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Lead-Based Paint Disclosure Notice
Disclosure of Information on Lead-Based Paint
and/or Lead-Based Paint Hazards
Housing Choice Voucher Program
Housing Authority of the City ofAtlanta, Georgia
Lead Warning Statement
Housing built before 1978 may contain lead-based 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 pre-1978
housing, lessors must disclose the presence of known lead-based paint and/or lead-based hazards in the dwelling. Lessees
must also receive a federally approved pamphlet on lead poisoning prevention. 42 U.S.C. 4582(d)
Presence of lead-based paint and/or lead-based paint hazards: (Check one below)
Owner/Landlord's Disclosure:
Participant's Acknowledgement:
Agent's Acknowledgement:
Certificate of Accuracy
Records and reports available to the Owner/Landlord: (Check one below)