Edit, Download, and Sign the Annual Lead-Based Paint Hazard Notice Form
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How do I fill this out?
To fill out this form, start by checking the appropriate box based on the child's residency status. Then, provide your name, address, and the date. Finally, return the completed form to the property owner or managing agent.

How to fill out the Annual Lead-Based Paint Hazard Notice Form?
1
Check if a child under six resides in the dwelling.
2
Write your name, address, and apartment number.
3
Sign and date the form.
4
Return one copy to the owner or agent.
5
Keep a copy for your records.
Who needs the Annual Lead-Based Paint Hazard Notice Form?
1
Property owners to comply with lead hazard regulations.
2
Tenants with children under six years old for safety compliance.
3
Landlords to maintain proper records of inspections.
4
Real estate agents to advise clients about lead safety.
5
Parents concerned about lead exposure in their home.
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What are the instructions for submitting this form?
To submit the form, return it to your property owner or managing agent by February 15. Ensure you keep a copy for your records. If online submission options are available, check with your property management for instructions.
What are the important dates for this form in 2024 and 2025?
Important dates for this form include the annual inspection requirement by February 15 each year to ensure compliance with safety regulations.

What is the purpose of this form?
The purpose of this form is to notify property owners of children under six living in their units to prevent lead exposure. This notice ensures that necessary inspections are performed annually. It helps in maintaining a safe living environment for vulnerable children.

Tell me about this form and its components and fields line-by-line.

- 1. Child Status: Indicates whether a child under six resides in the dwelling.
- 2. Occupant Signature: Space for the occupant to sign and confirm the information provided.
- 3. Address Details: Section for entering the occupant's name, address, and apartment number.
- 4. Owner Details: Space for entering the owner's representative name and address.
What happens if I fail to submit this form?
Failing to submit this form may result in uninspected properties that pose lead exposure risks. Owners are required to inspect regardless of form submission, leading to potential liabilities. It is crucial to comply for the health safety of children.
- Health Risks: Children may be exposed to lead paint hazards without inspection.
- Legal Repercussions: Property owners could face penalties for non-compliance.
- Inspection Requirements: Inappropriate risk without prior notification may lead to improper inspections.
How do I know when to use this form?

- 1. New Residents: When a new child moves into the dwelling.
- 2. Annual Compliance: For annual visual inspections mandated by law.
- 3. Inspection Requests: To formally request an inspection for deteriorating surfaces.
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