Disclosure And Acknowledgement Regarding

ADVERTISEMENT

DISCLOSURE AND ACKNOWLEDGEMENT REGARDING
LEAD-BASED PAINT AND/OR LEAD-BASED PAINT HAZARDS
THIS
IS
A
DISCLOSURE
AND
ACKNOWLEDGMENT
concerning
Property
(the
"Property")
located
at
. This document contains certain provisions required by federal
law. If Buyer and Seller enter into a contract for the purchase of the Property (a "REPC"), this document shall be attached to that
contract and made a part thereof.
1. LEAD WARNING STATEMENT. Every purchaser of any interest in residential real property on which a residential dwelling
was built prior to 1978 is notified that such property may present exposure to lead from lead-based paint that may place young
children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage,
including learning disabilities, reduced intelligence quotient, behavioral problems, and impaired memory. Lead poisoning also
poses a particular risk to pregnant women. The seller of any interest in residential real property is required to provide the buyer
with any information on lead-based paint hazards from risk assessments or inspections in the seller's possession and notify
the buyer of any known lead-based paint hazards. A risk assessment or inspection for possible lead-based paint hazards is
recommended prior to purchase.
2. SELLER'S DISCLOSURE AND ACKNOWLEDGMENT. (Initials will be completed on printed form)
(a) Presence of lead-based paint and/or lead-based paint hazards (Initials will be completed on printed form):
(i) [
] Known lead-based paint and/or lead-based paint hazards are present in the Property (explain):
(ii) [
] Seller has no knowledge of lead-based paint and/or lead-based paint hazards in the Property.
(b) Records and reports available to Seller (Initials will be completed on printed form):
(i) [
] Seller has provided Buyer with all available records and reports pertaining to lead-based paint and/or lead-based
hazards in the Property (list documents):
(ii) [
] Seller has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the Property.
(c) Seller understands that under federal law, if Seller has not yet made the disclosures in Sections 2(a) and 2(b) of this
document, or Buyer has not yet been provided with an EPA approved lead hazard information pamphlet, Seller may not
accept an offer by Buyer to purchase the property until after those steps have been completed and Buyer has been given an
opportunity to review that information and amend the offer.
(d) Seller understands that if Buyer initials the box in Section 3(d)(i) of this document, the REPC must include the Lead-Based
Paint Addendum.
3. BUYER'S ACKNOWLEDGMENT. (Initials will be completed on printed form)
(a) [
] Buyer has received copies of any information listed in Sections 2(a) and 2(b) above.
(b) [
] Buyer has received the pamphlet Protect Your Family from Lead in Your Home or an equivalent lead hazard
information pamphlet approved by the federal Environmental Protection Agency.
(c) [
] Buyer has read the Lead Warning Statement in Section 1 above and understands its contents.
(d) Buyer has (Initials will be completed on printed form):
(i) [
] a 10-day opportunity (or mutually agreed upon period) to conduct a risk assessment or inspection for the
presence of lead-based paint and/or lead-based paint hazards. If this box is initialed, the REPC must include
the Lead-Based Paint Addendum; OR
(ii) [
] by initialing this box, waived the opportunity to conduct a risk assessment or inspection for the presence of lead-
based paint and/or lead-based paint hazards.
4. AGENT'S ACKNOWLEDGMENT. (Initials will be completed on printed form)
[
]Agent has informed Seller of Seller's obligations under 42 U.S.C. 4852d and is aware of his/her responsibility to ensure
compliance.
5. CERTIFICATION OF ACCURACY. (Signatures will be completed on printed form)
The following parties have reviewed the information above and certify, to the best of their knowledge, that the information they
have each respectively provided is true and accurate.
Seller Signature
Date
Time
Seller Signature
Date
Time
Buyer Signature
Date
Time
Buyer Signature
Date
Time
Agent Signature
Date
Time
Agent Signature
Date
Time
THIS FORM APPROVED BY THE UTAH REAL ESTATE COMMISSION AND THE OFFICE OF THE UTAH ATTORNEY GENERAL, EFFECTIVE SEPTEMBER 5, 1996.
Page 1 of 1

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Prohibited Transaction Exemption 84-24 Disclosure And Acknowledgement Form Prohibited Transaction Exemption 84-24 Disclosure And Acknowledgement Form Legal
Disclosure And Notice Of Intent To Expedite Completion Of The Unclaimed Property Examination Pursuant Disclosure And Notice Of Intent To Expedite Completion Of The Unclaimed Property Examination Pursuant Legal
Declaration Regarding Service Of Declaration Of Disclosure And Income And Expense Declaration Declaration Regarding Service Of Declaration Of Disclosure And Income And Expense Declaration Legal
Fl-141 - Declaration Regarding Service Of Declaration Of Disclosure And Income And Expense Declaration Fl-141 - Declaration Regarding Service Of Declaration Of Disclosure And Income And Expense Declaration Legal
Fl-141 - Declaration Regarding Service Of Declaration Of Disclosure And Income And Expense Declaration Fl-141 - Declaration Regarding Service Of Declaration Of Disclosure And Income And Expense Declaration Legal
Addendum Disclosure Of Information And Acknowledgment About Lead-based Paint And/or Lead-based Paint Hazards Leases Addendum Disclosure Of Information And Acknowledgment About Lead-based Paint And/or Lead-based Paint Hazards Leases Legal
Form Hsmv 82993 Separate Odometer Disclosure Statement And Acknowledgment - State Of Florida Form Hsmv 82993 Separate Odometer Disclosure Statement And Acknowledgment - State Of Florida Legal
Form Sc-506 - Order For Financial Disclosure And Financial Disclosure Statement Form Sc-506 - Order For Financial Disclosure And Financial Disclosure Statement Legal
Athlete/parent/guardian Sudden Cardiac Arrest Symptoms And Warning Signs Information Sheet And Acknowledgement Of Receipt And Review Form - Pennsylvania Department Of Health Athlete/parent/guardian Sudden Cardiac Arrest Symptoms And Warning Signs Information Sheet And Acknowledgement Of Receipt And Review Form - Pennsylvania Department Of Health Business
Assumption And Acknowledgment Of Risks And Release Of Liability Agreement Assumption And Acknowledgment Of Risks And Release Of Liability Agreement Legal

Related Categories

Parent category: Legal
Download
Go