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Lead Paint Disclosure Statement

Free lead-based paint disclosure statement template — federally required for the sale or lease of most housing built before 1978.

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This free lead paint disclosure statement covers Lead Warning Statement, Seller's/Landlord's Disclosure, Buyer's/Tenant's Acknowledgment, Certification of Accuracy with 3 clearly marked [placeholder] fields to fill in — built for landlords, tenants, and small property owners documenting a lease or tenancy change clearly, without guessing at the right structure. Copy it into your own word processor, fill in the placeholders, and review it — or adapt it — before use. It's part of docstoc's free document template library, alongside business, legal, real estate, finance, and HR templates. Every template here is free to copy with no signup required, and each one carries a plain disclaimer: this is a starting point for informational purposes, not a substitute for advice from a licensed professional in your jurisdiction.

Template — click to edit

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

Property Address: [Address] · Seller/Landlord: [Name] · Buyer/Tenant: [Name] · Date: [Date]

Lead Warning Statement

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.

Seller's/Landlord's Disclosure

(a) Presence of lead-based paint and/or lead-based paint hazards: [ ] Known lead-based paint and/or lead-based paint hazards are present in the housing (explain): ______ [ ] Seller/Landlord has no knowledge of lead-based paint and/or lead-based paint hazards in the housing.

(b) Records and reports available to Seller/Landlord: [ ] Seller/Landlord has provided the Buyer/Tenant with all available records and reports pertaining to lead-based paint and/or lead-based paint hazards in the housing (list documents): ______ [ ] Seller/Landlord has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing.

Buyer's/Tenant's Acknowledgment

[ ] Buyer/Tenant has received the pamphlet "Protect Your Family from Lead in Your Home." [ ] Buyer has received a 10-day opportunity (or mutually agreed period) to conduct a risk assessment or inspection for lead-based paint hazards, or has waived this opportunity (buyer sale transactions only).

Certification of Accuracy

The parties certify that the information provided is true and accurate.

Seller/Landlord: ______________________ Date: ____________ Buyer/Tenant: ______________________ Date: ____________ Agent (if any): ______________________ Date: ____________

*This document is provided for informational and educational purposes only and does not constitute legal advice. This disclosure is FEDERALLY REQUIRED under 42 U.S.C. § 4852d for the sale or lease of most housing built before 1978 — sellers, landlords, and their agents can face real fines and, in some cases, treble damages in a lawsuit for failing to provide it, so this isn't an optional or "nice to have" form for pre-1978 properties.*

Edit directly in the box above. Download PDF anytime — the docstoc.io footer is always included and cannot be removed.

What's included

Edit online — click the document, fill in placeholders, download a PDF
4 standard sections: Lead Warning Statement, Seller's/Landlord's Disclosure, Buyer's/Tenant's Acknowledgment, Certification of Accuracy
3 clearly marked [placeholder] fields for quick personalizing
Free to use — no account or signup required
Fully editable — adjust any clause to match your actual situation
Includes a signature block, ready to print or sign digitally
Fixed docstoc.io footer on every PDF (not removable)

Who this template is for

Freelancers & solo founders

Handling routine business paperwork without commissioning custom legal drafting for every document.

Small businesses

Standardizing recurring documents — leases, agreements, notices — across a growing operation.

Anyone reviewing before signing

Using a clear starting structure to understand what a document should cover, even if a lawyer finalizes it.

Independent landlords

Managing a rental directly, without a property management company's paperwork.

FAQ

Is this lead paint disclosure statement template really free?

Yes — this Lead Paint Disclosure Statement template on docstoc is free to view, edit online, and download as a PDF with no account or signup required.

What does this lead paint disclosure statement cover?

This real estate template includes Lead Warning Statement, Seller's/Landlord's Disclosure, Buyer's/Tenant's Acknowledgment, Certification of Accuracy. Fill in the [bracketed] placeholders, edit any clause online, then download a PDF — the docstoc.io footer stays on every export.

Is this legal advice?

No. Landlord-tenant law is one of the most locally-specific areas of law in the US — notice periods, required disclosures, and even what a lease is allowed to say vary by state and often by city. Check your local requirements (or a real estate attorney) before using this for an actual lease or notice.

Can I edit the wording?

Yes — edit directly on the page, adjust any section or clause, and re-fill the 3 placeholder fields to match your situation before downloading a PDF. It's a starting structure, not a rigid script.

Where can I find more free templates like this?

Browse more free real estate and related document templates in the docstoc library at /document-templates/.

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