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Form HI-864LT
HAWAII RESIDENTIAL LEASE AGREEMENT
This Residential Lease Agreement (hereinafter “Lease”) is entered into this the ____ day of _____________________,
20____, by and between the Lessor: ______________________________________, (hereinafter referred to as “Landlord”),
and the Lessee(s): _____________________________________________________________________________________.
All Lessees (hereinafter referred to collectively as “Tenant”), are jointly, severally and individually bound by, and liable
under, the terms and conditions of this Lease.
For the valuable consideration described below, the sufficiency of which is hereby acknowledged, Landlord and Tenant do
hereby covenant, contract and agree as follows:
1. GRANT OF LEASE: Landlord does hereby
lease unto Tenant, and Tenant does hereby rent from
Landlord, solely for use as a personal residence,
excluding all other uses, the personal residence
located in __________________ County, Hawaii,
with address of:
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
______________________________, including the
following items of personal property:
__________________________________________
______
__________________________________________
__________________________________________
____________.
2. NATURE OF OCCUPANCY: As a special
consideration and inducement for the granting of
this Lease by the Landlord to the Tenant, the
personal residence described above shall be used
and occupied only by the members of the Tenant’s
family or others whose names and ages are set forth
below:
__________________________________________
______
__________________________________________
__________________________________________
__________________________________________
__________________.
3. TERM OF LEASE: This Lease shall
commence on the ____ day of
___________________, 20____, and extend until its
expiration on the ____ day of _________________,
20____, unless renewed or extended pursuant to the
terms herein.
4. SECURITY DEPOSIT: Upon execution of this
Lease, Tenant shall deposit the sum of
$___________ to be held by Landlord as a security
deposit for reasonable cleaning of, and repair of
damages to, the premises upon the expiration or
termination of this Lease, or other reasonable
damages resulting from a default by Tenant. Tenant shall be liable to Landlord for all damages to the
leased premises upon the termination of this Lease,
ordinary wear and tear excepted. Tenant is not
entitled to interest on the security deposit. Tenant
may not apply the security deposit to any rent due
under this Lease. If Landlord sells or assigns the
leased premises, Landlord shall have the right to
transfer Tenant’s security deposit to the new owner
or assignee to hold under this Lease, and upon so
doing Landlord shall be released from all liability to
Tenant for return of said security deposit.
In compliance with Hawaii Code § 521-44:
At the termination of a Lease agreement in which
the landlord required and received a security deposit
if the landlord proposes to retain any amount of the
security deposit for any of the purposes specified in
subsection (a), the landlord shall so notify the
tenant, in writing, unless the tenant had wrongfully
quit the dwelling unit, together with the particulars
of and grounds for the retention, including written
evidence of the costs of remedying tenant defaults,
such as estimates or invoices for material and
services or of the costs of cleaning, such as receipts
for supplies and equipment or charges for cleaning
services. The security deposit, or the portion of
the security deposit remaining after the landlord has
claimed and retained amounts authorized under this
section, if any, shall be returned to the tenant not
later than fourteen days after the termination of the
rental agreement. If the landlord does not furnish
the tenant with the written notice and other
information required by this subsection, within
fourteen days after the termination of the Lease
agreement, the landlord shall not be entitled to
retain the security deposit or any part of it, and the
landlord shall return the entire amount of the
security deposit to the tenant. A return of the
security deposit or the furnishing of the written
notice and other required information in compliance
with the requirements of this paragraph shall be
presumptively proven if mailed to the tenant, at an
address supplied to the landlord by the tenant, with
acceptable proof of mailing and postmarked
before midnight of the fourteenth day after the date
of the termination of the Lease agreement or if there
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is an acknowledgment by the tenant of receipt
within the fourteen-day limit.
5. RENT PAYMENTS: Tenant agrees to pay rent
unto the Landlord during the term of this Lease in
equal monthly installments of $_____________,
said installment for each month being due and
payable on or before the 1st day of the month, the
first full rent payment under this Lease being due on
the 1st day of ____________________, 20____.
Tenant agrees that if rent is not paid in full on or
before the _____ day of the month, Tenant will pay
a late charge of $________ as allowed by applicable
Hawaii law.
