Free NYC Bedbug Disclosure Form | Fillable PDF

๐Ÿ› NYC Bedbug Disclosure Form

Mandatory Annual Notice – NYC Admin Code ยง 27-2018

๐Ÿšจ MANDATORY NYC REQUIREMENT

New York City law REQUIRES landlords to provide this disclosure:

  • At lease signing: Must give to all new tenants before or at time of signing lease
  • Annually: Must provide to ALL current tenants every year by January 15th
  • Covers entire building: Must disclose bedbug history for all units and common areas
  • 12-month lookback: Report any bedbug infestations in past 12 months

Failure to provide = violation subject to fines

โš ๏ธ What Must Be Disclosed

Landlords must disclose:

  • Building-wide bedbug history for past 12 months
  • Every apartment where bedbugs were found or treated
  • Common areas where bedbugs were found or treated
  • Date of infestation/treatment for each unit

Must be truthful and complete. False or incomplete disclosure can result in penalties and tenant lawsuits.

๐Ÿ“‹ When to Provide This Form

New Tenants: At or before lease signing

Current Tenants: Every year by January 15th

Upon Request: Tenants can request at any time (landlord has reasonable time to provide)

Keep Records: Maintain signed copies for at least 1 year

๐Ÿ“ Disclosure Information

Date this disclosure is being provided to tenant(s)

Building Information

Bedbug History (Past 12 Months)

Current Tenant Information

Landlord/Owner Information

๐Ÿ“š Complete Guide to NYC Bedbug Disclosure Law

Understanding NYC’s Bedbug Disclosure Law

New York City enacted strict bedbug disclosure requirements in 2010 to combat widespread infestations and protect tenants. The law recognizes that:

  • Tenants have a right to know if building has bedbug history
  • Early detection and disclosure prevent spread
  • Transparency encourages proper treatment
  • Knowledge allows tenants to take preventive measures

Who Must Provide Disclosure

Building Type Disclosure Required? Notes
Rental apartment buildings YES All sizes – includes 3+ unit buildings
Single/two-family homes (rental) YES Must disclose if renting to tenants
Co-ops & Condos NO (for owners) But must disclose to rental tenants if renting out units
Hotels/Motels NO Different regulations apply

What Must Be Disclosed

Landlords must provide complete, accurate information about:

๐Ÿ“‹ Required Disclosure Elements

1. Building-Wide History (12 Months):

  • Every apartment where bedbugs were found
  • Every apartment that received treatment
  • All common areas affected (hallways, laundry, lobby, etc.)
  • Date of infestation/treatment for each location

2. Current Status:

  • Whether infestation has been resolved
  • If ongoing treatment is occurring
  • Follow-up inspections scheduled

3. Building Information:

  • Complete building address
  • Landlord/managing agent contact info

When Disclosure Must Be Provided

Situation Deadline Penalty for Non-Compliance
New Lease Signing At or before lease is signed $250-$500 violation
Lease Renewal At or before renewal signing $250-$500 violation
Annual Disclosure By January 15th every year $250-$500 violation per unit
Upon Tenant Request Within reasonable time (7-14 days typical) $250-$500 violation

How to Properly Complete Disclosure

1

Review All Bedbug Records (12 Months)

Gather information from:

  • Pest control company reports and treatment logs
  • Tenant complaints about bedbugs
  • Your own inspection notes
  • Work orders for bedbug-related issues
  • Any unit where treatment occurred, even if “just in case”
2

List Every Affected Unit/Area

For each location with bedbugs in past 12 months, document:

  • Apartment number: “Apt 4C” or “Unit 202”
  • Date: Month and year of detection/treatment
  • Status: “Treated and resolved” or “Ongoing treatment”

Don’t hide or minimize. Full disclosure is legally required.

3

Include Common Areas

List any common areas where bedbugs found:

  • Laundry room
  • Hallways
  • Lobby
  • Basement storage
  • Elevator
4

Complete Form Accurately

Fill out all required fields:

  • Date of disclosure
  • Building address
  • Yes/No on bedbug history
  • If yes: detailed list of all affected units
  • Tenant name(s) receiving disclosure
  • Landlord contact information
5

Provide to Tenant & Get Signature

Proper delivery:

  • Give tenant a copy (paper or electronic if they consent)
  • Ask tenant to sign acknowledgment of receipt
  • Keep signed copy in your records for at least 1 year
  • For annual disclosure, can post in lobby and mail to units
6

Update Records & Prepare for Next Year

Ongoing compliance:

  • Keep bedbug treatment log year-round
  • Track all pest control visits and findings
  • Document tenant complaints about bedbugs
  • Mark calendar for next January 15th annual disclosure
  • Update disclosure for new tenants as needed

Landlord Obligations Beyond Disclosure

NYC law requires landlords to take active steps to prevent and eliminate bedbugs:

