DocuSign Envelope ID: 64DAB22C-F40C-4419-A307-3CFEF9A727BC

3F6343AE-3ABD-4BC8-BBCF-48AC2758CA7B

CENTURY 21 S.G.R, INC.

EXCLUSIVE LISTING AGREEMENT
(Hereinafter referred to as the Agreement)

To: Century21 S.G.R., Inc. Date: ______________________

1823 S. Michigan Ave., Chicago, IL 60616 Tel 312.326.2121 Fax 312.326.7911 | ID: 16734
1161 W. Madison St., Chicago, IL 60607 Tel 312.455.1322 Fax 312.455.1324 | ID: 14210
6600 N. Lincoln Ave., Lincolnwood, IL 60712 Tel 847.983.4477 Fax 847.983.4436 | ID: 3592

1 1510 N Bosworth
Property Address: ___________________________________________________________________________Unit 3
#___________________
2 Chicago
City: __________________________, Illinois
State: ___________________________________, 606
Zip Code: _____________________
3 In consideration of the following agreements and of Brokers efforts to procure an acquiring party for the property (together
4 with its undivided interest in the common elements, and accumulated reserves, if a condominium), and improvements
5 described below, I/We, the undersigned Seller(s) (hereinafter referred to as Seller) appoint you, the Broker (hereinafter
6 referred to as Broker), the exclusive right to sell (or, at Sellers direction, exchange, lease or grant an option to purchase)
7 the property at a purchase price (or other applicable consideration) of $_________________________________________
415,000
8 (which may be changed from time to time).
9
10 This agreement shall begin at 12:00 AM. on _______________,20__
4/21 17 and shall terminate on ______________,
12/21 20__.
17 This
11 agreement is irrevocable and can only be terminated prior to the termination date by written agreement of the parties. From
12 the date of your acceptance of any offer to purchase the property, unless such offer to purchase is subject to the continual
13 marketing of the property, Broker shall have no further obligation to market, advertise for sale or show your property.
14
15 FIXTURES AND PERSONAL PROPERTY. Seller agrees to transfer to Purchaser by a Bill of Sale, all heating, electrical, and
16 plumbing systems together with the following: (check or enumerate applicable items):
17 ___T.V. Antenna ___Washer
1 ___Central
1 air conditioner ___Electronic garage door(s)
18 ___Refrigerator
1 ___Dryer
1 ___Window air conditioner ___Remote Units(s)
19 ___Oven/Range
1 ___Microwave
1 ___Sump pump ___Electronic air filter
20 ___Central
1 humidifier ___Fireplace
1 gas log ___Fireplace
1 screen and equipment ___Existing
All storms & screens
21 ___Window
All shades, attached shutters, draperies & curtains, hardware & other window treatments ___Ceiling fan
22 Other items included: ________________________________________________________________________________
23 Items excluded: _____________________________________________________________________________________
24
25 POSSESSION: Seller shall surrender possession and remove all debris and Sellers personal property not conveyed to Purchaser
26 no later than ____________.
closing Broker(s) and Seller(s) hereby agree that ___________________________________________,
Steven Powers
27 sales associate(s) affiliated with Broker, is (are) being named as Sellers exclusive designated legal agent(s) under Sellers
28 Exclusive Listing Agreement with Broker. Seller(s) understands and agrees that the Sellers Designated Agent(s) (hereinafter
29 sometimes referred to as Licensee) will be Sellers exclusive legal agent pursuant to the Exclusive Listing Agreement with
30 Broker and Broker will be free to enter into agreements with prospective buyers as legal agents of those buyers. Seller(s) also
31 understands and agrees that neither Broker nor other sales associates affiliated with Broker will be acting as legal agents of
32 the Seller(s). Broker, through one or more Licensees, must provide to Seller, at a minimum, the following services:
33 1. Accept delivery of and present to Seller offers and counteroffers to buy, sell, or lease Sellers property;
34 2. Assist Seller in developing, communicating, negotiating, and presenting offers, counteroffers, and notices that relate to the
35 offers and counteroffers until a lease or purchase agreement is signed and all contingencies are satisfied or waived; and
36 3. Answer Sellers questions relating to the offers, counteroffers, notices, and contingencies.
37
38 SELLER AGREES: To cooperate fully with Broker (and Sellers Designated Agent) and refer all inquiries to Broker (and
39 Sellers Designated Agent), to allow inspection of property and entry at convenient times by Broker and/or cooperating
40 Brokers whether alone or accompanied by Broker, for the purpose of showing it to prospective Purchasers, to conduct all
41 negotiations through Broker, to pay to Broker a commission of _____%
5 of the purchase price, or $ ____________________
N/A
42 whichever is greater and a transaction fee of $350 in the event Broker produces a Purchaser ready, willing and able to
43 purchase the premises on the terms herein provided; or if the property is sold, gifted, exchanged, optioned (and such option is
44 exercised before or subsequent to the termination of this agreement), a joint venture is contracted, or the property is
45 exchanged through or as a result of Brokers service and efforts, or Sellers, or any other person or persons during the period

