areas of professional expertise.
179 If Broker provides names or sources for such advice or assistance, Broker does not warrant or guarantee the services
180 and/or products obtained by Client.
181 11. AGENCY
182 A. Definitions.
183 1. Broker. In this Agreement, the term “Broker” shall mean a licensed Tennessee real estate broker or brokerage
184 firm and where the context would indicate, the Broker’s affiliated licensees.
185 2. Designated Agent for the Seller. The individual licensee that has been assigned by his/her Managing Broker
186 and is working as an agent for the Seller or Property Owner in this consumer’s prospective transaction, to the
187 exclusion of all other licensees in his/her company. Even if someone else in the licensee’s company represents
188 a possible Buyer for this Seller’s Property, the Designated Agent for the Seller will continue to work as an
189 advocate for the best interests of the Seller or Property Owner. An agency relationship of this type cannot, by
190 law, be established without a written agency agreement.
191 3. Facilitator/Transaction Broker (not an agent for either party). The licensee is not working as an agent for
192 either party in this consumer’s prospective transaction. A Facilitator may advise either or both of the parties to
193 a transaction but cannot be considered a representative or advocate of either party. “Transaction Broker” may
194 be used synonymously with, or in lieu of, “Facilitator” as used in any disclosures, forms or agreements. [By
195 law, any Licensee or company who has not entered into a written agency agreement with either party in the
196 transaction is considered a Facilitator or Transaction Broker until such time as an agency agreement is
197 established.]
198 4. Dual agency. The licensee has agreements to provide services as an agent to more than one (1) party in a
199 specific transaction and in which the interests of such parties are adverse. This agency status may only be
200 employed upon full disclosure to each party and with each party’s informed consent.
201 5. Adverse Facts. “Adverse Facts” means conditions or occurrences generally recognized by competent licensees
202 that have a negative impact on the value of the real estate, significantly reduce the structural integrity of
203 improvements to real property or present a significant health risk to occupants of the property.
204 6. Confidentiality. By law, every licensee is obligated to protect some information as confidential. This includes
205 any information revealed by a consumer which may be helpful to the other party IF it was revealed by the
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206 consumer BEFORE the licensee disclosed any agency relationship with that other party. AFTER the licensee
207 discloses that he/she has an agency relationship with another party, any such information which the consumer
208 THEN reveals must be passed on by the licensee to that other party.
209 B. Duties owed to all Parties to a Transaction.
210 Pursuant to the Tennessee Real Estate Broker License Act, every Real Estate Licensee owes the following
211 duties to every Buyer and Seller, Tenant and Landlord (collectively “Buyers” and “Sellers”) unless otherwise
212 provided by law:
213 1. To diligently exercise reasonable skill and care in providing services to all parties to the transaction.
214 2. To disclose to each party to the transaction any Adverse Facts of which licensee has actual notice or knowledge.
215 3. To maintain for each party in a transaction the confidentiality of any information obtained by a licensee prior to
216 disclosure to all parties of a written agency agreement entered into by the licensee to represent either or both
217 parties in the transaction. This duty of confidentiality extends to any information which the party would
218 reasonably expect to be held in confidence, except for information which the party has authorized for disclosure
219 or information required by law to be disclosed. This duty survives both the subsequent establishment of an
220 agency relationship and the closing of the transaction.
221 4. To provide services to each party to the transaction with honesty and good faith.
222 5. To disclose to each party to the transaction timely and accurate information regarding market conditions that
223 might affect such transaction only when such information is available through public records and when such
224 information is requested by a party.
225 6. To timely account for earnest money deposits and all other property received from any party to a transaction
226 and
227 7. A. To refrain from engaging in self-dealing or acting on behalf of licensee’s immediate family, or on behalf of
228 any other individual, organization or business entity in which licensee has a personal interest without prior
229 disclosure of such personal interest and the timely written consent of all parties to the transaction, and
230 B. To refrain from recommending to any party to the transaction the use of services of another individual,
231 organization or business entity in which the licensee has an interest or from whom the licensee may receive
232 a referral fee or other compensation for the referral, other than referrals to other licensees to provide real
233 estate services, without timely disclosure to the party who receives the referral, the licensee’s interest in
234 such referral or the fact that a referral fee may be received.
235 C. Duties owed to Client.
236 In addition to the above, the licensee has the following duties to his/her Client if the licensee has become an
237 Agent or Designated Agent in a transaction, pursuant to the Tennessee Real Estate Broker License Act:
238 1. Obey all lawful instructions of the client when such instructions are within the scope of the agency agreement
239 between the licensee and licensee’s client;
240 2. Be loyal to the interests of the client. Licensee must place the interests of the client before all others in
241 negotiation of a transaction and in other activities, except where such loyalty/duty would violate licensee’s
242 duties to a customer in the transaction; and
243 3. Unless the following duties are specifically and individually waived in writing by a client, licensee shall assist
244 the client by:
245 A. Scheduling all Property showings on behalf of the client;
246 B. Receiving all offers and counter offers and forwarding them promptly to the client;
247 C. Answering any questions that the client may have in negotiation of a successful purchase agreement
248 within the scope of the licensee’s expertise; and
249 D. Advising the client as to whatever forms, procedures and steps are needed after execution of the
250 purchase agreement for a successful closing of the transaction.
251 Upon waiver of any of the duties contained in paragraph 11.C.3., a consumer must be advised in writing by
252 such consumer’s agent that the consumer may not expect or seek assistance from any other licensees in the
253 transaction for the performance of said duties.
254 D. Seller’s Authorizations.
255 1. Appointment of Designated Agent. Seller hereby authorizes Managing Broker to appoint the Listing Licensee
256 as Designated Agent for the Seller, to the exclusion of any other licensees associated with Broker. A
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257 Designated Agent for the Seller can and will continue to advocate Seller’s interests in a transaction even if a
258 Designated Agent for the Buyer (other than the licensee below) is also associated with Broker. The Managing
259 Broker hereby appoints ______________________________________________________________________
260 to be the Designated Agent to the Seller in this transaction.
261 2. Appointment of Subsequent Designated Agent. Seller hereby authorizes the Managing Broker, if necessary,
262 to appoint a licensee, other than the licensee named above, as Designated Agent for the Seller, to the exclusion
263 of any other licensees associated with Broker. This shall be accomplished through an amendment to this
264 Agreement, if necessary.
265 3. Default to Facilitator in the event both parties are represented by the same Designated Agent. The
266 Designated Agent shall default to Facilitator status for all showings or transactions involving the same
267 Designated Agent for both the Seller and a prospective buyer, immediately notifying (verbally) the Buyer and
268 the Seller of the need to default to this Facilitator status to be confirmed in writing prior to the execution of the
269 contract. Upon any default to Facilitator status, the former Designated Agent must assume a neutral position
270 and will not be an advocate for either the Seller or any prospective buyers.
271 4. Resumption of Agency Status. In the event that the Designated Agent defaults to a Facilitator status, this
272 Facilitator status will only be temporary. The Facilitator status will only last until any transaction or
273 contemplated transaction in which the parties are all assisted by the same Facilitator is resolved (either because
274 the transaction is closed or the transaction or contemplated transaction between these parties is terminated or not
275 accepted and no further negotiations occur between the parties). At that time, the agent will immediately revert
276 to Designated Agency status for the Seller again.
277 12. EARNEST MONEY/TRUST MONEY. Broker is authorized to accept from Buyer a deposit as earnest money/trust
278 money to be applied to the purchase price for the Property. Such deposit is to be held by Broker in an escrow or trustee
279 account or forwarded to party authorized to hold said funds as set forth in an executed contract for the purchase, lease,
280 exchange, or option agreement until disbursed in accordance with the terms of said agreement.
281 13. TITLE. Seller warrants he is vested with good marketable title to the Property with full authority to execute this
282 Agreement and to sell the Property. Seller shall convey the Property by a good and sufficient general warranty deed.
283 14. HOME PROTECTION PLAN.
284 □ Seller agrees to provide a limited Home Protection Plan at a cost of $___________________ to be funded at closing.
285 Plan company: ____________________________________________________________________________________
286 OR
287 □ Home Protection waived.
288 15. OTHER PROVISIONS.
289 A. Binding Effect, Entire Agreement, Modification, and Assignment. This Agreement shall be for the benefit of,
290 and be binding upon, the parties hereto, their heirs, successors, legal representatives and permitted assigns. This
291 Agreement may only be assigned with the written consent of both parties. This Agreement constitutes the sole and
292 entire agreement between the parties hereto and no modification of this Agreement shall be binding unless signed by
293 all parties or assigns to this Agreement. No representation, promise, or inducement not included in this Agreement
294 shall be binding upon any party hereto. Any assignee shall fulfill all the terms and conditions of this Agreement.
295 B. Governing Law and Venue. This Agreement is intended as a contract for the listing of real property and shall be
296 governed by and interpreted in accordance with the laws and in the courts of the State of Tennessee.
297 C. Terminology. As the context may require in this Agreement: (1) the singular shall mean the plural and vice versa;
298 (2) all pronouns shall mean and include the person, entity, firm or corporation to which they relate; (3) the masculine
299 shall mean the feminine and vice versa; and (4) the term day(s) used throughout this Agreement shall be deemed to
300 be calendar day(s) ending at 11:59 p.m. local time unless otherwise specified in this Agreement. Local time shall be
301 determined by the location of Property.
302 D. Severability. If any portion or provision of this Agreement is held or adjudicated to be invalid or unenforceable for
303 any reason, each such portion or provision shall be severed from the remaining portions or provisions of this
304 Agreement, and the remaining portions or provisions shall be unaffected and remain in full force and effect.
305 E. Fair Housing. Broker and his affiliated Licensees shall provide services without regard to race, color, religion, sex,
306 handicap, familial status, national origin, sexual orientation or gender identity. A request to observe discriminatory
307 practices in the sale, lease, exchange, or option of property will not be granted.
308 16. LEGAL DOCUMENTS. THIS IS AN IMPORTANT LEGAL DOCUMENT CREATING VALUABLE RIGHTS
309 AND OBLIGATIONS. IF YOU HAVE QUESTIONS ABOUT IT, YOU SHOULD REVIEW IT WITH YOUR
310 ATTORNEY. NEITHER THE BROKER NOR ANY AGENT OR FACILITATOR IS AUTHORIZED OR
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311 QUALIFIED TO GIVE YOU ANY ADVICE ABOUT THE ADVISABILITY OR LEGAL EFFECT OF ITS
312 PROVISIONS. BY SIGNING THIS DOCUMENT, YOU ARE CERTIFYING THAT YOU HAVE READ AND
313 ACCEPT THESE TERMS AND ACKNOWLEDGE RECEIPT OF A COPY OF THIS AGREEMENT.
314 17. CONFIDENTIALITY. Information which Seller authorizes Broker and his affiliated Licensees to disclose which
315 might otherwise be confidential:
316
317
318
319
320
321 18. EXHIBITS AND ADDENDA. All exhibits and/or addenda attached hereto, listed below, or referenced herein are
322 made a part of this Agreement.
323
324
325
326
327 19. SPECIAL STIPULATIONS. The following Special Stipulations, if conflicting with any preceding paragraph, shall
328 control:
329
330
331
332
333
334
335
336
337
338 NOTE: Any provisions of this Agreement which are preceded by a “□” must be marked if a part of this Agreement.
339 The party(ies) below have signed and acknowledge receipt of a copy.
340 _____________________________________________ _____________________________________________

