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DNR Form 542-0960 Instructions. The transferor of real property is required to complete this form.Instructions for DNR form 542-0960 (July 18, 2012). 1. REAL ESTATE TRANSFER GROUNDWATER HAZARD STATEMENT. Use Fill to complete blank online POLK COUNTY (IA) pdf forms for free. Once completed you can sign your fillable form or send for signing. Items 10 - 17 — When and Where To Send Your Completed Report . Groundwater Hazard Statement. When selling a property in Iowa, you might be asked to complete a Groundwater Hazard Statement. Guidance for completing and submitting ADEM Form 8700-12.