Form Lc 142 – Fill Out and Use This PDF

The LC-142 form, known as the Landlord's Certificate, is a document that landlords in Vermont must furnish to their tenants. This certificate is crucial for tenants who wish to file for a renter rebate claim or a property tax adjustment claim, as it details the rent paid, including what portion of that rent was for actual occupancy. Essential components of this form include landlord and rental unit information, allocable rent calculation, and specific instructions for both subsidized and nonsubsidized rental scenarios. For guidance on how to accurately complete and submit the LC-142 form, click the button below.

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Form Lc 142 PDF Details

Every year, tenants and landlords engage with various forms that are essential for declaring income, claiming rebates, and ensuring compliance with state regulations. Among these, the LC-142 form, known as the Vermont Landlord’s Certificate, plays a pivotal role for individuals residing in rental units. This form is integral for tenants aiming to file for a Renter Rebate Claim or a Property Tax Adjustment Claim, necessitating accurate completion and timely submission. It requires landlords to provide detailed information about the rental property, including ownership details, rental unit specifics, and the amount of rent paid throughout the calendar year, after adjusting for any utilities or services included in the rent. Additionally, it distinguishes between government-subsidized and non-subsidized rent situations, offering a clear directive on how to calculate the rent eligible for a rebate. The form mandates landlords to list all tenants of a rental unit, ensuring that each tenant's rights to claim rebates are recognized and preserved. Through the meticulous provision of rental and tenant information, alongside the landlord's certification of accuracy, the LC-142 form facilitates a crucial process in Vermont's residential tenancy landscape. Failure to comply with the form's requirements by the stipulated deadlines can result in penalties for landlords, underscoring the importance of its proper management. Additionally, it provides specific instructions for different types of housing situations, including mobile homes and non-profit mobile home parks, thus covering a broad spectrum of residential arrangements in Vermont. The provided support and information channels ensure that both tenants and landlords can seek assistance if needed, emphasizing a supportive framework for navigating the complexities of rental rebates and tax adjustments.

Question	Answer
Form Name	Form Lc 142
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	state of vermont landlord certificate, lc 142 landlord certificate, vermont form lc 142, vermont renter rebate form lc 142

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VT	LANDLORD’S CERTIFICATE	FORM
		LC-142

*121421100*

* 1 2 1 4 2 1 1 0 0 *

CLAIMANT: Remember to enter your Social Security Number when you file the rebate claim. This schedule must be attached to the Renter Rebate Claim OR the Property Tax Adjustment Claim.

Claimant’s Last Name

First Name

Initial

Claimant’s Social Security Number

SECTION A: LANDLORD AND RENTAL UNIT INFORMATION

1.Name of owner or landlord

Landlord’s Full Mailing Address ________________________________________________________________________________________________

2.Location of

rental unit

number, street/road name

city/town

3. SPAN

(From property tax bill)

4. Enter the number of rental

Number

units in this building

5. RENTAL UNIT IS (check type)

6. ITEMS INCLUDED IN RENT (Check all that apply)

Apartment

Lot for

Boarding

Heat

Electricity

Other

mobile home

home

Services

Personal

House

Mobile

Nursing home/

Furnishings

home

community care

Care

7.List name(s) of renters for this rental unit during this period

SECTION B: ALLOCABLE RENT

8.	.Calendar year	8a.			. .Number of months rented	8b.

9.	Monthly rental amount paid	. . . .	. . . . . . . . .	. . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . .	. 9.		.	0 0

10.	Total Rent Paid for calendar year listed on Line 8a. . . .				. . . . . . . . . . . . . . . . . . . . . . .	10.		.	0 0
11.	Less dollar value of items checked in Box 6 above that were included in rent
11.								.	0 0
	(heat, electricity, etc.)	. . . .	. . . . . . . . .	. . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . .	11.		.	0 0

12.	Adjusted rent paid for calendar year listed on Line 8a (Line 10 minus Line 11)					12.		.	0 0
13.	For government subsidized rent, enter percent tenant pays.
13.	For government subsidized rent, enter percent tenant pays.						.			%
	For nonsubsidized rent, enter 100.00%					. . . . 13.. . .	.			%
14.	Rent Paid during calendar year solely for the right of occupancy
14.								.	0 0
	(Multiply Line 12 by Line 13)					14.		.	0 0
										%
15.	Rental Adjustment	. . . .	. . . . . . . . .	. . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . .	. . . . 15.. . .	2 1	.	0 0	%

16. Allocable Rent (Multiply Line 14 by Line 15) Enter here and on Form PR-141, Line 3. . . . . . . . . . . . . . . . . . 16. . For MOBILE HOME LOT RENT, enter on Property Tax Adjustment Claim. DO NOT FILE FORM PR-141.

0 0

I certify the rental information on this Landlord’s Certificate is, to the best of my knowledge and belief, true, correct, and complete.