SellerInitials______________BrokerInitial_______Century21S.G.R.,Inc.|ExecutiveListingAgreement|V13.10|Page1of5

DocuSign Envelope ID: 64DAB22C-F40C-4419-A307-3CFEF9A727BC
3F6343AE-3ABD-4BC8-BBCF-48AC2758CA7B

46 of this agreement; or if the property is sold, gifted, optioned, joint ventured, or exchanged within one hundred eighty (180)
47 days after termination of this agreement to any person to whom the property was submitted during the term of this agreement
48 provided that a valid, bonafide, written listing agreement has not been entered into with another licensed real estate broker
49 during such period. Broker hereby agrees to cooperate _____%
2.5 of purchase price or $ ___________________
N/A minus $ _____
350
50 to any co-broker procuring a buyer for property.
51
52 DUAL REPRESENTATION: Broker and Licensee may undertake a dual representation (represent both the seller or landlord
53 and the buyer or tenant) to sell, exchange, lease, or grant an option to purchase your property or properties they may show
54 you. The undersigned acknowledge they were informed of the possibility of this type of representation. Before signing this
55 document, please read the following: Representing more than one party to a transaction presents a conflict of interest since
56 both clients may rely upon Licensees advice and the clients respective interests may be adverse to each other. Licensee will
57 undertake this representation only with the written consent of ALL clients in the transaction. Any agreement between the
58 clients as to a final contract price and other terms is a result of negotiations between the clients acting in their own best
59 interests and on their own behalf. You acknowledge that Licensee has explained the implications of dual representation,
60 including the risks involved, and understand that you have been advised to seek independent advice from your advisors or
61 attorneys before signing any documents in this transaction.
62
63 WHAT A LICENSEE CAN DO FOR CLIENTS WHEN ACTING AS A DUAL AGENT:
64 1. Treat all clients honestly.
65 2. Provide information about the property to the buyer or tenant.
66 3. Disclose all latent material defects in the property that are known to the Licensee.
67 4. Disclose financial qualification of the buyer or tenant to the seller or landlord.
68 5. Explain real estate terms.
69 6. Help the buyer or tenant to arrange for property inspections.
70 7. Explain closing costs and procedures.
71 8. Help the buyer compare financing alternatives.
72 9. Provide information about comparable properties that have sold so both clients may make educated decisions on what
73 price to accept or offer.
74
75 WHAT A LICENSEE CANNOT DISCLOSE TO CLIENTS WHEN ACTING AS A DUAL AGENT:
76 1. Confidential information that the Licensee may know about the clients, without that clients permission.
77 2. The price the seller or landlord will take other than the listing price without permission of the seller or landlord.
78 3. The price the buyer or tenant is willing to pay without permission of the buyer or tenant.
79 4. A recommended or suggested price the buyer or tenant should offer.
80 5. A recommended or suggested price the seller or landlord should counter with or accept.
81 If either client is uncomfortable with this disclosure and dual representation, please let Licensee know. You are not required
82 to accept this section unless you want to allow the Licensee to proceed as a Dual Agent in this transaction. Seller
83 acknowledges having read the foregoing provisions regarding the issue of Agency and Representation as defined under
84 Illinois License Law. By checking yes, initialing below, and signing this Agreement, you acknowledge that you have read
85 and understand this language and voluntarily consent to the Licensee acting as a Dual Agent (that is, to represent BOTH the
86 Seller or landlord and the Buyer or tenant) should that become necessary. ____Yes ____No (check one) _____ (initials)
87 In the event the property is leased during the term of this agreement, Seller agrees to pay Broker a rental commission of one
88 months rent plus expenses. In the event the property is purchased by the lessee, or an option to purchase is granted to lessee
89 which is then exercised by lessee, then in addition to a rental commission, the sales commission or compensation shall be
90 paid to Broker as set forth above.
91
92 ADDITIONAL TERMS OR INFORMATION: Seller hereby represents the following information to be true and correct:
93 a) Real Estate taxes for 20___
15 are $___________.
5,989
Homeowners Exemption: _____Yes /_____No
94 Senior Citizens Exemption: ______Yes /_____No
95 b) Current monthly assessment $ _________;
168 includes________________________________________________________.
water, scavenger, common ins, exterior maintence
96 c) Percentage of interest in common elements is _____%.
0 Waiver of Right of First Refusal necessary ___Yes / ___No.

