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Radon Gas Disclosure Form

Through this form, a prospective property buyer is informed of probable exposure to radon should s/he proceed with the purchase. Download

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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 State  of  ______________________________ 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.  Property Address:    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 Acknowledgment (initial) (if applicable)  (g)    Agent has informed the seller of the seller's obligations under StateS 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 provided is true and accurate.  Seller    Seller     Printed Name  Printed Name  Seller    Date    Seller    Date     Signature    Signature    Purchaser    Purchaser     Printed Name  Printed Name  Purchaser    Date    Purchaser    Date     Signature    Signature    Agent    Agent     Printed Name  Printed Name  Agent    Date    Agent    Date     Signature    Signature
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