The prorated rent from the commencement of this
Lease to the first day of the following month is
$____________, which amount shall be paid at the
execution of this Lease.
Tenant agrees that rent shall be paid in lawful
money of the United States by (indicate those that
apply):
[ ] cash, [ ] personal check, [ ] money order, [
] cashier’s check, [ ] other___________________.
Rent payments shall be made payable to:
__________________________________________
______
and mailed or delivered to the following address:
__________________________________________
_____________________________. All notices
from Tenant to Landlord under this Lease and
applicable Hawaii law shall be delivered to the
above address.
Tenant agrees that rent monies will not be
considered paid until Landlord or Landlord’s agent
receives the rent monies, either by mail or by
delivery to the above address. Tenant placing rent
monies in the mail is not sufficient for rent to be
considered paid, and rent will be considered unpaid
until actual receipt thereof.
If there are multiple Tenants signed to this Lease, all
such Tenants are jointly, severally and individually
bound by, and liable under, the terms and conditions
of this Lease. A judgment entered against one
Tenant shall be no bar to an action against other
Tenants.
6. CONSEQUENCES OF BREACH BY
TENANT: If Tenant, by any act or omission, or by
the act or omission of any of Tenant’s family or
invitees, licensees, and/or guests, violates any of the
terms or conditions of this Lease or any other
documents made a part hereof by reference or attachment, Tenant shall be considered in breach of
this Lease (breach by one tenant shall be considered
breach by all tenants where Tenant is more than one
person).
In compliance with Hawaii Code § 521-69 et seq.:
If the tenant is in material noncompliance with §
521-51, the landlord, upon learning of any such
noncompliance and after notifying the tenant in
writing of the noncompliance and allowing a
specified time not less than ten (10) days after
receipt of the notice, for the tenant to remedy the
noncompliance:
(1) May terminate the Lease agreement and bring
a summary proceeding for possession of the
dwelling unit or any other proper proceeding,
action, or suit for possession if the tenant is in
material noncompliance with section 521-51(1); or
(2) May remedy the tenant's failure to comply
and bill the tenant for the actual and reasonable cost
of such remedy if the noncompliance can be
remedied by the landlord by cleaning, repairing,
replacing a damaged item, or the like, which bill
shall be treated by all parties as rent due and
payable on the next regular rent collection date or, if
the Lease has terminated, immediately upon receipt
by the tenant. No allowance of time to remedy
noncompliance shall be required when
noncompliance by the tenant causes or threatens to
cause irremediable damage to any person or
property. If the tenant cannot be served with notice
as required, notice may be given the tenant by
posting the same in a conspicuous place on the
dwelling unit.
The landlord may bring an action or proceeding for
waste or for breach of contract for damage suffered
by the tenant's willful or negligent failure to comply
with the tenant's obligations under § 521-51.
If the breach by the Tenant is nonpayment of rent ,
landlord may, any time after rent is due, demand
payment thereof and notify the tenant in writing that
unless payment is made within a time mentioned in
the notice, not less than five (5) business days after
receipt thereof, the Lease agreement will be
terminated. If the tenant cannot be served with
notice as required, notice may be given the tenant
by posting the same in a conspicuous place on the
dwelling unit.
If the tenant breaches any rule or regulation
promulgated by landlord, the landlord may notify
the tenant in writing of the tenant's breach. The
notice shall specify the time, not less than ten days,
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within which the tenant is required to remedy the
breach.
No allowance of time to remedy the breach of any
rule or regulation shall be required when the breach
by the tenant causes or threatens to cause damage to
any person or constitutes a violation of section 521-
51(1) or (6). If the breach complained of continues
or recurs after the date specified in the notice, the
landlord may bring a summary proceeding for
possession within thirty days after such continued or
recurring breach.
Tenant expressly agrees and understands that upon
Landlord’s termination of this Lease, the entire
remaining balance of unpaid rent for the remaining
term of this Lease shall ACCELERATE , whereby
the entire sum shall become immediately due,
payable, and collectable. Landlord may hold the
portion of Tenant’s security deposit remaining after
reasonable cleaning and repairs as a partial offset to
satisfaction of the accelerated rent.