Benchmark Realty, LLC
341 BY: Broker or Licensee Authorized by Broker BROKER/FIRM
342 _______________ at __________ o’clock □ am/ □ pm _____________________________________________
2500 21st Ave South No. 102
343 Date Address Nashville TN 37212
344 _____________________________________________ Phone: ________________
615-432-2919 Fax: _________________
615-432-2974
345 Print/Type Name Email: ______________________________________
347 _____________________________________________ _____________________________________________

348 SELLER/OWNER SELLER/OWNER
349 _____________________________________________ _____________________________________________
350 Print/Type Name Print/Type Name
351 _________________ at __________ o’clock □ am/ □ pm _________________ at __________ o’clock □ am/ □ pm
352 Date Date
353 _____________________________________________ _____________________________________________
354 Address Address
355 Phone:________________ (H)_______________ (Cell) Phone: _______________(H) ______________ (Cell)
356 ____________ (W) Email: ____________________ _______________ (W) Email: ___________________
NOTE: This form is provided by TAR to its members for their use in real estate transactions and is to be used as is. By downloading and/or using this form,
you agree and covenant not to alter, amend, or edit said form or its contents except as where provided in the blank fields, and agree and acknowledge that
any such alteration, amendment or edit of said form is done at your own risk. Use of the TAR logo in conjunction with any form other than standardized
forms created by TAR is strictly prohibited. This form is subject to periodic revision and it is the responsibility of the member to use the most recent
available form.
Mike Nichols
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CONFIRMATION OF AGENCY STATUS
1 Every real estate licensee is required to disclose his or her agency status in a real estate transaction to any buyer or
2 seller who is not represented by an agent and with whom the Licensee is working directly in the transaction. The
3 purpose of this Confirmation of Agency Status is to acknowledge that this disclosure occurred. Copies of this
4 confirmation must be provided to any signatory thereof. As used below, "Seller" includes sellers and landlords;
5 "Buyer" includes buyers and tenants. Notice is hereby given that the agency status of this Licensee (or Licensee’s
6 company) is as follows in this transaction:
7 The real estate transaction involving the property located at:
8 ____________________________________________________________________________________________________
9 PROPERTY ADDRESS
10 SELLER NAME: __________________________________ BUYER NAME: _______________________________