โš ๏ธ Landlord Bedbug Responsibilities

Prevention & Education:

  • Provide bedbug fact sheet from DOHMH with lease
  • Annual notice about bedbug prevention
  • Educational materials about early detection

Inspection:

  • Inspect unit within reasonable time after tenant report
  • Inspect adjacent units (above, below, sides)
  • Conduct follow-up inspections after treatment

Treatment:

  • Hire licensed pest control professional
  • Treat infested units promptly
  • Treat adjacent units preventively
  • Follow NYC-approved treatment protocols
  • Cannot charge tenant for treatment (unless tenant caused infestation)

Follow-up:

  • Re-inspect after treatment (typically 2 weeks, 4 weeks)
  • Additional treatment if bedbugs return
  • Document all treatment and inspections

Common Mistakes & How to Avoid Them

โŒ Top 10 Disclosure Errors

  1. Not providing disclosure at all: Forgetting to give to new tenant or missing January 15 deadline. Result: $250-$500 violation per unit.
  2. False “no bedbugs” statement: Saying no bedbugs when records show treatment. Result: Violation + potential fraud claim.
  3. Incomplete unit list: Listing only tenant’s unit, not entire building. Result: Violation for incomplete disclosure.
  4. Only disclosing confirmed infestations: Failing to list units treated “as precaution.” If treated, must disclose.
  5. Using old disclosure: Giving tenant disclosure from 18 months ago. Must be current 12-month history.
  6. Missing common areas: Not mentioning laundry room or hallway treatment. Must disclose all areas.
  7. No proof of delivery: Can’t prove tenant received disclosure. Get signature or delivery confirmation.
  8. Verbal disclosure only: Telling tenant about bedbugs instead of written form. MUST be in writing.
  9. Blaming prior owner: “Bedbugs were here before I bought building” doesn’t excuse disclosure. Still required.
  10. Waiting for tenant to ask: Must provide proactively at lease signing and annually. Don’t wait for request.

Penalties for Non-Compliance

Violation Fine Range Additional Consequences
Failure to provide disclosure $250-$500 per unit Tenant can withhold rent, sue for damages
False/misleading disclosure $250-$500 + potential fraud Tenant lawsuit for fraud, lease voidable
Late annual disclosure $250-$500 per unit Violation for each affected tenant
Failure to treat bedbugs $500-$2,000+ HPD violation, possible rent reduction
Retaliating against tenant who reports $1,000-$5,000 Eviction barred, tenant damages

What Tenants Can Do

Tenants have significant rights regarding bedbug disclosures:

  • Request disclosure: Can ask for current 12-month history any time
  • File complaint: Report non-disclosure to 311 or HPD
  • Withhold rent: If landlord fails to treat bedbugs (must follow legal procedure)
  • Sue for damages: If false disclosure or failure to treat causes harm
  • Break lease: Constructive eviction if severe infestation not treated

Best Practices for Landlords

โœ… Recommended Compliance Steps

  • Maintain bedbug log: Track all reports, inspections, treatments year-round
  • Use licensed pest control: Work with reputable NYC-licensed company
  • Calendar reminders: Set annual reminder for January 15 disclosure
  • Template forms: Keep updated disclosure template ready
  • Proof of delivery: Always get tenant signature or certified mail receipt
  • Keep records: Maintain disclosure records for at least 3 years
  • Educate tenants: Provide prevention tips and encourage early reporting
  • Act quickly: Inspect and treat within days of report
  • Be truthful: Complete honesty prevents legal problems later

Resources

NYC Department of Housing Preservation & Development (HPD):

  • Bedbug information: nyc.gov/hpd
  • File complaint: Call 311

NYC Department of Health (DOHMH):

  • Bedbug fact sheets and prevention guides
  • Information on licensed pest control operators

โš–๏ธ Legal Disclaimer

This form is provided for informational purposes only and does not constitute legal advice. NYC bedbug disclosure law is strictly enforced with significant penalties for non-compliance. Providing false or incomplete disclosure can result in violations, fines, and tenant lawsuits.

You MUST disclose ALL bedbug incidents in past 12 months, including units that were treated preventively or where bedbugs were suspected but not confirmed. If pest control company treated a unit, list it on disclosure regardless of outcome.

Annual disclosure deadline is January 15th. Missing this deadline results in violations. Mark your calendar and prepare disclosure in December to ensure timely delivery to all tenants.

Keep proof of delivery. Get tenant signature acknowledgment or use certified mail. Without proof, you cannot prove compliance if violation alleged.

For buildings with bedbug history or questions about compliance, we recommend consulting a qualified NYC landlord-tenant attorney or property management professional familiar with NYC bedbug regulations. Legal consultation ($200-$500) is minimal compared to potential fines and tenant lawsuits from improper disclosure.