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Lead Disclosure Form (DC) Mobile App

The Lead Disclosure Form (DC) mobile app allows property owner’s to complete a lead disclosure form to be in compliance with the District of Columbia “Lead-Hazard Prevention and Elimination Act of 2008,” as amended (the “Act”), D.C. Official Code § 8-231.01 et seq., requiring s an owner of a residential property constructed before 1978 to disclose the information contained in this Lead Disclosure Form to prospective tenants or prospective property purchasers, before any change in occupancy or contract for possession is executed. This app is filled out using a mobile device, then captures a signature and once submitted generates an easy to store and share PDF. GoCanvas allows you to export your data in a CSV Format.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Lead Disclosure Form (DC) Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico statictext

    Federal Lead Warning Statement: Housing built before 1978 may contain lead-based paint.

  • Ico multiline

    ADDRESS OF PROPERTY, INCLUDING UNIT NUMBER IF ANY:

  • Ico statictext

    The District of Columbia “Lead-Hazard Prevention and Elimination Act of 2008,” as amended (the “A...

  • Ico multiline

    I am the owner or authorized owner’s agent of (Insert Full Address of Property)

  • Ico statictext

    and affirm that the following answers state what I reasonably know about my property.

  • Ico statictext

    CHECK ONE BOX UNDER A, B, AND C, BELOW.

  • Ico statictext

    A.

  • Ico checkbox

    Lead-based paint is known or reasonably known to be present on the interior or on the exterior of...

  • Ico multiline

    (specify components, rooms, and any other relevant details, and provide access to any available r...

  • Ico checkbox

    To my knowledge, lead-based paint is not known or reasonably known to be present on the interior ...

  • Ico checkbox

    While lead-based paint is not known by me to be present in the dwelling unit, it is presumed to b...

  • Ico statictext

    B.

  • Ico statictext

    NOTE: The following definitions must be followed to comply with District law.

  • Ico statictext

    DISTRICT OF COLUMBIA DEFINITION OF LEAD-BASED PAINT HAZARD: “Lead-based paint hazard” means any c...

  • Ico statictext

    DEFINITION OF PRESUMED LEAD-BASED PAINT: “Presumed lead-based paint” means paint or other surface...

  • Ico checkbox

    I have reason to believe a lead-based paint hazard is present on the interior or on the exterior ...

  • Ico multiline

    (specify components, rooms, and any other relevant details, and provide access to any available r...

  • Ico checkbox

    To my knowledge, lead-based paint hazards are not present nor likely to be present on the interio...

  • Ico statictext

    C.

  • Ico checkbox

    There are currently no pending actions ordered by a District Government agency with respect to th...

  • Ico checkbox

    There are currently pending actions that have been ordered by a District Government agency with r...

  • Ico multiline

    as follows:

  • Ico statictext

    By my signature below, I agree that this Lead Disclosure Form states information about my propert...

  • Ico textbox

    NAME OF OWNER/OWNER’S

  • Ico textbox

    AUTHORIZED AGENT

  • Ico date

    DATE

  • Ico statictext

    GOVERNMENT OF THE DISTRICT OF COLUMBIA

  • Ico statictext

    ACKNOWLEDGEMENT FORM

  • ...and More!

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