1. 414 North William Street_COA 2025-0310B PACKET

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Property address (number and street, city, state, and ZIP code) 414 North William Street, South Bend, IN 46601 i D. HEATING & COOLING SYSTEM Not Applicable / Rented Defective Not Defective Unknown Attic Fan ■ ■ ■ ❑ Boiler / Radiator 0 Central Air Conditioning e Electric Heat Pump Furnace Heat / Gas ■ ❑ ❑ • Furnace Heat / Electric ■ ■ ■ 0 Geothermal ■ ■ ■ ■ Solar House -Heating ■ ■ ■ ❑ Woodburning Stove ■ ❑ ■ 0 Fireplace ❑ Fireplace Insert ■ ■ ■ ■ Air Cleaner ■ ■ ■ ■ Humidifier ❑ ■ ■ ■ Propane Tank • • • ❑ Other Heating Source ■ ■ ■ ❑ 2. ROOF Yes No Unknown Age, if known: Years. ■ ■ ■ Does the roof leak? ■ ■ ■ Is there present damage to the roof? ❑ 0 ❑ Is there more than one layer of shingles on the house? ❑ 0 0 If yes, how many layers? ■ ■ ❑ 3. WATER HEATER ■ ■ ■ Age, if known: Years. ■ ■ ❑ 4. FURNACE ■ ■ ■ Age, if known: Years. ■ ■ ■ 5. CENTRAL AIR CONDITIONING ■ ■ ■ Age, if known: Years. ■ ■ 0 6. HAZARDOUS CONDITIONS Yes No Unknown Have there been or are there any hazardous conditions on the property, such as methane gas, lead paint, radon gas in house or well, radioactive material, landfill, mineshaft, expansive soil, toxic materials, mold, other biological contaminants, asbestos insulation, or PCB's? n Is there contamination caused by the manufacture of a controlled substance on the property that has not been certified as decontaminated by an inspector approved under IC 15-19-3.1? ■ 0 ■ Has there been manufacture of methamphetamine or dumping of waste from the manufacture of methamphetamine in a residential structure on the property? • • • Explain:Asbestos removal complete. SELLER NEVER LIVED AT HOUSE The information contained in this Disclosure has been furnished by the Seller, who certifies to the truth thereof, based on the Seller's CURRENT ACTUAL KNOWLEDGE. A disclosure form is not a warranty by the owner or the owners broker, if any, and the disclosure form may not be used as a substitute for any inspections or warranties that the prospective buyer or owner may later obtain. At or before settlement, the owner is required to disclose any material change in the physical condition of the property or certify to the purchaser at settlement that the condition of the property is substantially the same as it was when the disclosure form was provided. Seiler and Purchaser hereby acknowledge receipt of this Disclosure by signing below. Signature of Seller 1 Date (mm /dd / yyyy) Signature of Buyer I Date (mm /dd /yyyy) C.rz—a AfEr�se( a ciore 6v Win,:'« µ szT 1 aignarure at sewer i [sate imm / as I yyyy) signature or buyer I uate (mm / ea / yyyy) The Seller hereby certifies that the condition of the property is substantially the same as it was when the Seller's Disclosure form was originally provided to the Buyer. Signature of Seller (at dosing) L Dale (mm 1 dd I yyyy) Signature of Seller (al closing) Date (mm I dd 1 yyyy)