Dane & Lynn Brandt

1504 W. Prospect

Fort Collins, CO 80526

(970) 482-4000

 

The Brandt Company

 

Real Estate Management & Sales


LEASE AGREEMENT

 

THIS IS A LEGALLY BINDING AGREEMENT. READ IT CAREFULLY

 

 

_____________________________________________________________________________ (RESIDENT[S]) agree to lease

from The Brandt Company (MANAGEMENT)  the property located  at ___________________________________________, ________________________, Colorado, (Premises) upon the following terms and conditions:

Management acknowledges receipt of these sums, payable prior                Received                        Balance Due

                                                                                        to Occupancy

                                                Rent for first month    $______________         $______________           $______________                                                           

                                                Security Deposit         $______________         $______________           $______________

                                                Processing Fee/       

                                                Other                             $______________          $______________         $______________

                                               

                                                Other                             $______________         $______________          $______________             

                                                                                                               

                                               

                                                Total                          $______________              $______________         $______________             

 

1)  The Term of this lease shall begin at 12 noon on ____________________ , __________ and end at 12 noon on

_________________, _________.  If there is a delay in delivery of premises, rent shall be charged on a daily basis.   If Management/Owner is unable to deliver the Premises to Residents on or before the commencement of the Lease as set forth above, for whatever reason, including a previous resident’s failure to vacate, Management/Owner shall not be in default hereunder.  In any such event, Resident agrees to accept possession of the Premises at such time as Management/Owner tenders the Premises to Resident with appropriate rent pro-rations.  Resident  waives any right to collect damages as a result of Management/Owner’s failure to deliver the Premises on the date specified.  Resident agrees they are renting the property “AS IS” and that no warranty or guarantee is expressed or implied by Management/Owner,  and no other promises or changes will be made unless specified in writing.  

 

2)  The Resident(s) agree to pay $__________ per month in advance for rent, being a total of $________________________

for the term of this lease.   All rent due must be paid prior to taking occupancy.  Rent shall be due on the 1st of each month and a late fee charged ($50.00 for the first day delinquent and an additional $50.00 per week  thereafter). Any rent not received by Management/Owner on or before the first shall be delinquent.     A charge of $30.00 may be made to cover the extra cost of handling any Non-Sufficient Fund (NSF) checks.  NSF checks are considered DELINQUENT and late fees will be assessed on a per day basis from the 1st of the month.  Following the return of any check, the Resident shall make all payments under the Lease with a certified check or money order only.  Residents will submit one (1) check per household.   For any expenses charged by a Credit Card there will be an additional charge of $5.00 per $100.00 for Credit Card processing fees.   It is understood and agreed that ALL Residents signing this Lease Agreement are jointly and severally liable for any and all financial obligations pertaining to the occupancy of this property.

 

3)  Rent shall be made payable to:                    

                                                         The Brandt Company

                                                             1504 W. Prospect                              (970) 482-4000

                                                         Ft Collins, CO  80526

 

4)  The Damage/Security deposit of $________________is required for this property.  In the event that Resident is transferring from another property, their Deposit will be determined by the amount that transfers.  The Security Deposit Report will become an attachment to the Lease and will note the Deposit that is transferred.  Any shortages due to damages from their other rental will be paid promptly upon receipt of their Security Deposit Report.  It is understood that the Deposit is held by The Brandt Company in a non-interest bearing Security Deposit Trust Account in accordance with the rules and regulations of the Real Estate Commission. 