7. DELIVERY OF NOTICES: Any giving of
notice under this Lease or applicable Hawaii law
shall be made by Tenant in writing and delivered to
the address noted above for the payment of rent,
either by hand delivery or by mail. Certified or
registered mail is recommended. Delivery by mail
shall not be considered complete until actual receipt
by Landlord or Landlord’s agent.
Any notices from Landlord to Tenant shall be in
writing and shall be deemed sufficiently served
upon Tenant when deposited in the mail addressed
to the leased premises, or addressed to Tenant’s last
known post office address, or hand delivered, or
placed in Tenant’s mailbox. If Tenant is more than
one person, then notice to one shall be sufficient as
notice to all.
8. UTILITIES: Tenant will provide and pay for
the following utilities (indicate those that apply):
[ ] Electric, [ ] Gas, [ ] Telephone, [ ] Cable
Television, [ ] Water, [ ] Garbage pick-up.
Landlord will provide and pay for the following
utilities (indicate those that apply):
[ ] Electric, [ ] Gas, [ ] Telephone, [ ] Cable
Television, [ ] Water, [ ] Garbage pick-up.
Tenant shall be responsible for contacting and
arranging for any utility service not provided by the
Landlord, and for any utilities not listed above.
Tenant shall be responsible for having same utilities
disconnected on the day Tenant delivers the leased
premises back unto Landlord upon termination or
expiration of this Lease. 9. NOTICE OF INTENT TO SURRENDER:
Any other provision of this lease to the contrary
notwithstanding, at least thirty (30) days prior to the
normal expiration of the term of this Lease as noted
under the heading TERM OF LEASE above, Tenant
shall give written notice to Landlord of Tenant’s
intention to surrender the residence at the expiration
of the Lease term. If said written notice is not
timely given, the Tenant shall become a month-to-
month tenant as defined by applicable Hawaii law,
and all provisions of this Lease will remain in full
force and effect, unless this Lease is extended or
renewed for a specific term by written agreement of
Landlord and Tenant.
If Tenant becomes a month-to-month tenant in the
manner described above, Tenant must give a thirty
(30) day written notice to the Landlord of Tenant’s
intention to surrender the residence. At any time
during a month-to-month tenancy Landlord may
terminate the month-to-month Lease by serving
Tenant with a written notice of termination, or by
any other means allowed by applicable Hawaii law.
Upon termination, Tenant shall vacate the premises
and deliver same unto Landlord on or before the
expiration of the period of notice.
10. OBLIGATIONS AND DUTIES OF
LANDLORD:
In compliance with Hawaii Code § 521-42,
Landlord shall:
(1) Comply with all applicable building and housing
laws materially affecting health and safety;
(2) Keep common areas of a multi-dwelling unit
premises in a clean and safe condition;
(3) Make all repairs and arrangements necessary to
put and keep the premises in a habitable condition;
(4) Maintain all electrical, plumbing, and other
facilities and appliances supplied by the landlord in
good working order and condition, subject to
reasonable wear and tear;
(5) Except in the case of a single family residence,
provide and maintain appropriate receptacles and
conveniences for the removal of normal amounts of
rubbish and garbage, and arrange for the frequent
removal of such waste materials; and
(6) Except in the case of a single family residence,
or where the building is not required by law to be
equipped for the purpose, provide for the supplying
of running water as reasonably required by the
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tenant.
(7) Prior to the initial date of initial occupancy, the
landlord shall inventory the premises and make a
written record detailing the condition of the
premises and any furnishings or appliances
provided. Duplicate copies of this inventory shall be
signed by the landlord and by the tenant and a copy
given to each tenant. In an action arising under this
section, the executed copy of the inventory shall be
presumed to be correct. If the landlord fails to make
such an inventory and written record, the condition
of the premises and any furnishings or appliances
provided, upon the termination of the Lease shall be
rebuttably presumed to be the same as when the
tenant first occupied the premises.
