For more information on Fair Housing Act rights and responsibilities please visit https://dhr.ny.gov/fairhousing and https://www.dos.ny.qov/licensinq/fairhousing.html.
This form was provided to me by __________________________ (print name of Real Estate Salesperson/ Broker) of _____________________ (print name of Real Estate company, firm or brokerage (Buyer/Tenant/Seller/Landlord) I) We ___________________________________________ acknowledge receipt of a copy of this disclosure form:
Real Estate Consumer/Seller/Landlord Signature _________________________ Date: ________________________
Real Estate brokers and real estate salespersons are required by New York State law to provide you with this Disclosure.