11 LICENSEE NAME:_________________________________ LICENSEE NAME: _____________________________
12 in this consumer’s current or prospective transaction is in this consumer’s current or prospective transaction
13 serving as: is serving as:
14 □ Transaction Broker or Facilitator. □ Transaction Broker or Facilitator.
15 (not an agent for either party). (not an agent for either party).
16 □ Seller is Unrepresented. □ Buyer is Unrepresented.
17 □ Agent for the Seller. □ Agent for the Buyer.
18 □ Designated Agent for the Seller. □ Designated Agent for the Buyer.
19 □ Disclosed Dual Agent (for both parties), □ Disclosed Dual Agent (for both parties),
20 with the consent of both the Buyer and the Seller with the consent of both the Buyer and the Seller
21 in this transaction. in this transaction.
22 This form was delivered in writing, as prescribed by law, to any unrepresented buyer prior to the preparation of any offer
23 to purchase, OR to any unrepresented seller prior to presentation of an offer to purchase; OR (if the Licensee is listing a
24 property without an agency agreement) prior to execution of that listing agreement. This document also serves as
25 confirmation that the Licensee’s Agency or Transaction Broker status was communicated orally before any real estate
26 services were provided and also serves as a statement acknowledging that the buyer or seller, as applicable, was informed that
27 any complaints alleging a violation or violations of Tenn. Code Ann. § 62-13-312 must be filed within the applicable statute
28 of limitations for such violation set out in Tenn. Code Ann. § 62-13-313(e) with the Tennessee Real Estate Commission, 710
29 James Robertson Parkway, 3rd Floor, Nashville, TN 37232, PH: (615) 741-2273. This notice by itself, however, does not
30 constitute an agency agreement or establish any agency relationship.
31 By signing below, parties acknowledge receipt of Confirmation of Agency relationship disclosure by Realtor® acting as
32 Agent/Broker OR other status of Seller/Landlord and/or Buyer/Tenant pursuant to the National Association of Realtors®
33 Code of Ethics and Standards of Practice.
34 __________________________________________________ ________________________________________________
35 Seller Signature Date Buyer Signature Date
36 __________________________________________________ ________________________________________________
37 Seller Signature Date Buyer Signature Date
38 __________________________________________________ ________________________________________________
39 Listing Licensee Date Selling Licensee Date
40 __________________________________________________
Benchmark Realty, LLC ________________________________________________
41 Listing Company Selling Company
available form.
Mike Nichols
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RF302 – Confirmation of Agency Status, Page 1 of 1
TENNESSEE RESIDENTIAL PROPERTY CONDITION
DISCLOSURE
1 PROPERTY ADDRESS________________________________________________________ CITY ___________________
2 SELLER’S NAME(S) __________________________________________________________ PROPERTY AGE ________
3 DATE SELLER ACQUIRED THE PROPERTY __________________ DO YOU OCCUPY THE PROPERTY? _________
4 IF NOT OWNER-OCCUPIED, HOW LONG HAS IT BEEN SINCE THE SELLER OCCUPIED THE PROPERTY? _____
5 (Check the one that applies) The property is a □ site-built home □ non-site-built home
6 The Tennessee Residential Property Disclosure Act requires sellers of residential real property with one to four dwelling
7 units to furnish to a buyer one of the following: (1) a residential property disclosure statement (the “Disclosure”), or (2) a
8 residential property disclaimer statement (permitted only where the buyer waives the required Disclosure). Some property
9 transfers may be exempt from this requirement (See Tenn. Code Ann. § 66-5-209). The following is a summary of the
10 buyers’ and sellers’ rights and obligations under the Act. A complete copy of the Act may be found at
11 http://www.lexisnexis.com/hottopics/tncode/ (See Tenn. Code Ann. § 66-5-201, et seq.)
12 1. Sellers must disclose all known material defects and must answer the questions on the Disclosure form in good faith to
13 the best of the seller’s knowledge as of the Disclosure date.
14 2. Sellers must give the buyers the Disclosure form before the acceptance of a purchase contract.
15 3. Sellers must inform the buyers, at or before closing, of any inaccuracies or material changes in the condition that have
16 occurred since the time of the initial Disclosure, or certify that there are no changes.
17 4. Sellers may give the buyers a report or opinion prepared by a professional inspector or other expert(s) or certain
18 information provided by a public agency, in lieu of responding to some or all of the questions on the form (See Tenn.
19 Code Ann. § 66-5-204).
20 5. Sellers are not required to have a home inspection or other investigation in order to complete the Disclosure form.
21 6. Sellers are not required to repair any items listed on the Disclosure form or on any past or future inspection report unless
22 agreed to in the purchase contract.
23 7. Sellers involved in the first sale of a dwelling must disclose the amount of any impact fees or adequate facility taxes
24 paid.
25 8. Sellers are not required to disclose if any occupant was HIV–positive, or had any other disease not likely to be
26 transmitted by occupying a home, or whether the home had been the site of a homicide, suicide or felony, or act or
27 occurrence which had no effect on the physical structure of the property.
28 9. Sellers may provide an “as is”, “no representations or warranties” disclaimer statement in lieu of the Disclosure form
29 only if the buyer waives the right to the required disclosure, otherwise the sellers must provide the completed Disclosure
30 form (See Tenn. Code Ann. § 66-5-202).
31 10. Sellers may be exempt from having to complete the Disclosure form in certain limited circumstances (e.g. public
32 auctions, court orders, some foreclosures and bankruptcies, new construction with written warranty or owner has not
33 resided on the property at any time within the prior 3 years). (See Tenn. Code Ann. § 66-5-209).
34 11. Buyers are advised to include home, wood infestation, well, water sources, septic system, lead-based paint, radon, mold,
35 and other appropriate inspection contingencies in the contract, as the Disclosure form is not a warranty of any kind by
36 the seller, and is not a substitute for any warranties or inspections the buyer may desire to purchase.
37 12. Any repair of disclosed defects must be negotiated and addressed in the Purchase and Sale Agreement; otherwise, seller
38 is not required to repair any such items.
39 13. Buyers may, but do not have to, waive their right to receive the Disclosure form from the sellers if the sellers provide a
40 disclaimer statement with no representations or warranties (See Tenn. Code Ann. § 66-5-202).
41 14. Remedies for misrepresentations or nondisclosure in a Property Condition Disclosure statement may be available to
42 buyer and are set out fully in Tenn. Code Ann. § 66-5-208. Buyer should consult with an attorney regarding any such
43 matters.
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RF 201 – Tennessee Residential Property Condition Disclosure, Page 1 of 5
44 15. Representations in the Disclosure form are those of the sellers only, and not of any real estate licensee, although
45 licensees are required to disclose to all parties adverse facts of which the licensee has actual knowledge or notice.
46 16. Pursuant to Tenn. Code Ann. § 47-18-104(b), sellers of newly constructed residences on a septic system are prohibited
47 from knowingly advertising or marketing a home as having more bedrooms than are permitted by the subsurface sewage
48 disposal system permit.
49 17. Sellers must disclose the presence of any known exterior injection well, the presence of any known sinkhole(s), the
50 results of any known percolation test or soil absorption rate performed on the property that is determined or accepted by
51 the Department of Environment and Conservation, and whether the property is located within a Planned Unit
52 Development as defined by Tenn. Code Ann. § 66-5-213 and, if requested, provide buyers with a copy of the
53 development’s restrictive covenants, homeowner bylaws and master deed. Sellers must also disclose if they have
54 knowledge that the residence has ever been moved from an existing foundation to another foundation.
55 The Buyers and Sellers involved in the current or prospective real estate transaction for the property listed above
56 acknowledge that they were informed of their rights and obligations regarding Residential Property Disclosures, and that this
57 information was provided by the real estate licensee(s) prior to the completion or reviewing of a Tennessee Residential
58 Property Condition Disclosure, a Tennessee Residential Property Condition Disclaimer Statement, or a Tennessee Residential
59 Property Condition Exemption Notification. Buyers and Sellers also acknowledge that they were advised to seek the advice
60 of an attorney on any legal questions they may have regarding this information or prior to taking any legal actions.
61 The Tennessee Residential Property Disclosure Act states that anyone transferring title to residential real property must
62 provide information about the condition of the property. This completed form constitutes that disclosure by the Seller. The
63 information contained in the disclosure is the representation of the owner and not the representation of the real estate licensee
64 or sales person, if any. This is not a warranty or a substitute for any professional inspections or warranties that the purchasers
65 may wish to obtain.
66 Buyers and Sellers should be aware that any sales agreement executed between the parties will supersede this form as
67 to the terms of sale, property included in the sale and any obligations on the part of the seller to repair items identified
68 below and/or the obligation of the buyer to accept such items “as is.”
69 INSTRUCTIONS TO THE SELLER
