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Asbestos Disclosure Form

Every state has disclosure laws when a seller transfers a property that will be used as a dwelling. Asbestos is a material that must be fully disclosed, be sure to check with your local state authority first. Below is a sample of a disclosure form for asbestos.

Asbestos Template

Asbestos Disclosure Agreement

Effective Date: ____/____/______

Tenant [Legal Name] (AKA, "The Tenant")

Located at [Address]

[City], [State] [Zip Code]


Landlord [Legal Name](AKA, "The Landlord")

Located at [Address]

[City], [State] [Zip Code]

Lease Property Location:

Address: _________________________

City: __________ State: ___ Zip: ____

The above mentioned parties do hereby agree as follows:

A common building material that is sometimes present in many buildings that were built before 1981 is asbestos.

Only the presence of asbestos materials does not create a health risk to residents according to the EPA. Only when asbestos materials are disturbed or dislodged causing the asbestos fibers to be released are there health risks involved. Some activities of concern are sanding, scraping, pounding and any other remodeling activity that may release dust into the air and cause asbestos particles to be released.

Federal law requires that certain precautions be taken to minimize the chances of damaging or disturbing materials that contain asbestos. The EPA does not require asbestos material to be removed.

The below signed Tenant(s) hereby acknowledge that this Asbestos Disclosure is a warning that the Leased Property may contain asbestos and due to this the Tenant may be exposed to a chemical that is known to cause cancer.

The Tenant(s) also hereby agree that there are to be no modifications, repairs, and or alterations to the premises without the written approval of the Landlord and this approval will be based upon the acceptance of a written plan of protection from the possible release of or exposure to the asbestos substance.

The Tenant(s) may only hang items on the wall with hangers that are less than one-quarter of an inch in diameter. The Tenant(s) will also immediately notify the Landlord when a hole larger than one-quarter of an inch in diameter exists, when wallboard or ceilings begin to crumble or peel, and / or any evidence of water leakage.

[__] The Landlord hereby discloses any known information regarding asbestos that is located in or around the following areas of the Leased Property:





[__] The Landlord has no knowledge of any asbestos located in or around the Leased Property.

Signature of the Tenant

Signature of the Landlord



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