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Lead-Based Paint Disclosure Statement

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Lead-Based Paint Disclosure Statement Powered By Docstoc
					This Lead-Based Paint Disclosure Statement is intended to be used by the seller of any
residential property in order to be in compliance with governing federal laws pertaining
to lead-based paint hazards. This document contains the necessary information
regarding the presence of lead-based paint on the property and the risks associated
with lead exposure, as required by law. This form should be used by a seller of real
property and presented to the purchaser.
    LEAD-BASED PAINT DISCLOSURE STATEMENT (SALES)

LEAD-BASED PAINT HAZARDS DISCLOSURE 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 contain lead-based paint. Lead from paint,
paint chips, and dust can pose health hazards if not managed properly. Lead exposure is
especially harmful to young children and pregnant women. Lead poisoning in young children
may produce permanent neurological damage, including learning disabilities, reduced
intelligence quotient, behavioural problems, and impaired memory. 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.

Seller’s Disclosure:


□        The Seller hereby discloses to the purchaser that the Seller is unaware of the presence of
         any lead-based paint or lead-based paint hazards in the property located at
         __________________. [Instruction: Insert property address.]


□        The Seller hereby discloses to the purchaser that the Seller is aware of the following lead-
         based paint or lead-based paint hazards in the property located at
         ____________________: [Instruction: Insert property address.]


         (i)       _____________________________________

         (ii)      _____________________________________

         (iii)     _____________________________________

[Instruction and Comment: List any known lead based paint or lead-based paint hazards in
the property. Sellers disclosing any such known hazard should consult an attorney prior to
completing this document, to ensure its rights are preserved and disclosure obligations are
properly fulfilled.]


□        The Seller has no records, documents or reports in respect of the presence of any lead-
         based paint or paint hazards for the property located at _______________________.
         [Instruction: Insert property address.]

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□        The Seller has the following records, documents and reports available for the purchaser to
         review in respect of the presence of any lead-based paint or paint hazards for the property
         located at _______________________________:

         (i)       __________________________________

         (ii)      __________________________________

[Instruction and Comment: List any available documents regarding lead-based paint or
paint hazards in the property. Sellers disclosing any such documents should consult an
attorney prior to completing this document, to ensure its rights are preserved and
disclosure obligations are properly fulfilled.]


Purchaser’s Acknowledgment:

        The Purchaser hereby acknowledges to the Seller that the Purchaser has received from
the Seller, all of the records, documents and reports indicated above, if any, from the Seller in
respect to the property located at _________________________. [Instruction: Insert property
address.]

      The Purchaser hereby acknowledges that Purchaser has received the pamphlet Protect
Your Family from Lead in Your Home.

        The Purchaser hereby further acknowledges that he/she/they have ______ (__)
[Instruction: Insert number of days to perform inspection, commonly 10.] days to perform at
the Purchaser’s own expense, a risk assessment of the property in respect to the risks and hazards
of lead-based paint and the hazards associated therewith. The Purchaser has the right to waive
his/her/their right to performing a risk assessment of the property. In the event the Purchaser
wishes to waive such right, the Purchaser shall sign as indicated below:



Witness:                                                            Purchaser



Real Estate Agent’s Acknowledgment:

       The Seller hereby acknowledges that the Seller’s Real Estate Agent has provided all
information necessary and required to the Seller in respect of the Seller’s obligations to disclose
any and all information relating to the presence and hazards of lead-based paint in the property
pursuant to the laws and regulations of the governing jurisdiction. The Seller acknowledges such
information received from the Real Estate Agent by the Seller’s signature below.
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Witness:                                                            Seller


        THE PARTIES HERETO have reviewed the information above and certify, to the best
of their knowledge, that the information they have provided is true and accurate.

Date:
                                                                    Seller


                                                                    Witness as to Seller’s Signature

Date:
                                                                    Purchaser


                                                                    Witness as to Purchaser’s Signature
Date:
                                                                    Real Estate Agent


                                                                    Witness as to Real Estate Agent’s Signature




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DOCUMENT INFO
Description: This Lead-Based Paint Disclosure Statement is intended to be used by the seller of any residential property in order to be in compliance with governing federal laws pertaining to lead-based paint hazards. This document contains the necessary information regarding the presence of lead-based paint on the property and the risks associated with lead exposure, as required by law. This form should be used by a seller of real property and presented to the purchaser.
This document is also part of a package Real Estate Business Templates 153 Documents Included