5) This property DOES______ or DOES NOT _______allow pets.  If the property does not allow pets, none can be added to the lease at any time. No Pet will be permitted on the Premises, not even to visit, without a signed  Pet Addendum approved and executed by the Management/Owner  prior to occupancy and the receipt by the Management/Owner of an additional pet fee of $200.00 or additional pet rent.   If at any time during the term of this lease any pets are being kept other than those permitted pursuant to the Lease, Management/Owner may elect to increase the total amount of monthly rent the Resident pays for the entire term of this Lease by 10% for each pet. Additionally, a  $25.00 fine will be assessed for each unauthorized pet and for each violation.  At the time of the violation the resident will also be required to pay the pet fee, even if the pet no longer is at the property.    Such additional rent payment shall be due with the monthly rent.  Such an election by Management/Owner to increase the rent shall not preclude Management/Owner from treating this as a breach of this Lease and electing to terminate the Lease or the occupancy of the Resident.  Additionally, by signing this agreement, Resident has agreed that the Management/Owner or Animal Control  may remove , and put up for adoption ANY unauthorized pets found on the premises, or any pet reported to be a nuisance or vicious, if they have made no attempt to resolve the violation. 

 

6)  NOTICE:  Residents are required to notify The Brandt Company of their desire to renew the lease or  give notice to vacate by March 1, ____________.  A new Lease must be negotiated and signed by March 15,______________.    The Lease DOES NOT continue on a month to month basis. If no new Lease is negotiated or notice to vacate has been given,  Residents understand that Management/Owner may commence showing the Premises to prospective residents 120 or more days before the expiration of the lease term.  However we may show the Premises to prospective Residents, purchasers, owners,  or lenders at any time, during the lease period. If entry can’t be gained to the property, or any part thereof, due to a pet not being removed or secured, or for any other reason,  there will be a $50.00 fine per incident.    The Residents understand that if a full thirty (30) days notice from the first of the month is not given by the Residents, the following month's rent will be due and payable in full.  Residents also understand holding over beyond the notice move-out date without prior approval or a new lease  will result in a $200.00 per day fine starting at noon on the lease end date.  If the Residents fail to take occupancy or should vacate the premises for any reason prior to the agreed date without an approved sublease or paying the full lease amount, the Security deposit will be forfeited and the entire rental amount due for the term of the lease shall be accelerated.

 

7)  Management/Owner may enter the Premises during reasonable hours and without notice for inspection, repairs, display to Owners or prospective residents, or for maintenance and improvements.  Management/Owner will make every attempt to notify the resident in advance of any showings.  Management/Owner may enter at any time if it is deemed there is an emergency which must be taken care of to prevent loss of life or property.

 

8)  In the event of a sublease/relet,  Residents are responsible for all showings and advertising costs, and rent differential, if applicable.    All subleases/ relets must be agreed upon and approved in writing  by all current residents and the Management/Owner.   Residents will not be  eligible for a deposit refund if the new subleasee does not pay a full deposit,  or does not sign a  new lease, or we have not received a full two months rent from the subleasee.    Resident shall not be relieved of responsibility or further liability for rent prior to the signing of a new lease accompanied by a full deposit.  Residents will be subject to $200.00 administrative fee for processing the paperwork.     The Management reserves the right to commence subleasing efforts if it is deemed to be in the best interest of Residents and/or Owner.  The sublease fee is neither a lease contract cancellation fee or Buyout and does not release Residents from  their obligations under this lease if those efforts are unsuccessful and/or new renters fail to execute the lease and pay monies due under the lease such as the security deposit.

 

9)  The residence is:  Not____   Partially____   Fully____   Furnished  (Inventory sheet attached) and

includes the following appliances: Refrigerator____  Stove____  Dishwasher____   Washer/Dryer____

The washer/dryers are provided as a courtesy and convenience to the Residents.  The cost of repair of washer/dryer are the responsibility of  ________________.    Residents are responsible for all repairs of the window coverings, screens, garbage disposal jams, and blinds.   Resident agrees to operate the above marked  items properly and return them in good working condition.  In the event of the necessity for major repairs of  washer/dryer, or other items that were damaged by misuse, Manager/Owner may elect to remove these objects from the premises without replacing them.  Manager/Owner is not responsible for food loss due to refrigerator malfunctions or any damage to personal property due to malfunction of any other appliance.

