Lead-Based Paint Disclosure

*INDICATES A REQUIRED FIELD

If you are unsure about a field, CONTACT US and we will assist you.

PLEASE NOTE: THIS FORM CANNOT BE SAVED TO COME BACK TO LATER.

    * Address:

    * City:

    * Zip Code:

    Is seller aware of any lead-based paint and/or lead-based paint hazards in the housing?
    *Check One:
    No
    Yes

    If yes, explain:

    Records and reports available to Seller:
    *Check One:
    No (Seller has no records or reports of lead-based paint or lead-based paint hazards in the housing.)
    Yes (Seller to provide Buyer with all available records or reports of lead-based paint or lead-based paint hazards in the housing.)

    If yes, list documents to be provided to Buyer:

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