70 Complete this form yourself and answer each question to the best of your knowledge. If an answer is an estimate, clearly
71 label it as such. The Seller hereby authorizes any agent(s) representing any party in this transaction to provide a copy of this
72 statement to any person or entity in connection with any actual or anticipated sale of the subject property.
73 A. THE SUBJECT PROPERTY INCLUDES THE ITEMS CHECKED BELOW:
74 □ Range □ Wall/Window Air Conditioning □ Garage Door Opener(s) (Number of openers____)
75 □ Window Screens □ Oven □ Fireplace(s) (Number) _____
76 □ Intercom □ Microwave □ Gas Starter for Fireplace
77 □ Garbage Disposal □ Gas Fireplace Logs □ TV Antenna/Satellite Dish
78 □ Trash Compactor □ Smoke Detector/Fire Alarm □ Central Vacuum System and attachments
79 □ Spa/Whirlpool Tub □ Burglar Alarm □ Current Termite contract
80 □ Water Softener □ Patio/Decking/Gazebo □ Hot Tub
81 □ 220 Volt Wiring □ Installed Outdoor Cooking Grill □ Washer/Dryer Hookups
82 □ Sauna □ Irrigation System □ Pool
83 □ Dishwasher □ A key to all exterior doors □ Access to Public Streets
84 □ Sump Pump □ Rain Gutters □ Heat Pump
85 □ Central Heating □ Central Air
86 □ Water Heater □ Electric □ Gas □ Solar
87 □ Other _____________________________________ □ Other __________________________________
88 Garage □ Attached □ Not Attached □ Carport
89 Water Supply □ City □ Well □ Private □ Utility □ Other _______________________
90 Gas Supply □ Utility □ Bottled □ Other
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91 Waste Disposal □ City Sewer □ Septic Tank □ Other _____________________________________________
92 Roof(s): Type _______________________________________ Age (approx): __________________________________
93 Other Items:
94
95
96 To the best of your knowledge, are any of the above NOT in operating condition? □ YES □ NO
97 If YES, then describe (attach additional sheets if necessary):
98
99
100
101 If leases are not assumable, it will be Seller’s responsibility to pay balance.
102 B. ARE YOU (SELLER) AWARE OF ANY DEFECTS/MALFUNCTIONS IN ANY OF THE FOLLOWING?
YES NO UNKNOWN YES NO UNKNOWN
103 Interior Walls □ □ □ Roof □ □ □
104 Ceilings □ □ □ Basement □ □ □
105 Floors □ □ □ Foundation □ □ □
106 Windows □ □ □ Slab □ □ □
107 Doors □ □ □ Driveway □ □ □
108 Insulation □ □ □ Sidewalks □ □ □
109 Plumbing System □ □ □ Central Heating □ □ □
110 Sewer/Septic □ □ □ Heat Pump □ □ □
111 Electrical System □ □ □ Central Air Conditioning □ □ □
112 Exterior Walls □ □ □
113 If any of the above is/are marked YES, please explain:
114 ____________________________________________________________________________________________________
115 C. ARE YOU (SELLER) AWARE OF ANY OF THE FOLLOWING: YES NO UNKNOWN
116 1. Substances, materials or products which may be environmental hazards □ □ □
117 such as, but not limited to: asbestos, radon gas, lead-based paint, fuel
118 or chemical storage tanks, methamphetamine, contaminated soil or
119 water, and/or known existing or past mold presence on the subject
120 property?
121 2. Features shared in common with adjoining land owners, such as walls, but □ □ □
122 not limited to, fences, and/or driveways, with joint rights and obligations
123 for use and maintenance?
124 3. Any authorized changes in roads, drainage or utilities affecting the □ □ □
125 property, or contiguous to the property?
126 4. Any changes since the most recent survey of the property was done? □ □ □
127 Most recent survey of the property: □ (check here if unknown)
128 _________________________________________________________
129 5. Any encroachments, easements, or similar items that may affect your □ □ □
130 ownership interest in the property?
131 6. Room additions, structural modifications or other alterations or □ □ □
132 repairs made without necessary permits?
133 7. Room additions, structural modifications or other alterations or □ □ □
134 repairs not in compliance with building codes?
135 8. Landfill (compacted or otherwise) on the property or any portion □ □ □
136 thereof?
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YES NO UNKNOWN
137 9. Any settling from any cause, or slippage, sliding or other soil problems? □ □ □
138 10. Flooding, drainage or grading problems? □ □ □
139 11. Any requirement that flood insurance be maintained on the property? □ □ □
140 12. Any past or present interior water intrusions(s) from outside home, □ □ □
141 standing water within foundation and/or basement?
142 If yes, please explain. If necessary, please attach an additional sheet
143 and any available documents pertaining to these repairs/corrections.
144
145
146
147 13. Property or structural damage from fire, earthquake, floods, landslides, □ □ □
148 tremors, wind, storm or wood destroying organisms?
149 If yes, please explain (use separate sheet if necessary).
150
151
152 If yes, has said damage been repaired?__________________
153 14. Is the property serviced by a fire department? □ □ □
154 If yes, in what fire department’s service area is the property located?
155 _____________________________________________________________________________________________
156 Is the property owner subject to charges or fees for fire protection, □ □ □
157 such as subscriptions, association dues or utility fees?
158 15. Any zoning violations, nonconforming uses and/or violations of □ □ □
159 “setback” requirements?
160 16. Neighborhood noise problems or other nuisances? □ □ □
161 17. Subdivision and/or deed restrictions or obligations? □ □ □
162 18. A Condominium/Homeowners Association (HOA) which has any authority □ □ □
163 over the subject property?
164 Name of HOA: _________________________________ HOA Address: __________________________________
165 HOA Phone Number: ____________________________ Monthly Dues: __________________________________
166 Special Assessments: _____________________________ Transfer Fees: __________________________________
167 Management Company: ___________________________ Phone: ________________________________________
168 Management Co. Address: ___________________________________________________________________________
169 19. Any “common area” (facilities such as, but not limited to, pools, tennis □ □ □
170 courts, walkways or other areas co-owned in undivided interest with others)?
171 20. Any notices of abatement or citations against the property? □ □ □
172 21. Any lawsuit(s) or proposed lawsuit(s) by or against the seller which affects □ □ □
173 or will affect the property?
174 22. Is any system, equipment or part of the property being leased? □ □ □
175 If yes, please explain, and include a written statement regarding payment
176 information.
177
178
179 23. Any exterior wall covering of the structure(s) covered with exterior □ □ □
180 insulation and finish systems (EIFS), also known as “synthetic stucco”?
181 If yes, has there been a recent inspection to determine whether the structure □ □ □
182 has excessive moisture accumulation and/or moisture related damage?
183 (The Tennessee Real Estate Commission urges any buyer or seller who encounters this product to have a qualified
184 professional inspect the structure in question for the preceding concern and provide a written report of the
185 professional’s finding.)
186 If yes, please explain. If necessary, please attach an additional sheet.
187
188
189 24. Is heating and air conditioning supplied to all finished rooms? □ □ □
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190 If the same type of system is not used for all finished rooms, please explain.
191
192
193
YES NO UNKNOWN
194 25. If septic tank or other private disposal system is marked under item (A), does □ □ □
195 it have adequate capacity and approved design to comply with present state
196 and local requirements for the actual land area and number of bedrooms and
197 facilities existing at the residence?
198 26. Is this property in a historical district or has it been declared historical by □ □ □
199 any governmental authority such that permission must be obtained before
200 certain types of improvements or aesthetic changes to the property are made?
201 27. Is there an exterior injection well anywhere on the property? □ □ □
202 28. Is seller aware of any percolation tests or soil absorption rates being □ □ □
203 performed on the property that are determined or accepted by
204 the Tennessee Department of Environment and Conservation?
205 If yes, results of test(s) and/or rate(s) are attached.
206 29. Has any residence on this property ever been moved from its original □ □ □
207 foundation to another foundation?
208 30. Is this property in a Planned Unit Development? Planned Unit Development □ □
209 is defined pursuant to Tenn. Code Ann. § 66-5-213 as "an area of land,
210 controlled by one (1) or more landowners, to be developed under unified
211 control or unified plan of development for a number of dwelling units,
212 commercial, educational, recreational or industrial uses, or any combination of
213 the foregoing, the plan for which does not correspond in lot size, bulk or type
214 of use, density, lot coverage, open space, or other restrictions to the existing
215 land use regulations." Unknown is not a permissible answer under the statute.
216 31. Is a sinkhole present on the property? A sinkhole is defined pursuant to Tenn. □ □ □
217 Code Ann. § 66-5-212(c) as "a subterranean void created by the dissolution of
218 limestone or dolostone strata resulting from groundwater erosion, causing a
219 surface subsidence of soil, sediment, or rock and is indicated through the
220 contour lines on the property's recorded plat map."
221 D. CERTIFICATION. I/We certify that the information herein, concerning the real property located at
222 _________________________________________________________________________________________________
223 is true and correct to the best of my/our knowledge as of the date signed. Should any of these conditions change prior to
224 conveyance of title to this property, these changes will be disclosed in an addendum to this document.
225 Transferor (Seller) _____________________________________________ Date ____________ Time _____________
226 Transferor (Seller) _____________________________________________ Date ____________ Time _____________

