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 | 2014 certificate, wi dor certificate, rent certificate paid, wi revenue certificate |
CAUTION:
Schedule H or
Rent Certiicate |
2014 |
Wisconsin Department of Revenue |
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NOTE: • Attach to Schedule H or
•Alterations (whiteouts, erasures, etc.) or errors VOID this rent certiicate.
Renter (Claimant) – Enter Social Security Number AFTER your landlord ills in section below and signs.
Legal last name
Legal irst 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 2014 FROM |
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2014 |
TO |
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2014 |
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M M |
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D D |
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M M D D |
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Do NOT sign your rent certiicate.
If your landlord won’t sign, complete ields above and below and lines 1 to 8, attach rent veriication (see instructions), and check here.
Landlord or Authorized Representative
Name of property owner |
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Telephone number |
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Address |
City |
State |
Zip |
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1 |
Is the rental property a |
1 |
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Yes |
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2a |
Is the above rental property subject to property taxes? |
2a |
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Yes |
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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 certiicate for rent of a mobile/manufactured: a Home? |
3a |
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Yes |
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c |
b Home site/Lot? |
3b |
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Yes |
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Mobile or manufactured home taxes or municipal permit fees you collected |
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from this renter for 2014 |
. . . . |
. . . |
. . . . . . |
4a |
Total rent collected for this rental unit for 2014 |
. . . . |
. . . |
. . . . . . |
bIf monthly rent did not change during the year, go to line 5. Otherwise, enter monthly amounts below.
No
No
No
No
3c.00
4a.00
Jan. |
.00 |
Feb. |
.00 |
Mar. |
.00 |
Apr. |
.00 |
May |
.00 |
June |
.00 |
July |
.00 |
Aug. |
.00 |
Sept. |
.00 |
Oct. |
.00 |
Nov. |
.00 |
Dec. |
.00 |
5 |
Number of occupants in this rental unit – do NOT count spouse or children under 18 . . . . |
. . . |
. |
5 |
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6 |
This renter’s share of total 2014 rent |
. . . . |
. . . |
. . . . . . |
6 |
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.00 |
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7 |
Value of food and services provided by landlord (this renter’s share) . . . |
. . . . |
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. . . . . . |
7 |
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.00 |
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8a |
Rent paid for occupancy only – Subtract line 7 from line 6 |
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8a |
.00 |
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .b Was heat included in the rent? |
8b |
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Yes |
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No |
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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
Name of landlord or authorized representative (print)
2014 Rent Certiicate
Name
Address of rental property
SSN
Page 2 of 2
Shared Living Expenses Schedule – To be completed by renter only if line 5 on page one is 2 or more and each occupant did not pay an equal share of the living expenses.
Step 1: List name(s) of other occupants: |
Step 3: Using the amounts listed in Step 2, compute your allowable |
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rent paid for occupancy only: |
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.00 |
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1 Total rent paid (line 1a) |
1 |
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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 |
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Amount |
Expenses |
All Occupants |
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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 |
2 |
Shared living expenses |
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.00 |
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you paid (line 5b) |
2 |
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3 |
Total shared living |
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.00 |
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expenses (line 5a) |
3 |
4Divide line 2 by line 3. Fill
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in decimal amount |
4 |
x . |
5 |
Multiply line 1 by line 4 |
5 |
.00 |
6 |
Value of food and services provided by |
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.00 |
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landlord (line 7 of page 1) |
6 |
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7 |
Subtract line 6 from line 5. This is your |
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allowable rent. Fill in here and on |
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line 14a or 14c of Schedule H |
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.00 |
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(line 9a or 9c of Schedule |
7 |
Instructions for Renter (Claimant)
Complete all ields 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 veriied will not be allowed.
After your landlord returns the completed rent certiicate, enter your social security number and then ill in the allowable amounts from lines 3c and 8a on Schedule H or
Instructions for Landlord/Authorized Representative
Lines 2a and 2b If you checked “No” on line 2a, do NOT complete the rent certiicate unless line 2b applies.
Line 4a Fill in the total rent collected for this unit for the time occupied by this renter in 2014. 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 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 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 certiicate to be sure that all applicable ields and lines have an entry. Sign (by hand) and date, print your name, and return the rent certiicate to the renter. Only an original signature is acceptable.
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