DOS form for Buyers

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New York State
DEPARTMENT OF STATE
Division of licensing services

P.O. Box 22001
Albany, NY 12201-2001
Customer Service: (518) 474-4429
www.dos.state.ny.us

New York State Disclosure Form for Buyer and Seller

THIS IS NOT A CONTRACT

New York State law requires real estate licensees who
are acting as agents of buyers or sellers of property to
advise the potential buyers or sellers with whom they
work of the nature of their agency relationship and the
rights and obligations it creates. This disclosure will help
you to make informed choices about your relationship
with the real estate broker and its sales agents.

Throughout the transaction you may receive more than
one disclosure form. The law may require each agent
assisting in the transaction to present you with this disclosure form. A real estate agent is a person qualified to
advise about real estate.

If you need legal, tax or other advice, consult with a
professional in that field.

Disclosure Regarding Real Estate
Agency Relationships
- Seller’s Agent A seller’s agent is an agent who is engaged by a seller to
  represent the seller’s interests. The seller’s agent does this
  by securing a buyer for the seller’s home at a price and on
  terms acceptable to the seller. A seller’s agent has, without limitation, the following fiduciary duties to the seller:
  reasonable care, undivided loyalty, confidentiality, full
  disclosure, obedience and duty to account. A seller’s
  agent does not represent the interests of the buyer. The
  obligations of a seller’s agent are also subject to any specific provisions set forth in an agreement between the
  agent and the seller. In dealings with the buyer, a seller’s
  agent should (a) exercise reasonable skill and care in performance of the agent’s duties; (b) deal honestly, fairly
  and in good faith; and (c) disclose all facts known to the
  agent materially affecting the value or desirability of
  property, except as otherwise provided by law.
- Buyer’s Agent A buyer’s agent is an agent who is engaged by a buyer to
  represent the buyer’s interests. The buyer’s agent does
  this by negotiating the purchase of a home at a price and
  on terms acceptable to the buyer. A buyer’s agent has,
  without limitation, the following fiduciary duties to the
  buyer: reasonable care, undivided loyalty, confidentiality,
  full disclosure, obedience and duty to account. A buyer’s
  agent does not represent the interest of the seller. The obligations of a buyer’s agent are also subject to any specific provisions set forth in an agreement between the agent
  and the buyer. In dealings with the seller, a buyer’s agent
  should (a) exercise reasonable skill and care in performance of the agent’s duties; (b) deal honestly, fairly and
  in good faith; and (c) disclose all facts known to the agent
  materially affecting the buyer’s ability and/or willingness
  to perform a contract to acquire seller’s property that are
  not inconsistent with the agent’s fiduciary duties to the
  buyer.
- Broker’s Agents
  A broker’s agent is an agent that cooperates or is engaged
  by a listing agent or a buyer’s agent (but does not work
  for the same firm as the listing agent or buyer’s agent) to
  assist the listing agent or buyer’s agent in locating a
  property to sell or buy, respectively, for the listing agent’s
  seller or the buyer agent’s buyer. The broker’s agent does
  not have a direct relationship with the buyer or seller and
  the buyer or seller can not provide instructions or direction directly to the broker’s agent. The buyer and the seller therefore do not have vicarious liability for the acts of
  the broker’s agent. The listing agent or buyer’s agent do
  provide direction and instruction to the broker’s agent
  and therefore the listing agent or buyer’s agent will have
  liability for the acts of the broker’s agent.
- Dual Agent A real estate broker may represent both the buyer and seller if both the buyer and seller give their informed consent in writing. In such a dual agency situation, the agent
  will not be able to provide the full range of fiduciary duties to the buyer and seller. The obligations of an agent
  are also subject to any specific provisions set forth in an
  agreement between the agent, and the buyer and seller.
  An agent acting as a dual agent must explain carefully to
  DOS-1736-a (Rev. 11/10)
  both the buyer and seller that the agent is acting for the
  other party as well. The agent should also explain the
  possible effects of dual representation, including that by
  consenting to the dual agency relationship the buyer and
  seller are giving up their right to undivided loyalty. A
  buyer or seller should carefully consider the possible consequences of a dual agency relationship before agreeing
  to such representation. A seller or buyer may provide advance informed consent to dual agency by indicating the
  same on this form.
- Dual Agent with Designated Sales Agents If the buyer and seller provide their informed consent in
  writing, the principals and the real estate broker who
  represents both parties as a dual agent may designate a
  sales agent to represent the buyer and another sales agent
  to represent the seller to negotiate the purchase and sale
  of real estate. A sales agent works under the supervision
  of the real estate broker. With the informed consent of the
  buyer and the seller in writing, the designated sales agent
  for the buyer will function as the buyer’s agent representing the interests of and advocating on behalf of the buyer
  and the designated sales agent for the seller will function
  as the seller’s agent representing the interests of and advocating on behalf of the seller in the negotiations between the buyer and seller. A designated sales agent cannot provide the full range of fiduciary duties to the buyer
  or seller. The designated sales agent must explain that
  like the dual agent under whose supervision they function, they cannot provide undivided loyalty. A buyer or
  seller should carefully consider the possible consequences of a dual agency relationship with designated
  sales agents before agreeing to such representation. A seller or buyer may provide advance informed consent to dual agency with designated sales agents by indicating the same on this form.
This form was provided to me by
This form was provided to me by
Of
Of
(print name of company, firm or brokerage), a licensed real estate broker acting in the interest of the:
(print name of company, firm or brokerage), a licensed real estate broker acting in the interest of the:
- Buyer as a (check relationship below)
- Buyer’s agent
- Broker's Agent
- Dual Agent
- Dual agent with designated sales agent
For advance informed consent to either dual agency or dual agency with designated sales agents complete section below:
- Advanced informed consent dual agency
- Advance informed consent to dual agency with designated sales agents
If dual agent was designated sales agent is indicated above:
If dual agent was designated sales agent is indicated above:
is appointed to represent the buyer; and
is appointed to represent the seller; and
is appointed to represent the seller in this transaction. ( I ) ( We )
is appointed to represent the seller in this transaction. ( I ) ( We )*
acknowledge receipt of a copy of this disclosure form. Signature of
acknowledge receipt of a copy of this disclosure form. Signature of
- Buyer(s)
- and/or Seller(s):
Signature*

