Lead Based Paint Disclosure

Com
mprehens
sive Ride
er to the
Res
sidential Contractt For Sale
e And Purrchase
THIS FORM HAS BE
EEN APPROVE
ED BY THE FLO
ORIDA REALTO
ORS AND THE FLORIDA BAR
R
If inittialed by all parties,
p
the clauses
c
below
w will be incorp
porated into th
he Florida Rea
altors®/Florid
da Bar Reside
ential Contract
For S
Sale And Purc
chase between __________
___________
___________
___________
____________
___________
___ (SELLER
R)
and ___________
___________
___________
___________
____________
___________
___________
___________
____ (BUYER)
concerning the Prroperty descriibed as ____
___________
____________
___________
___________
___________
____________
_
____
____________
___________
___________
___________
____________
___________
___________
___________
____________
_
er’s Initials
Buye
__________
__
______
______
Sellerr’s Initials
__________
__
_______
____
P. LEAD-BASE
ED PAINT DIS
SCLOSURE
ead-Based Pa
aint Warning Statement
Le
“Every purchaser of any interest in residential real pro
operty on whiich a residen
ntial dwelling was built prior to 1978 is
s
notified that such property may
y present exp
posure to lead from lead-b
based paint that may placce young child
dren at risk of
o
deve
eloping lead poisoning.
p
Le
ead poisoning
g in young ch
hildren may p
produce perm
manent neuro
ological dama
age, including
g
learn
ning disabilitie
es, reduced in
ntelligence quotient, behav
vioral problem
ms, and impairred memory. Lead poisoning also poses
a parrticular risk to
o pregnant wo
omen. The se
eller of any in
nterest in resid
dential real p
property is req
quired to provvide the buye
er
with a
any informatio
on on lead-ba
ased paint ha
azards from ris
sk assessme nts or inspecttion in the selller’s possesssion and notify
y
the b
buyer of any known
k
lead-based paint ha
azards. A risk
k assessmentt or inspection for possible
e lead-based paint hazards
s
is reccommended prior
p
to purchase.”
Selle
er’s Disclosu
ure (INITIAL)
____
________ (a) Presence of lead-based paint
p
or lead-b
based paint h
hazards (CHE
ECK ONE BELOW):
Known le
ead-based pa
aint or lead-ba
ased paint hazzards are pre
esent in the ho
ousing.
Seller ha
as no knowled
dge of lead-ba
ased paint or lead-based p
paint hazards in the housin
ng.
____
________ (b) Records and
d reports available to the Seller
S
(CHECK
K ONE BELO
OW):
Seller ha
as provided th
he Buyer with all available records and rreports pertaining to lead-b
based paint or
o
lead-based paint
p
hazards
s in the housin
ng. List docum
ments: _____
___________
___________
____________
_
Seller has no reports or records pertaining to le
ead-based pa
aint or lead-b
based paint h
hazards in the
e
housing.
Buye
er’s Acknowledgement (IINITIAL)
____
________ (c) Buyer has re
eceived copies of all inform
mation listed a
above.
____
________ (d) Buyer has re
eceived the pa
amphlet Prote
ect Your Fam
mily from Lead
d in Your Hom
me.
____
________ (e) Buyer has (C
CHECK ONE BELOW):
Received
d a 10-day op
pportunity (or other mutual ly agreed upo
on period) to conduct a rissk assessmen
nt
or inspection
n for the prese
ence of lead-b
based paint o
or lead-based paint hazard
ds; or
Waived th
he opportunitty to conduct a risk assesssment or insspection for th
he presence of lead-based
d
paint or lead-based paint hazards.
Licen
nsee’s Acknowledgemen
nt (INITIAL)
____
________ (f) Licensee has informed th
he Seller of the Seller’s o bligations under 42 U.S.C
C. 4852(d) an
nd is aware of
o
Licensee’s re
esponsibility to
t ensure com
mpliance.
Certiification of Accuracy
A
The ffollowing partties have reviiewed the info
ormation abov
ve and certifyy, to the best of their know
wledge, that th
he information
n
they have provide
ed is true and accurate.
____
____________
___________
_____
SELL
LER
____
____________
___________
_____
SELL
LER
____
____________
___________
_____
Sellin
ng Licensee
____
___________
__
Date
e
____
___________
__
Date
e
____
___________
__
Date
e
______
____________
___________
____
BUYE R
______
____________
___________
____
BUYE R
______
____________
___________
____
Listing
g Licensee
_____
___________
_
Date
_____
___________
_
Date
_____
___________
_
Date
Any p
person or perrsons who kn
nowingly viola
ate the provisions of the R
Residential Lea
ad-Based Paint Hazard Red
duction Act of
o
1992 may be subje
ect to civil and
d criminal penalties and pottential triple da
amages in a p
private civil law
wsuit.
C
e Rider to the Residential
R
Con
ntract For Sale
e And Purchase
e
Page ________ of Comprehensive
CR-1 Rev. 6/10 © 20
010 Florida Realtors® and The Florida Bar. All rig
ghts reserved.