227
Parties may wish to obtain professional advice and/or inspections of the property and to negotiate
228
appropriate provisions in the purchase agreement regarding advice, inspections or defects.
229
230 Transferee/Buyer’s Acknowledgment: I/We understand that this disclosure statement is not intended as a substitute for any
231 inspection, and that I/we have a responsibility to pay diligent attention to and inquire about those material defects which are
232 evident by careful observation. I/We acknowledge receipt of a copy of this disclosure.
233 Transferee (Buyer) _____________________________________________ Date ____________ Time _____________
234 Transferee (Buyer) _____________________________________________ Date ____________ Time _____________

235 If the property being purchased is a condominium, the transferee/buyer is hereby given notice that the transferee/buyer is
236 entitled, upon request, to receive certain information regarding the administration of the condominium from the developer or
237 the condominium association as applicable, pursuant to Tennessee Code Annotated §66-27-502.
NOTE: This form is provided by TAR to its members for their use in real estate transactions and is to be used as is. This form contains language that is in
addition to the language mandated by the state of Tennessee pursuant to the disclosure requirements of the “Tennessee Residential Property Disclosure
Act”. Tennessee Code Annotated § 66-5-201, et seq. By downloading and/or using this form, you agree and covenant not to alter, amend, or edit said form
or its contents except as where provided in the blank fields, and agree and acknowledge that any such alteration, amendment or edit of said form is done at
your own risk. Use of the TAR logo in conjunction with any form other than standardized forms created by TAR is strictly prohibited. This form is subject to
periodic revision and it is the responsibility of the member to use the most recent available form.
Mike Nichols
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TENNESSEE RESIDENTIAL PROPERTY
CONDITION EXEMPTION NOTIFICATION
1 Property Address: _____________________________________________________________________________________
2 Buyer: ______________________________________________________________________________________________
3 Seller: _______________________________________________________________________________________________
4 The Tennessee Residential Property Disclosure Act requires sellers of residential real property with one to four dwelling
5 units to furnish to a buyer one of the following: (1) a residential property disclosure statement (the “Disclosure”), or (2) a
6 residential property disclaimer statement (permitted only where the buyer waives the required Disclosure). Some property
7 transfers may be exempt from this requirement (See Tenn. Code Ann. § 66-5-209). The following is a summary of the
8 buyers’ and sellers’ rights and obligations under the Act. A complete copy of the Act may be found at:
9 http://www.tn.gov/regboards/trec/law.shtml. (See Tenn. Code Ann. § 66-5-201, et seq.)
10 1. Sellers must disclose all known material defects, and must answer the questions on the Disclosure form in good faith to
15 4. Sellers may give the buyers a report or opinion prepared by a professional inspector or other expert(s), or certain
17 Code Ann. § 66-5-204).
22 paid.
30 auctions, court orders, some foreclosures and bankruptcies, new construction with written warranty, or owner has not
31 resided on the property at any time within the prior 3 years). (See Tenn. Code Ann. § 66-5-209).
38 disclaimer statement with no representations or warranties. (See Tenn. Code Ann. § 66-5-202).
41 matters.
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RF203 – Tennessee Residential Property Condition Exemption Notification, Page 1 of 3
56 Property Condition Disclosure, a Tennessee Residential Property Condition Disclaimer Statement, or a Tennessee Residential
57 Property Condition Exemption. Buyers and Sellers also acknowledge that they were advised to seek the advice of an attorney
58 on any legal questions they may have regarding this information or prior to taking any legal actions.
67 The undersigned Seller of the property described as _______________________________________________________
68 does hereby notify Buyer that said property is being offered without a Residential Property Condition Disclosure Statement
69 as provided by the Tennessee Residential Property Disclosure Act. This transfer is excluded under Tenn. Code Ann. § 66-5-
70 209 for the following reason(s):
71 □ This is a transfer pursuant to court order including, but not limited to, transfers ordered by a court in the
72 administration of an estate, transfers pursuant to a writ of execution, transfers by foreclosure sale, transfers by a
73 trustee in a bankruptcy, transfers by eminent domain and transfers resulting from a decree of specific performance.
74 □ This is a transfer to a beneficiary of a deed of trust by a trustor or successor in interest who is in default; transfers by
75 a trustee under a deed of trust pursuant to a foreclosure sale, or transfers by a beneficiary under a deed of trust who
76 has acquired the real property at a sale conducted pursuant to a foreclosure sale under a deed of trust or has acquired
77 the real property by a deed in lieu of foreclosure.
78 □ This is a transfer by a fiduciary in the course of the administration of a decedent’s estate, guardianship,
79 conservatorship or trust.
80 □ This is a transfer from one (1) or more co-owners solely to one (1) or more co-owners. This provision is intended to
81 apply and only does apply in situations where ownership is by a tenancy by the entirety, a joint tenancy or a tenancy
82 in common and the transfer will be made from one (1) or more of the owners to another owner or co-owners holding
83 property either as a joint tenancy, tenancy in common or tenancy by the entirety.
84 □ This is a transfer made by virtue of the record owner’s failure to pay federal, state or local taxes.
85 □ This is a transfer between spouses resulting from a decree of divorce or a property settlement stipulation.
86 □ This is a transfer made solely to any combination of a spouse or a person or persons in the lineal line of
87 consanguinity of one (1) or more of the transferors.
88 □ This is a transfer to or from any governmental entity of public or quasi-public housing authority or agency.
89 □ This is a transfer involving the first sale of a dwelling provided that the builder offers a written warranty.
90 □ This is a transfer of any property sold at public auction.
91 □ This is a transfer of any property where the owner has not resided on the property at any time within three (3) years
92 prior to the date of transfer.
93 □ This is a transfer from a debtor in a chapter 7 or a chapter 13 bankruptcy to a creditor or third party by a deed in lieu
94 of foreclosure or by a quitclaim deed.
95 Pursuant to Tenn. Code Ann. § 66-5-212, Sellers are required to disclose, in writing, the presence of any known exterior
96 injection well on the Property, whether the Sellers have knowledge that any single family residence on the Property has ever
97 been moved from an existing foundation to another foundation, whether the Sellers have knowledge of any percolation tests
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98 or soil absorption rates performed on the Property that are determined or accepted by the Tennessee Department of
99 Environment and Conservation and the results of said tests and/or rates, and the presence of any known sinkholes. Sellers,
100 pursuant to Tenn. Code Ann. § 66-5-213, are also required to disclose in writing if the Property is located in a Planned Unit
101 Development and upon request, provide buyers with a copy of the development’s restrictive covenants, homeowner bylaws
102 and master deed.
103 CHECK ALL THAT APPLY:
104 YES NO UNKNOWN
105 □ □ □ 1. Seller knows of the presence of an exterior injection well on the Property.
106 □ □ □ 2. Seller knows that a single family residence located on Property has been moved from an
107 existing foundation to another foundation.
108 □ □ □ 3. Seller knows of a percolation test(s) that has been performed on the Property that is
109 determined or accepted by the Tennessee Department of Environment and Conservation.
110 If yes, results of test(s) are attached.
111 □ □ □ 4. Seller knows of soil absorption rate(s) that has been performed on the property that is
113 If yes, results of rate(s) are attached.
114 □ □ □ 5. Seller knows of a sinkhole(s) present on the Property. A sinkhole is defined pursuant to
115 Tenn. Code Ann. § 66-5-212(c) as "a subterranean void created by the dissolution of
116 limestone or dolostone strata resulting from groundwater erosion, causing a surface
117 subsidence of soil, sediment, or rock and is indicated through the contour lines on the
118 Property's recorded plat map."
119 □ □ 6. This Property is located in a Planned Unit Development. Planned Unit Development is
120 defined pursuant to Tenn. Code Ann. § 66-5-213 as "an area of land, controlled by one
121 (1) or more landowners, to be developed under unified control or unified plan of
122 development for a number of dwelling units, commercial, educational, recreational or
123 industrial uses, or any combination of the foregoing, the plan for which does not
124 correspond in lot size, bulk or type of use, density, lot coverage, open space, or other
125 restrictions to the existing land use regulations." Upon request, Seller shall provide to
126 buyers copies of the development’s restrictive covenants, homeowner bylaws and master
127 deed. Unknown is not an appropriate response under the statute.
128 Buyer is advised that no representation or warranties, express or implied, as to the condition of the property and its
129 improvements, are being offered by Seller except in the case where transfer involves the first sale of a dwelling in which
130 builder offers a written warranty and those required by Seller pursuant to Tenn. Code Ann. §§ 66-5-212 and 66-5-213.
131 Furthermore, the Buyer should make or have made on the Buyer’s behalf a thorough and diligent inspection of the property.
134 the condominium association, as applicable, pursuant to Tennessee Code Annotated § 66-27-502.
136 _____________________________________________ _____________________________________________

137 SELLER SELLER
138 _______________ at __________ o’clock □ am/ □ pm _______________ at __________ o’clock □ am/ □ pm
139 Date Date
141 _____________________________________________ _____________________________________________
142 BUYER BUYER
144 Date Dat
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TENNESSEE RESIDENTIAL PROPERTY CONDITION
DISCLAIMER STATEMENT
1 Property Address: _____________________________________________________________________________________
2 Buyer: ______________________________________________________________________________________________
3 Seller: _______________________________________________________________________________________________
4 The Tennessee Residential Property Disclosure Act (Tenn. Code Ann. § 66-5-201, et seq.) requires sellers of residential real
5 property with one to four dwelling units to furnish to a buyer one of the following: (1) a residential property disclosure
6 statement (the “Disclosure”), or (2) a residential property disclaimer statement (permitted only where the buyer waives the
7 required Disclosure). Some property transfers may be exempt from this requirement (See Tenn. Code Ann. § 66-5-209). The
8 following is a summary of the buyers’ and sellers’ rights and obligations under the Act. A complete copy of the Act may be
9 found at: http://www.lexisnexis.com/hottopics/tncode/. (See Tenn. Code Ann. § 66-5-201, et seq.)
10 1. Sellers must disclose all known material defects and must answer the questions on the Disclosure form in good faith to
15 4. Sellers may give the buyers a report or opinion prepared by a professional inspector or other expert(s), or certain
17 Code Ann. § 66-5-204).
22 paid.
30 auctions, court orders, some foreclosures and bankruptcies, new construction with written warranty, or owner has not
31 resided on the property at any time within the prior three (3) years). (See Tenn. Code Ann. § 66-5-209).
38 disclaimer statement with no representations or warranties (See Tenn. Code Ann. § 66-5-202).
41 matters.
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RF204 – Tennessee Residential Property Condition Disclaimer Statement, Page 1 of 3
56 Property Condition Disclosure, Tennessee Residential Property Condition Disclaimer Statement or a Tennessee Residential
57 Property Condition Exemption Notification. Buyers and Sellers also acknowledge that they were advised to seek the advice
58 of an attorney on any legal questions they may have regarding this information or prior to taking any legal actions.
66 been moved from an existing foundation to another foundation, and whether the Sellers have knowledge of any percolation
67 tests or soil absorption rates performed on the Property that are determined or accepted by the Tennessee Department of
68 Environment and Conservation and the results of said tests and/or rates, and the presence of any known sinkholes. Sellers,
69 pursuant to Tenn. Code Ann. § 66-5-213, are also required to disclose in writing if the Property is located in a Planned Unit
70 Development and upon request, provide buyers with a copy of the development’s restrictive covenants, homeowner bylaws
71 and master deed.
72 CHECK ALL THAT APPLY:

73 YES NO UNKNOWN
74 □ □ □ 1. Seller knows of the presence of an exterior injection well on the Property.
75 □ □ □ 2. Seller knows that a single family residence located on Property has been moved from an
76 existing foundation to another foundation.
77 □ □ □ 3. Seller knows of a percolation test(s) that has been performed on the Property that is
79 If yes, results of test(s) are attached.
80 □ □ □ 4. Seller knows of soil absorption rate(s) that has been performed on the property that is
82 If yes, results of rate(s) are attached.
83 □ □ □ 5. Seller knows of a sinkhole(s) present on the Property. A sinkhole is defined pursuant to

84 Tenn. Code Ann. § 66-5-212(c) as "a subterranean void created by the dissolution of
85 limestone or dolostone strata resulting from groundwater erosion, causing a surface
86 subsidence of soil, sediment, or rock and is indicated through the contour lines on the
87 Property's recorded plat map."

