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C.A.R. Form from PEAD, each visitor, 04/30/20


(A new declaration should be obtained from each time they enter a property) 

(May be used for more than one property provided a copy Is delivered to each listing Broker,)


Property Address: 350 Somerset Drive Placentia Ca. 92870


1.     RISKS OF EXPOSURE: The Coronavirus (COVID-19) pandemic is a worldwide risk to human health. COVID-19 is highly contagious and has a mortality rate many times greater than the flu. COVID-19 can spread easily and exponentially. While people of all ages are at risk of catching COVID-19, persons with compromised immune systems and older persons may be at particular risk. 


2.    "STAY HOME ORDERS": In order to reduce the spread of COVID-19, the State of California, as well as many California cities and counties have issued so-called "Safer at Home" or "Shelter in Place" ("Stay Home") Orders, obligating many businesses to close and residents to stay at home with limited exceptions for essential activities. 


3.    REAL ESTATE SALES ACTIVITIES AS ESSENTIAL: Under Federal and State guidelines, activities required to facilitate a real estate transaction are considered essential activities. Nevertheless, this designation does not make them free from COVID-19 risks. All persons must still practice "social distancing" and take all steps necessary to protect themselves and others. Some county and city orders are more restrictive than, and may take precedence over, Federal and State guidelines. You understand that if you engage in any activities in violation of any Stay Home Order, you are acting against the advice of Broker. Brokers and Agents (i) will not violate any Stay Home Orders, notwithstanding any Party's instructions and (ii) will obey all Fair Housing laws while pursuing safe COVID-19 practices.


4.    PURPOSE OF ENTRY: The purpose of the entry is for viewing or inspecting a Property or performing an activity or providing services in furtherance of or to facilitate a real estate transaction or service .


5. SELLER OR OCCUPANT REPRESENTATIONS: If the person Signing below is a seller or occupant, Signer is voluntarily allowing someone to enter the Property. Signer acknowledges being advised to clean and disinfect the Property after the persons allowed to enter leave the Property. Special attention should be given to areas that are likely to be touched such as doorknobs, handles, and counter tops. 


6.    PROPERTY ENTRANT REPRESENTATIONS: If the person Signing below is a prospective or actual buyer, real estate agent, or other person whose services facilitate the completion of a real estate transaction or service, Signer is voluntarily entering the Property. Signer acknowledges that although others have been advised to clean and disinfect the property after each entry, doing so may not. be possible, and may not have occurred prior to your entry, due to Stay Home Orders and other circumstances. Signer agrees to take all reasonable and necessary precautions to protect Signer and others from the spread of COVID-19, including, but not limited to, the following:

A.    Following all Federal, State, and local laws and Stay Home Orders, even though such laws and orders may be changing rapidly.

B.    Exercising care to protect yourself, and assessing your own risks, by considering your age, underlying health conditions, recent travel, possible exposure to COVID-19, doctor's recommendations, and local, State and Federal recommendations. You agree and understand that it is your responsibility to evaluate the risks and protect yourself.

C.    · Washing your hands with soap and water or using hand sanitizer, and wearing rubber gloves, a protective face mask, and protective shoe coverings. Remember to not touch your eyes, nose, or mouth .

D. Practicing social distancing by keeping at least 6 feet between yourself and others. Do not gather in groups, and do not touch surfaces or items in the Property. If you believe it necessary to touch surfaces or items in the Property, consider the risks of doing so. 

E.After viewing the Property, discarding any gloves, masks, or shoe coverings worn during the visit and washing hands with soap nd water for at least twenty seconds.



A.    You understand that allowing access to or accessing a property for any of the purposes above may be dangerous or unsafe and could expose you or others to COVID-19 and that you are allowing or conducting those activities voluntarily.

B.    You represent that: 

(1)To the best of your knowledge, you are not currently afflicted with, and have not knowingly, within the last 14 days, been in contact with someone afflicted with, COVID-19;

(2)You are not experiencing a fever, or signs of respiratory illness such as cough, shortness of breath or difficulty breathing, or other COVID-19 symptoms and; 

(3) You understand that persons may be afflicted with COVID-19 and: (i) not exhibit symptoms; (ii) not be aware that they are afflicted or (iii) may not voluntarily agree to disclose their condition.

C.You will inform Broker if, after the date this document is signed, there is a change In your health condition or knowledge that potentially puts others at risk or invalidates the representations made In this document.




9.    AGREEMENT, DECLARATION AND ASSUMPTION OF RISK: By signing below, you are declaring the foregoing is true, that you agree to take all recommended and reasonable actions to protect yourself and others from exposure to COVID-19, and that you ASSUME THE RISK,· as applicable, of entering the Property, or allowing someone to enter the Property. You understand and agree that no one, including but not limited to real estate brokers and agents, can guarantee that you will not be exposed to or contract COVID-19.


By signing below, the person allowing entry or the person entering Property acknowledges that Signer has read, understands, voluntarily agrees to the foregoing, and has received a copy of this Coronavirus Property Entry Advisory and Declaration. 











We must have your contact information for your safety:



Cell phones

Home Address:




Seller Broker


Buyer’s Broker


Seller initial


© 2020, California Association of REALTORS®, Inc. United States copyright law (Title 17 U.S. Code) forbids the unauthorized distribution, display and reproduction of this form, or any portion thereof, by photocopy machine or any other means, including facsimile or computerized formats. THIS FORM HAS BEEN APPROVED BY THE CALIFORNIA ASSOCIATION OF REALTORS®. NO REPRESENTATION IS MADE AS TO THE LE AL VALIDITY OR ACCURACY OF ANY PROVISION IN ANY SPECIFIC TRANSACTION. A REAL ESTATE BRO ER IS THE PERSON UALIFIED TO ADVISE ON REAL ESTATE TRANSACTIONS. IF YOU DESIRE LE AL OR TA ADVICE, CONSULT AN APPROPRIATE PROFESSIONAL. This form is made available to real estate professionals through an agreement with or purchase from the California Association of REAL TORS®. It is not intended to identify the user as a REAL TOR®. REAL TOR® is a registered collective membership mark which may be used only by members of the NATIONAL ASSOCIATION OF REAL TORS® who subscribe to its Code of Ethics.

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