This form is a Lead-Based Paint Disclosure form required for the rental of residential dwellings. If the rental unit was constructed PRIOR TO 1978, this form is REQUIRED to be 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 pamphlet discussed below.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.