Lead Poisoning and Window Falls Form

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Annual Required Form

New York City law requires that tenants living in buildings with 3 or more apartments complete this form and return it to their landlord before February 15, each year. If you do not return this form, your landlord is required to visit your apartment to determine if children live in your apartment.


Please download and print the form. This form needs to be returned to your landlord by the deadline.
Protect Your Child from Lead Poisoning and Window Falls