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Rent Certificate PDF Details

A rent certificate form is an important document that proves that a tenant is up to date on their rent payments. This document can be used in a court of law to prove that the tenant is in good standing with their landlord. In some cases, a rent certificate may also be used as evidence of residency.Landlords often require tenants to provide a rent certificate as proof of payment before signing a lease agreement. This document can also help landlords determine whether or not they should offer a tenant credit for future rent payments. In some cases, landlords will offer credits for up to one year's worth of rent payments. Therefore, it is important for tenants to carefully review their lease agreement and understand the terms and conditions before signing any documents.

The listing provides details about the rent certificate. You might like to look at it before filling out the gaps.

Question	Answer
Form Name	Rent Certificate
Form Length	3 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	45 sec
Other names	wi form certificate, wi revenue certificate, rent certificate have, wi cert

12

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CAUTION:

Schedule H or H-EZ must be completed and filed with this rent certificate

Instructions		Tab to navigate within form. Use mouse to check
		applicable boxes, press spacebar or press Enter.
		applicable boxes, press spacebar or press Enter.

Rent Certificate

Wisconsin Department of Revenue

NOTE: • Attach to Schedule H or H‑EZ

•Alterations (whiteouts, erasures, etc.) or errors void this rent certificate.

•Only attach rent certificate if filing a homestead credit claim

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Print		Clear

2020

Renter (Claimant) – Enter Social Security Number AFTER your landlord fills in section below and signs.

Legal last name

Legal first name

M.I.

Social security number

Address of rental property (property must be in Wisconsin)

City

State Zip

Time you actually lived at this address in 2020 From

2020 To

2020

Do NOT sign your rent certificate.

M M D DM M D D

If your landlord won’t sign, complete fields above and below and lines 1 to 8, attach rent verification (see instructions), and check here.

Landlord or Authorized Representative

Name of property owner

Telephone number

				(				)

Address		City			State			Zip

1	Is the rental property a long-term care facility, CBRF, or nursing home?		1		Yes					No
1			1		Yes					No
2a	Is the above rental property subject to property taxes?		2a		Yes					No
2a	Is the above rental property subject to property taxes?		2a		Yes					No

bIf 2a is “No” and you are a sec. 66.1201 municipal housing authority

that makes payments in lieu of taxes, check here . . . . . . . . . 2b

3	Is this certificate for rent of a mobile/manufactured: a Home?	3a					Yes			No
c	b Home site/Lot?	3b					Yes			No


	Mobile or manufactured home taxes or municipal permit fees							3c		.00
	you collected from this renter for 2020							3c		.00
4a	Total rent collected for this rental unit for 2020 – do NOT include amounts received							4a		.00
	directly from a governmental agency, security deposits, or late fees							4a		.00
b	If monthly rent paid didn’t change during 2020, enter monthly rent paid							4b		.00

cIf monthly rent changed during 2020, enter rent paid for each month below. Do not include security deposits or late fees.

Jan.	.00	Feb.	.00	Mar.	.00	Apr.	.00
May	.00	June	.00	July	.00	Aug.	.00
Sept.	.00	Oct.	.00	Nov.	.00	Dec.	.00
5a Number of occupants in this rental unit – do NOT count spouse or children under 18								5a

bRenters, if line 5a is more than 1, did each occupant pay an equal share of living

	expenses? (if no, complete shared living expenses schedule on page 2)	5b			Yes			No

6	This renter’s share of total 2020 rent	. .	. . . . .			6		.00
7	Value of food and services provided by landlord (this renter’s share) . .	. .	. . . . .			7		.00
8a	Rent paid for occupancy only – Subtract line 7 from line 6	. . . . . . . 8a					.00
. . . . . . . . . . . . . . . .b Was heat included in the rent?		8b			Yes			No

I certify that the information shown on this rent certificate is true, correct, and complete to the best of my knowledge.

Signature (by hand) of landlord or authorized representative

Date

Print name (must match signature)

I-017i (R. 07-20)

2020 Rent Certificate

Renter’s name

Address of rental property

Renter’s

SSN

Page 2 of 2

Shared Living Expenses Schedule – To be completed by renter only if line 5b on page one is “No.”