97 (check one) aware of a proposed special assessment. Seller shall keep listing Broker informed of all
d) Seller is___ is not___
98 Board of Directors/Managers actions. Seller shall keep Broker informed of all changes to the above.
99 e) If applicable, the amount of special assessment is $_______________
0 with a remaining balance due of $________.
0
100 f) The lot size is approximately _______________________.
N/A If condo, approximate square feet _________________.
N/A
101 g) For residential properties located within the City of Chicago, local ordinances require that all properties must have smoke
102 and carbon monoxide detectors present and in working condition. In addition, Seller shall provide Broker with the

SellerInitials______________BrokerInitial_______Century21S.G.R.,Inc.|ExecutiveListingAgreement|V13.10|Page2of5

DocuSign Envelope ID: 64DAB22C-F40C-4419-A307-3CFEF9A727BC
3F6343AE-3ABD-4BC8-BBCF-48AC2758CA7B

103 following, if applicable, within 72 hours after the written acceptance of this Agreement: (a) Illinois Residential Real
104 Property Disclosure Report; (b) Heat Disclosure; (c) Lead Paint Disclosure; (d) Radon Disclosure; and (e) Zoning
105 Certificate.
106
107 PROVISIONS:
108
109 1. Brokers sole duty is to use Brokers best efforts to effect a sale, exchange, lease, or option of the property, and Broker is not
110 charged with the custody of the property, its management, maintenance, upkeep or repair.
111
112 2. The parties agree that any dispute, controversy, or claim arising out of or relating to this exclusive listing
113 agreement, or any breach thereof by either party, shall be resolved by arbitration in accordance with the
114 Code of Ethics and Arbitration Manual of the National Association of Realtors, as amended from time to
115 time, through the facility of the Chicago Association of Realtors. The parties agree to be bound by any award
116 rendered by any professional standards arbitration hearing panel of the Chicago Association of Realtors and
117 further agree that judgment upon any award rendered by a professional standards arbitration hearing panel
118 of the Chicago Association of Realtors may be entered in any court having competent jurisdiction thereof.
119 The parties agree to execute any arbitration agreement and documents as may be required by the Chicago
120 Association of Realtors to facilitate any arbitration.
121
122 3. Seller shall comply with the Real Estate Settlement Procedures Act of 1974, if applicable, and furnish all information
123 required for compliance therewith, and, if applicable, Seller agrees to comply with the Residential Real Property Disclosure
124 Act.
125
126 4. If the property is other than a condominium or a cooperative, then prior to closing, Seller shall furnish a survey by a licensed
127 land surveyor dated not more than six (6) months prior to date of closing of Real Estate Sale Contract showing the present
128 location of all improvements. If Purchaser or Purchasers mortgagee desires a more recent or extensive survey, same shall be
129 obtained at Purchasers expense. If the property is a condominium, then no later than 15 days from the date hereof Seller
130 shall furnish to Broker a complete set of condominium documents, to include declaration, bylaws, and if available, a survey.
131 If the property is a cooperative, then, no later than 15 days from the date hereof Seller shall furnish to broker a complete set
132 of cooperative documents, to include the proprietary lease or trust agreement, the bylaws, and if available, a survey. In the
133 event the property is a townhouse or condominium and dependent upon the condominium associations governing
134 documents, either upon execution of this multiple listing agreement or upon acceptance of an offer to Purchaser by Seller,
135 Seller shall promptly notify the appropriate representative of the condominium association or any affiliated organization of
136 the contemplated transaction. Seller shall furnish Purchaser a statement from an authorized officer or agent of the
137 condominium association certifying payment of assessments for condominium common expenses, and if applicable, proof of
138 waiver or termination of any right of refusal or general option contained in the declaration of condominium together with any
139 other documents required by the declaration of condominium or its bylaws as a precondition to the transfer of ownership. At
140 time of closing Seller shall deliver to the Purchaser all appropriate documents properly endorsed and a survey or plat of the
141 condominium unit showing the location of all improvements of such unit and further showing any parking spaces or garages
142 that will be conveyed. Seller shall comply with all of the conditions and stipulations of the Illinois Condominium Property
143 Act, as amended, as may be applicable.
144
145 5. Seller shall furnish an owners title insurance policy in the amount of the purchase price showing good and merchantable
146 title, and execute and deliver, or cause to be executed and delivered to Purchaser a proper instrument of conveyance.
147
148 6. Seller hereby indemnifies and holds Broker and Brokers agents harmless, from any and all claims, disputes, litigation,
149 judgments, costs and legal fees from the defense of same, including reasonable attorneys fees and costs, arising from the
150 misrepresentations by the Seller or other incorrect information supplied by the Seller to Broker or any third party.
151
152 7. Where applicable, the singular form shall include the plural, and the masculine form shall include the feminine and neuter.
153
154 8. This agreement shall be binding upon and inure to the benefit of the heirs, executors, administrators, successors, and assigns
155 of the parties hereto.
156
157 9. Seller warrants his authority to execute this agreement and to deal with and on behalf of the said property as herein provided.
158

SellerInitials______________BrokerInitial_______Century21S.G.R.,Inc.|ExecutiveListingAgreement|V13.10|Page3of5