 

10)  The Resident(s) shall arrange for and be responsible for the following utilities and services within one business day:         Water/sewer______   Gas_____  Electricity_____  Phone (if desired)_____ 

Trash pickup_____   Cable (if desired)_____  Lawn Maintenance______   Snow Removal_____

Phone backer wire service_____ Sprinkler Winterization_______ Other__________________________________________

 

For any utilities not in the Residents name there will be a penalty of $20.00 per day.  Other utilities not checked or otherwise specified shall become the responsibility of the Owner.  The Residents also acknowledge that they must cancel service upon vacating the premises.  Resident is responsible for all utility costs throughout the lease end date even if they leave prior to that date.  Residents will be responsible for utility transfer fees if utilities are turned off prior to the Lease expiration date.   Residents are solely responsible for their own utility charges.   If  Residents elect not to add the  phone backer wire service agreement with the phone company,  Management/Owner will not be responsible for wiring problems related to the phone service.  Any additional cable or phone jack installation will be the responsibility  and expense of the resident.

 

 11)  Residents shall be given one set of keys and have permission to make additional copies at their own expense.  Anyone desiring to change locks, add additional deadbolts, chains, or door viewers may do so at their own expense, with the Manager/Owners permission, and copies of new keys must be provided to the Management Company.  Any additions must remain upon termination of this Lease.  The original keys provided and any additional keys made must be returned at the end of the lease term.  If keys are not returned, rent will be due at a daily rate in the amount of $100.00 per day until all keys are returned and Residents will be charged for changing the locks. Residents must contact a locksmith at his/her own expense if you get locked out.   If Management does open a unit for a Resident, the cost will be $45.00.

 

12)  The Damage/Security deposits will be refunded within sixty (60) days upon moving provided that the terms and conditions of the Lease have been adhered to and the premises and grounds are returned in the same condition as when rented, except for normal wear and tear.  Residents are responsible for having the carpets professionally cleaned upon move-out.  Residents must provide a valid forwarding address.  Residents must make arrangements for payment of their final utility bills.  Residents will be liable for any damage caused to the premises or furnishings.  The deposit does not limit the liability of the Residents and retention of said deposit shall not prevent Management/Owner from recovering additional damages. Management/Owner has the right of offset with regards to back rent, late fees or damages. Any unpaid charge (e.g.. late fees, check charges, back owing rent, maintenance bills...) may be deducted from the deposit, credit card on file, or from any and all available sources at the end of the lease.  Residents shall not apply the deposit to any rent payments.  Management/Owner cannot be held liable for delays in security deposit refunds if Residents fail to provide a valid forwarding address, or have any unpaid bills, or charges.  Residents understand that not providing proof of utility payments could delay the security deposit refund beyond sixty(60) days.  Only one refund check per unit will be issued.  Residents must provide written instruction signed by all parties to the lease of how and where they want the Security Deposit disbursed.  If no instructions are given, the Security Deposit will be refunded to all parties at the last know address.  If Residents wish to have separate refund checks, there will be an additional administrative charge of $10.00 per additional check.  In the event that a resident notifies Management/Owner of intent to transfer from one property to another, verbally or in writing, and they fail to enter into the new lease or fail to move into the property we are Holding for them, they will forfeit their current deposit as damages for having removed the property from the market. 

 

13)  A Move-In Inspection report has been provided and must be returned to the Management office within five days after move in.  If this form is not returned, the property will be deemed to be in excellent condition and will be required to be the same upon vacating.  Management does not have to accept an inspection report that is late or inaccurate.  Residents must make an appointment for no later than 12:00 noon on the lease end date for Move-Out inspection, at which time all cleaning, moving, etc..., must have been completed.   For each additional move out inspection required,  there will be an additional $50.00 charge.  If move-out is not done prior to 12 noon, Residents will be charged an additional $200.00 in rent  unless, move-out time was agreed upon in advance with Management.

