Begin typing address and select from the populated dropdown
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
(609) 347-6450
{[AWEBSITE]}
ZIP
ZIP
Lot
Block
Address 2
Ordinance
Property Information
Lead Free Certificate?
DCA Inspection Certificate?
State
{[PNAME]}
State
Property Unit #
Lead Safe Certificate?
City
Address
# of Residential Units
Type
If Other
Application Type

The State of New Jersey has enacted a statute which mandates all residential rental properties to be inspected for lead-based paint to determine if the property is lead free, lead safe or needs to be remediated. The City Ordinance Chapter 209A – Article V requires landlords that are NOT DCA “New Jersey Department of Affairs” inspected to remit the findings of this inspection.

Lead Safe Certificates will expire in three years from issuance. Another inspection must be completed at the end of the third year of the certificate to then remit the findings to the City of Atlantic City. Failure to comply can result in a denial of Landlord Registration and/or Occupancy Permit.

Year Built
  • Contacts
  • Attachments/Certification
ZIP
Name
Phone #
Landlord/Superintendent/Manager Information
City, State, ZIP
Email
Name
Owner Information
Type
State
City
Landlord Same as Owner?
Address
If Other, Please Specify
Phone #
Email
Residential Address
Type Full Name :
Sign With Hand
I acknowledge that the certificate has a two-year validity period, and it is the responsibility of the applicant to apply before the certificate expires.
Certification
Signature

Attach documents below and any other related documents:

  • Please upload the following certifications: 'Lead Safe' or 'Lead Free'.
Amount Due
I am aware that the transition of tenancy necessitates the submission of a new application if I am lead safe.
Attachments
I hereby attest and affirm the content stated above.
Fee
I hereby declare and affirm that I am the legal owner or authorized agent of the legal owner of this property, and that all information on this form is complete and accurate to the best of my knowledge.

I, the legal owner or authorized agent of the legal owner of this property, understand that failure to comply with state, county, and local ordinances regarding residential rental dwelling units will result in legal action, which can include but is not limited to Notices of Violation, summons to Municipal Court, property liens, and other penalties.