Property Condition Confirmation Form 1-13

Property Condition Confirmation Form 1-13

Property Condition Confirmation Form 
(Notification for Land  & Building  / Land) (Property Name: __________)
(There is no need to fill in items ① through ⑪ if the land is currently vacant nor to fill in items ① through ③ and ⑦ through ⑪ if the land is to be handed over after the building is demolished.)

​The Seller hereby provides the Buyer with the following information regarding the condition of the property for sale that the Seller is currently aware of.

Property Condition
​In addition to normal wear and tear over time, the property is in the following condition.

① Rainwater leaks​
□ No leaks have been found to date.
□ There have been leaks in the past. Location(s): _____　
Repair work: not yet completed / completed (month and year)
□ There are currently leaky areas. Location(s):_____
② Termite damage
□ No termite damage has been found to date.
□ Termite prevention work: not done/done (month and year)
□ Termite damage has occurred in the past. (month and year)
Extermination and repair work: not yet completed / completed (month and year)
□ There is currently termite damage. Location(s): _____
③ Building defects (tilt, corrosion, problems, etc.)
□ Not found
□ Found 
Location(s) and condition(s): _____
④ ​Failure or leakage of water supply and drainage facilities
□ Not found
□ Found 
Location(s) and condition(s): _____
⑤ History and documentation of renovations, extensions, repairs, remodeling, and changes in use
□ Not conducted
□ Conducted (month and year)
□ Unknown
Location(s) and condition(s): _____
Construction company: _____
Building permit: Yes/No
Inspection certificate: Yes/No
Design specifications: Yes/No
⑥ Damage from fires (including a small fire)
□ No
□ Yes (month and year)
Location and condition: _____
⑦ Records of asbestos use survey results​
Date of survey: month/date/year
Organization that conducted the survey: _____
Scope of survey：_____
Remarks: _____

⑧ Inspection of building conditions
Yes/No
(□ Building Condition Inspection Report ​□ Building Condition Inspection Report Summary)
Date: month/date/year
Inspected by: _____
⑨ ​Seismic diagnosis and earthquake safety data
Yes/No
​(Available documents)
□ Certificate of Compliance with Earthquake Resistance Standards
□ Report of Seismic Assessment Results 
□ Existing Home Performance Evaluation Report
□ Certificate of Existing Home Sales Defect Insurance
□ Other: _____
⑩ Housing Performance Evaluation
Yes/No (Available documents)
□ Housing Design Performance Evaluation Report
□ Housing Construction Performance Evaluation Report
□ Existing Home Performance Evaluation Report
⑪ Documentation at the time of construction and the name of the developer
Building permit: Yes/No
Design specifications: Yes/No
Inspection certificate: Yes/No
Developer / real estate agent: _____
⑫ About the boundaries
Boundary with the adjacent land: confirmed / not confirmed
Location(s) that cannot be confirmed: _____
Written agreement: Yes/No
Disputes: Yes/No
​Details of the disputes: _____
⑬ Issues involving the boundaries
Is there anything crossing the boundaries?  Yes/No/Unknown
Objects/equipment crossing the boundaries: 
□ Wall □ Fence □ Retaining wall □ Building □ Trees and plants □ Water pipe □ Drainage pipe　
□ Gas pipe □ Other: _____
Written agreement: Yes/No
Disputes: Yes/No
Details of the disputes: _____
​Location(s)/circumstances: _____