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ILLINOIS ASSOCIATION OF REALTORS DISCLOSURE OF INFORMATION AND

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ILLINOIS ASSOCIATION OF REALTORS
DISCLOSURE OF INFORMATION AND ACKNOWLEDGMENT
LEAD-BASED PAINT AND/OR LEAD BASED PAINT HAZARDS
Lead Warning Statement
Every purchaser of any interest in residential real property on which a residential dwelling was built prior to 1978 is notified
that such property may present exposure to lead from lead-based paint that may place young children at risk of developing
lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities,
reduced intelligence quotient, behavioral problems, and impaired memory. Lead poisoning also poses a particular risk to
pregnant women. The seller of any interest in residential real property is required to provide the buyer with any information on
lead-based paint hazards from risk assessments or inspections in the seller's possession and notify the buyer of any known
lead-based paint hazards. A risk assessment or inspection for possible lead-based paint hazards is recommended prior to
purchase.
Seller's Disclosure (initial)
_
________(a) Presence of lead-based paint and/or lead-based paint hazards (check one below):
฀ nown lead-based paint and/or lead-based paint hazards are present in the housing (explain): K
_________________________________________________________________________
_________________________________________________________________________
฀
Seller has no knowledge of lead-based paint and/or lead-based paint hazards in the housing.
(b) Records and Reports available to the seller (check one below):
฀ Seller has provided the purchaser with all available records and reports pertaining to lead-
based paint and/or lead-based paint hazards in the housing (list documents below):
_________________________________________________________________________
___________________________________________________________________________
฀ Seller has no reports or records pertaining to lead-based paint and/or lead-based paint hazards
in the housing.
Purchaser's Acknowledgment (initial)
_________(c) Purchaser has received copies of all information listed above.
________(d) Purchaser has received the pamphlet Protect Your Family From Lead in Your Home. _
_________(e) Purchaser has (check one below):
฀ Received a 10-day opportunity (or mutually agreed upon period) to conduct a risk assessment
or inspection of the presence of lead-based paint or lead-based paint hazards; or
฀
Waived the opportunity to conduct a risk assessment or inspection for the presence of lead-
based paint and/or lead-based paint hazards.
Agent's Acknowledgment (initial)
_________(f ) Agent has informed the seller of the seller's obligations under 42 U.S.C. 4852 d and is aware of
his/her responsibility to ensure compliance.
Certification of Accuracy
The following parties have reviewed the information above and certify to the best of their knowledge, that
the information they have provided is true and accurate.
Seller ________________________ Date / / Purchaser ___________________ Date / /
Seller ________________________ Date / / Purchaser____________________ Date / /
Agent ________________________ Date / / Agent _______________________ Date / /
Property Address:_____________________________________ __________________________________
Form 420 Revised 10/96 (This disclosure form should be attached to the Contract to Purchase)
ILLINOIS ASSOCIATION OF REALTORS
MOLD DISCLOSURE
Printed Name(s) of Seller(s) ______________________________________________________
Printed Name(s) of Buyer(s) ______________________________________________________
Property Address ____________________________________________________________
1. SELLER DISCLOSURE. To the best of Seller’s actual knowledge, Seller represents:
a. The Property described herein ___ has ___has not been previously tested for molds;
Note: If answer to a. is “has not”, then skip b. and c. and go to Section #2.
If answer to a. is “has”, then complete b. and c.
b. The molds found ___were ___were not identified as toxic molds;
c. With regard to any molds that were found, measures ___were ___were not taken to remove those
molds.
Buyers Initials
Ƒ Ƒ 2. MOLD INSPECTIONS. Molds, funguses, mildew, and similar organisms may exist
in the Property of which the Seller is unaware and has no actual knowledge. These contaminants generally grow in
places where there is excessive moisture, such as where leakage may have occurred in roofs, pipes, walls, plant pots,
or where there has been flooding. A professional home inspection may not disclose molds. Buyer may wish to
obtain an inspection specifically for molds to more fully determine the condition of the Property and its
environmental status. Neither Seller’s agents nor Buyer’s agents are experts in the field of mold. The Buyers are
strongly encouraged to satisfy themselves as to the Property condition.
3. HOLD HARMLESS. Buyer makes the decision to purchase the Property independent of any
representation of the Agents or Brokers involved in the transaction regarding mold. Accordingly, Buyer agrees to
indemnify and hold ___________________________________________________________________________
___________________________________________________________ (print names of Brokers and Designated
Agents) harmless in the event any mold is present on the Property.
4. RECEIPT OF COPY. Seller and Buyer have read this Mold Disclosure and by their signatures hereon
acknowledge receipt of a copy thereof.
5. PROFESSIONAL ADVICE.
Seller and Buyer execute this Disclosure with the understanding that they
should consult with a professional of their choice regarding any questions or concerns before its execution.
Seller: _____________________________________________ Date:______________________
Seller: _____________________________________________ Date: _____________________
Buyer: _____________________________________________ Date: _____________________
Buyer: _____________________________________________ Date: _____________________
Form 348 9/2002 Copyright by Illinois Association of REALTORS
FORM 422 (10/2012) COPYRIGHT ILLINOIS ASSOCIATION OF REALTORS®
Illinois Association of REALTORS®
DISCLOSURE OF INFORMATION ON RADON HAZARDS
(For Residential Real Property Sales or Purchases)
Radon Warning Statement
Every buyer of any interest in residential real property is notified that the property may present exposure to
dangerous levels of indoor radon gas that may place the occupants at risk of developing radon-induced lung cancer.
Radon, a Class-A human carcinogen, is the leading cause of lung cancer in non-smokers and the second leading
cause overall. The seller of any interest in residential real property is required to provide the buyer with any
information on radon test results of the dwelling showing elevated levels of radon in the seller’s possession.
The Illinois Emergency Management Agency (IEMA) strongly recommends ALL homebuyers have an indoor radon
test performed prior to purchase or taking occupancy, and mitigated if elevated levels are found. Elevated radon
concentrations can easily be reduced by a qualified, licensed radon mitigator.
Seller’s Disclosure (initial each of the following which applies)
_______ (a) Elevated radon concentrations (above EPA or IEMA recommended Radon Action Level) are known to
be present within the dwelling. (Explain).
_______ (b) Seller has provided the purchaser with the most current records and reports pertaining to elevated
radon concentrations within the dwelling.
_______ (c) Seller either has no knowledge of elevated radon concentrations in the dwelling or prior elevated radon
concentrations have been mitigated or remediated.
_______ (d) Seller has no records or reports pertaining to elevated radon concentrations within the dwelling.
Purchaser’s Acknowledgment (initial each of the following which applies)
_______ (e) Purchaser has received copies of all information listed above.
_______ (f) Purchaser has received the IEMA approved Radon Disclosure Pamphlet.
Agent’s Acknowledgement (initial IF APPLICABLE)
_______ (g) Agent has informed the seller of the seller’s obligations under Illinois law.
Certification of Accuracy
The following parties have reviewed the information above and each party certifies, to the best of his or her
knowledge, that the information he or she has provided is true and accurate.
Seller _________________________________________ Date_________________________________
Seller _________________________________________ Date_________________________________
Purchaser _____________________________________ Date _________________________________
Purchaser _____________________________________ Date _________________________________
Agent _________________________________________ Date _________________________________
Agent__________________________________________ Date__________________________________
Property Address _______________________________ City, State, Zip Code____________________
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ILLINOIS ASSOCIATION OF REALTORS DISCLOSURE OF INFORMATION AND

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Completed 7 October 2021

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