89 defined pursuant to Tenn. Code Ann. § 66-5-213 as "an area of land, controlled by one
90 (1) or more landowners, to be developed under unified control or unified plan of
91 development for a number of dwelling units, commercial, educational, recreational or
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92 industrial uses, or any combination of the foregoing, the plan for which does not
93 correspond in lot size, bulk or type of use, density, lot coverage, open space, or other
94 restrictions to the existing land use regulations." Upon request, Seller shall provide to
95 buyers copies of the development’s restrictive covenants, homeowner bylaws and master
96 deed. Unknown is not an appropriate response under the statute.
100 RESIDENTIAL PROPERTY DISCLAIMER STATEMENT
101 NOTE TO SELLER(S): Sign this statement only if you elect to sell the property without representations and warranties as to
102 its condition, except as otherwise provided in the Purchase Contract; otherwise, complete and sign the RESIDENTIAL
103 PROPERTY CONDITION DISCLOSURE form.
104 Property Address/Legal Description:
105
106
107 The undersigned Seller(s) of the real property described above makes no representations or warranties as to the condition of
108 the real property or any improvements thereon other than those required by Seller pursuant to Tenn. Code Ann. §§ 66-5-212
109 and 66-5-213. Buyer(s) will be receiving the real property “as is”, that is, with all defects which may exist, if any, except as
110 otherwise provided in the real estate Purchase Contract.
111 SELLER(S) ACKNOWLEDGEMENT

112 The Seller(s) acknowledge having carefully examined this statement and further acknowledge that they have been informed
113 of their rights and obligations under the Tennessee Residential Property Disclosure Act.
115 _____________________________________________ _____________________________________________

116 SELLER SELLER
118 Date Date
119 BUYER(S) ACKNOWLEDGEMENT

120 A disclaimer statement may only be permitted where the purchaser waives the required disclosure under
121 Tenn. Code Ann. § 66-5-202. Buyers acknowledge that by signing below they are waiving their statutory
122 right to the Sellers Property Condition Disclosure. The Buyer(s) acknowledges receipt of this disclaimer
123 statement and further acknowledges that they have been informed of their rights and obligations under the
124 Tennessee Residential Property Disclosure Act.
126 _____________________________________________ _____________________________________________

127 BUYER BUYER
129 Date Date
132 the condominium association, as applicable, pursuant to Tennessee Code Annotated § 66-27-502.
available form.
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TENNESSEE RESIDENTIAL PROPERTY DISCLOSURE
(For Exempt Properties & Property Residential Disclaimers)
1 Regarding: (“Property”) _______________________________________________________________________________
2 PROPERTY ADDRESS
5 been moved from an existing foundation to another foundation, the presence of any known sinkhole, and whether the Sellers
6 have knowledge of any percolation tests or soil absorption rates performed on the Property that are determined or accepted by
7 the Tennessee Department of Environment and Conservation and the results of said tests and/or rates. Sellers, pursuant to
8 Tenn. Code Ann. § 66-5-213, are also required to disclose in writing if the Property is located in a Planned Unit Development
9 as defined therein and upon request, provide buyers with a copy of the development’s restrictive covenants, homeowner
10 bylaws and master deed.
11 ARE YOU (SELLER) AWARE OF ANY OF THE FOLLOWING?:
12 YES NO UNKNOWN
13 □ □ □ 1. An exterior injection well is located on the Property.
14 □ □ □ 2. A single family residence located on Property has been moved from an existing foundation to another
15 foundation.
16 □ □ □ 3. A percolation test(s) has been performed on the Property that is determined or accepted by the
17 Tennessee Department of Environment and Conservation. If yes, results of test(s) are attached.
18 □ □ □ 4. A soil absorption rate(s) has been performed on the Property that is determined or accepted by the
19 Tennessee Department of Environment and Conservation. If yes, results of rate(s) are attached.
21 defined pursuant to Tenn. Code Ann. § 66-5-213 as "an area of land, controlled by one (1) or more
22 landowners, to be developed under unified control or unified plan of development for a number of
23 dwelling units, commercial, educational, recreational or industrial uses, or any combination of the
24 foregoing, the plan for which does not correspond in lot size, bulk or type of use, density, lot coverage,
25 open space, or other restrictions to the existing land use regulations." Upon request, Seller shall provide
26 to Buyer copies of the development’s restrictive covenants, homeowner bylaws and master deed.
27 Unknown is not an appropriate response under the statute.
28 □ □ □ 6. Seller knows of the presence of a sinkhole on the property. A sinkhole is defined pursuant to Tenn.
29 Code Ann. § 66-5-212(c) as "a subterranean void created by the dissolution of limestone or dolostone
30 strata resulting from groundwater erosion, causing a surface subsidence of soil, sediment, or rock and is
31 indicated through the contour lines on the property's recorded plat map."
33 _____________________________________________ _____________________________________________
34 SELLER SELLER
36 Date Date
38 _____________________________________________ _____________________________________________
39 BUYER BUYER
41 Date Date
available form.
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RF205 – Additional Required Residential Disclosures, Page 1 of 1
DISCLAIMER NOTICE
1 The Brokers and their affiliated licensees (hereinafter collectively “Licensees”) involved in the Purchase and Sale
2 Agreement (hereinafter “Agreement”) regarding real estate located at
3 _______________________________________________________________________ (hereinafter “Property”)
4 are not attorneys and are not structural or environmental engineers. They are engaged in bringing together buyers
5 and sellers in real estate transactions. Licensees expressly deny any expertise with respect to advice or informed
6 opinions regarding any of the following matters. This Disclaimer Notice is an express warning to all sellers and
7 buyers that they should not rely on any statement, comment or opinion expressed by any Licensee when making
8 decisions about any of the following matters, including the selection of any professional to provide services on
9 behalf of buyers or sellers. Any professional selected by buyers or sellers should be an “independent, qualified
10 professional”, who complies with all applicable state/local requirements, which may include licensing, insurance,
11 and bonding requirements. It is strongly recommended that buyers include contingency clauses in their offers to
12 purchase with respect to these or any other matters of concern and that buyers, in writing the offer, allow enough
13 time to get an evaluation of the following matters from an independent, qualified professional. The matters listed
14 below are not an exclusive list of actions or circumstances which are not the responsibility of the Licensees with
15 whom you work. These items are examples and are provided only for your guidance and information.
16 1. THE STRUCTURAL OR OTHER CONDITIONS OF THE PROPERTY. Consult with professional
17 engineers or other independent, qualified professionals to ascertain the existence of structural issues, the
18 condition of synthetic stucco (E.I.F.S.) and/or the overall condition of the Property.
19 2. THE CONDITION OF ROOFING. Consult with a bonded roofing company for any concerns about the
20 condition of the roof.
21 3. HOME INSPECTION. We strongly recommend that you have a home inspection, which is a useful tool for
22 determining the overall condition of a home including, but not limited to, electrical, heating, air conditioning,
23 plumbing, water-heating systems, fireplaces, windows, doors and appliances. Contact several sources (like
24 the Tennessee Department of Commerce & Insurance (http://tn.gov/commerce/), the American Society of
25 Home Inspectors (www.ashi.com), the National Association of Certified Home Inspectors (www.nahi.org),
26 and Home Inspectors of Tennessee Association (www.hita.us) and independently investigate the competency
27 of an inspector, including whether he has complied with State and/or local licensing and registration
28 requirements in your area. The home inspector may, in turn, recommend further examination by a specialist
29 (heating-air-plumbing, etc.). Failure to inspect typically means that you are accepting the Property “as
30 is”.
31 4. WOOD DESTROYING ORGANISMS, PESTS AND INFESTATIONS. It is strongly recommended that
32 you use the services of a licensed, professional pest control company to determine the presence of wood
33 destroying organisms (termites, fungus, etc.) or other pests or infestations and to examine the Property for any
34 potential damage from such.
35 5. ENVIROMENTAL HAZARDS. Environmental hazards, such as, but not limited to: radon gas, mold,
36 asbestos, lead-based paint, hazardous wastes, landfills, byproducts of methamphetamine production, high-
37 voltage electricity, noise levels, etc., require advanced techniques by environmental specialists to evaluate,
38 remediate and/or repair. It is strongly recommended that you secure the services of knowledgeable
39 professionals and inspectors in all areas of environmental concern.
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RF304 – Disclaimer Notice, Page 1 of 3
40 6. SQUARE FOOTAGE. There are many ways of measuring square footage. Information is sometimes
41 gathered from tax or real estate records on the Property. Square footage provided by builders, real estate
42 licensees, or tax records is only an estimate with which to make comparisons, but it is not guaranteed. It is
43 advised that you have a licensed appraiser determine actual square footage.
44 7. CURRENT VALUE, INVESTMENT POTENTIAL, OR RESALE VALUE OF THE PROPERTY. A
45 true estimate of the value can only be obtained through the services of a licensed appraiser. No one, not even
46 a professional appraiser, can know the future value of a property. Unexpected and unforeseeable things
47 happen. NOTE: A real estate licensee’s Comparative Market Analysis (CMA) or Broker’s Price Opinion
48 (BPO), etc., while sometimes used to set an asking price or an offer price, is not an appraisal.
49 8. BOUNDARY LINES, EASEMENTS, ENCROACHMENTS, AND ACREAGE. It is strongly advised
50 that you secure the services of a licensed surveyor for a full-stake boundary survey with all boundary lines,
51 easements, encroachments, flood zones, total acreage, etc., clearly identified. It is also advised that you not
52 rely on mortgage loan inspection surveys, previous surveys, plat data, or Multiple Listing Service (MLS) data
53 for this information, even if acceptable to your lender.
54 9. ZONING, CODES, COVENANTS, RESTRICTIONS, AND RELATED ISSUES. Zoning, codes,
55 covenants, restrictions, home owner association by-laws, special assessments, city ordinances, governmental
56 repair requirements and related issues need to be verified by the appropriate sources in writing. If your
57 projected use requires a zoning or other change, it is recommended that you either wait until the change is in
58 effect before committing to a property or provide for this contingency in your Purchase and Sale Agreement.
59 10. UTILITY CONNECTIONS, SEPTIC SYSTEM CAPABILITY, AND RELATED SERVICES. The
60 availability, adequacy, connection and/or condition of waste disposal (sewer, septic system, etc.), water
61 supply, electric, gas, cable, internet, telephone, or other utilities and related services to the Property need to be
62 verified by the appropriate sources in writing. You should have a professional check access and/or
63 connection to public sewer and/or public water source and/or the condition of any septic system(s) and/or
64 wells. To confirm that any septic systems are properly permitted for the actual number of bedrooms, it is
65 recommended that sellers and/or buyers request a copy of the information contained in the file for the
66 Property maintained by the appropriate governmental permitting authority. If the file for this Property cannot
67 be located or you do not understand the information contained in the file, you should seek professional advice
68 regarding this matter. For unimproved land, septic system capability can only be determined by using the
69 services of a professional soil scientist and verifying with the appropriate governmental authorities that a
70 septic system of the desired type, size, location, and cost can be permitted and installed to accommodate the
71 size home that you wish to build.
72 11. FLOODING, DRAINAGE, FLOOD INSURANCE, AND RELATED ITEMS. It is recommended that
73 you have a civil or geotechnical engineer or other independent expert determine the risks of flooding,
74 drainage or run-off problems, erosion, land shifting, unstable colluvial soil, sinkholes and landfills. The risk
75 of flooding may increase and drainage or storm run-off pathways may change. Be sure to consult with the
76 proper governmental authorities, elevation surveyors, and flood insurance professionals regarding flood and
77 elevation certificates, flood zones, and flood insurance requirements, recommendations and costs.
78 12. CONDEMNATION. It is recommended that you investigate whether there are any pending or proposed
79 condemnation proceedings or similar matters concerning any portion of the Property with the State, County
80 and city/town governments in which the Property is located. Condemnation proceedings could result in all or
81 a portion of the Property being taken by the government with compensation being paid to the landowner.
82 13. SCHOOL DISTRICTS AND OTHER SCHOOL INFORMATION. It is advised that you independently
83 confirm school zoning with the appropriate school authorities, as school districts are subject to change. Other
84 school information (rankings, curriculums, student-teacher ratios, etc.) should be confirmed by appropriate
85 sources in writing.
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86 14. INFORMATION ABOUT CRIMES, METHAMPHETAMINE PROPERTIES, OR SEX
87 OFFENDERS. You should consult with local, state and federal law enforcement agencies for information or
88 statistics regarding criminal activity at or near the Property, the presence of methamphetamine manufacturing,
89 or for the location of sex offenders in a given area.
90 15. LEGAL AND TAX ADVICE. You should seek the advice of an attorney and/or certified tax specialist on
91 any legal or tax questions concerning any offers, contracts, issues relating to title or ownership of the
92 Property, or any other matters of concern, including those itemized in this Disclaimer Notice. Real estate
93 licensees are not legal or tax experts, and therefore cannot advise you in these areas.
94 16. RECOMMENDED INSPECTORS, SERVICE PROVIDERS, OR VENDORS. The furnishing of any
95 inspector, service provider or vendor named by the real estate licensee is done only as a convenience and a
96 courtesy, and does not in any way constitute any warranty, representation, or endorsement. Buyers and sellers
97 have the option to select any inspectors, service providers or vendors of the buyer’s or seller’s choice. You
98 are advised to contact several sources and independently investigate the competency of any inspector,
99 contractor, or other professional expert, service provider or vendor and to determine compliance with any
100 licensing, registration, insurance and bonding requirements in your area.
101 The Buyer/Seller acknowledges that they have not relied upon the advice, casual comments, or verbal
102 representations of any real estate licensee relative to any of the matters itemized above or similar matters.
103 The Buyer/Seller understands that it has been strongly recommended that they secure the services of
104 appropriately credentialed experts and professionals of the buyer’s or seller’s choice for the advice and
105 counsel about these and similar concerns.
107 _____________________________________________ _____________________________________________

