Seller’s Utility Disclosure Form

Seller’s Utility Disclosure Form

**IMPORTANT NOTICE TO SELLER: All information provided in this form will be shared with potential buyers to assist in their purchasing decision. Please complete accurately to the best of your knowledge.
Property Information
Property Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Providers

Let us know who your current providers are:
Who is your Electricity Provider?
Who is your Water Provider?
Is the property served by Sewer or Septic?

Other
Is your property serviced by Gas?
If you answered yes to the previous question, what type of Gas?

Other
Who is your Gas Provider?
What Appliances Require Gas?

Other
Who is your Trash/Recycling Provider? If you use convenience centers, just type convenience.
Who is your Internet Provider?
Other Utility Providers (please specify)
Should be Empty:

Property Information