New York State

DEPARTMENT OF STATE,

Division of licensing services

(518) 474-4429

www.dos.ny.gov

(888) 392-3644

New York State Housing and Anti-Discrimination Disclosure Form

Federal, State and local Fair Housing Laws provide comprehensive protections from discrimination in
housing. It is unlawful for any property owner, landlord, property manager or other person who sells, rents or
leases housing, to discriminate based on certain protected characteristics, which include, but are not limited
to race, creed, color, national origin, sexual orientation, gender identity or expression, military status,
sex, age, disability, marital status, lawful source of income or familial status. Real estate professionals
must also comply with all Fair Housing Laws.

Real estate brokers and real estate salespersons, and their employees and agents violate the Law if they:
- Discriminate based on any protected characteristic when negotiating a sale, rental or lease,
  including representing that a property is not available when it is available.
- Negotiate discriminatory terms of sale, rental or lease, such as stating a different price because of race,
  national origin or other protected characteristic.
- Discriminate based on any protected characteristic because it is the preference of a seller or landlord.
- Discriminate by “steering” which occurs when a real estate professional guides prospective buyers or
  renters towards or away from certain neighborhoods, locations or buildings, based on any protected
  characteristic
- Discriminate by “blockbusting” which occurs when a real estate professional represents that a change has
  occurred or may occur in future in the composition of a block, neighborhood or area, with respect to any
  protected characteristics, and that the change will lead to undesirable consequences for that area, such
  as lower property values, increase in crime, or decline in the quality of schools.
- Discriminate by pressuring a client or employee to violate the Law.
- Express any discrimination because of any protected characteristic by any statement, publication,
  advertisement, application, inquiry or any Fair Housing Law record.
- Discriminate by pressuring a client or employee to violate the Law.
YOU HAVE THE RIGHT TO FILE A COMPLAINT

If you believe you have been the victim of housing discrimination you should file a complaint with the
New York State Division of Human Rights (DHR). Complaints may be filed by:
- Downloading a complaint form from the DHR website: www.dhr.ny.gov;
- Stop by a DHR office in person, or contact one of the Division’s offices, by telephone or by mail, to obtain
  a complaint form and/or other assistance in filing a complaint. A list of office locations is available online at:
  https://dhr.ny.gov/contact-us, and the Fair Housing HOTLINE at (844)-862-8703.
You may also file a complaint with the NYS Department of State, Division of Licensing Services. Complaints
may be filed by:
- Downloading a complaint form from the Department of State’s website
  https://www.dos.ny.gov/licensing/complaint_links.html
- Stop by a Department’s office in person, or contact one of the Department’s offices, by telephone or by
  mail, to obtain a complaint form.
- Call the Department at (518) 474-4429.
There is no fee charged to you for these services. It is unlawful for anyone to retaliate against you for filing a complaint.

For more information on Fair Housing Act rights and responsibilities please visit
https://dhr.ny.gov/fairhousing and https://www.dos.ny.gov/licensing/fairhousing.html.
This form was provided to me by
This form was provided to me by
Of
Of
(print name of Real Estate company, firm or brokerage)
( I ) ( We )
( I ) ( We )*
(Buyer/Tenant/Seller/Landlord) acknowledge receipt of a copy of this disclosure form:
Real Estate Consumer/Seller/Landlord Signature
Real Estate Consumer/Seller/Landlord Signature*
Real Estate broker and real estate salespersons are required by New York State law to provide you with this Disclosure.
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Step 1 of 3 - Your Information

Tell us about yourself.

New York State Disclosure Form for Buyer and Seller

New York State Housing and Anti-Discrimination Disclosure Form

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