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LEAD-BASED PAINT DISCLOSURE (SALES)
___________________________________________________________________
Street Address City State Zip
WARNING! LEAD FROM PAINT, DUST, AND SOIL CAN BE DANGEROUS IF NOT MANAGED PROPERLY
Disclosure of Information on Lead-Based Paint and/or Lead-Based Paint Hazards
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.
Seller's Disclosure
(a) Presence of lead-based paint and/or lead-based paint hazards (check (i) or (ii) below):
(i) ______ Known lead-based paint and/or lead-based paint hazards are present in the housing (explain).
__________________________________________________________________________
__________________________________________________________________________
(ii) ______ Seller has no knowledge of lead-based paint and/or lead-based paint hazards in the housing.
(b) Records and reports available to the seller (check (i) or (ii) below):
(i) ______ Seller has provided the purchaser with all available records and reports pertaining to lead-based paint and/or lead-based paint hazards in the housing (list documents below).
__________________________________________________________________________
__________________________________________________________________________
(ii) _____ Seller has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing.
Purchaser's Acknowledgment (initial)
(c) ______ Purchaser has received copies of all information listed above.
(d) ______ Purchaser has received the pamphlet Protect Your Family from Lead in Your Home.
(e) Purchaser has (check (i) or (ii) below):
(i) ______ 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
(ii) ______ waived the opportunity to conduct a risk assessment or inspection for the presence of lead-based paint and/or lead-based paint hazards.
Agent's Acknowledgment (initial)
(f) ______ Agent has informed the seller of the seller' obligations under 42 U.S.C. 4852(d) and is aware of his/her responsibility to ensure compliance.
Seller Initials: ______ ______ Buyer Initials: ______ ______ Agent Initials: ______ ______
Certification of Accuracy
The following parties have reviewed the information above and certify, to the best of their knowledge, that the information they have provided is true and accurate. Penalties for failure to comply with Federal Lead-Based Paint Disclosure Laws include treble (3 times) damages, attorney fees, costs, and a penalty up to $10,000 for each violation.
PURCHASER:
____________________ ____________________________________________
Date [purchaser's signature above/printed name below]
____________________________________________
[purchaser's signature above/printed name below]
SELLER:
____________________ ____________________________________________
Date [seller's signature above/printed name below]
____________________________________________
[seller's signature above/printed name below]
AGENT:
____________________ ____________________________________________
Date [agent's signature above/printed name below]
Protect Your Family from Lead in Your Home
United States Environmental Protection Agency
United States Consumer Product Safety Commission
United States Department of Housing and Urban Development
Simple Steps To Protect Your Family From Lead Hazards
If you think your home has high levels of lead:
Are You Planning To Buy, Rent, or Renovate a Home Built Before 1978?
Many houses and apartments built before 1978 have paint that contains high levels of lead (called leadbased paint). Lead from paint, chips, and dust can pose serious health hazards if not taken care of properly.
OWNERS, BUYERS, and RENTERS are encouraged to check for lead (see page 2) before renting, buying or renovating pre-1978 housing.
Federal law requires that individuals receive certain information before renting, buying, or renovating pre-1978 housing:
LANDLORDS have to disclose known information on lead-based paint and lead-based paint hazards before leases take effect. Leases must include a disclosure about lead-based paint.
SELLERS have to disclose known information on lead-based paint and lead-based paint hazards before selling a house. Sales contracts must include a disclosure about lead-based paint. Buyers have up to 10 days to check for lead.
RENOVATORS disturbing more than 2 square feet of painted surfaces have to give you this pamphlet before starting work.
IMPORTANT!
Lead From Paint, Dust, and Soil Can Be Dangerous If Not Managed Properly
Lead Gets in the Body in Many Ways
People can get lead in their body if they:
Lead is even more dangerous to children under the age of 6:
Childhood lead poisoning remains a major environmental health problem in the U.S. Even children who appear healthy can have dangerous levels of lead in their bodies.
