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Lead Paint Tenant Disclosure Form

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LEAD PAINT TENANT DISCLOSURE FORM

Property Identification

Parties

Disclosure of Lead-Based Paint and/or Lead-Based Paint Hazards

The following information is provided in compliance with federal and applicable state lead-based paint disclosure laws for residential properties constructed prior to 1978.

1. Is the dwelling known to have been constructed before 1978? Yes No

2. Is there any known presence of lead-based paint or lead-based paint hazards in the housing? Yes No

3. Are records or reports available that indicate the presence of lead-based paint or lead-based paint hazards? Yes No

Pamphlet and Notices

Landlord must provide tenants with the federally recommended lead hazard information pamphlet and any available records or reports concerning lead-based paint or hazards. Tenant acknowledges receipt as indicated below.

Tenant received the lead hazard information pamphlet: Yes No

Tenant received records/reports described above: Yes No

Tenant Rights and Opportunity to Inspect

Tenant is hereby informed of the potential health effects of lead exposure and of the right to request further information or an inspection. Tenant acknowledges receipt of the disclosures above and the opportunity to ask questions regarding known lead conditions.

Landlord Certification

The undersigned Landlord certifies, to the best of Landlord's knowledge, that the information provided above is true and accurate. Landlord further certifies that all available records and reports pertaining to lead-based paint and lead-based paint hazards have been disclosed to Tenant.

Additional Disclosures / Notes

Default; Remedies; Governing Law

Any material misrepresentation of facts in this disclosure by Landlord shall constitute a breach of the rental agreement and entitle Tenant to pursue all available remedies at law or in equity. This disclosure shall be governed by the laws of the state in which the property is located. The parties intend that this disclosure, together with any lease or rental agreement, constitutes the complete understanding with respect to lead-based paint information for the property identified above.

Certifications and Warnings

WARNING: Lead from paint, paint chips, and dust can pose health hazards if not properly managed. Exposure to lead can cause serious health problems, especially in young children and pregnant women. Landlord and Tenant should take all reasonable precautions to avoid creating lead hazards.

By signing below, Landlord certifies the accuracy of the disclosures above. By signing below, Tenant acknowledges receipt of the information contained in this Lead Paint Tenant Disclosure Form and receipt of any reports and the lead hazard informational pamphlet if indicated.

Landlord (Printed Name):

By (Signature):

Date:

Tenant (Printed Name):

By (Signature):

Date:

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What the Lead Paint Tenant Disclosure Form Is

The Lead Paint Tenant Disclosure Form documents whether a residential dwelling built before 1978 contains known lead-based paint or lead hazards and confirms delivery of the EPA pamphlet Protect Your Family From Lead In Your Home. Federal law (Residential Lead-Based Paint Hazard Reduction Act, 42 U.S.C. §4852d) requires landlords to disclose known information and provide the pamphlet before a lease is signed for qualifying properties.

Why this disclosure matters for landlords and tenants

The form reduces health risk by making tenants aware of potential lead hazards, documents landlord compliance with federal requirements, and creates a record that the EPA pamphlet was provided prior to lease execution.

Why this disclosure matters for landlords and tenants

Who completes and signs this disclosure

The form is completed by the property owner or authorized agent and signed by the tenant(s) and landlord at lease formation.

  • Landlords and owners — prepare and attest to known lead information before lease signing.
  • Tenants and occupants — review and sign to acknowledge receipt of disclosure and pamphlet.
  • Property managers and agents — deliver pamphlet, keep records, and manage responses to tenant inquiries.

Property managers, leasing agents, and legal counsel also commonly handle distribution and retention to ensure regulatory compliance and tenant safety.

Key components of a complete disclosure package

A professional Lead Paint Tenant Disclosure Form pairs clear statements about known lead conditions with evidence of pamphlet delivery, signature blocks, and references to inspection or remediation history where applicable.

Identification

Property address, unit number, and owner or managing agent contact information so the disclosure is tied to a specific dwelling and party responsible for communication.

Lead statement

Clear declaration whether the property was built before 1978 and whether the owner knows of lead-based paint or lead hazards on the premises.

Pamphlet delivery

Affirmation that the EPA pamphlet Protect Your Family From Lead In Your Home was given to tenants, including the delivery date or method of provision.

Inspection history

Optional section for listing past lead inspections, risk assessments, or abatement actions, with dates and contractor or agency names when available.

Signature block

Signed and dated acknowledgment lines for landlord/agent and tenant(s), including printed names and relationship to the property to evidence consent and receipt.

Attachments

Space to attach test results, clearance certificates, or municipal notices that substantiate the disclosure or describe remedial measures taken.

Essential data fields the form must include

Property address: Full street address
Owner name: Legal owner or managing agent
Construction year: Year built
Lead condition: Known / Unknown / Not applicable
Pamphlet provided: Yes / No
Signatures: Landlord and tenant dates

Step-by-step: completing and delivering the disclosure

Follow these steps to ensure a compliant disclosure is completed, delivered, and documented before lease execution.

  • 01
    Confirm applicability: Verify if property was built before 1978.
  • 02
    Prepare form: Fill owner, property, and known lead information.
  • 03
    Provide pamphlet: Give EPA pamphlet and note delivery method.
  • 04
    Obtain signatures: Collect landlord and tenant signatures with dates.

Where to send or store signed disclosures

After signatures, distribute and retain copies according to landlord practices and legal retention guidance; share copies with tenants and maintain an owner/agent file.

  • Tenant copy: Give signed copy to tenant at lease signing.
  • Owner file: Store original in owner or manager records.
  • Property management: Upload to management system or tenant portal.
  • Third parties: Provide copies to abatement contractors as needed.

Digital delivery and eSigning considerations

Electronic delivery and eSignature are permissible when they capture signer intent, consent, attribution, and allow record retention consistent with ESIGN and UETA.

  • Authentication: Email link, SMS code, or stronger
  • Audit trail: Timestamp, IP, and action log
  • File formats: PDF and DOCX supported

Timing rules and when the disclosure must be provided

Provide the disclosure and EPA pamphlet to tenants before they become obligated under a lease; timing and renewals are important to maintain compliance.

Before lease signing:

Must be provided prior to executing a lease agreement.

During renewals:

If conditions change, provide updated disclosure on renewal.

New tenants:

Provide pamphlet and disclosure at move-in for new occupants.

Record date:

Record the delivery date in MM/DD/YYYY format.

Inspections:

Attach inspection dates when available to document history.

Common mistakes to avoid when preparing the disclosure

  • Failing to confirm the building year and assuming modern construction when records are incomplete, which can lead to noncompliance.
  • Providing the EPA pamphlet but not recording the delivery date or method, leaving no proof of compliance in case of dispute.
  • Using vague language like 'may contain lead' without attaching inspection results or explicit statements about known hazards.
  • Accepting unsigned or undated disclosures, or failing to maintain a signed copy in the owner’s records for the recommended retention period.

Consequences of incorrect or missing disclosures

Civil liability: Tenant health or property claims
Regulatory enforcement: HUD or EPA inquiries
Contract disputes: Lease validity questioned
Remediation costs: Unexpected abatement expenses
Reputational harm: Tenant relations and listing impact
Record deficiencies: Fines or corrective orders

How signNow compares on price and core features

Basic pricing and feature availability for common eSignature vendors; signNow appears first per comparison conventions and offers multiple plan formats.

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Free Trial Yes, 7-day free trial Yes, trial available Yes, trial available Yes, trial available Yes, trial available
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Frequently asked questions about the Lead Paint Tenant Disclosure Form

Answers to common practical and legal questions about completion, electronic signing, retention, and tenant interactions.


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