Common use of LEAD-BASED PAINT DISCLOSURE Clause in Contracts

LEAD-BASED PAINT DISCLOSURE. 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 property. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, Lessors/Landlords 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/Landlord’s Disclosure Presence of lead-based paint and/or lead-based paint hazards (check only one box) ¨ Lessor (Landlord) has no knowledge of lead-based paint and/or lead-based paint hazards in the housing x Lessor (Landlord) knows that lead-based paint and/or lead-based paint hazards are present in the housing (explain) Agent was verbally informed by previous property management company that the property does contain lead based paint. Records and reports available to Lessor (check only one box) x Lessor (Landlord) has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. ¨ Lessor (Landlord) has reports or records indicating the presence of some lead-based paint and/or lead-based paint hazards in the housing, and has provided the Prospective Resident/Applicant with all such records and reports that are available to lessor (list documents) Applicants’ Acknowledgment (Initial) NA_____ Applicant has received copies of all information listed above. ________ Applicant has received the pamphlet Protect Your Family From Lead In Your Home (“the pamphlet”). Applicant further acknowledges that the pamphlet is written in English, and that Applicant speaks, reads, and understands the English Language. AGENT’S STATEMENT If another person or entity is involved in leasing the dwelling as an agent of the lessor (i.e., as a management company, real estate agent or locator service acting for the owner), such agent represents that: (1) agent has informed the lessor of the lessor’s obligations under 42 U.S.C.4852 (d); and (2) agent is aware of agent’s responsibility to ensure that lessor complies with such disclosure laws. Such compliance may b through lessor himself or herself, or through lessor’s employees, officers or agents. Lessor’s obligations include those in 24 CFR Sections 35.88 and 35.92 and 40 CFR Sections 745.107 and 745.113. Agent’s obligations include those in 24 CFR Section 35.94 and 40 CFR Section 745.115. ACCURACY CERTIFICATIONS and APPLICANT”S ACKNOWLEDGMENT Lessor and any agent named below certify that to the best of their knowledge the above information and statements made or provided by them, respectively, are true and accurate. The person who signs for the LESSOR may be (1) the owner himself or herself; (2) an employee, officer or partner of the owner; or (3) a representative of the owner’s management company, real estate agent or locator service if such person is authorized to sign for the lessor. The person who signs for the AGENT may be: (1) the agent himself or herself; or (2) an employee, officer or partner of the agent if such person is authorized to sign for the agent. The Prospective Resident/Applicant by signing below acknowledge that they have received a copy of this lease disclosure before becoming obligated under the lease.

LEAD-BASED PAINT DISCLOSURE. 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 property. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, Lessors/Landlords 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/Landlord’s Disclosure Presence of lead-based paint and/or lead-based paint hazards (check only one box) ¨ Lessor (Landlord) has no knowledge of lead-based paint and/or lead-based paint hazards in the housing x Lessor (Landlord) knows that lead-based paint and/or lead-based paint hazards are present in the housing (explain) Agent was verbally informed by previous property management company that the property does contain lead based paint. Records and reports available to Lessor (check only one box) x Lessor (Landlord) has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. ¨ Lessor (Landlord) has reports or records indicating the presence of some lead-based paint and/or lead-based paint hazards in the housing, and has provided the Prospective Resident/Applicant with all such records and reports that are available to lessor (list documents) Applicants’ Acknowledgment (Initial) NA_____ Applicant has received copies of all information listed above. ________ Applicant has received the pamphlet Protect Your Family From Lead In Your Home (“the pamphlet”). Applicant further acknowledges that the pamphlet is written in English, and that Applicant speaks, reads, and understands the English Language. AGENT’S STATEMENT If another person or entity is involved in leasing the dwelling as an agent of the lessor (i.e., as a management company, real estate agent or locator service acting for the owner), such agent represents that: (1) agent has informed the lessor of the lessor’s obligations under 42 U.S.C.4852 (d); and (2) agent is aware of agent’s responsibility to ensure that lessor complies with such disclosure laws. Such compliance may b through lessor himself or herself, or through lessor’s employees, officers or agents. Lessor’s obligations include those in 24 CFR Sections 35.88 and 35.92 and 40 CFR Sections 745.107 and 745.113. Agent’s obligations include those in 24 CFR Section 35.94 and 40 CFR Section 745.115. ACCURACY CERTIFICATIONS and APPLICANT”S ACKNOWLEDGMENT Lessor and any agent named below certify that to the best of their knowledge the above information and statements made or provided by them, respectively, are true and accurate. The person who signs for the LESSOR may be (1) the owner himself or herself; (2) an employee, officer or partner of the owner; or (3) a representative of the owner’s management company, real estate agent or locator service if such person is authorized to sign for the lessor. The person who signs for the AGENT may be: (1) the agent himself or herself; or (2) an employee, officer or partner of the agent if such person is authorized to sign for the agent. The Prospective Resident/Applicant by signing below acknowledge acknowledges that they have received a copy of this lease disclosure before becoming obligated under the lease.

