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Lead paint disclosure form

Renting out a home built before 1978? Federal law requires this disclosure, signed by both sides, before the tenant is bound by the lease. The sheet follows the regulation's required elements in order, with the warning statement word for word.

Pre-filled with an example. Add each lead report you hold as a line below; leave the list empty if you have none.

Lead-based paint disclosure (lessor)

Lead records and reports you hold (one per line)

    Preview

    DISCLOSURE OF INFORMATION ON LEAD-BASED PAINT AND/OR LEAD-BASED PAINT HAZARDS
Attachment to the lease for: 27 Orchard Row, Apt 3
Year built: 1962   Lease begins: 1 December 2026

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. Before renting pre-1978 housing, lessors must disclose the presence of known lead-based paint and/or lead-based paint hazards in the dwelling. Lessees must also receive a federally approved pamphlet on lead poisoning prevention.

LESSOR'S DISCLOSURE (initial)
_____ (a) Presence of lead-based paint and/or lead-based paint hazards:
      Lessor has no knowledge of lead-based paint or lead-based paint hazards in the housing
_____ (b) Records and reports available to the lessor:
      Lessor has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing.

LESSEE'S ACKNOWLEDGMENT (initial)
_____ (c) Lessee has received copies of all information listed above.
_____ (d) Lessee has received the pamphlet Protect Your Family From Lead in Your Home.

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.

Lessor: M. Reyes   Signature: ________________   Date: [date]
Lessee: Dana Whitfield   Signature: ________________   Date: [date]

Lessor keeps a signed copy for at least 3 years from the start of the lease.

    Not legal advice. The federal rule sets the minimum; some states and cities add their own lead disclosures. HUD-assisted housing has further rules beyond this sheet.

    Federal minimum, not legal advice

    This sheet covers the federal disclosure for a private rental. Some states and cities add their own lead rules, and federally owned or HUD-assisted housing must also meet the further requirements in 24 CFR part 35. Check both before you rely on this form alone.

    Does the rule cover your unit?

    The rule applies to every lease or sublease of "target housing" unless one of the exemptions fits. The test is the build date and the unit, not whether you have ever seen peeling paint.

    SituationDisclosure needed?Where it comes from
    Built in 1978 or laterNot coveredTarget housing is housing built before 1978
    Studio, efficiency or a single rented roomExempt, unless a child under 6 lives or is expected to live there0-bedroom dwelling
    Housing for the elderly or persons with disabilitiesExempt, with the same child-under-6 exceptionTarget housing definition
    Lease of 100 days or less, no renewal or extension possibleExempt§ 745.101(c)
    Found lead-based paint free by a certified inspectorExempt§ 745.101(b)
    Renewal, everything already disclosed, nothing new learnedExempt§ 745.101(d)

    Source: 40 CFR part 745, subpart F (EPA), and HUD's matching 24 CFR part 35, subpart A, both checked 2026-10-18.

    If you are unsure whether an exemption fits, disclose anyway. A completed form costs you one signature; a missing one is a federal violation.

    What the form must contain

    The regulation lists the elements a lease of target housing must include, either attached or written into the lease, in the language of the lease. The sheet above carries each one:

    1. 01The Lead Warning Statement, in the regulation's exact words. Do not shorten or reword it.
    2. 02Your disclosure of known lead-based paint or hazards, or a statement that you have no knowledge of any. If you know of some, say where it is, what the finding was based on, and what condition the painted surfaces are in.
    3. 03A list of the records and reports you have given the tenant, or a statement that there are none. In a multi-unit building this includes reports on common areas and building-wide evaluations.
    4. 04The tenant's acknowledgment that they received that information and the lead pamphlet.
    5. 05An agent statement, only if a leasing agent or property manager is involved. Fill in the agent line and the sheet adds it.
    6. 06Signatures and dates of the lessor, any agent and the tenants, certifying their statements are accurate to the best of their knowledge.

    Nothing in the rule makes you test the unit. It requires you to pass on what you know and what you hold.

    When to hand it over

    All of it, including the pamphlet, has to happen before the tenant is bound by the lease. If the tenant has already made an offer to lease before you disclose, you must finish the disclosure before you accept it, and give them a chance to review it and change their offer. Handing the form over with the rental application avoids that problem entirely.

    The simplest habit: staple the signed form to the lease at signing, as covered in how to write a lease agreement. At renewal you can skip it only if you disclosed everything before and have learned nothing new since; any new report means a fresh form. The renewal steps are in the lease renewal guide.

    Keeping the record

    Keep the signed form, or the lease that contains it, for at least 3 years from the start of the lease. A knowing violation can make you liable to the tenant for three times their damages, and a court may add their costs and attorney fees if they win. Federal civil penalties come on top.

    File it with the rest of the tenancy record: the lease, the rent ledger and the move-in and move-out inspection reports. If the tenancy outlasts three years, keep the form for as long as you keep the lease.

    Repairs in a pre-1978 rental

    Disclosure is not the only lead rule a landlord meets. Repair work that disturbs painted surfaces falls under EPA's renovation rule unless it stays within the minor-repair limits: 6 square feet or less of painted surface per room inside, or 20 square feet or less outside, with no window replacement or demolition of painted surfaces (40 CFR 745.83, checked 2026-10-18). Above those limits, the work must be directed by a certified renovator and follow the rule's work practices. Log the size of each paint-disturbing job on the maintenance request form so you can show which side of the line it fell on.

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