DocuSign Envelope ID: 64DAB22C-F40C-4419-A307-3CFEF9A727BC
3F6343AE-3ABD-4BC8-BBCF-48AC2758CA7B

159 10. If a dispute arises between Seller and Purchaser as to whether a default had occurred, Broker shall hold the earnest money
160 and pay it out as agreed in writing by Seller and Purchaser or as directed by a court of competent jurisdiction. In the event of
161 such dispute Seller agrees that Broker may deposit the funds with the Clerk of the Circuit Court by the filing of an action in
162 the Nature of an Interpleader. The Seller agrees that Broker may be reimbursed from the earnest money for all costs,
163 including reasonable attorneys fees and court costs, related to the filing of the Interpleader and hereby agrees to Indemnify
164 and hold Broker harmless from any and all claims and demands, including the payment of reasonable attorneys fees, costs
165 and expenses arising out of such default claims and demands. If Seller defaults, earnest money, at option of Purchaser, and
166 upon written direction by Seller and Purchaser or as directed by a Court of competent jurisdiction, shall be refunded to
167 Purchaser, but such refunding shall not release Seller from the obligation of this agreement. Notwithstanding anything herein
168 to the contrary, disbursement of earnest money shall be in accordance with the Real Estate License Act, as amended.
169
170 11. Seller understands and agrees that Broker may from time to time represent or assist other sellers who may be interested in
171 selling property to buyers with whom Broker has a buyer agency contract or with whom Broker is working as a customer.
172 The Seller consents to Brokers representation of such other sellers before, during and after the expiration of this Exclusive
173 Listing Agreement and expressly waives any claims, including, but not limited to, breach of fiduciary duty or breach of
174 contract, based solely upon Brokers representation or assistance of other sellers who may be interested in selling property to
175 buyers with whom Broker has a buyer agency contract or with whom Broker is working as a customer.
176
177 12. Promoting and advertising property per the Illinois Real Estate Act of 2000, as revised. Broker is hereby authorized to
178 promote and advertise the Property as Broker deems appropriate, including but not limited to (i) displaying signs on the
179 Property, (ii) placing the Property in any multiple listing service in which Broker's internet website and on the internet
180 websites of other brokers, and/or through any other advertising medium which Broker may subscribe to or otherwise use, and
181 (iv) releasing information as to the amount of the selling price, type of financing, and number of days to sell this Property to
182 any multiple listing service in which Broker participates at the time a contract is executed. Consistent with the foregoing, any
183 internet website on which the Property is promoted may (a) allow third parties to write comments or reviews about the
184 Property, or display a hyperlink to such comments or reviews, or (b) include an automated estimate of the fair market value
185 of the Property, or display a hyperlink to such an estimate. The foregoing notwithstanding, by checking one or both of the
186 boxes at the end of this Paragraph 12, and writing its initials below, Seller requests that on any internet website on which the
187 Property is promoted, one or both of these features be disabled or discontinued. Broker in turn will disable or discontinue
188 such designated features on its website, and will communicate to each multiple listing service in which it participates, and to
189 each broker or other third party on whose internet website the Property is promoted or advertised, that the Seller has elected
190 to have one or both of these features disabled or discontinued. However, notwithstanding any such Seller request, a broker's
191 internet website may (1) communicate the broker's professional judgment concerning the Property, and (2) notify its
192 customers and visitors to its website that a feature has been disabled or discontinued "at the request of Seller".
193
194 Disable/Discontinue Website Features (check any that apply):
195 Disable/Discontinue Comments/Reviews regarding Property;
196 Disable/Discontinue Automated Estimate of Market Value of Property.
197 Initial if boxes above are checked. (Seller initials) _______ (Seller initials) ________.
198
199 13. In the event this Agreement is cancelled by Seller in contravention of the early termination provisions of lines 8 and 9 of this
200 Agreement, unless mutually agreed to in writing by Broker and Seller, Seller shall pay to Broker, upon written demand by
201 Broker a cancellation fee of $2,000 (Two Thousand Dollars) to compensate broker for time, expenses and services involved
202 in marketing the property. In cases of the Sellers breach of this Agreement, Seller shall pay to Broker the commission or
203 compensation previously described within this Agreement payable on the full price previously listed within this Agreement to
204 compensate Broker for his or her time, expenses and services involved in marketing the property. No amendment or
205 alteration with respect to the amount of commission or time of payment of commission shall be valid or binding unless made
206 in writing and signed by the parties hereto. Brokers commission is to be paid at time of execution and delivery of deed,
207 option, lease, joint venture agreement, or installment agreement for deed, whichever occurs sooner, and Broker is authorized
208 to deduct the commission and expenses from the earnest money deposit at such time.
209
210 BROKER IS AUTHORIZED TO ACCEPT AN EARNEST MONEY DEPOSIT FROM PURCHASER. IF
211 PURCHASER DEFAULTS AND SELLER(s) DECLARES A FORFEITURE OF THE EARNEST MONEY, THE
212 EARNEST MONEY SHALL BE APPLIED FIRST TO PAYMENT OF BROKERS COMMISSION AND ANY
213 EXPENSES INCURRED, AND THE BALANCE PAID TO SELLER.
214

