Fill and Sign the Lead Saftey Booklet New Hampshire Housing Finance Authority Form

Lead-Based Paint Disclosure (Sales) ________________________________________ ___________________ North Dakota _____________________ 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 or
Records pertaining to lead-based paint and/or lead-based paint hazards in the housing. (c) disclosure to tenant or homeowner of lead-based paint (check (i) or (ii) below): (i) seller has no knowledge of lead-based paint hazards in the housing (explain). (ii) seller did not discover and/or confirm lead based paint hazards in the housing. (d) any information not disclosed as required in subsection (2) listed below is made known. Disclosure statement (a): this disclosure statement is to be used in all residential real property sales in violation of this policy. You must provide information on the lead-based paint hazards present in the property as indicated upon inspection. All required information is in these four categories. No other disclosure statement or information is required in lieu of the above information. Each area of the home is considered to be individual. You must also include a risk assessment or inspection for possible lead-based paint hazards in the property. See “risk assessment - landmark homes" for additional information. (i) the primary hazard may be lead and/or lead-based paint. The hazard is identified on the certificate of occupancy at the front of the property. Additional hazards may occur in the living areas of the home. (ii) all hazards in the home shall receive the same level of investigation, inspection, and disclosure unless it cannot be determined that they require different levels of examination or discovery (check (i) or (ii). (iii) each hazardous area shall receive equal attention in the same order of priority (check (i) below). Hazard priority (i) 1. Water 2. Corrosive liquids 3. Flammable gases 4. Combustible liquids and gasses 5. Explosives 6. Vacuum pumps 7. Gas leaks 8. Appliances (check (1-8) below) 9. Fumes 9a. Fumes from burning combustibles 10. Fumes produced by cooking, hot plate or stove, refrigerator, and stove, or cooking gas 11. Smoke 11a. Fumes from cooking, hot plate or stove, refrigerator, and stove 12. Fumes from hot water tank 13. Fumes produced by plumbing systems 14. Fumes or fumes emanating from sewage, liquid waste, septic tank, refuse collection, gas storage, or air conditioning units and from other sources 15. Pesticides 16. Other hazards on the premises for which a separate disclosure statement from the seller is required.