Signature of landlord or authorized representative	Date	Daytime Telephone Number
5454		FORM LC-142
5454		Rev. 10/12
		Rev. 10/12

INSTRUCTIONS FOR FORM LC-142 LANDLORD’S CERTIFICATE

ISSUE CERTIFICATES TO TENANTS

By January 31st. . . . . . . . . . If you have 2 OR MORE residential units. Upon tenant request . . . . . . . . . . . . . . .If you have 1 residential unit

IF TENANT MOVES BEFORE END OF YEAR

You can provide a completed certificate to the tenant when he or she leaves or mail the certificate to the new address or last known address by the time shown above for issuing certificates to tenants. Please

use certificate with 10/12 revision date.

FAILURE TO ISSUE A CERTIFICATE

You may be assessed a $200 per certificate penalty for failing to provide a tenant a certificate or failing to provide accurate information on the certificate.

NON-PROFIT MOBILE HOME PARKS OWNED BY COOPERATIVE OR TENANT/OWNERS

Do not issue a landlord certificate for lot rent. The non-profit park provides a letter to the tenant allocating the property tax assessed on the lot.

OTHER MOBILE HOME LOT RENT

Issue a landlord certificate for the lot rent.

RENT ELIGIBLE FOR REBATE

The rent eligible for rebate is only the rent actually paid for the right of occupancy. The part of rent attributable to items included in rent on Line 6 must be deducted to arrive at the rent paid for occupancy.

NURSING HOMES, COMMUNITY CARE AND LIKE FACILITIES

Payments by Medicaid on behalf of the tenant cannot be included as part of rent eligible for rebate.

A person who resides in a nursing or residential care home who owns a homestead with a sibling or spouse can claim a renter rebate if the sibling or spouse does not make a property adjustment claim.

LINE-BY-LINE INSTRUCTIONS

CLAIMANT INFORMATION

The Social Security Number of the Claimant is entered by the Claimant after the certificate is completed.

LANDLORD AND RENTAL UNIT INFORMATION

Line 1 Enter the name of the owner of the rental property. If multiple owners, print each owner name separated by a comma. Attach a separate sheet of paper if you need more room. Print the mailing address where you wish any correspondence concerning this rental unit to be sent.

Line 2 Enter the physical location of the rental unit.

Example: 123 Main Street Apt 3

Line 3 Enter the School Parcel Account Number (SPAN) for this rental property. The SPAN is found on the property tax bill.

Line 4 Enter the number of rental units in this property. For mobile home parks, enter the number of lots.

Line 5 Check the applicable box that best describes the rental unit type.

Line 6 Check the items included in rent. “Other services” include rubbish removal, snow removal, etc. It does not include services necessary for occupancy such as water or sewer costs. NOTE: If you check items included in rent, be sure to enter the dollar value on Line 11.

Line 7 Print the name(s) of the tenants. If two or more individuals share the same unit for the same period of time, print the name of each tenant separated by a comma. Only one certificate per rental unit can be issued even if there is more than one tenant in the unit.

Line 8a Enter the calendar year the certificate covers.

Line 8b Enter the number of months the tenant rented the unit from you in the calendar year in Line 8a. Only the rent paid during the calendar year is eligible for a renter rebate.

Line 9 Enter the full monthly rent for the rental unit. If the rent changed during the year, average the monthly rental amount. For subsidized rent, this is the full rent charge prior to the subsidy.

Line 10 Enter the total rent amount paid in this calendar year by the tenant for this calendar year. Do not include delinquent rent paid for prior year(s). Deposits are not part of rent paid. Do not include room charges for any month when paid by Medicare on behalf of the tenant.

Line 11 If Line 6 indicates items included in rent, enter the dollar value of those items. If the items are not recorded by rental unit, use a reasonable allocation method such as number of rooms or square footage of the unit compared to the total number of rooms or square footage of the rental units in the building.

Line 13 Enter 100.00% if rent is not subsided.

For state or federal rent subsidy, enter the percentage the tenant pays. If the subsidy pays 80% of the rent, enter 20.00 on this line. If the subsidy changed during the year, average the subsidy percentage.

Signature The landlord or authorized representative signs the completed certificate. Give or mail the original certificate to the tenant. Keep a copy for your records.

ASSISTANCE TO COMPLETE CERTIFICATE

Phone: 1-866-828-2865 (toll-free in VT)

802-828-2865 (local or out-of-state)

Fax: 802-828-2720

INFORMATION FOR TENANTS

If you are unable to get a certificate from your landlord, call the phone number above for assistance and more information on filing a renter rebate claim.

You may claim a renter rebate even if you are not required to file an income tax return.

FORM LC-142

Rev. 10/12

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Stage no. 1 in filling out fillable lc142

2. Right after filling out this section, go on to the subsequent step and enter the necessary details in all these blank fields - Efile Certificate Number, Calendar year a, Number of months rented b, Monthly rental amount charged, Total rent paid for calendar year, Less dollar values of items above, Adjusted rent paid for calendar, For government subsidized rent, Rent paid during calendar year, Rental adjustment, Allocable rent Multiply Line by, Renters Enter on Form PR Vermont, Section C Signature I certify the, Signature of landlord or, and Date MMDDYYYY.

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