To comply with the provisions of this chapter, a form shall set forth a statement of purpose of the form, including statements substantially similar to the following:
(1) The form constitutes a statement of the conditions of the property and of information concerning the property actually known by the transferor.
(2) That unless the transferee is otherwise advised in writing, the transferor, other than having lived at or owning the property possesses no greater knowledge than that which could be obtained by a careful inspection of the property by a potential transferee.
(3) That the statement is not a warranty of any kind by the transferor or by any agent or subsequent agent representing the transferor in this transaction.
(4) That the statement is not a substitute for any inspections.
(5) That the transferor is familiar with the particular residential real property and each act that may be performed in making a disclosure of an item of information shall be made and performed in good faith.