108 CLIENT/CUSTOMER (□ BUYER / □ SELLER) CLIENT/CUSTOMER (□ BUYER / □ SELLER)
110 Date Date
available form.
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RESPA AFFILIATED BUSINESS DISCLOSURE STATEMENT
Date: ________________
Property Address: ______________________________________________________________
Benchmark Client
or Customer Name(s): _______________________________________________________
Pursuant to the Real Estate Settlement & Procedures Act (“RESPA”) and the regulations adopted
pursuant to that statute, Benchmark Realty, LLC hereby makes the following disclosures:
In order to facilitate your transaction, Benchmark Realty, LLC has established certain affiliated or
related companies or business relationships. You are NOT required to use the listed provider as a
condition for settlement of your loan or repurchase, sale or refinancing of the subject property.
There are frequently other providers available with similar services. You are free to shop around
to determine that you are receiving the best services and the best rate for these services.
Benchmark Realty, LLC is a real estate brokerage business providing residential and commercial
brokerage services to buyers and sellers, and receives compensation on those services.
Title & Escrow Services Disclosure: Benchmark Realty, LLC or individual owner does not have
any interest in any company offering title and escrow services.
Mortgage Disclosure: Bond Mortgage LLC (NMLS # 1587882) provides mortgage lending services. The
controlling principals of Benchmark Realty, LLC own 65% of Bond Mortgage LLC. Benchmark Realty
LLC also receives monetary benefit from an office space rental agreement with Bond Mortgage LLC.
Home Warranty Insurance Disclosure: Benchmark Realty, LLC or individual owner does not have
any interest in any company offering home warranty insurance.
Broker Base Commission: A Broker Base Commission of $150 will be charged to the Buyer or
Seller client or customer represented by Benchmark Realty LLC, exclusive of any other commissions
described in the contract or agency agreements, payable only upon the closing of the subject
property.
I/We have read this disclosure form, and understand that Benchmark Realty, LLC may receive
financial or other benefit as a result of referring me/us to purchase the above-described service
provider(s).
______________________________________ ______________________________________
Benchmark Client/Customer Signature Benchmark Client/Customer Signature
______________________________________
Benchmark Agent Signature
Revised 01/02/2018
RESPA AFFILIATED BUSINESS DISCLOSURE STATEMENT
Date: ________________
Property Address: ______________________________________________________________