SellerInitials______________BrokerInitial_______Century21S.G.R.,Inc.|ExecutiveListingAgreement|V13.10|Page4of5

DocuSign Envelope ID: 64DAB22C-F40C-4419-A307-3CFEF9A727BC
3F6343AE-3ABD-4BC8-BBCF-48AC2758CA7B

215 14. IT IS ILLEGAL FOR EITHER THE SELLER OR THE BROKER TO REFUSE TO DISPLAY OR TO SELL TO ANY
216 PERSON BECAUSE OF ONES MEMBERSHIP IN A PROTECTED CLASS, E.G.: RACE, COLOR, RELIGION,
217 NATIONAL ORIGIN, SEX, ANCESTRY, AGE, MARITAL STATUS, PHYSICAL OR MENTAL HANDICAP,
218 FAMILIAL STATUS, OR ANY OTHER CLASS PROTECTED BY ARTICLE 3 OF THE ILLINOIS HUMAN RIGHTS
219 ACT. SELLER AND BROKER ACKNOWLEDGE THAT THEY SHALL ALSO BE BOUND BY THE PROVISIONS OF
220 STATE AND LOCAL (CITY AND/OR COUNTY) HUMAN RIGHTS OR FAIR HOUSING ORDINANCES IF ANY AND
221 AGREE TO COMPLY WITH SAME.
222
223 15. Seller hereby authorizes Broker and its agent to place an electronic or combination lock box on the above property in
224 accordance with the terms and conditions previously described within this Agreement for the purpose of keeping a key to the
225 property for access by cooperating real estate agents. Seller shall hold Broker, its agents, and any Multiple Listing Service of
226 which Broker is a participant harmless from any and all liability, claims, judgments, obligations, or demands against Broker
227 and/or agent as a result of Sellers authorization to use a Lock Box, including, but not limited to, any and all liabilities and
228 costs, including reasonable attorney fees incurred by Broker and/or agents as a result of this authorization, except for criminal
229 or gross negligence on the part of the Broker and/or agents. Seller has been advised by the Listing Broker on the safeguarding
230 or removal of valuables now located within said premises and the need to obtain personal property insurance through the
231 Sellers insurance company. If the property is leased, Seller acknowledges that he has in fact noticed and advised the
232 tenant/occupant of the foregoing and that the tenant/occupant agrees to the foregoing terms and provisions.
233
234
235
236
237
238
239 SELLER 1 Date_________ 247 SELLER 2 Date_________
240 Signature: ____________________________________ 248 Signature: ____________________________________
241 Ryan Mott
Print Name: ___________________________________ 249 Katie Mott
Print Name: ___________________________________
242 1510 N Bosworth #3
Address:______________________________________ 250 1510 N Bosworth #3
Address:______________________________________
243 585-414-5950
Home Phone: __________________________________ 251 585-233-9266
Home Phone: __________________________________
244 Work Phone: __________________________________ 252 Work Phone: __________________________________
245 Fax: __________________________________________ 253 Fax: __________________________________________
246 supermott@gmail.com
Email: ________________________________________ 254 kburns27@gmail.com
Email: ________________________________________
255 George Xamplas
Sellers Attorney: ____________________________________ 312-345-0510
Tel: ____________________ Fax: __________________
256
257
258
259 BROKER Signature: _______________________________________ ______________
260 Century21 S.G.R., Inc. Managing Broker Date

SellerInitials______________BrokerInitial_______Century21S.G.R.,Inc.|ExecutiveListingAgreement|V13.10|Page5of5

DocuSign Envelope ID: 64DAB22C-F40C-4419-A307-3CFEF9A727BC
3F6343AE-3ABD-4BC8-BBCF-48AC2758CA7B

Illinois REALTORS
RESIDENTIAL REAL PROPERTY DISCLOSURE REPORT
(765 ILCS 77/35)
NOTICE: THE PURPOSE OF THIS REPORT IS TO PROVIDE PROSPECTIVE BUYERS WITH INFORMATION ABOUT MATERIAL
DEFECTS IN THE RESIDENTIAL REAL PROPERTY. THIS REPORT DOES NOT LIMIT THE PARTIES RIGHT TO CONTRACT FOR THE
SALE OF RESIDENTIAL REAL PROPERTY IN AS IS CONDITION. UNDER COMMON LAW, SELLERS WHO DISCLOSE MATERIAL
DEFECTS MAY BE UNDER A CONTINUING OBLIGATION TO ADVISE THE PROSPECTIVE BUYERS ABOUT THE CONDITION OF
THE RESIDENTIAL REAL PROPERTY EVEN AFTER THE REPORT IS DELIVERED TO THE PROSPECTIVE BUYER. COMPLETION OF
THIS REPORT BY THE SELLER CREATES LEGAL OBLIGATIONS ON THE SELLER; THEREFORE SELLER MAY WISH TO CONSULT
AN ATTORNEY PRIOR TO COMPLETION OF THIS REPORT.