LEAD-BASED PAINT DISCLOSURE. 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 property. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, Lessors/Landlords 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/Landlord’s Disclosure Presence of lead-based paint and/or lead-based paint hazards (check only one box) ¨ Lessor (Landlord) has no knowledge of lead-based paint and/or lead-based paint hazards in the housing x Lessor (Landlord) knows that lead-based paint and/or lead-based paint hazards are present in the housing (explain) Agent was verbally informed by previous property management company that the property does contain lead based paint. Records and reports available to Lessor (check only one box) x Lessor (Landlord) has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. ¨ Lessor (Landlord) has reports or records indicating the presence of some lead-based paint and/or lead-based paint hazards in the housing, and has provided the Prospective Resident/Applicant with all such records and reports that are available to lessor (list documents) Applicants’ Acknowledgment (Initial) NA______ Applicant has received copies of all information listed above. ________ Applicant has received the pamphlet Protect Your Family From Lead In Your Home (“the pamphlet”). Applicant further acknowledges that the pamphlet is written in English, and that Applicant speaks, reads, and understands the English Language. AGENT’S STATEMENT If another person or entity is involved in leasing the dwelling as an agent of the lessor (i.e., as a management company, real estate agent or locator service acting for the owner), such agent represents that: (1) agent has informed the lessor of the lessor’s obligations under 42 U.S.C.4852 (d); and (2) agent is aware of agent’s responsibility to ensure that lessor complies with such disclosure laws. Such compliance may b through lessor himself or herself, or through lessor’s employees, officers or agents. Lessor’s obligations include those in 24 CFR Sections 35.88 and 35.92 and 40 CFR Sections 745.107 and 745.113. Agent’s obligations include those in 24 CFR Section 35.94 and 40 CFR Section 745.115. ACCURACY CERTIFICATIONS and APPLICANT”S ACKNOWLEDGMENT Lessor and any agent named below certify that to the best of their knowledge the above information and statements made or provided by them, respectively, are true and accurate. The person who signs for the LESSOR may be (1) the owner himself or herself; (2) an employee, officer or partner of the owner; or (3) a representative of the owner’s management company, real estate agent or locator service if such person is authorized to sign for the lessor. The person who signs for the AGENT may be: (1) the agent himself or herself; or (2) an employee, officer or partner of the agent if such person is authorized to sign for the agent. The Prospective Resident/Applicant by signing below acknowledge acknowledges that he/she/they have received a copy of this lease disclosure before becoming obligated under the lease.

LEAD-BASED PAINT DISCLOSURE. LEAD WARNING STATEMENT Housing built before 1978 may contain lead-based paint. Lead from paintIf one or more residential buildings is located upon, paint chipsor included with, the Property, and dust can pose health hazards if not managed property. Lead exposure is especially harmful one or more of such residential buildings were constructed prior to young children and pregnant women. Before renting pre-1978 housingJanuary 1, Lessors/Landlords 1978, Owner must disclose the presence of known lead-based paint and/or lead-based paint hazards in the dwellingbuilding(s). Lessees must also receive Owner hereby acknowledges the following obligations, which shall be completed before Broker or any proposed tenant is obligated to enter into a federally approved pamphlet contract to lease the Property or any portion of the Property: Owner shall provide the required lead warning statement set forth on lead poisoning prevention. Lessor’s/Landlord’s the Lead-Based Paint Disclosure Presence form, attached here to as "Exhibit B" Owner shall disclose to Broker and the proposed tenant the presence of lead-based paint and/or lead-based paint hazards (check only one box) ¨ Lessor (Landlord) has no knowledge of any known lead-based paint and/or lead-based paint hazards in the housing x Lessor (Landlord) knows Property. Owner shall also disclose any additional information available to Owner concerning the known lead-based paint and/or lead-based paint hazards, such as the basis for the determination that lead-based paint and/or lead-based paint hazards are present in exist, the housing (explain) Agent was verbally informed by previous property management company that location of the property does contain lead lead-based paintpaint and/or lead-based paint hazards, and the condition of the painted surfaces. Records and Owner shall disclose to Broker the existence of any available records or reports. Owner shall also provide the proposed tenant with any records or reports available to Lessor (check only one box) x Lessor (Landlord) has no reports or records Owner pertaining to lead-based paint and/or lead-based paint hazards in the Property being leased. This requirement includes records and reports regarding common areas. This requirement also includes records and reports regarding other residential dwellings in multi- family target housing. ¨ Lessor (Landlord) has reports , provided that such information is part of any evaluation or records indicating the presence reduction of some lead-based paint and/or lead-based paint hazards in the housing, and has provided the Prospective Resident/Applicant with all building as a whole. If no such records or reports are available, Owner