11. OBLIGATIONS AND DUTIES OF
TENANT:
In compliance with Hawaii Code § 521-51, Tenant
shall:
(1) Comply with all applicable building and housing
laws materially affecting health and safety;
(2) Keep that part of the premises which the tenant
occupies and uses as clean and safe as the conditions
of the premises permit;
(3) Dispose from the tenant's dwelling unit all
rubbish, garbage, and other organic or flammable
waste in a clean and safe manner;
(4) Keep all plumbing fixtures in the dwelling unit
or used by the tenant as clean as their condition
permits;
(5) Properly use and operate all electrical and
plumbing fixtures and appliances in the dwelling
unit or used by the tenant;
(6) Not permit any person on the premises with the
tenant's permission to willfully destroy, deface,
damage, impair, or remove any part of the premises
which include the dwelling unit or the facilities,
equipment, or appurtenances thereto, nor oneself do
any such thing;
(7) Keep the dwelling unit and all facilities,
appliances, furniture, and furnishings supplied
therein by the landlord in fit condition, reasonable
wear and tear excepted; and
(8) Comply with all obligations, restrictions, rules,
and the like which are in accordance with any rules,
obligations or restrictions promulgated by landlord,
and which the landlord can demonstrate are reasonably necessary for the preservation of the
property and protection of the persons of the
landlord, other tenants, or any other person.
Tenant agrees that any violation of these provisions
shall be considered a breach of this Lease.
12. NO ASSIGNMENT: Tenant expressly
agrees that the leased premises nor any portion
thereof shall not be assigned or sub-let by Tenant
without the prior written consent of Landlord.
13. TENANT INSURANCE: Landlord shall not
be liable to Tenant, Tenant’s family or Tenant’s
invitees, licensees, and/or guests for damages not
proximately caused by Landlord or Landlord’s
agents. Landlord will not compensate Tenant or
anyone else for damages proximately caused by any
other source whatsoever, or by Acts of God, and
Tenant is therefore strongly encouraged to
independently purchase insurance to protect Tenant,
Tenant’s family, Tenant’s invitees, licensees, and/or
guests, and all personal property on the leased
premises and/or in any common areas from any and
all damages.
14. CONDITION OF LEASED PREMISES:
Tenant hereby acknowledges that Tenant has
examined the leased premises prior to the signing of
this Lease, or knowingly waived said examination.
Tenant acknowledges that Tenant has not relied on
any representations made by Landlord or Landlord’s
agents regarding the condition of the leased
premises and that Tenant takes premises in its AS-IS
condition with no express or implied warranties or
representations beyond those contained herein or
required by applicable Hawaii law. Tenant agrees
not to damage the premises through any act or
omission, and to be responsible for any damages
sustained through the acts or omissions of Tenant,
Tenant’s family or Tenant’s invitees, licensees,
and/or guests. If such damages are incurred, Tenant
is required to pay for any resulting repairs at the
same time and in addition to the next month’s rent
payment, with consequences for non-payment
identical to those for non-payment of rent described
herein. At the expiration or termination of the
Lease, Tenant shall return the leased premises in as
good condition as when taken by Tenant at the
commencement of the lease, with only normal wear-
and-tear excepted. Tenant shall have the right to
remove from the premises Tenant’s fixtures placed
thereon by Tenant at his expense, provided,
however, that Tenant in effecting removal, shall
restore the leased premises to as good, safe, sound,
orderly and sightly condition as before the addition
of Tenant’s fixture. Failing this, Tenant shall be
obligated to pay for repairs as stated above.
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15. ALTERATIONS: Tenant shall make no
alterations, decorations, additions, or improvements
to the leased premises without first obtaining the
express written consent of Landlord. Any of the
above-described work shall become part of the
dwelling. If carried out by independent contractors,
said contractors must be approved by Landlord.
Tenant shall not contract for work to be done
without first placing monies sufficient to satisfy the
contract price in an escrow account approved by
Landlord. All work shall be done at such times and
in such manner as Landlord may designate. If a
construction or mechanic’s lien is placed on the
leased premises as a result of the work, such shall be
satisfied by Tenant within ten (10) days thereafter at
Tenant’s sole expense. Tenant shall be considered
in breach of this Lease upon failure to satisfy said
lien.