Property Address: 1510 N Bosworth #3

City, State & Zip Code: Chicago, Illinois 60642
Sellers Name: Ryan & Katie Mott

This Report is a disclosure of certain conditions of the residential real property listed above in compliance with the Residential Real Property
Disclosure Act. This information is provided as of _____________________________,
4/21/17 20___, and does not reflect any changes made or occurring
after that date or information that becomes known to the seller after that date. The disclosures herein shall not be deemed warranties of any kind by
the seller or any person representing any party in this transaction.
In this form, am aware means to have actual notice or actual knowledge without any specific investigation or inquiry. In this form, a material
defect means a condition that would have a substantial adverse effect on the value of the residential real property or that would significantly impair
the health or safety of future occupants of the residential real property unless the seller reasonably believes that the condition has been corrected.
The seller discloses the following information with the knowledge that even though the statements herein are not deemed to be warranties,
prospective buyers may choose to rely on this information in deciding whether or not and on what terms to purchase the residential real property.
The seller represents that to the best of his or her actual knowledge, the following statements have been accurately noted as yes (correct), no
(incorrect), or not applicable to the property being sold. If the seller indicates that the response to any statement, except number 1, is yes or not
applicable, the seller shall provide an explanation, in the additional information area of this form.

YES NO N/A
1.
___ ___ ___ Seller has occupied the property within the last 12 months. (No explanation is needed.)
2. ___
___ ___ I am aware of flooding or recurring leakage problems in the crawl space or basement.
3. ___
___ ___ I am aware that the property is located in a flood plain or that I currently have flood hazard insurance on the property.
4. ___
___ ___ I am aware of material defects in the basement or foundation (including cracks and bulges).
5. ___
___ ___ I am aware of leaks or material defects in the roof, ceilings, or chimney.
6. ___ ___
___ I am aware of material defects in the walls, windows, doors, or floors.
7. ___ ___
___ I am aware of material defects in the electrical system.
8. ___ ___
___ I am aware of material defects in the plumbing system (includes such things as water heater, sump pump, water
treatment system, sprinkler system, and swimming pool).
9. ___ ___
___ I am aware of material defects in the well or well equipment.
10. ___
___ ___ I am aware of unsafe conditions in the drinking water.
11. ___
___ ___ I am aware of material defects in the heating, air conditioning, or ventilating systems.
12. ___
___ ___ I am aware of material defects in the fireplace or wood burning stove.
13. ___
___ ___ I am aware of material defects in the septic, sanitary sewer, or other disposal system.
14. ___ ___
___ I am aware of unsafe concentrations of radon on the premises.
15. ___ ___
___ I am aware of unsafe concentrations of or unsafe conditions relating to asbestos on the premises.
16. ___ ___
___ I am aware of unsafe concentrations of or unsafe conditions relating to lead paint, lead water pipes, lead plumbing pipes
or lead in the soil on the premises.
17. ___
___ ___ I am aware of mine subsidence, underground pits, settlement, sliding, upheaval, or other earth stability defects on the
premises.
18. ___
___ ___ I am aware of current infestations of termites or other wood boring insects.
19. ___
___ ___ I am aware of a structural defect caused by previous infestations of termites or other wood boring insects.
20. ___
___ ___ I am aware of underground fuel storage tanks on the property.
21. ___
___ ___ I am aware of boundary or lot line disputes.
22. ___
___ ___ I have received notice of violation of local, state or federal laws or regulations relating to this property, which violation
has not been corrected.
23. ___ ___
___ I am aware that this property has been used for the manufacture of methamphetamine as defined in Section 10 of the
Methamphetamine Control and Community Protection Act.

Note: These disclosures are not intended to cover the common elements of a condominium, but only the actual residential real property
including limited common elements allocated to the exclusive use thereof that form an integral part of the condominium unit.
Note: These disclosures are intended to reflect the current condition of the premises and do not include previous problems, if any, that the seller
reasonably believes have been corrected.

FORM 108 (7/28/16) COPYRIGHT ILLINOIS REALTORS Page 1 of 4

DocuSign Envelope ID: 64DAB22C-F40C-4419-A307-3CFEF9A727BC
3F6343AE-3ABD-4BC8-BBCF-48AC2758CA7B

If any of the above are marked not applicable or yes, please explain here or use additional pages, if necessary:

Check here if additional pages used: ______

Seller certifies that seller has prepared this statement and certifies that the information provided is based on the actual notice or actual knowledge of
the seller without any specific investigation or inquiry on the part of the seller. The seller hereby authorizes any person representing any principal in
this transaction to provide a copy of this report, and to disclose any information in the report, to any person in connection with any actual or
anticipated sale of the property.