shall so indicate. Owner must sign and reports that are available to lessor date the Lead-Based Paint Disclosure (list documents) Applicants’ Acknowledgment (Initial) NA_____ Applicant has received copies of all information listed above. ________ Applicant has received the pamphlet Protect Your Family From Lead In Your Home (“the pamphlet”). Applicant further acknowledges that the pamphlet is written in English, and that Applicant speaks, reads, and understands the English Language. AGENT’S STATEMENT If another person or entity is involved in leasing the dwelling as an agent of the lessor (i.e., as a management company, real estate agent or locator service acting for the ownerRentals), such agent represents that: (1) agent has informed certifying to the lessor accuracy of the lessor’s obligations under 42 U.S.C.4852 (d); and (2) agent is aware of agent’s responsibility to ensure that lessor complies with such disclosure laws. Such compliance may b through lessor himself or herselfOwner's statements, or through lessor’s employees, officers or agents. Lessor’s obligations include those in 24 CFR Sections 35.88 and 35.92 and 40 CFR Sections 745.107 and 745.113. Agent’s obligations include those in 24 CFR Section 35.94 and 40 CFR Section 745.115. ACCURACY CERTIFICATIONS and APPLICANT”S ACKNOWLEDGMENT Lessor and any agent named below certify that to the best of their knowledge Owner's knowledge. There is no obligation of Owner to conduct any evaluation or reduction activities. If any of the disclosure activities identified above occurs after the proposed tenant has provided an offer to lease the Property or a portion of the Property, Owner shall complete the required disclosure activities prior to accepting the proposed tenant's offer and the proposed tenant shall have the opportunity to review the information and statements made or provided by them, respectively, are true and accuratepossibly amend the offer. The person who signs Owner is required to retain a copy of each completed Lead-Based Paint Disclosure (Rentals) form for the LESSOR may be (1) the owner himself or herself; (2) an employee, officer or partner a period of the owner; or not less than three (3) a representative years from the commencement date of the owner’s management company, real estate agent or locator service if such person is authorized to sign for the lessor. The person who signs for the AGENT may be: (1) the agent himself or herself; or (2) an employee, officer or partner of the agent if such person is authorized to sign for the agent. The Prospective Resident/Applicant by signing below acknowledge that they have received a copy of this lease disclosure before becoming obligated under the leaseapplicable leasing period.

LEAD-BASED PAINT DISCLOSURE. 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 property. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, Lessors/Landlords 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/Landlord’s Disclosure Presence of lead-based paint and/or lead-based paint hazards (check only one box) ¨ Lessor (Landlord) has no knowledge of lead-based paint and/or lead-based paint hazards in the housing x Lessor (Landlord) knows that lead-based paint and/or lead-based paint hazards are present in the housing (explain) Agent was verbally informed by previous property management company that the property does contain lead based paint. Records and reports available to Lessor (check only one box) x Lessor (Landlord) has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. ¨ Lessor (Landlord) has reports or records indicating the presence of some lead-based paint and/or lead-based paint hazards in the housing, and has provided the Prospective Resident/Applicant with all such records and reports that are available to lessor (list documents) Applicants’ Acknowledgment (Initial) NA______ Applicant has received copies of all information listed above. ________ Applicant has received the pamphlet Protect Your Family From Lead In Your Home (“the pamphlet”). Applicant further acknowledges that the pamphlet is written in English, and that Applicant speaks, reads, and understands the English Language. AGENT’S STATEMENT If another person or entity is involved in leasing the dwelling as an agent of the lessor (i.e., as a management company, real estate agent or locator service acting for the owner), such agent represents that: (1) agent has informed the lessor of the lessor’s obligations under 42 U.S.C.4852 (d); and (2) agent is aware of agent’s responsibility to ensure that lessor complies with such disclosure laws. Such compliance may b through lessor himself or herself, or through lessor’s employees, officers or agents. Lessor’s obligations include those in 24 CFR Sections 35.88 and 35.92 and 40 CFR Sections 745.107 and 745.113. Agent’s obligations include those in 24 CFR Section 35.94 and 40 CFR Section 745.115. ACCURACY CERTIFICATIONS and APPLICANT”S ACKNOWLEDGMENT Lessor and any agent named below certify that to the best of their knowledge the above information and statements made or provided by them, respectively, are true and accurate. The person who signs for the LESSOR may be (1) the owner himself or herself; (2) an employee, officer or partner of the owner; or (3) a representative of the owner’s management company, real estate agent or locator service if such person is authorized to sign for the lessor. The person who signs for the AGENT may be: (1) the agent himself or herself; or (2) an employee, officer or partner of the agent if such person is authorized to sign for the agent. The Prospective Resident/Applicant by signing below acknowledge that they have received a copy of this lease disclosure before becoming obligated under the lease.

