Required Federal 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. The Massachusetts Tenant Lead Law Notification and Certification Form is for compliance with state and federal lead notification requirements.
(a) Presence of lead-based paint and/or lead-based paint hazards (check (i) or (ii)
(i) __________ Known lead-based paint and/or lead-based paint hazards are present in the housing (explain).
(ii) __________Owner/Lessor has no knowledge of lead-based paint and/or lead-based pain! hazards in the housing.
(b) Records and reports available to the owner/lessor (check (i) or (ii) below]:
(i) Owner/Lessor has provided the tenant with all available records and reports pertaining to lead-based paint and/or lead-based paint hazards in the housing
Lead Inspection Report; Risk Assessment Report; Letter of Interim Control; Letter of Compliance
(ii) ___________Owner/Lessor has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing.
Tenant's Acknowledgment (initial)
(c) ____Tenant has received copies of all documents circled above.
(d) ____Tenant has received no documents listed above.
(e) ____Tenant has received the Massachusetts Tenant Lead Law Notification. Agent's Acknowledgment (initial)
(f) ____Agent has informed the owner/lessor of the owner's/lessor's obligations under federal and state law for lead-based paint disclosure and notification and is aware of
his/her 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.