Lead-Safe Certificate Application

Blue house with Lead Safe Toledo written inside

Lead-Safe Certificate Application

PLEASE READ FIRST

If your rental unit has passed inspection by a Local Lead Inspector, then you may apply for your Lead-Safe Certificate from the Toledo-Lucas County Health Department online by using this form and paying the fee with your credit card. The Lead-Safe Certificate may also be downloaded for printing and mailing to the Health Department with a $25.00 check.

If you have not passed a lead-safe inspection and are seeking to register your rental with the Lucas County Auditor, that can be done online or also via mail. You must register your rental with the Lucas County Auditor before you fill out this Lead-Safe Certificate application below.

If you have completed an inspection or lead-safe certificate under a previous ordinance, that work is grandfathered in. Previously issued lead-safe certificates will be reissued to you in the mail and there is nothing more you need to do. Previous inspections that an owner did not receive a certificate for, should be submitted using the form below; simply upload the passing inspection report. You do not need to pay for a new inspection. All grandfathered in 5-year certificates will expire on 10/20/2025.

Step-by-step instructions are available on the For Owners page. Please review those before applying here.

Property Description*
Have you registered this rental property with the Lucas County Auditor?*
NOTE: Property must be registered in order to proceed with this application.
(Online registration can be done at the Auditor's website.)
Property Information
Owner Name*
(As registered with the Lucas County Auditor and title recorded in Lucas County Records.)
Year Property Built*
(Only properties built before 1978 are subject to the ordinance.)
Please enter a number from 1700 to 1977.
Parcel #*
(Available on AREIS website).
Property Address*
Street Address Unit # or location (e.g. lower/upper) City State ZIP Code
How many rental units are at this property address?*
(Only 1-4 unit rentals are subject to the ordinance; a single-family home is considered 1 unit.)
Please enter a number from 1 to 4.
Contact Information
Provide owner’s and designated agent’s (if any) information required under Chapter 1760 of Toledo Municipal Code. It is the Owner's obligation to notify the Health Department, in writing, of any change in the name, address, telephone number, and/or email address of any Agent designated within sixty (60) days after the change occurs. We will mail your Lead-Safe Certificate to the Owner’s and/or Agent’s mailing addresses.
Owner's Name*
First Last
Owner's Phone Number*
Owner's Mailing Address*
Street Address Address Line 2 City State ZIP Code
Owner's Email Address*
Designated Agent’s Name
(Required for all owners outside of Lucas County, must be a natural person, not a business entity, at least 18 years of age and of sound mind.)
First Last
Agent's Phone Number
Agent's Mailing Address
Street Address Address Line 2 City State ZIP Code
Agent's Email Address
Local Lead Inspection Information
Property must have a passing Lead-Safe Report from a Local Lead Inspector to receive a Lead-Safe Certificate.
If you are applying for a reissue of an unexpired Lead-Safe Certificate under a new owner's name, you do not need to provide any documentation.
Note: 20-year Lead-Safe Certificates are only available if there is documentation that a property has been fully lead abated or determined to be lead-free by a licensed Lead Risk Assessor.
Hidden
REMOVE: What kind of Lead-Safe Certificate are you applying for?
What kind of Lead-Safe Certificate are you applying for?*
Date of Local Lead Inspection or Certified Abatement*
MM slash DD slash YYYY
Name of Local Lead Inspector who prepared Lead-Safe Inspection Report (5-year) or Lead Risk Assessor who Certified Abatement/Lead-Free (20-year):*
Final Checklist
UPLOAD: Passing Lead-Safe Inspection Report*
(5-year Lead-Safe Certificate)
Accepted file types: pdf, doc, jpg, png, Max. file size: 50 MB.
UPLOAD: Proof of Certified Abatement/Lead-Free at Property*
(20-year Lead-Safe Certificate)
Accepted file types: pdf, doc, jpg, png, Max. file size: 50 MB.
Applicant's E-signature*
First Last
Relationship to Owner*
Today's Date*
MM slash DD slash YYYY
Total
A credit card processing fee of 2.9% + 30¢ will apply to online transactions.
5 and 20-year certificates are $25 + CC fee; reissues are $10 + CC fee.
$0.00
Credit Card
Card Details
Cardholder Name

Lead-Safe Certificate Application

Lead-Safe Certificate Application

Property Information

Contact Information

Local Lead Inspection Information

Final Checklist

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