Property ID
Street address and legal description to clearly identify the unit or parcel involved in the sale or lease for recordkeeping and title/charting purposes.
Federal law and HUD/EPA rules require disclosure for residential properties built before 1978; complying protects buyers, tenants, and sellers and documents that required information and educational materials were provided.
Each signer should retain a copy in the transaction record; agents typically keep the form in the file for the recommended retention period.
Street address and legal description to clearly identify the unit or parcel involved in the sale or lease for recordkeeping and title/charting purposes.
The construction year or best approximation to determine applicability—properties built before 1978 are subject to federal disclosure rules.
Seller/lessor statement about known lead-based paint or hazards, including whether any remediation, testing, or abatement has been performed.
Acknowledgment that the EPA/HUD lead hazard information pamphlet was provided to buyer/tenant prior to sale or lease as required by federal rules.
Space to list any existing lead inspection or risk assessment reports and indicate availability to the prospective buyer or tenant.
Signature lines for seller/lessor, buyer/tenant, and agent with printed names and dates to show mutual receipt and acknowledgment.
Include the federally required lead warning statement text and a checklist for known paint, hazards, or previous abatement so recipients see the facts at a glance.
Provide a distinct line confirming handoff of the EPA/HUD lead hazard information pamphlet and require buyer/tenant initials and date.
List any existing inspection or hazard assessment reports with dates and indicate how recipients may obtain copies for review.
Collect dated signatures and printed names for seller/lessor, buyer/tenant, and agents with license numbers where applicable for traceability.
Deliver disclosure and pamphlet prior to execution of a binding sale contract
Provide disclosure and pamphlet before tenant signs a lease for pre-1978 housing
Allow buyer/tenant access to any reports and reasonable time to review prior to closing
Date the signed form to show when disclosure occurred relative to contract events
Retention runs from the signed date; keep copies for the recommended period
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