Benchmark Client
or Customer Name(s): ______________________________________________________
Pursuant to the Real Estate Settlement & Procedures Act (“RESPA”) and the regulations adopted
pursuant to that statute, Benchmark Realty, LLC hereby makes the following disclosures:
In order to facilitate your transaction, Benchmark Realty, LLC has established certain affiliated or
related companies or business relationships in the area of mortgage. You are NOT required to use
the listed provider as a condition for settlement of your loan or repurchase, sale or refinancing
of the subject property. There are frequently other providers available with similar services. You
are free to shop around to determine that you are receiving the best services and the best rate
for these services.
Benchmark Realty, LLC is a real estate brokerage business providing residential and commercial
brokerage services to buyers and sellers, and receives compensation on those services.
Title & Escrow Services Disclosure: Benchmark Realty, LLC or individual owner does not have
any interest in any company offering title and escrow services.
Mortgage Disclosure: Bond Mortgage LLC (NMLS # 1587882) provides mortgage lending services. The
controlling principals of Benchmark Realty, LLC own 65% of Bond Mortgage LLC. Benchmark Realty
LLC also receives monetary benefit from an office space rental agreement with Bond Mortgage LLC.
Home Warranty Insurance Disclosure: Benchmark Realty, LLC or individual owner does not have
any interest in any company offering home warranty insurance.
I/We have read this disclosure form, and understand that Benchmark Realty, LLC may receive
financial or other benefit as a result of referring me/us to purchase the above-described service
provider(s).
______________________________________ ______________________________________
Benchmark Client/Customer Signature Benchmark Client/Customer Signature
______________________________________
Benchmark Agent Signature
Revised 01/02/2018
LEAD-BASED PAINT DISCLOSURE
1 Federal law mandates that Sellers of housing constructed prior to 1978 must complete certain Lead-Based Paint
2 Disclosure requirements. These should be completed before the Buyer makes an offer and certainly before the
3 Seller accepts a purchase offer, otherwise the Buyer may not be obligated under any contract to purchase such
4 housing.
5 Lead Warning Statement
6 Every purchaser of any interest in residential real property on which a residential dwelling was built prior to 1978
7 is notified that such property may present exposure to lead from lead-based paint that may place young children at
8 risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological
9 damage, including learning disabilities, reduced intelligence quotient, behavioral problems, and impaired
10 memory. Lead poisoning also poses a particular risk to pregnant women. The Seller of any interest in residential
11 real property is required to provide the Buyer with any information on lead-based paint hazards from risk
12 assessments or inspections in the Seller’s possession and notify the Buyer of any known lead-based paint hazards.
13 A risk assessment or inspection for possible lead-based paint hazards is recommended prior to purchase.
14 Property Address: ____________________________________________________________________________
15 Seller Disclosure
16 Seller to check one box below:
17 □ Seller has no knowledge, records, or reports of lead-based paint and/or lead-based paint hazards in the
18 housing.
19 □ Seller is aware of the presence of lead-based paint and/or lead-based paint hazards in the housing and has
20 provided the Buyer with all available records and reports pertaining to lead-based paint and/or lead-based
21 paint hazards in the housing. List any records, reports and/or additional information, including but not limited
22 to the basis for the determination that lead-based paint and/or lead-based paint hazards exists, the location of
23 the lead-based paint and the conditions of the painted surfaces. This requirement includes records or reports
24 regarding common areas. It also includes records or reports of other residential dwellings in multifamily
25 housing, provided that such information is part of an evaluation or reduction of lead-based paint and/or lead-
26 based paint hazards in the target housing as a whole. If no reports or records are available, Seller shall
27 indicate as such.
28 ________________________________________________________________________________________
29 ________________________________________________________________________________________
30 Buyer Acknowledgment
31 1) Buyer has received copies of all records, reports and information listed above (if any);
32 2) Buyer has read the Lead Warning Statement (above) and understands its contents;
33 3) Buyer has received the lead hazard information pamphlet, “Protect Your Family From Lead In Your
34 Home” (Copies available at http://www.hud.gov and http://www.epa.gov);
35 4) Buyer has received a 10-day opportunity (unless the parties mutually agreed upon a different period of
36 time) before becoming obligated under the contract to purchase the housing to conduct a risk assessment
37 or inspection for the presence of lead-based paint hazards. This opportunity is waived if Buyer checks the
38 second box below.
39 Buyer to check one box below:
40 □ Contract is subject to Buyer’s approval of the results of a risk assessment or inspection of the property for the
41 presence of lead-based paint and/or lead-based paint hazards, to be completed at the Buyer’s expense. This
42 contingency shall be satisfied within 10 calendar days after the Binding Agreement Date.
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RF209 – Lead-Based Paint Disclosure, Page 1 of 2
43 □ Buyer waives the opportunity to conduct a risk assessment or inspection for the presence of lead-based paint
44 and/or lead-based paint hazards.
45 Licensee Acknowledgment
46 Licensees have informed the Seller of the Seller’s obligations under 42 U.S.C. § 4852d, as amended, and are
47 aware of listing and selling licensees’ duty to ensure compliance.
48 Certification of Accuracy
49 The Sellers, Buyers, and Licensees have reviewed the information above and certify, to the best of their
50 knowledge, that the information they have provided is true and accurate and they have received a copy hereof.
51 The parties agree that the Licensees' signatures on this document are for certification and acknowledgment
52 purposes only as required and do not make either said Licensee a party to the Purchase and Sale Agreement.
54 _____________________________________________ _____________________________________________
55 SELLER SELLER
57 Date Date
59 _____________________________________________ _____________________________________________
60 BUYER BUYER
62 Date Date
64 ______________________________________________
65 REAL ESTATE LICENSEE FOR SELLER
66 _______________ at __________ o’clock □ am/ □ pm
67 Date
69 ______________________________________________
70 REAL ESTATE LICENSEE FOR BUYER
71 _______________ at __________ o’clock □ am/ □ pm
72 Date
For Information Purposes Only:
__________________________________________
Benchmark Realty, LLC _____________________________________________
Listing Company Selling Company
______________________________________________ __________________________________________________
Independent Licensee Independent Licensee
available form.
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RF209 – Lead-Based Paint Disclosure, Page 2 of 2
SUBSURFACE SEWAGE DISPOSAL SYSTEM PERMIT
DISCLOSURE
1 Regarding: ___________________________________________________________________________________________
PROPERTY ADDRESS
2 The owner of this residential property discloses the following:
3 □ According to the subsurface sewage disposal system permit issued for this property, this property is permitted for _____
4 (number of) bedrooms. A copy of the permit was obtained from the appropriate governmental permitting authority and
5 is attached to this disclosure.
6 □ I/We have requested a copy of the subsurface sewage disposal system permit issued for this property from the
7 appropriate governmental permitting authority. However, I/we were informed that
8 □ The file could not be located.
9 OR
10 □ A permit was not issued for this property.
11 As a result, I/we do not have any knowledge as to the number of bedrooms for which this property has been permitted.
12 NOTE: There may be additional information which may be of interest and/or concern to Buyers contained in the official file
13 with the Tennessee Department of Environment and Conservation, Groundwater Protection division located in the
14 county office regulating septic systems. This file may contain information concerning maintenance that has been
15 done on the system as well as any violations imposed by the state. Buyers are encouraged to obtain this information
16 and if of concern to them, to have a soil engineer interpret the contents of the file. Real estate licensees are not soil
17 engineers and are not experts who can provide an interpretation of the contents of the official file.
18 The following parties have reviewed the information above and certify, to the best of their knowledge, that the information
19 they have provided is true and accurate and acknowledge receipt of a copy:
21 _____________________________________________ _____________________________________________
22 BUYER BUYER
24 Date Date
26 _____________________________________________ _____________________________________________
27 SELLER SELLER
29 Date Date
available form.
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RF208 – Subsurface Sewage Disposal System Permit Disclosure, Page 1 of 1

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LISTING CHECKLIST

EMAIL listing documents to PAPERLESS PIPELINE:

STREET ADDRESS __________________________________________ MLS # __________________

OFFICE: q Cool Springs-112 q Cool Springs-115 q Hendersonville q West Nashville

Please submit the following:

q Additional Required Residential Disclosures (RF205) – If client completed PC Exemption, this

q Disclaimer Notice (RF304)

If applicable, check appropriate box:

q Relist q Limited Service Listing q New Construction q Short Sale

340 _____________________________________________ _____________________________________________

347 _____________________________________________ _____________________________________________

10 SELLER NAME: __________________________________ BUYER NAME: _______________________________

226 Transferor (Seller) _____________________________________________ Date ____________ Time _____________

234 Transferee (Buyer) _____________________________________________ Date ____________ Time _____________

136 _____________________________________________ _____________________________________________

72 CHECK ALL THAT APPLY:

74 □ □ □ 1. Seller knows of the presence of an exterior injection well on the Property.

83 □ □ □ 5. Seller knows of a sinkhole(s) present on the Property. A sinkhole is defined pursuant to

88 □ □ 6. This Property is located in a Planned Unit Development. Planned Unit Development is

100 RESIDENTIAL PROPERTY DISCLAIMER STATEMENT

111 SELLER(S) ACKNOWLEDGEMENT

115 _____________________________________________ _____________________________________________

119 BUYER(S) ACKNOWLEDGEMENT

126 _____________________________________________ _____________________________________________

107 _____________________________________________ _____________________________________________

Property Address: ______________________________________________________________

53 The party(ies) below have signed and acknowledge receipt of a copy.

63 The party(ies) below have signed and acknowledge receipt of a copy.

68 The party(ies) below have signed and acknowledge receipt of a copy.

For Information Purposes Only:

20 The party(ies) below have signed and acknowledge receipt of a copy.

25 The party(ies) below have signed and acknowledge receipt of a copy.

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STREET ADDRESS ________________________ MLS #

340 _ _

347 _ _

10 SELLER NAME: ____ BUYER NAME: _

226 Transferor (Seller) _________________________________ Date Time _

234 Transferee (Buyer) _________________________________ Date Time _

136 _ _

115 _ _

126 _ _

107 _ _