16. NO ILLEGAL USE: Tenant shall not
perpetrate, allow or suffer any acts or omissions
contrary to law or ordinance to be carried out upon
the leased premises or in any common area. Upon
obtaining actual knowledge of any illegal acts or
omissions upon the leased premises, Tenant agrees
to immediately inform Landlord and the appropriate
authorities. Tenant shall bear responsibility for any
and all illegal acts or omissions upon the leased
premises and shall be considered in breach of this
Lease upon conviction of Tenant or any of Tenant’s
family or invitees, licensees, and/or guests for any
illegal act or omission upon the leased premises-
whether known or unknown to Tenant.
17. NOTICE OF INJURIES: In the event of
any significant injury or damage to Tenant, Tenant’s
family, or Tenant’s invitees, licensees, and/or
guests, or any personal property, suffered in the
leased premises or in any common area, written
notice of same shall be provided by Tenant to
Landlord at the address designated for delivery of
notices (identical to address for payment of rent) as
soon as possible but not later than five (5) days after
said injury or damage. Failure to provide such
notice shall constitute a breach of this Lease.
18. LANDLORD’S RIGHT TO
MORTGAGE: Tenant agrees to accept the
premises subject to and subordinate to any existing
or future mortgage or other lien, and Landlord
reserves the right to subject premises to same.
Tenant agrees to and hereby irrevocably grants
Landlord power of attorney for Tenant for the sole
purpose of executing and delivering in the name of
the Tenant any document(s) related to the
Landlord’s right to subject the premises to a
mortgage or other lien. 19. ABANDONMENT: Abandonment shall
be defined as the absence of the Tenant from the
leased premises for a period of seven (7) or more
consecutive days while rent or any owing monies
remain unpaid- whereupon Tenant will be
considered in breach of this Lease. This definition
is subordinate to, and shall not in any way impair,
the rights and remedies of Landlord under this Lease
or applicable Hawaii law, except that in case of
abandonment, Landlord or Landlord’s agents may
immediately or any time thereafter enter and re-take
the leased premises as provided by applicable
Hawaii law, and terminate this Lease without notice
to Tenant.
20. NOTICE OF ABSENCE FROM PREMISES:
If Tenant is to be absent from the leased premises
for seven (7) or more consecutive days, written
notice of such should be served upon Landlord. If
such absences are to be customary or frequent, the
expected frequency and duration of absence should
be summarily noted here:
______________________
__________________________________________
__________________________________________
____________
Tenant expressly agrees and understands that
absence from the premises, with or without notice,
in no way obviates the requirement to pay rent and
other monies as stated herein, or the consequences
of failure to timely pay same.
21. POSSESSION OF PREMISES: Tenant shall
not be entitled to possession of the premises
designated for lease until the security deposit and
first month’s rent (or prorated portion thereof), less
any applicable promotional discount, is paid in full
and the premises designated for lease is vacated by
the prior tenant.
22. MATERIALITY OF APPLICATION TO
RENT: All representations made by Tenant(s) on
the Application to Rent (or like-titled document) are
material to the grant of this Lease, and the Lease is
granted only on condition of the truthfulness and
accuracy of said representations. If a failure to
disclose or lack of truthfulness is discovered on said
Application, Landlord may deem Tenant to be in
breach of this Lease.
23. MODIFICATION OF THIS LEASE: Any
modification of this lease shall not be binding upon
Landlord unless in writing and signed by Landlord
or Landlord’s authorized agent. No oral
representation shall be effective to modify this
Lease. If, as per the terms of this paragraph, any
provision of this lease is newly added, modified, or
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Form HI-864LT
stricken out, the remainder of this Lease shall
remain in full force and effect.
24. REMEDIES NOT EXCLUSIVE: The
remedies and rights contained in and conveyed by
this Lease are cumulative, and are not exclusive of
other rights, remedies and benefits allowed by
applicable Hawaii law.
25. SEVERABILITY: If any provision
herein, or any portion thereof, is rendered invalid by
operation of law, judgment, or court order, the
remaining provisions and/or portions of provisions
shall remain valid and enforceable and shall be
construed to so remain.
26. NO WAIVER: The failure of Landlord to
insist upon the strict performance of the terms,
covenants, and agreements herein shall not be
construed as a waiver or relinquishment of
Landlord's right thereafter to enforce any such term,
covenant, or condition, but the same shall continue
in full force and effect. No act or omission of
Landlord shall be considered a waiver of any of the
terms or conditions of this Lease, nor excuse any
conduct contrary to the terms and conditions of this
Lease, nor be considered to create a pattern of
conduct between the Landlord and Tenant upon
which Tenant may rely upon if contrary to the terms
and conditions of this Lease.
