Fill and Sign the Lead Based Paint Disclosure Sales Street Address City Form

Lead-Based Paint Disclosure (Sales) ________________________________________ ___________________ New Hampshire _____________________ Street Address City State Zip Code 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 o
I lead-based paint and/or lead-based paint hazards in the housing (explain). (iii) seller has no knowledge of any lead-based paint and/or lead-based paint hazards in the housing (explain). (iv) the seller has made all inquiries reasonably available to the seller to confirm whether there are any lead-based paint and/or lead-based paint hazards in or on the residential real property sold to the purchaser. (v) seller has no knowledge oi any lead-based paint in or on the residential real property and/or any other real property (explain). (vi) seller has made all inquiries reasonably available to the seller as to the sale of a property including, without limitation, searching the records of any real estate office, inspection report, mortgage, title or any other source (list documents below). (c) (i) failure to disclose (check (c)(ii) below): (ii) (the seller) has failed to comply with this paragraph (5) by a sale or transfer at a public or private sale or transfer of real property and/or real property within a municipality. (iii) (the seller) has failed to comply with this paragraph (5) by sale or transfer of real property within a municipality under circumstances which are established by the court(s) in the proceedings or by a settlement agreement. (d)(i) failure to take affirmative action to correct or address lead, except to the extent necessary for reasonable safety to occupants of a structure or a building, or reasonable health and safety to the occupants of the dwelling, unless such action is required by law, if not more than one of the following has occurred: (a) prior contact or previous history of contamination of the occupant's home with lead (explain). (b) no remedial action has been taken by the seller pursuant to section 17b-25 or section 17b-26 and a lead service pipe has been installed in an occupied building without an adequate ground source of water in conformity with the requirements of section 38-35-110. (c) compliance with the environmental protection agency lead-based paint standard for residential properties (check (i) or (ii) below). (ii) a report of remediation has been made under subsection (b) (i) of this section. (e) failure to obtain necessary testing and/or remedial action, including but not limited to, a notification to the purchaser on the listing or listing