"Disclosure of Information on"
Washington County American Dream Downpayment Initiative Program Acknowledgement of Receipt EPA Lead Paint Pamphlet Lead Warning Statement Housing built before 1978 may contain lead-based paint. Lead from paint, paint chips and dust can pose health hazards if not taken care of properly. Lead exposure is especially harmful to young children and pregnant women. Before receiving federal funds, buyers of pre-1978 housing must receive a federally approved pamphlet on lead poisoning prevention. Owner/Occupants Acknowledgment I have received the pamphlet “Protect Your Family from Lead in Your Home”. _________________________________ ______________ Buyer Date _________________________________ ______________ Buyer Date _________________________________________________________ Address of property being purchased _________________________________________________________ Name of person supplying EPA pamphlet LBP Acknowledgement