27. ATTORNEY FEES: In the event that
Landlord employees an attorney to collect any rents
or other charges due hereunder by Tenant or to
enforce any of Tenant's covenants herein or to
protect the interest of the Landlord hereunder,
Tenant agrees to pay a reasonable attorney's fee and
all expenses and costs incurred thereby, to the
greatest extent allowed by applicable law.
28. HEIRS AND ASSIGNS: It is agreed and
understood that all covenants of this lease shall
succeed to and be binding upon the respective heirs,
executors, administrators, successors and, except as
provided herein, assigns of the parties hereto, but
nothing contained herein shall be construed so as to
allow the Tenant to transfer or assign this lease in
violation of any term hereof.
29. DESTRUCTION OF PREMISES: In the
event the leased premises shall be destroyed or
rendered totally untenable by fire, windstorm, or
any other cause beyond the control of Landlord,
then this Lease shall cease and terminate as of the
date of such destruction, and the rent shall then be
accounted for between Landlord and Tenant up to
the time of such damage or destruction of said
premises as if being prorated as of that date. In the event the leased premises are damaged by fire,
windstorm or other cause beyond the control of
Landlord so as to render the same partially
untenable, but repairable within a reasonable time,
then this lease shall remain in force and effect and
the Landlord shall, within said reasonable time,
restore said premises to substantially the condition
the premises were in prior to said damage, and there
shall be an abatement in rent in proportion to the
relationship the damaged portion of the leased
premises bears to the whole of said premises.
30. EMINENT DOMAIN: In the event that
the leased premises shall be taken by eminent
domain, the rent shall be prorated to the date of
taking and this Lease shall terminate on that date.
31. LANDLORD ENTRY: In addition to the rights
provided by applicable Hawaii law, Landlord shall
have the right to enter the leased premises at all
reasonable times for the purpose of inspecting the
same and/or showing the same to prospective
tenants or purchasers, and to make such reasonable
repairs and alterations as may be deemed necessary
by Landlord for the preservation of the leased
premises or the building and to remove any
alterations, additions, fixtures, and any other objects
which may be affixed or erected in violation of the
terms of this Lease. Landlord shall give reasonable
notice of intent to enter premises except in the case
of an emergency.
32. GOVERNING LAW: This Lease is governed
by the statutory and case law of the State of Hawaii.
33. LEAD-BASED PAINT DISCLOSURE:
HOUSING BUILT BEFORE 1978 MAY
CONTAIN LEAD-BASED PAINT. LEAD FROM
PAINT, PAINT CHIPS, AND DUST CAN POSE
HEALTH HAZARDS IF NOT MANAGED
PROPERLY. LEAD EXPOSURE IS
ESPECIALLY HARMFUL TO YOUNG
CHILDREN AND PREGNANT WOMEN.
BEFORE RENTING PRE-1978 HOUSING,
LESSORS MUST DISCLOSE THE PRESENCE
OF KNOWN LEAD-BASED PAINT AND/OR
LEAD-BASED PAINT HAZARDS IN THE
DWELLING. LEASEES MUST ALSO
RECEIVE A FEDERALLY APPROVED
PAMPHLET ON LEAD POISONING
PREVENTION.
Landlord states as follows: [Landlord check one]
The leased premises was constructed in 1978 or
later.