 

14)  No repairman shall be hired by the Residents at Owner's expense without the approval of the Management/Owner, unless in an extreme emergency.   Management shall maintain the right to enter the Premises to make repairs at our convenience upon a Resident's request for maintenance.  Residents accepts the residence "As Is" unless otherwise stipulated in writing under the additional provisions of this lease.  No demands can be made to prevent enforcement of this lease agreement, that were not previously agreed upon in writing. Residents can not withold rent for maintenance.  Any damage requiring maintenance that is deemed to have been caused by Residents or Resident's family  or guest(s), shall be at the Resident's expense, and shall be paid within five (5) days of receipt of the bill. Failure to report maintenance items in a timely manner that result in additional damages to the property may bring  liability for damages to the Resident due to not reporting maintenance items promptly.  

 

15)  Residents agree to keep and, at end of the term, return the residence, grounds, and fixtures therein in a clean and sanitary condition and in good repair.

 

a.   Residents are required to keep all vehicles in good operating condition and repair.  All vehicles must have a current license and registration.  Any out of date, unlicensed or unregistered vehicles, or inoperable vehicles, will be posted with a tow notice and  towed at the vehicle owners expense.  No maintenance of vehicles is allowed on the Premises.

b.  Residents are required to check and maintain the smoke alarms, or other safety devises and are responsible for replacing batteries of their safety devices at least twice a year.  Any malfunction should be reported to the Management. Residents may not disconnect the smoke detectors and  will be held liable for any loss or damage from fire, smoke, or water if that condition arises from your failure to report malfunctions.

c.    Residents shall be responsible for replacing furnace filters at least twice per year. If the residents would like to have the fireplace serviced they may do so at their own expense.  Our maintenance will take care of gutter cleaning.  Please notify us if you have any gutter clogs, or problems.    Any damages caused by poor drainage from poor gutter maintenance will be the responsibility of the Residents if it was not reported to Owner/Management. 

d.   Management/Owner will not replace any screen doors or screens.  Any screens or screen doors that are damaged during your occupancy will be repaired or replaced by the Resident.

e.  All clogged drains, toilet, sewer lines are the sole responsibility of the Residents to pay for and must be paid at the time of repair, unless said stoppage is a result of structural defect or root growth in the main sewer line.

f.  Residents must use a minimum of small tacks or nails to hang pictures and personal effects and accepts responsibility for damage caused, if any.  Residents must not patch, or putty nail holes at move out, or use any tape, molly bolts, sticky hooks, or poster putty to hang pictures. 

g.  Residents agree to keep the Premises heated 24 hours a day to at least 60 degrees and to keep cabinet and closet doors open so that heat will circulate around the water pipers during severe cold weather.  Residents agree to disconnect outside hoses during the months from September through April.  Residents will be held liable for damage to the property if damage is caused by broken water pipes due to violating the above requirements. 

h.  Management/Owner are not required to provide extermination at the property for pest.  It is at the  Management/Owner’s discretion as to whether pest control will be done. 

 

16)  The Residents are responsible for their own contents/renter insurance and are hereby advised to purchase renter’s insurance for all personal property prior to receipt of keys and possession.    Management/Owner cannot be held liable for damages to the Residents personal property on the premises as a result of fire, theft, pests, water damage , wind and/or other casualty caused by the condition of the Premises, or other residents or occupants of the building in which the Premises are located.  Residents agree to indemnify, defend and hold the Management/Owner harmless from and against any claim for loss or damage to persons or property of the Residents or his/her guests, whether from theft, accident or otherwise.     Management/Owner shall not be liable for an injury to Resident, Resident's family, guests, or any person entering the residence, building, or property in which the premises is a part.