Lead’s Effects
It is important to know that even exposure to low levels of lead can severely harm children.
In children, lead can cause:
While low-lead exposure is most common, exposure to high levels of lead can have devastating effects on children, including seizures, unconsciousness, and, in some cases, death.
Although children are especially susceptible to lead exposure, lead can be dangerous for adults too.
In adults, lead can cause:
Lead affects the body in many ways: Brain or Nerve Damage, Slowed Growth, Hearing Problems, Reproductive Problems (adults), Digestive Problems.
Where Lead-Based Paint Is Found
Many homes built before 1978 have leadbased paint. The federal government banned lead-based paint from housing in 1978. Some states stopped its use even earlier. Lead can be found:
In general, the older your home, the more likely it has leadbased paint.
Checking Your Family for Lead
To reduce your child's exposure to lead, get your child checked, have your home tested (especially if your home has paint in poor condition and was built before 1978), and fix any hazards you may have.
Children's blood lead levels tend to increase rapidly from 6 to 12 months of age, and tend to peak at 18 to 24 months of age. Consult your doctor for advice on testing your children. A simple blood test can detect high levels of lead. Blood tests are usually recommended for:
Get your children and home tested if you think your home has high levels of lead.
Identifying Lead Hazards
Lead-based paint is usually not a hazard if it is in good condition, and it is not on an impact or friction surface, like a window. It is defined by the federal government as paint with lead levels greater than or equal to 1.0 milligram per square centimeter, or more than 0.5% by weight.
Deteriorating lead-based paint (peeling, chipping, chalking, cracking or damaged) is a hazard and needs immediate attention. It may also be a hazard when found on surfaces that children can chew or that get a lot of wear-and-tear, such as:
Lead dust can form when lead-based paint is scraped, sanded, or heated. Dust also forms when painted surfaces bump or rub together. Lead chips and dust can get on surfaces and objects that people touch. Settled lead dust can re-enter the air when people vacuum, sweep, or walk through it. The following two federal standards have been set for lead hazards in dust:
The following two federal standards have been set for lead hazards in residential soil:
The only way to find out if paint, dust and soil lead hazards exist is to test for them. The next page describes the most common methods used.
Lead from paint chips, which you can see, and lead dust, which you can’t always see, can both be serious hazards.
Checking Your Home for Lead
You can get your home tested for lead in several different ways:
There are state and federal programs in place to ensure that testing is done safely, reliably, and effectively. Contact your state or local agency (see pages 3 and 4) for more information, or call 1-800-424-LEAD (5323) for a list of contacts in your area.
Home test kits for lead are available, but may not always be accurate. Consumers should not rely on these kits before doing renovations or to assure safety.
Just knowing that a home has leadbased paint may not tell you if there is a hazard.
What You Can Do Now To Protect Your Family
If you suspect that your house has lead hazards, you can take some immediate steps to reduce your family’s risk:
Reducing Lead Hazards In The Home
In addition to day-to-day cleaning and good nutrition:
Call your state or local agency (see bottom of page 11) for help in locating certified professionals in your area and to see if financial assistance is available.
Removing lead improperly can increase the hazard to your family by spreading even more lead dust around the house. Always use a professional who is trained to remove lead hazards safely.
Remodeling or Renovating a Home With Lead-Based Paint
Take precautions before your contractor or you begin remodeling or renovating anything that disturbs painted surfaces (such as scraping off paint or tearing out walls):
If you have already completed renovations or remodeling that could have released lead-based paint or dust, get your young children tested and follow the steps outlined on page 7 of this brochure.
If not conducted properly, certain types of renovations can release lead from paint and dust into the air.
Other Sources of Lead
While paint, dust, and soil are the most common sources of lead, other lead sources also exist.
For More Information
The National Lead Information Center
EPA’s Safe Drinking Water Hotline
Consumer Product Safety Commission (CPSC) Hotline
Health and Environmental Agencies
For the hearing impaired, call the Federal Information Relay Service at 1-800-877-8339 to access any of the phone numbers in this brochure.
