DISCLOSURE OF INFORMATION ON LEAD-BASED PAINT AND LEAD-BASED PAINT
HAZARDS ADDENDUM FOR AGREEMENT TO BUY AND SELL REAL ESTATE
Lead Warning Statement
Every buyer 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
developing lead poisoning.
of
Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced
intelligence quotient, behavioral problems, and im p aired memory. i e a d poisoning also poses a
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.
risk assessment or inspection for possible lead-based paint hazards is recommended prior to purchase.
A
Seller's Disclosure (initial)
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(a) Presence of lead-based paint and/or lead-based paint hazards (check one below):
Known lead-based paint and/or lead-based paint hazards are present in the housing (explain).
Seller has no knowledge of lead-based paint and/or lead-based paint hazards in the housing,
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(b) Records and reports available to the seller (check one below):
Seller has provided the buyer with all available records and reports pertaining to lead-based paint and/or lead-based
pait hazards in the housing (list documents below).
Seller has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing.
Buyer's Acknowledgment (initial)
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(c) Buyer has received copies of all information listed above.
-
(d) Buyer has received the pamphlet Protect Your Family from Lead in Your Home.
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(e) Buyer has (check one below):
Received 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: or
Waived the opportunity to conduct a risk assessment or inspection for the presence of lead-based paint
lead-
based paint hazards.
Agent's Acknowledgment (initial)
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Agent has informed the seller of the seller's obligations under 42 U.S.C. 4852dand is aware of his/her responsibility
to ensure compliance.
Certification o f Accuracy
The following patties have reviewed the information above and certify, to the best o f their knowledge, that the
information provided by the signatory is true and accurate.
Seller
Date
Seller
Date
Agent
Date
Agent
Date
Buyer
Date
Buyer
Date
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