Seller: Date:

Seller: Date:

THE PROSPECTIVE BUYER IS AWARE THAT THE PARTIES MAY CHOOSE TO NEGOTIATE AN AGREEMENT FOR THE SALE OF
THE PROPERTY SUBJECT TO ANY OR ALL MATERIAL DEFECTS DISCLOSED IN THIS REPORT (AS IS). THIS DISCLOSURE IS
NOT A SUBSTITUTE FOR ANY INSPECTIONS OR WARRANTIES THAT THE PROSPECTIVE BUYER OR SELLER MAY WISH TO
OBTAIN OR NEGOTIATE. THE FACT THAT THE SELLER IS NOT AWARE OF A PARTICULAR CONDITION OR PROBLEM IS NO
GUARANTEE THAT IT DOES NOT EXIST. THE PROSPECTIVE BUYER IS AWARE THAT HE MAY REQUEST AN INSPECTION OF THE
PREMISES PERFORMED BY A QUALIFIED PROFESSIONAL.

Prospective Buyer: ________________________________________________________ Date: ______________ Time: _________

Prospective Buyer: ________________________________________________________ Date: ______________ Time: _________

A COPY OF ARTICLE 2 OF THE RESIDENTIAL REAL PROPERTY DISCLOSURE ACT IS AFFIXED HERETO AND SHOULD BE
REVIEWED BY PROSPECTIVE BUYER.

FORM 108 (7/28/16) COPYRIGHT ILLINOIS REALTORS Page 2 of 4

DocuSign Envelope ID: 64DAB22C-F40C-4419-A307-3CFEF9A727BC
3F6343AE-3ABD-4BC8-BBCF-48AC2758CA7B

RESIDENTIAL REAL PROPERTY DISCLOSURE ACT

ARTICLE 2: DISCLOSURES
765 ILCS 77/5 et seq.