 

17) Residents agree that no more than 3 unrelated people shall occupy the Premises as per city code.  No other occupants may reside on the Premises other than those named on the application and in this lease.  Any occupant who resides longer than ten days  must be included on the lease.  If any additional person should occupy the Premises without written permission of Management/Owner, Management has the authorization of the Residents through the authority of this Lease agreement to Evict the additional party effective as of the date of notice of violation.   Residents shall be responsible for any fines imposed on Management/Owner due to a breach in this provision of the Lease.   Management/Owner shall not be responsible for any fines or penalties caused by the action/inaction of the Resident.  All parties acknowledge receipt of the city occupancy disclosure form  which is incorporated into this lease agreement and agree to abide by the terms and conditions set forth therein. If Resident is evicted due to violation of this provision, Resident shall remain liable for the balance of rent remaining for the term of the lease.  If any person other than those on the lease reside at the property without managements consent there will be an additional $100. 00 per month rent due per person.  Upon being notified of the additional person the additional rent will still be due and if the person  is in violation of the City occupancy ordinance they will be required to move.

 

18)  Residents agree that the Premises shall be used for residential purposes only.  The Premises shall not be used in violation of any applicable laws or ordinances nor so as to interfere with other resident's quiet enjoyment.  Residents, resident's family, and guests agree to adhere to any rules and regulations that may be inherent to the property, which include condominium association rules, covenants and governing doctrines,  and which may be changed by the Management/Owner during the term of this Agreement. 

 

19)  Failure of Management/Owner to insist upon strict compliance with the terms of this Lease Agreement shall not constitute a waiver of their right to act on any violation.  If any provision of the Lease Agreement is invalid under applicable law, such provision shall be ineffective to the extent of such invalidity only, without invalidating the remainder of this Agreement.

 

20)  If either party institutes legal action under the Lease Agreement, the prevailing party shall receive reasonable attorney's fees in addition to court and other costs.  All remedies under this Lease Agreement, or by law or equity, shall be cumulative.

It is agreed by all parties that in the event of a dispute, other than non payment of rent, that all parties are required to seek mediation before any court action, legal action, or reporting to any regulatory agency,  Better Business Bureau etc.

  

21)  If the property includes a yard, it shall be the Resident's sole responsibility and expense to maintain the yard in an acceptable condition.  This shall include but not be limited to watering, mowing, and trimming walks and bushes.  If the yard has a sprinkler system, Residents are responsible for cooperating with scheduling to have the system winterized.  Residents are required to turn the system on and to provide adequate watering to keep the lawn alive.  The Residents shall also maintain the residence grounds, garage, patio, breezeway, and storage areas in good order. Even if the yard mowing is conducted by the Management/Owner the Resident is still responsible for watering, controlling weeds, raking leaves, removing trash and caring for trees and shrubs.  An damages to trees, shrubs, and lawn due to Residents neglect will be repaired or replaced entirely at the Residents expense.  If Management/Owner feel that the grounds are not being maintained in an acceptable condition, they will notify the Residents of such fact, and will, if not remedied within three days, hire the work to be done at the Resident's expense.

 

22)  If the property is vacated or abandoned by Residents, or if the Residents shall be in default in rent due, Management/Owner may enter and remove all personal property from the residence, as provided by law, in order to exercise of Owner's lien.   Permission is hereby granted to enter the residence for the purpose of enforcing a Landlord' s lien under applicable State law.  If  Resident abandons the premises or, upon legal termination of the lease agreement,  has his/her personal effects remaining  upon the premises, said belongings become the property of the Management/Owner, to be disposed of as he so chooses.  At that time the Management will change the locks on the premises, at Residents  expense, and may deny the Resident all further access thereto.  Resident agrees that the Management/Owner shall not be liable in any way for any destruction, conversion or disposition of personal property.  Management/Owner shall be entitled to collect all costs and expenses in removing and/or storing such property.

 

23)  In the event of failure of Residents to pay any rental due hereunder within five (5) days after the same shall be due then the Management/Owner, besides other rights or remedies it may have, shall have the right to declare this lease terminated and the term ended and/or shall have the immediate right of reentry.  Should the Management/Owner elect to reenter, it may either terminate this lease or it may from time to time, without terminating this lease, relet said premises.  Upon such reletting, all rentals and other sums received by Management/Owner from such reletting shall be applied: first to the payment of debt other than rent due to Owner; second, to cost and expenses of reletting; third, to past due rent; and the residue, if any, shall be held by the Management/ Owner and payable hereunder....  No such reentry or taking possession of said premises by Management/Owner shall be construed as an election of its part to terminate this lease unless written notice of such intention be given to resident or unless the termination thereof  be decreed by a court of competent jurisdiction.

