Maryland Property Lead Paint Disclosure Form
Property Information
Property Address:
Owner/Landlord Name:
Tenant Name(s):
Lead Paint Disclosure
The property was built before 1978:
Yes
No
Known lead-based paint and/or lead-based paint hazards are present in the housing:
Yes
No
If yes, explain:
Records and reports available to the lessor regarding lead-based paint and/or lead-based paint hazards:
Yes
No
If yes, list documents:
Tenant Acknowledgment
Tenant has received the pamphlet "Protect Your Family from Lead in Your Home"
Tenant has received all available records and reports
Owner/Landlord Signature:
Date:
Tenant Signature:
Date: