Property Profile | Lead Paint Report | Disclosure Statement | Gallery | Lockbox | Home Page | Contact Us | FAQs | Service Area |
|
![]() |
|
![]() |
MLS Listing
Until Your Home is
Sold
Full Money-Back Guarantee and Free-Listing Give-Away![]() |
ILLINOIS ASSOCIATION OF REALTORS
DISCLOSURE OF INFORMATION AND ACKNOWLEDGMENT
LEAD-BASED PAINT AND/0R LEAD-BASED PAINT HAZARDS
SELLER DISCLOSURE (Initial)
___(a) Presence of lead-based paint and/or lead-based paint hazard (check one below):
Known lead-based paint and/or lead-based paint hazards are present in the housing (explain):
____________________________________________________________________
____________________________________________________________________
Seller has no knowledge of lead-based paint and/or lead-based paint hazards in the housing.
___(b) Records and Reports available to the seller (check one below):
Seller has provided the purchaser with all available records and reports pertaining to lead-based paint and/or lead-based paint hazards in the housing (list documents below):
____________________________________________________________________
____________________________________________________________________
Seller has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing
PURCHASER'S ACKNOWLEDGMENT (Initial):
___(c) Purchaser has received copies of all information listed above.
___(d) Purchaser has received the pamphlet Protect Your Family From Lead in Your Home
___(e) Purchaser has (check one below):
Received a 10-day opportunity (or mutually agreed upon period) to conduct a risk assessment or inspection of the presence of lead-based paint or lead-based paint hazards; or
Waived the opportunity to conduct a risk assessment or inspection for the presence or lead-based paint and/or lead-based paint hazards.
AGENT'S ACKNOWLEDGMENT (Initial):
___(f) Agent has informed the seller of the seller's obligations under 42 U.S.C. 4852d and is aware of his/her responsibility to ensure compliance .
CERTIFICATION OF ACCURACY
The following parties have reviewed the information above and certify to the best of their knowledge, that the information they have provided is true and accurate
Seller__________________________ Date _________
Seller__________________________ Date _________
Agent _________________________ Date _________
Purchaser______________________ Date _________
Purchaser______________________ Date _________
Agent_________________________ Date _________
Property Address:_______________________
_____________________