The printed portions of this form except differentiated additions, have been approved by the Colorado Real Estate Commission. (LP46-9-12) THIS FORM HAS IMPORTANT LEGAL CONSEQUENCES AND THE PARTIES SHOULD CONSULT LEGAL AND TAX OR OTHER COUNSEL BEFORE SIGNING. LEAD-BASED PAINT DISCLOSURE (Rentals) Attachment to Residential Lease or Rental Agreement for the Premises known as: Street Address City State Zip WARNING! LEAD FROM PAINT, DUST, AND SOIL CAN BE DANGEROUS IF NOT MANAGED PROPERLY Penalties for failure to comply with Federal Lead-Based Paint Disclosure Laws include treble (3 times) damages, attorney fees, costs, and a base penalty up to $11,000 (plus adjustment for inflation). The current penalty is up to $16,000 for each violation. Disclosure for Target Housing Rentals and Leases Disclosure of Information on Lead-Based Paint and/or Lead-Based Paint Hazards Landlord has no knowledge of lead-based paint and/or lead-based paint hazards in the housing. Landlord has knowledge of lead-based 3. Records and reports available to Landlord (check one box below): Landlord has no reports or records pertaining to lead-based paint and/or lead-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 Tenant's Acknowledgment 4. Tenant has read the Lead Warning Statement above and understands its contents. 5. Tenant has received copies of all information, including any records and reports listed by Landlord above. 6. Tenant has received the pamReal Estate Licensee's Acknowledgment 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 LP46-9-12. LEAD-BASED PAINT DISCLOSURE (RENTALS) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com LP46-9-12. LEAD-BASED PAINT DISCLOSURE (RENTALS) Page 2 of 2 I certify that the statements I have made are accurate to the best of my knowledge. Landlord Date Tenant Date Landlord Date Tenant Date Real Estate Licensee (Listing) Date Real Estate Licensee (Leasing) Date American LegalNet, Inc. www.FormsWorkFlow.com