The leased premises was constructed prior to
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Form HI-864LT
1978. Landlord has conformed with all federal
requirements regarding lead-based paint
disclosure including the completion and mutual
signing with Tenant and any agents, of the
Lead-Based Paint Disclosure Form attached
hereto and incorporated into this lease as a part
hereof. All associated information required by
the Disclosure form (if any) was furnished to
Tenant, and Tenant received the EPA pamphlet
“ Protect Your Family from Lead in Your
Home. ”
34. ADDITIONAL PROVISIONS:
_________________________________________
__________________________________________
_____________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
____________________________________
***********************
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WITNESS THE SIGNATURES OF THE PARTIES TO THIS RESIDENTIAL LEASE AGREEMENT:
LANDLORD
Sign: ___________________________________ Print: __________________________________ Date: ______________
TENANT
Sign: ___________________________________ Print: __________________________________ Date: ______________
TENANT
Sign: ___________________________________ Print: __________________________________ Date: ______________
TENANT
Sign: ___________________________________ Print: __________________________________ Date: ______________
TENANT
Sign: ___________________________________ Print: __________________________________ Date: ______________
THIS IS A SEPARATE INSTRUCTION PAGE REGARDING LEAD-BASED PAINT DISCLOSURE
THIS PAGE IS NOT PART OF THE LEASE. IT IS PROVIDED BY USLF TO AID THE
LANDLORD IN COMPLYING WITH FEDERAL LEAD-BASED PAINT DISCLOSURE
LAW, FOR DWELLING UNITS BUILT PRIOR TO 1978.
IMPORTANT!!! NOTES CONCERNING LEAD-PAINT DISCLOSURE REQUIREMENTS
Introduction: If the rental dwelling unit was constructed PRIOR TO 1978, federal law REQUIRES a Lead-
Based Paint Disclosure Form to be attached to the lease, completed and signed by the lessor/landlord and
lessee/tenant. If the rental dwelling was constructed in 1978 or later, this form is not required. If in doubt about
the timing of construction, use the disclosure form. Whenever the form is used, the landlord must also give the
tenant the EPA lead-based paint pamphlet discussed below. Landlords must retain a copy of the signed
disclosure form for no less than three years from the date the lease begins.
Background: To protect families from exposure to lead from paint, dust, and soil, Congress passed the
Residential Lead-Based Paint Hazard Reduction Act of 1992. HUD and EPA require the disclosure of known
information on lead-based paint and related hazards before the lease of most housing built before 1978.
Requirements: Before the lease is signed and agreed to, landlords must fully comply with lead-paint disclosure
law. Compliance is accomplished by:
(1) Fully completing and delivering to the tenants, as an attachment to the lease, the LEAD-BASED PAINT
DISCLOSURE form (the lessees/renters also initial and sign this form), and
(2) Giving the tenants the EPA pamphlet entitled "Protect Your Family From Lead In Your Home." (See the
download link for the pamphlet, below.)
Purchase the Disclosure Form: If you need to purchase a Lead-Based Paint Disclosure Form, you can easily
do so using USLF. http://www.uslegalforms.com/lead-paint-disclosure-forms.htm Click this link (or copy it
into the address window of you internet browser) and select your state. Two forms will be accessed. You want
the “LEAD2” form, for rental transactions ( not the “LEAD1” form for sales). Click the “Information and
Preview” link for more info on the form, and then order the form.
The Free EPA Pamphlet: The landlord must give the tenants the EPA-approved information pamphlet on
identifying and controlling lead-based paint hazards entitled "Protect Your Family From Lead In Your Home."
You may obtain and print this pamphlet free by clicking the following download link (or copying the link into
the address window of your internet browser):
http://www.epa.gov/lead/pubs/leadpdfe.pdf
The form is in .pdf format and you will need the free Adobe Acrobat Reader to view the form. In the unlikely
circumstance that the Adobe Acrobat Reader is not installed on your computer, you can download it free from
http://www.adobe.com/products/acrobat/readstep2.html . The download is quick and easy.
~ Thank you for using USLF ~
Thank you for downloading our
Residential Lease Agreement
For Landlords who already have a Lease Agreement form, our database also offers
our Supplemental Lease Forms Package for your state – without the Lease – to
ensure you have all the forms necessary to complete your transaction.
The Supplemental Lease Forms Package contains the following state-specific
forms:
1. Residential Lease Application
2. Consent to Background and Reference Check
3. Salary Verification for Potential Lease or Loan
4. Lead Based Paint Disclosure (Rental)
5. Inventory and Condition of Leased Premises: Pre-Lease
6. Inventory and Condition of Leased Premises: Post-Lease
7. Tenant Welcome Letter
8. Warning Notice for Failure to Pay Rent
9. Notice to Pay Rent or Lease Terminates (Residence)
10. Landlord Tenant Closing Statement
Save time, money and hassle by having these forms at your fingertips.
