Fillable Lead Based Paint Disclosure printable pdf download

The printed portions of this form except differentiated additions, have been approved by the Colorado Real Estate Commission. (LP45-9-12)

THIS FORM HAS IMPORTANT LEGAL CONSEQUENCES AND THE PARTIES SHOULD CONSULT LEGAL AND TAX OR OTHER

COUNSEL BEFORE SIGNING.

LEAD-BASED PAINT DISCLOSURE (Sales)

Attachment to Contract to Buy and Sell Real Estate for the Property known as:

Street Address

City

State

Zip

WARNING! LEAD FROM PAINT, DUST, AND SOIL CAN BE DANGEROUS IF NOT MANAGED PROPERLY

Penalties for failure to comply with Federal Lead-Based Paint Disclosure Laws include treble (3 times) damages, attorney

fees, costs, and a base penalty up to $11,000 (plus adjustment for inflation). The current penalty is up to $16,000 for each

violation.

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 to Buyer and Real Estate Licensee(s) and Acknowledgment

1. Seller acknowledges that Seller has been informed of Seller’s obligations. Seller is aware that Seller must retain a copy of this

disclosure for not less than three years from the completion date of the sale.

2. Presence of lead-based paint and/or lead-based paint hazards (check one box below):

Seller has no knowledge of any lead-based paint and/or lead-based paint hazards present in the housing.

Seller has knowledge of lead-based paint and/or lead-based paint hazards present in the housing (explain):

3. Records and reports available to Seller (check one box below):

Seller has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing.

Seller has provided Buyer with all available records and reports pertaining to lead-based paint and/or lead-based paint

hazards in the housing (list documents below):

Buyer's Acknowledgment

4. Buyer has read the Lead Warning Statement above and understands its contents.

5. Buyer has received copies of all information, including any records and reports listed by Seller above.

Buyer has received the pamphlet "Protect Your Family From Lead in Your Home".

7. Buyer acknowledges federal law requires that before a buyer is obligated under any contract to buy and sell real estate, Seller

shall permit Buyer a 10-day period (unless the parties mutually agree, in writing, upon a different period of time) to conduct a

risk assessment or inspection for the presence of lead-based paint and/or lead-based paint hazards.

8. Buyer, after having reviewed the contents of this form, and any records and reports listed by Seller, has elected to (check one box

below):

Obtain a risk assessment or an inspection of the Property for the presence of lead-based paint and/or lead-based paint hazards,

within the time limit and under the terms of § 10 of the Contract to Buy and Sell Real Estate; or

Waive the opportunity to conduct a risk assessment or inspection for the presence of lead-based paint and/or lead-based

paint hazards.

Real Estate Licensee's Acknowledgment

LP 45-9-12. LEAD-BASED PAINT DISCLOSURE (SALES)

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Lead Based Paint Disclosure

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