 

24)  It is understood that all monies received shall be applied first to non-rent balances owed, and lastly

to rent.  All monies received shall be in the form of personal check, cashier's check, money order or traveler's check.  Cash will not be accepted.  Management assumes no responsibility for cash left in the Night Drop.  Late rents, will only be accepted in form of money order,  or cashier's check.

 

25)  Resident releases Management/Owner from liability for and agrees to indemnify Management/ Owner against all losses incurred by Management/Owner as a result of (a) resident's failure to comply with this Agreement and the Rules and Regulations; (b) any damage or injury happening in or about the residence to Residents, Resident's guest or Resident's family or such person's property; (c) damage or loss about the residence or community caused by Residents, Resident's family or guest; (d) Resident's failure to comply with any requirements imposed by any governmental authority; and (e) any judgment, lien or other encumbrance filed against the residence as a result of Resident's action/inaction.

 

26) Residents hereby agree and acknowledge that Management/Owner shall not provide and shall have no duty to provide any security services to residents at the community.  Residents shall look soley to the public Police Force for security protection.  Residents agree and acknowledge that protection against criminal action is not within the power of Management/Owner.  Management/Owner shall not be liable for failure to provide security services or for criminal or wrongful actions by others against Residents, Resident's relatives or Resident's guests.

 

27)  Residents take responsibility for any violations of the City of Fort Collins “Nuisance Ordinance” or “Occupancy Code” and will be responsible for all fines imposed if found in violation.  Residents will also act quickly to remedy the complaint, and agree to refrain from any activity that violates the City Ordinances.  Additionally, if the property is identified as a nuisance and the city exercises it’s right to evict/or restrict the Resident from being on the property,  the Residents are still responsible for all rent due for the term of the lease or until a new renter is found.  The nuisance ordinance relates to, but may not be limited to, cleanliness of the grounds, weeds, snow removal, mowing of grass, and noise or party violations.  Residents agree to pay for any bills from the City for violations of any kind for which the Resident is responsible.

 

28)  BROKERAGE RELATIONSHIPS AND DISCLOSURE:  The Brandt Company and its agents are working with you as a Seller's (Landlords Agent) on properties that we manage.  LANDLORD'S AGENT:  On properties that we manage we are an agent for the landlord and not your agent, unless we enter into a written agreement to act as your agent.  We owe duties to the landlord which include utmost good faith, loyalty and fidelity.  We will negotiate on behalf of and act as an advocate for the landlord.  Please do not tell us any information which you do not want shared with the landlord. 

 

29)  Tenant acknowledges the receipt of the "Disclosure of Information on Lead-based paint and Lead-based paint Hazards  form, and the EPA pamphlet "Protect Your Family From Lead In Your Home" which is hereby attached to this lease, if applicable to the property. Any property built before 1978 could have lead paint. 

 

30)  No smoking  is allowed in the premises at any time.  Smoking in the premises will be grounds for eviction.  Smoking outside is allowed, however, cigarette butts must be placed in appropriate containers, and not thrown on or around the property.  Any clean up required for cigarette butts will be charged back to the resident.  If smoke/incense odor or damages occur , Residents will be responsible for all cost to clean, replace window coverings and paint to remove the odor and other damages as is necessary.

DISCLOSURE STATEMENT REGARDING OCCUPANCY LIMITS from the Fort Collins Neighborhood & Building Services. 281 N. College Ave.  P.O. Box 580, Fort Collins, CO 80522, phone:224-6046

 

A certificate of occupancy for use as a boarding house has NOT been issued for this dwelling.  The maximum permissible occupancy of this dwelling unit under Section 3.8.16 of the City of Fort Collins Land use code is:

                1.  One family as defined in Section5.1.2 (see below) and not more than one(1) additional person: or

                2.  Two adults and their dependents, if any, and not more than one additional person.

*Family shall mean an individual living alone or any number of persons who are all related by blood, marriage, adoption, guardianship or other duly authorized custodial relationship, and who live together as a single housekeeping unit and share common living, sleeping, cooking and eating facilities.  

