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LEAD CHILD INQUIRY (LOCAL LAW 1)




Purchaser(s)/Lessee(s) are required by law to disclose to Sellers/Lessors if a child under seven years of age resides or will reside in the dwelling unit (apartment) for which you are purchasing, leasing/commencing occupancy. If such a child resides or will reside in the unit, the Seller/Lessor of the building is required to perform an annual visual inspection of the unit to determine the presence of lead-based paint hazards. IT IS IMPORTANT THAT YOU RETURN THIS FORM TO THE SELLER/LESSOR OR MANAGING AGENT OF YOUR BUILDING TO PROTECT THE HEALTH OF YOUR CHILD. If you do not respond to this notice, the Seller/Lessor is required to attempt to inspect your unit to determine if a child under seven years of age resides there.

If a child under seven years of age does not reside in the unit now, but does come to live in it at any time during the year, you must inform the Seller/Lessor in writing immediately. If a child under seven years of age resides in the unit, you should also inform the Seller/Lessor immediately at the address below if you notice any peeling paint or deteriorated subsurfaces in the unit during the year.

Please complete this form with your application package and return one copy to the Seller/Lessor or his or her agent or representative when you sign the lease/commence occupancy of the unit. Keep one copy of this form for your records. You should also receive a copy of a pamphlet developed by the New York City Department of Health and Mental Hygiene explaining about lead-based paint hazards when you purchase/lease the property and/or commence occupancy along with this form or when you purchase/lease the property and/or commence occupancy.

CHECK ONE:





Purchaser/Lessee Name

Purchaser/Lessee Address

Unit

City, State, Zip Code
x
Purchaser/Lessee Signature

Date

(NOT APPLICABLE TO RENEWAL LEASE) Certification by Seller/Lessor: I certify that I have complied with the provisions of 27-2056.8 of Article 14 of the Housing Maintenance Code and the rules promulgated thereunder relating to duties to be performed in vacant units, and that I have provided a copy of the New York City Department of Health and Mental Hygiene pamphlet concerning lead-based paint hazards to the Purchaser/Lessee.


Seller/Lessor Name
x
Seller/Lessor Signature

Date


PURCHASER/LESSEE: KEEP ONE COPY FOR YOUR RECORDS
SELLER/LESSOR: COPY/OCCUPANT COPY