Fill and Sign the Lead Based Paint Disclosure in Real Estate Form

Page 1 of 2 EQUAL HOUSING OPPORTUNITYAPPROVED BY THE TEXAS REAL ESTATE COMMISSION ADDENDUM FOR SELLER'S DISCLOSURE OF INFORMATION ON LEAD-BASED PAINT AND LEAD-BASED PAINT HAZARDS AS REQUIRED BY FEDERAL LAW CONCERNING THE PROPERTY AT____________________________________________ (Street Address and City) A. 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-paint hazards is recommended prior to purchase." B. SELLER'S DISCLOSURE: 1. PRESENCE OF LEAD-BASED PAINT AND/OR LEAD-BASED PAINT HAZARDS (check one box only): ( ) (a) Known lead-based paint and/or lead-based paint hazards are present in the Property (explain):____________________________________________________________________________________________________________________________________________________ ( ) (b) Seller has no actual knowledge of lead-based paint and/or lead-based paint hazards in the Property. 2. RECORDS AND REPORTS AVAILABLE TO SELLER (check one box only): ( ) (a) Seller has provided the purchaser with all available records and reports pertaining to lead-based paint and/or lead-based paint hazards in the Property (list documents):__________________________________________________________________________________________________________________________________________________ ( ) (b) Seller has no reports or records pertaining to lead-based paint and/or lead- based paint hazards in the Property. C. BUYER'S RIGHTS (check one box only): ( ) 1. Buyer waives the opportunity to conduct a risk assessment or inspection of the Property for the presence of lead-based paint or lead-based paint hazards. ( ) 2. Within ten days after the effective date of this contract, Buyer may have the Property inspected for the presence of lead-based paint and/or lead-based paint hazards. If lead-based paint or lead-based paint hazards are present, Buyer may terminate this contract by giving Seller written notice within 14 days after the effective date of this contract. Page 2 of 2 D. BUYER'S ACKNOWLEDGMENT(check applicable boxes): ( ) 1. Buyer has received copies of all information listed above. ( ) 2. Buyer has received the pamphlet Protect Your Family from Lead in Your Home . E. BROKERS' ACKNOWLEDGMENT: Brokers have informed Seller of Seller's obligations under 42 U.S.C. 4852d to: (a) provide Buyer with the federally approved pamphlet on lead poisoning prevention; (b) complete this addendum; (c) disclose any known lead-based paint and/or lead-based paint hazards in the Property; (d) deliver all records and reports to Buyer pertaining to lead-based paint and/or lead-based paint hazards in the Property; (e) provide Buyer a period of up to 10 days to have the Property inspected; and (f) retain a completed copy of this addendum for at least 3 years following the sale. Brokers are aware of their responsibility to ensure compliance. F. CERTIFICATION OF ACCURACY: The following persons have reviewed the information above and certify, to the best of their knowledge, that the information they have provided is true and accurate. _________________________________ ____________________________________ Seller Date Buyer Date _________________________________ ____________________________________ Seller Date Buyer Date _________________________________ ____________________________________ Listing Broker Date Other Broker Date The form of this addendum has been approved for voluntary use by the Texas Real Estate Commission for use only with similarly approved or promulgated forms of contracts. No representation is made as to the legal validity or adequacy of any provision in any specific transactions. Texas Real Estate Commission, P.O. Box 12188, Austin, TX 78711-2188, 1-800-250-8732 or (512) 459-6544. 01A TREC No. OP-L