Step 1: List name(s) of other occupants:	Step 3: Using the amounts listed in Step 2, compute your allowable
	rent paid for occupancy only:

Step 2: List the total amount (not the monthly amount) of all shared living expenses (rent, food, utilities, and other) paid by all occupants and the amount that you paid:

Shared Living	Total Paid by			Amount
Expenses	All Occupants			You Paid
Rent	1a)	.00	1b)	.00
Food	2a)	.00	2b)	.00
Utilities	3a)	.00	3b)	.00
Other	4a)	.00	4b)	.00
Total	5a)	.00	5b)	.00

1	Total rent paid (line 1a)			.	1
2	Shared living expenses	2			.00
	you paid (line 5b). . . .	2			.00
3	Total shared living	3			.00
	expenses (line 5a) . . . .	3			.00
4	Divide line 2 by line 3. Fill				4 .
	in decimal amount			.	4 .
5	Multiply line 1 by line 4				5
6	Value of food and services provided by				6
	landlord (line 7 of page 1)				6

7Subtract line 6 from line 5. This is your allowable rent. Fill in here and on the applicable rent line of Schedule H or Schedule H-EZ . . . . . . . . . . . 7

.00

.00

.00

.00

Instructions for Renter (Claimant)

Complete all fields in the “Renter (Claimant)” section except the social security number. Then give to your landlord to complete and sign.

If your landlord won’t sign, place a checkmark in the designated area. Complete the “Landlord or Authorized Representative” section, and attach a copy of each canceled check or bank money order you have to verify your rent. Any portion not veri- fied will not be allowed.

Note: Do NOT sign the rent certificate yourself. Rent certifi- cates signed by you or someone other than the landlord or his/ her authorized representative will not be accepted.

After your landlord returns the completed rent certificate, enter your social security number, complete line 5b if applicable, and then fill in the allowable amounts from lines 3c and 8a (or line 7 of the above Shared Living Expenses Schedule – see instructions below) on Schedule H or H‑EZ, as appropriate.

Renter Instructions for Shared Living Expenses Schedule

Complete this schedule if line 5b on page 1 is “No.” All lines on the schedule must be filled in. If all lines on the schedule are not filled in, paid rent will be divided by the number of occupants.

Instructions for Landlord/Authorized Representative

Lines 2a and 2b  If you checked “No” on line 2a, do not complete the rent certificate unless line 2b applies.

Line 4a  Fill in the total rent collected from all occupants for this unit for the time occupied by this renter in 2020. Include any separate amounts the renter paid to you for items such as parking, a garage, utilities, appliances, or furnishings. Do not include rent for a prior year, late fees, security deposit paid during the year, or amounts you received directly from a governmental agency through a subsidy, voucher, grant, etc., for the unit (except amounts an agency paid as a claimant’s representative payee).

Line 5a  Fill in the number of adult occupants who lived in this rental unit during the rental period. Do not count the renter’s spouse or children under age 18 as of December 31, 2020.

Line 5b Do not complete this line. This will be completed by the renter.

Line 7  Fill in this renter’s share of the value of food and personal services (medical, laundry, transportation, counseling, grooming, recreational, therapeutic, etc.) you provided for this rental unit.

Signature  Review the rent certificate to be sure that all applicable fields and lines have an entry. Sign (by hand) and date, print your name, and return the rent certificate to the renter. Only an original signature is acceptable.

Applicable Laws and Rules

This document provides statements for interpretations of the following provisions of Wisconsin Statutes in effect as of July 7, 2020: Chapter 71, Wis. Stats.

Laws enacted and in effect after July 7, 2020, new administrative rules, and court decisions may change the interpretations in this document. Guidance issued prior to July 7, 2020, that is contrary to the information in this document is superseded by this document, pursuant to sec. 73.16(2)(a), Wis Stats.

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stage 1 to filling out rent certificate printable

Put the requested details in the Telephone, number, State Zip, Address, City, NoNo, Yes, Yes Yes, Yes NoNo, Jan, May, Sept Feb, June, Oct Mar, July, Nov and Apr, Aug, Dec field.

part 2 to completing rent certificate printable

The program will request information to quickly submit the section Jan, May, Sept Feb, June, Oct Mar, July, Nov Apr, Aug, Dec Yes, Yes, Print, name, must, match, signature Date, and Ii, R

rent certificate printable JanMaySept, FebJuneOct, MarJulyNov, AprAugDec, Yes, Yes, Printnamemustmatchsignature, Date, and IiR blanks to fill

Describe the rights and obligations of the parties inside the field Rent, Certificate Renters, name, Address, of, rental, property Renters, S, SN Page, of Expenses, Total, Paid, by, All, Occupants Amount, You, Paid Rent, Food, Utilities, Other, Total, and landlord, line, of, page

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rent certificate printable Total blanks to fill out

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