EPA Regional Offices
Region 1 (Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, Vermont)
Regional Lead Contact
U.S. EPA Region 1
Suite 1100 (CPT)
One Congress Street
Boston, MA 02114-2023
1 (888) 372-7341
Region 2 (New Jersey, New York, Puerto Rico, Virgin Islands)
Regional Lead Contact
U.S. EPA Region 2
2890 Woodbridge Avenue
Building 209, Mail Stop 225
Edison, NJ 08837-3679
(732) 321-6671
Region 3 (Delaware, Maryland, Pennsylvania, Virginia, Washington DC, West Virginia)
Regional Lead Contact
U.S. EPA Region 3 (3WC33)
1650 Arch Street
Philadelphia, PA 19103
(215) 814-5000
Region 4 (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee)
Regional Lead Contact
U.S. EPA Region 4
61 Forsyth Street, SW
Atlanta, GA 30303
(404) 562-8998
Region 5 (Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin)
Regional Lead Contact
U.S. EPA Region 5 (DT-8J)
77 West Jackson Boulevard
Chicago, IL 60604-3666
(312) 886-6003
EPA Regional Offices
Region 6 (Arkansas, Louisiana, New Mexico, Oklahoma, Texas)
Regional Lead Contact
U.S. EPA Region 6
1445 Ross Avenue, 12th Floor
Dallas, TX 75202-2733
(214) 665-7577
Region 7 (Iowa, Kansas, Missouri, Nebraska)
Regional Lead Contact
U.S. EPA Region 7
(ARTD-RALI)
901 N. 5th Street
Kansas City, KS 66101
(913) 551-7020
Region 8 (Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming)
Regional Lead Contact
U.S. EPA Region 8
999 18th Street, Suite 500
Denver, CO 80202-2466
(303) 312-6021
Region 9 (Arizona, California, Hawaii, Nevada)
Regional Lead Contact
U.S. Region 9
75 Hawthorne Street
San Francisco, CA 94105
(415) 947-4164
Region 10 (Alaska, Idaho, Oregon, Washington)
Regional Lead Contact
U.S. EPA Region 10
Toxics Section WCM-128
1200 Sixth Avenue
Seattle, WA 98101-1128
(206) 553-1985
Your Regional EPA Office can provide further information regarding regulations and lead protection programs.
CPSC Regional Offices Eastern
Regional Center
Consumer Product Safety Commission
201 Varick Street, Room 903
New York, NY 10014
(212) 620-4120
Central Regional Center
Consumer Product Safety Commission
230 South Dearborn Street, Room 2944
Chicago, IL 60604
(312) 353-8260
Western Regional Center
Consumer Product Safety Commission
1301 Clay Street, Suite 610-N
Oakland, CA 94612
(510) 637-4050
HUD Lead Office
Please contact HUD's Office of Healthy Homes and Lead Hazard Control for information on lead regulations, outreach efforts, and lead hazard control and research grant programs.
U.S. Department of Housing and Urban Development
Office of Healthy Homes and Lead Hazard Control
451 Seventh Street, SW, P-3206
Washington, DC 20410
(202) 755-1785
Your Regional CPSC Office can provide further information regarding regulations and consumer product safety.
U.S. EPA Washington DC 20460 EPA747-K-99-001
U.S. CPSC Washington DC 20207 June 2003
U.S. HUD Washington DC 20410
This document is in the public domain. It may be reproduced by an individual or organization without permission. Information provided in this booklet is based upon current scientific and technical understanding of the issues presented and is reflective of the jurisdictional boundaries established by the statutes governing the co-authoring agencies. Following the advice given will not necessarily provide complete protection in all situations or against all health hazards that can be caused by lead exposure.
This form has been reformatted from its original PDF format as released by the U.S. government. It was reformatted by the Internet Legal Research Group, a service of PublicLegal, LLC. No changes have been made to this document other than to internal page number references. Graphical illustrations have been omitted or summarized wherever possible.
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