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Useful Forms

This topic provides you with the following links to useful worksheets, checklists, notices and other forms, which will be useful to HOME Grantee and Subrecipient staff. The forms are categorized according to whether they address crosscutting federal requirements, type of activity, i.e., rehabilitation, homebuyer, or tenant-based rental assistance; and general reference documents.

Crosscutting Federal Requirements Forms.
These forms are useful for ensuring that federal requirements are being met, regardless of the type of activity.

  • Abatement and Clearance Reports: PDF
  • Meaning of De Minimis Amounts of Paint: PDF
  • Disclosure Form - Rentals: PDF
  • Disclosure Form - Sales: PDF
  • Lead Safe Housing Requirements Screening Worksheet: PDF
  • Lead Safe Housing Requirements Screening Worksheet - Rehab Addendum: PDF | WORD
  • Requirements for Ongoing LBP Maintenance Activities: PDF
  • List of Prohibited Methods of Paint Removal: PDF
  • Pamphlet: Protect Your Family From Lead in the Home: PDF | En Español
  • Lead Hazard Evaluation Notice - Sample Form: PDF
  • Lead Hazard Presumption Notice - Sample Form: PDF
  • Notice of Lead Hazard Reduction Sample Form: PDF
  • Elderly Relocation Waiver: PDF | WORD
  • Guidance on Relocation: PDF | WORD

Rehabilitation. These forms are useful when undertaking rehabilitation activities.

  • Calculating Level of Rehabilitation Assistance Worksheets (Single and Multi-Family Units): PDF
  • Chart 1: Rehabilitation Process: Application to Assistance Threshold: PDF
  • Chart 2: Rehabilitation Assistance up to $5,000: PDF
  • Chart 3: Rehabilitation Assistance $5,000 up to $25,000: PDF
  • Chart 4: Rehabilitation Assistance Over $25,000: PDF
  • HUD-EPA Abatement Letter: PDF
  • Guidance for Volunteer Programs: PDF
  • Guidance on HUD-EPA Abatement Letter: PDF
  • List of Circumstances When Occupant Relocation Is Not Required: PDF
  • Rehabilitation Job File Checklist: PDF | WORD
  • Post Construction Certifications: PDF | WORD
  • Pre-construction Conference Checklist: PDF | WORD
  • Sample Calculation of Level of Assistance in Multi-Family Properties: PDF
  • Sample Construction Contract LBP Addendum: PDF | WORD
  • Sample Risk Assessment RFP and Protocol: PDF | WORD
  • Summary of Lead Hazard Reduction Methods: PDF
  • Model/sample SF Risk Assessment Report: PDF | WORD

Homebuyer. These forms are useful when undertaking homebuyer activities.

  • Homebuyer Program Lead Compliance Document Checklist: PDF | WORD
  • Sample Letter to Lender, Realtors, and Title Companies on LSHR: PDF | WORD
  • Seller Certification (Homebuyer Program) Sample Form: PDF | WORD
  • Guidance on the Homebuyer's Option to Test: PDF | WORD

Tenant-Based Rental Assistance. These forms are useful for owners accepting tenant-based rental assistance.

  • Requirements for Responding to Notification of Child With Environmental Intervention Blood Lead Level: PDF
  • Sample Instructions for Owners of TBRA units: PDF | WORD
  • TBRA Owner Certification - Sample Form: PDF | WORD
  • Sample TBRA Resident Instructions: PDF | WORD
  • TBRA Program Lead Compliance Document Checklist: PDF | WORD

Reference Documents that Provide Information on Lead Safe Housing Rule. The following documents have been referenced in previous topics.

  • Frequently Asked Questions about the Lead Safe Housing Rule: PDF
  • Lead-Based Paint Resources: PDF
  • Lead Speak: A Brief Glossary: PDF
  • Legislative History of Lead-Based Paint: PDF
  • Residential Lead-Based Paint Hazard Reduction Act of 1992 (Title X): PDF
  • Summary of Lead-Based Paint Requirements by Activity: PDF