Section 5. Definitions: As used in this Act, unless the context otherwise requires the following terms have the meaning given in this section:
Residential real property means real property improved with not less than one nor more than four residential dwelling units: units in
residential cooperatives; or, condominium units including the limited common elements allocated to the exclusive use thereof that form an integral
part of the condominium unit. The term includes a manufactured home as defined in subdivision (53) of Section 9-102 of the Uniform Commercial
Code that is real property as defined in the Conveyance and Encumbrance of Manufactured Homes as Real Property and Severance Act.
Seller means every person or entity who is an owner, beneficiary of a trust, contract purchaser or lessee of a ground lease, who has an interest
(legal or equitable) in residential real property. However, seller shall not include any person who has both (i) never occupied the residential real
property and (ii) never had the management responsibility for the residential real property nor delegated such responsibility for the residential real
property to another person or entity.
Prospective buyer means any person or entity negotiating or offering to become an owner or lessee of residential real property by means of a
transfer for value to which this Act applies.
Section 10. Applicability. Except as provided in Section 15, this Act applies to any transfer by sale, exchange, installment land sale-contract,
assignment of beneficial interest, lease with an option to purchase, ground lease or assignment of ground lease of residential real property.
Section 15. Applicability; Exceptions. The provisions of this Act do not apply to the following:
(1) Transfers pursuant to court order, including, but not limited to, transfers ordered by a probate court in administration of an estate, transfers
between spouses resulting from a judgment of dissolution of marriage or legal separation, transfers pursuant to an order of possession, transfers by a
trustee in bankruptcy, transfers by eminent domain and transfers resulting from a decree for specific performance.
(2) Transfers from a mortgagor to a mortgagee by deed in lieu of foreclosure or consent judgment, transfer by judicial deed issued pursuant to
a foreclosure sale to the successful bidder or the assignee of a certificate of sale, transfer by a collateral assignment of a beneficial interest of a land
trust, or a transfer by a mortgagee or a successor in interest to the mortgagees secured position or a beneficiary under a deed in trust who has
acquired the real property by deed in lieu of foreclosure, consent judgment or judicial deed issued pursuant to a foreclosure sale.
(3) Transfers by a fiduciary in the course of the administration of a decedents estate, guardianship, conservatorship, or trust.
(4) Transfers from one co-owner to one or more other co-owners.
(5) Transfers pursuant to testate or intestate succession.
(6) Transfers made to a spouse, or to a person or persons in the lineal line of consanguinity of one or more of the sellers.
(7) Transfers from an entity that has taken title to residential real property from a seller for the purpose of assisting in the relocation of the
seller, so long as the entity makes available to all prospective buyers a copy of the disclosure form furnished to the entity by the seller.
(8) Transfers to or from any governmental entity.
(9) Transfers of newly constructed residential real property that has not been occupied.
Section 20. Disclosure Report; Completion; Time of Delivery. A seller of residential real property shall complete all applicable items in the
disclosure document described in Section 35 of this Act. The seller shall deliver to the prospective buyer the written disclosure statement required by
this Act before the signing of a written agreement by the seller and prospective buyer that would, subject to the satisfaction of any negotiated
contingencies, require the prospective buyer to accept a transfer of the residential real property.
Section 25. Liability of seller.
(a) The seller is not liable for any error, inaccuracy, or omission of any information delivered pursuant to this Act if (i) the seller had no
knowledge of the error, inaccuracy, or omission, (ii) the error, inaccuracy, or omission was based on a reasonable belief that a material defect or other
matter not disclosed had been corrected, or (iii) the error, inaccuracy, or omission was based on information provided by a public agency or by a
licensed engineer, land surveyor, structural pest control operator, or by a contractor about matters within the scope of the contractors occupation and
the seller had no knowledge of the error, inaccuracy, or omission.
(b) The seller shall disclose material defects of which the seller has actual knowledge.
(c) The seller is not obligated by this Act to make any specific investigation or inquiry in an effort to complete the disclosure statement.
Section 30. Disclosure supplement. If, prior to closing, any seller has actual knowledge of an error, inaccuracy, or omission in any prior
disclosure document after delivery of that disclosure document to a prospective buyer, that seller shall supplement the prior disclosure document with
a written supplemental disclosure.
Section 35. Disclosure report form. . . .[omitted]
Section 40. Material defect. If a material defect is disclosed in the Residential Real Property Disclosure Report, after acceptance by the
prospective buyer of an offer or counter-offer made by a seller or after the execution of an offer made by a prospective buyer that is accepted by the
seller for the conveyance of the residential real property, then the Prospective Buyer may, within three business days after receipt of that Report by
the prospective buyer, terminate the contract or other agreement without any liability or recourse except for the return to prospective buyer of all
earnest money deposits or down payments paid by prospective buyer in the transaction. If a material defect is disclosed in a supplement to this
disclosure document, the prospective buyer shall not have a right to terminate unless the material defect results from an error, inaccuracy, or omission
of which the seller had actual knowledge at the time the prior disclosure document was completed and signed by the seller. The right to terminate the
contract, however, shall no longer exist after the conveyance of the residential real property. For purposes of this Act the termination shall be deemed
to be made when written notice of termination is personally delivered to at least one of the sellers identified in the contract or other agreement or
when deposited, certified or registered mail, with the United States Postal Service, addressed to one of the sellers at the address indicated in the
contract or agreement, or, if there is not an address contained therein, then at the address indicated for the residential real property on the Report.
Section 45. Effect of Act on Other Statutes or Common Law. This Act is not intended to limit or modify any obligation to disclose created
by any other statute or that may exist in common law in order to avoid fraud, misrepresentation, or deceit in the transaction.
Section 50. Disclosure Report; Method of Delivery. Delivery of the Residential Real Property Disclosure Report provided by this Act shall
be by:
(1) personal or facsimile delivery to the prospective buyer;
(2) depositing the report with the United States Postal Service, postage prepaid, first class mail, addressed to the prospective buyer at the
address provided by the prospective buyer or indicated on the contract or other agreement; or
(3) depositing the report with an alternative delivery service such as Federal Express, UPS, or Airborne, delivery charges prepaid, addressed to
the prospective buyer at the address provided by the prospective buyer or indicated on the contract or other agreement.

FORM 108 (7/28/16) COPYRIGHT ILLINOIS REALTORS Page 3 of 4

DocuSign Envelope ID: 64DAB22C-F40C-4419-A307-3CFEF9A727BC
3F6343AE-3ABD-4BC8-BBCF-48AC2758CA7B

For purposes of this Act, delivery to one prospective buyer is deemed delivery to all prospective buyers. Delivery to an authorized individual
acting on behalf of a prospective buyer constitutes delivery to all prospective buyers. Delivery of the Report is effective upon receipt by the
prospective buyer. Receipt may be acknowledged on the Report, in an agreement for the conveyance of the residential real property, or shown in any
other verifiable manner.
Section 55. Violations and damages. If the seller fails or refuses to provide the disclosure document prior to the conveyance of the residential
real property, the buyer shall have the right to terminate the contract. A person who knowingly violates or fails to perform any duty prescribed by any
provision of this Act or who discloses any information on the Residential Real Property Disclosure Report that he knows to be false shall be liable in
the amount of actual damages and court costs, and the court may award reasonable attorney fees incurred by the prevailing party.
Section 60. Limitation of Action. No action for violation of this Act may be commenced later than one year from the earlier of the date of
possession, date of occupancy or date of recording of an instrument of conveyance of the residential real property.
Section 65. Disclosure Report Form; Contents; Copy of Act. A copy of this Act, excluding Section 35, must be printed on or as a part of the
Residential Real Property Disclosure Report form.

Date provided to Buyer: ______________________________

Seller: _______________________________________________________________

FORM 108 (7/28/16) COPYRIGHT ILLINOIS REALTORS Page 4 of 4