 

ADDITIONAL LEASE PROVISIONS: _______________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

 

 

Residents agree to the lease terms and the city of Fort Collins Disclosure statement regarding occupancy limits as attested  by their signatures below for the property located at _____________________________________________________________.

 

 

RESIDENT(S)                                                                                             

 

 

_____________________________   _____________________________________   _________________     __________

Name                                                          Signature                                                                   phone #                         date        

 

_____________________________   _____________________________________   _________________     __________

Name                                                          Signature                                                                   phone #                             date

 

____________________________    _____________________________________   __________________    __________

Name                                                         Signature                                                                   phone #                              date   

 

MANAGEMENT

 

___________________________________________           ______________________________

AUTHORIZED AGENT                                                             date                

 

                                                                LEAD BASED PAINT DISCLOSURE (RENTALS)

 

Attachment to Residential Lease or Rental Agreement for the Property known as:

 

_________________________________________________________________________________________________

Street Address                                                                         City                        State                                        Zip          

 

WARNING!  LEAD FROM PAINT, DUST AND SOIL CAN BE DAGEROUS IF NOT MANAGED PROPERLY

Penalties for failure to comply with Federal Lead Based Paint Disclosure Laws include treble damages, attorneys fee, costs, and a penalty up to $10,000 for each violation. Disclosure For Target Housing Rentals and Leases.  Disclosure of Information on Lead-Based Paint and/or Lead-Based Paint Hazards.

                                                                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, landlords must disclose the presence of known lead-based paint and/or lead-based paint hazards in the dwelling.  Tenants must also receive a federally approved pamphlet on lead poisoning prevention.

________________________________________________________________________________________________________

 

Landlord’s Disclosure to Tenant and Real Estate Licensee(s)

(a)  Landlord acknowledges that Landlord has been informed of Landlord’s obligations.  Landlord is aware that Landlord must retain a copy of this disclosure for not less than three years from the commencement of the leasing period.

(b) Presence of lead-based paint and/or lead-based paint hazards (check one box below):

      ˙Landlord has no knowledge of lead-based paint and/or lead-based paint hazards in the housing.

      ˙Landlord has knowledge of lead-based paint and/or lead-based paint hazards are present in the housing. (explain)

________________________________________________________________________________________________          ________________________________________________________________________________________________                                                                          

© Records and Reports available to Landlord (check one box below):

         ˙Landlord has no reports or records pertaining to lead-based paint and/or lea-based paint hazards in the housing.

         ˙Landlord has provided Tenant with all available records and reports pertaining to lead-based paint and/or lead-based

           paint hazards in the housing.  (list documents below).     

________________________________________________________________________________________________

________________________________________________________________________________________________

 

Tenant’s Acknowledgement

(d)  Tenant has read the Lead Warning Statement above and understands its contents. 

(e)  Tenant has received copies of all information, including any records and reports listed by Landlord above. 

(f)  Tenant has received the pamphlet “Protect Your Family From Lead In Your Home”. 

________________________________________________________________________________________________________

Real Estate Licensee’s Acknowledgement

Each real estate licensee signing below acknowledges receipt of the above Landlord’s Disclosure, has informed Landlord of Landlord’s obligations and is aware of licensee’s responsibility to ensure compliance

Certification of Accuracy

 

I certify that the statements I have made are accurate to the best of my knowledge.

 

________________________________________________                        ____________________________________________

Landlord                                                                Date                                 Tenant                                                              Date

 

________________________________________________                         ____________________________________________

Real Estate licensee (leasing)                             Date                                  Tenant                                                             Date