WPCo  
      2      Z   B   0           I      g  OKIPAGE                                           X     P    7             XP X     P    7XP* [X  	   Z  ( C G   T I m e s   R e g u l a r                                                                                       X      3| x     3                      ,X4hp x (#%'0*,.8135@8:<H?A                      Lessors Disclosure of Information
	 LeadBased Paint and LeadBased Paint Hazardsă

Lead Warning Statement:
Housing built before 1978 may contain leadbased 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 pre1978 housing, Lessors must disclose thepresence of known leadbased paint and leadbased paint hazards in the dwelling.  Lessees mustalso receive a Federally approved pamphlet on lead poisoning prevention.

    Lessors Disclosure: (initial)

  3  (a)   444Presence of leadbased paint or leadbased paint hazards (check one):
    444Lessor has no knowledge of leadbased paint and/or leadbased paint hazards in thehousing.
    444Lessor knows of the following leadbased paint and/or leadbased paint hazards in thehousing:`(#(#K ă
    

  3  (b)   444Records and reports available to the lessor (check one):
    444Lessor has no reports or records pertaining to leadbased paint and/or leadbased painthazards in the housing.
    444Lessor has provided the lessee with all available records and reports pertaining to leadbased paint and/or leadbased paint hazards in the housing as follows:`(#(#K ă
    444`(#(#K ă

    Lessees Acknowledgment (initial)

  3     444Lessee has received a copy of all information listed above and has received thepamphlet Protect Your Family from Lead in Your Home.

    Agents Acknowledgment (initial)

  3     444Agent has informed the owner of owners obligations under 42 USC 4582d and isaware of his/her responsibility to ensure compliance.

Certification:
 The undersigned have reviewed the information contained herein and certify to the best oftheir knowledge that the information provided by the signatory is true and accurate.


         `(#(#K ă
Landlord   444      Date   hhh      Tenant            xxxDate

    444         hhh      `(#(#K ă
    444         hhh      Tenant            xxxDate
leadrent.for (c) Beran Law Office 2000