LEAD-BASED PAINT DISCLOSURE. LEAD WARNING STATEMENT 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 propertyproperly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, Lessors/Landlords Lessor must disclose the presence of known lead-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/Landlord’s Disclosure Presence of Intact lead-based paint and/or lead-based paint hazards (check only one box) ¨ paid that is in good condition is not necessarily a hazard, See the EPA Pamphlet “Protect Your Family from Lead in Your Home” for more information. Lessor’s Disclosure: Lessor (Landlord) has no knowledge of lead-based paint and/or lead-lead- based paint hazards in the housing x housing. Lessor (Landlord) knows that lead-based paint and/or lead-based paint hazards are present in the housing (explain) Agent was verbally informed by previous property management company that the property does contain lead based paint. Records and reports available to Lessor (check only one box) x Lessor (Landlord) has no not reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. ¨ Lessor (Landlord) has reports or records indicating the presence of some lead-based paint and/or lead-based paint hazards in the housing, and has provided the Prospective Resident/Applicant with all such records and reports Lessee Acknowledgement: By initialing this provision Lessees acknowledge that are available to lessor (list documents) Applicants’ Acknowledgment (Initial) NA_____ Applicant has received copies of all information listed above. ________ Applicant has they have received the pamphlet “Protect Your Family From from Lead In in Your Home (“the pamphlet”). Applicant further acknowledges that the pamphlet is written in EnglishHome” , and that Applicant speaks, reads, and understands the English Language. AGENT’S STATEMENT If another person or entity is involved in leasing the dwelling as an agent of the lessor (i.e., as a management company, real estate agent or locator service acting for the owner), such agent represents thatAgent’s Acknowledgement: (1) agent Agent has informed the lessor Lessor of the lessor’s Lessees’ obligations under 42 U.S.C.4852 (d); U.S.C. 4582(d) and (2) agent is aware of agent’s his/her responsibility to ensure that lessor complies with such disclosure laws. Such compliance may b through lessor himself or herself, or through lessor’s employees, officers or agents. Lessor’s obligations include those in 24 CFR Sections 35.88 and 35.92 and 40 CFR Sections 745.107 and 745.113. Agent’s obligations include those in 24 CFR Section 35.94 and 40 CFR Section 745.115. ACCURACY CERTIFICATIONS and APPLICANT”S ACKNOWLEDGMENT Lessor and any agent named below certify that to the best of their knowledge the above information and statements made or provided by them, respectively, are true and accuratecompliance. The person who signs for covenants, conditions, and agreements made and entered into by the LESSOR may be (1) the owner himself or herself; (2) an employeeparties hereto are also declared binding on their respective heirs, officer or partner of the owner; or (3) a representative of the owner’s management companysuccessors, real estate agent or locator service if such person is authorized to sign for the lessorand assigns. The person who signs for undersigned have read and understand the AGENT may be: (1) the agent himself or herself; or (2) an employee, officer or partner terms herein and intend to become legally bound upon execution of the agent if such person is authorized to sign for the agent. The Prospective Resident/Applicant by signing below acknowledge that they this document and have received a copy of this lease disclosure before becoming obligated under the lease.document. DATED: SIGNED: LESSOR LESSEE’S SIGNATURE: DATE: LESSEE’S PRINTED NAME: LESSEE’S SOCIAL SECURITY NUMBER: LESSEE’S PERMANENT ADDRESS: LESSEE’S CELL PHONE: (please include area code) LESSEE’S PERMANENT E-MAIL ADDRESS: LESSEE’S PERSONAL CONTACT IN CASE OF AN EMERGENCY: NAME: RELATIONSHIP: TELEPHONE:

LEAD-BASED PAINT DISCLOSURE. LEAD WARNING STATEMENT 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 propertyproperly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, Lessors/Landlords Lessor 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/Landlord’s Disclosure Presence of Intact lead-based paint and/or lead-based paint hazards (check only one box) ¨ paid that is in good condition is not necessarily a hazard, See the EPA Pamphlet “Protect Your Family from Lead in Your Home” for more information. Lessor’s Disclosure: Lessor (Landlord) has no knowledge of lead-based paint and/or lead-lead- based paint hazards in the housing x housing. Lessor (Landlord) knows that lead-based paint and/or lead-based paint hazards are present in the housing (explain) Agent was verbally informed by previous property management company that the property does contain lead based paint. Records and reports available to Lessor (check only one box) x Lessor (Landlord) has no not reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. ¨ Lessor (Landlord) has reports or records indicating the presence of some lead-based paint and/or lead-based paint hazards in the housing, and has provided the Prospective Resident/Applicant with all such records and reports Lessee Acknowledgement: By initialing this provision Lessees acknowledge that are available to lessor (list documents) Applicants’ Acknowledgment (Initial) NA_____ Applicant has received copies of all information listed above. ________ Applicant has they have received the pamphlet “Protect Your Family From from Lead In in Your Home (“the pamphlet”). Applicant further acknowledges that the pamphlet is written in EnglishHome” , and that Applicant speaks, reads, and understands the English Language. AGENT’S STATEMENT If another person or entity is involved in leasing the dwelling as an agent of the lessor (i.e., as a management company, real estate agent or locator service acting for the owner), such agent represents thatAgent’s Acknowledgement: (1) agent Agent has informed the lessor Lessor of the lessor’s Lessees’ obligations under 42 U.S.C.4852 (d); U.S.C. 4582(d) and (2) agent is aware of agent’s his/her responsibility to ensure that lessor complies with such disclosure laws. Such compliance may b through lessor himself or herself, or through lessor’s employees, officers or agents. Lessor’s obligations include those in 24 CFR Sections 35.88 and 35.92 and 40 CFR Sections 745.107 and 745.113. Agent’s obligations include those in 24 CFR Section 35.94 and 40 CFR Section 745.115. ACCURACY CERTIFICATIONS and APPLICANT”S ACKNOWLEDGMENT Lessor and any agent named below certify that to the best of their knowledge the above information and statements made or provided by them, respectively, are true and accuratecompliance. The person who signs for covenants, conditions, and agreements made and entered into by the LESSOR may be (1) the owner himself or herself; (2) an employeeparties hereto are also declared binding on their respective heirs, officer or partner of the owner; or (3) a representative of the owner’s management companysuccessors, real estate agent or locator service if such person is authorized to sign for the lessorand assigns. The person who signs for undersigned have read and understand the AGENT may be: (1) the agent himself or herself; or (2) an employee, officer or partner terms herein and intend to become legally bound upon execution of the agent if such person is authorized to sign for the agent. The Prospective Resident/Applicant by signing below acknowledge that they this document and have received a copy of this lease disclosure before becoming obligated under the lease.document. DATED: SIGNED: LESSOR LESSEE’S SIGNATURE: DATE: LESSEE’S PRINTED NAME: LESSEE’S SOCIAL SECURITY NUMBER: LESSEE’S PERMANENT ADDRESS: LESSEE’S CELL PHONE: (please include area code) LESSEE’S PERMANENT E-MAIL ADDRESS: LESSEE’S PERSONAL CONTACT IN CASE OF AN EMERGENCY: NAME: RELATIONSHIP: TELEPHONE:

LEAD-BASED PAINT DISCLOSURE. 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 property. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, Lessors/Landlords 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/Landlord’s Disclosure Presence of lead-based paint and/or lead-based paint hazards (check only one box) ¨ Lessor (Landlord) has no knowledge of lead-based paint and/or lead-based paint hazards in the housing x Lessor (Landlord) knows that lead-based paint and/or lead-based paint hazards are present in the housing (explain) Agent was verbally informed by previous property management company that the property does contain lead based paint. Records and reports available to Lessor (check only one box) x Lessor (Landlord) has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. ¨ Lessor (Landlord) has reports or records indicating the presence of some lead-based paint and/or lead-based paint hazards in the housing, and has provided the Prospective Resident/Applicant with all such records and reports that are available to lessor (list documents) Applicants’ Acknowledgment (Initial) NA_____ NA Applicant has received copies of all information listed above. ________ Applicant has received the pamphlet Protect Your Family From Lead In Your Home (“the pamphlet”). Applicant further acknowledges that the pamphlet is written in English, and that Applicant speaks, reads, and understands the English Language. AGENT’S STATEMENT If another person or entity is involved in leasing the dwelling as an agent of the lessor (i.e., as a management company, real estate agent or locator service acting for the owner), such agent represents that: (1) agent has informed the lessor of the lessor’s obligations under 42 U.S.C.4852 (d); and (2) agent is aware of agent’s responsibility to ensure that lessor complies with such disclosure laws. Such compliance may b through lessor himself or herself, or through lessor’s employees, officers or agents. Lessor’s obligations include those in 24 CFR Sections 35.88 and 35.92 and 40 CFR Sections 745.107 and 745.113. Agent’s obligations include those in 24 CFR Section 35.94 and 40 CFR Section 745.115. ACCURACY CERTIFICATIONS and APPLICANT”S ACKNOWLEDGMENT Lessor and any agent named below certify that to the best of their knowledge the above information and statements made or provided by them, respectively, are true and accurate. The person who signs for the LESSOR may be (1) the owner himself or herself; (2) an employee, officer or partner of the owner; or (3) a representative of the owner’s management company, real estate agent or locator service if such person is authorized to sign for the lessor. The person who signs for the AGENT may be: (1) the agent himself or herself; or (2) an employee, officer or partner of the agent if such person is authorized to sign for the agent. The Prospective Resident/Applicant by signing below acknowledge acknowledges that they have received a copy of this lease disclosure before becoming obligated under the lease.

LEAD-BASED PAINT DISCLOSURE. 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 property. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, Lessors/Landlords 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/Landlord’s Disclosure Presence of lead-based paint and/or lead-based paint hazards (check only one box) ¨ Lessor (Landlord) has no knowledge of lead-based paint and/or lead-based paint hazards in the housing x Lessor (Landlord) knows that lead-based paint and/or lead-based paint hazards are present in the housing (explain) Agent was verbally informed by previous property management company that the property does contain lead based paint. Records and reports available to Lessor (check only one box) x Lessor (Landlord) has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. ¨ Lessor (Landlord) has reports or records indicating the presence of some lead-based paint and/or lead-based paint hazards in the housing, and has provided the Prospective Resident/Applicant with all such records and reports that are available to lessor (list documents) Applicants’ Acknowledgment (Initial) NA_____ Applicant has received copies of all information listed above. ________ Applicant has received the pamphlet Protect Your Family From Lead In Your Home (“the pamphlet”). Applicant further acknowledges that the pamphlet is written in English, and that Applicant speaks, reads, and understands the English Language. AGENT’S STATEMENT If another person or entity is involved in leasing the dwelling as an agent of the lessor (i.e., as a management company, real estate agent or locator service acting for the owner), such agent represents that: (1) agent has informed the lessor of the lessor’s obligations under 42 U.S.C.4852 (d); and (2) agent is aware of agent’s responsibility to ensure that lessor complies with such disclosure laws. Such compliance may b through lessor himself or herself, or through lessor’s employees, officers or agents. Lessor’s obligations include those in 24 CFR Sections 35.88 and 35.92 and 40 CFR Sections 745.107 and 745.113. Agent’s obligations include those in 24 CFR Section 35.94 and 40 CFR Section 745.115. ACCURACY CERTIFICATIONS and APPLICANT”S ACKNOWLEDGMENT Lessor and any agent named below certify that to the best of their knowledge the above information and statements made or provided by them, respectively, are true and accurate. The person who signs for the LESSOR may be (1) the owner himself or herself; (2) an employee, officer or partner of the owner; or (3) a representative of the owner’s management company, real estate agent or locator service if such person is authorized to sign for the lessor. The person who signs for the AGENT may be: (1) the agent himself or herself; or (2) an employee, officer or partner of the agent if such person is authorized to sign for the agent. The Prospective Resident/Applicant by signing below acknowledge acknowledges that he/she/they have received a copy of this lease disclosure before becoming obligated under the lease.