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<br />Disclosure of Information on Lead-Based PaInt and/or ~Based Paint Hazards <br /> <br />Lead Warning Statement <br /> <br />Every purchaser of any Interest In residential real property on whidJ a residential dwelling was built prior to 197815 <br />notified that such properly may present exposure to lead from lead-based paint that may place young children at risk <br />of developing lead poisoning. Lead poisoning in young children may produce pennanent neurological damage, <br />including leamlng disabilities, reduced Intelligence quotient, behavioral problems, and Impolred memory. Lead <br />poisoning also poses a particular risk to pregnant women. The seller of any Interest in residential real property 15 <br />required to provide the buyer with any il?formation on lead-based paint hazards from risk assessments or inspections <br />in the seiler's possession and notify the buyer of any known lead-based paint hazards. A risk assessment or Ill5pedJon <br />for possible lead-based paint hazards is recommended prior to purchase <br /> <br />Seller's Disclosure <br /> <br />(al Presence of lead-based paint and/or lead-based paint hazards (check (i) or (ii) below): <br /> <br />(i) Known lead-based paint and/or lead-based paint hazards are present in the housing <br />(explain). <br /> <br />(ii) _ Seifer has no knowledge of lead-based paint and/or lead-based paint hazards In the housing. <br /> <br />(b) Records and reports available to the seller (check (i) or (il) below): <br /> <br />(I) _ Seifer has provided the purchaser with all available records and reports pertaining to iead- <br />based paint andlor lead-based paint hazards in the housing (list documents below). <br /> <br />(ii) _ Seller has no reports or records pertaining to iead-based paint and/or lead-based paint <br />hazards in the housing. <br /> <br />Purchaser's Acknowledgment (initial) <br /> <br />(c) Purchaser has received copies of all information listed above. <br /> <br />(d) Purchaser has received the pamphlet Protect tbur Family from Lead In tbur Home. <br /> <br />(e) Purchaser has (check (i) or (ii) below): <br /> <br />(i) _ received a l()-day opportunity (or mutuaily agreed upon period) to conduct a risk assess- <br />ment or inspection for the presence of lead-based paint and/or lead-based paint hazards; or <br /> <br />(ii) _ waived the opportunity to conduct a risk assessment or inspection for the presence of <br />lead-based paint andlor lead-based paint hazards. <br /> <br />Agent's Acknowledgment (initial) <br />(t) Agent has Informed the seifer of the sellers obligations under 42 US.c. 4852(d) and is <br />aware of hislher responsibility to ensure compliance. <br /> <br />Certification of Accuracy <br /> <br />The follOWing parties have reviewed the infonnation above and certify, to the best of their knowledge, that the <br />infonnation they have provided is true and accurate. <br /> <br />Seller <br /> <br />Date <br /> <br />Date <br /> <br />Seifer <br /> <br />Purchaser <br /> <br />Date <br /> <br />Purchaser <br /> <br />Date <br /> <br />Agent <br /> <br />Date <br /> <br />Agent <br /> <br />Date <br />