Commerce control number STIPULATION Rental Unit Energy Efficiency Standards Type or print using black ink Personal information you provide may be used for secondary purposes [Privacy Law s. 15.04(1)(m)] The Department of Commerce does not discriminate on the basis of disability in the provision of services or in employment. If you need this printed material interpreted or in a different form or if you need assistance in using this service, please contact us, TTY 608-264-8777. Sellers Name(s): Rental Building Location - Street Address: Seller’s Street address: City: City: County: Zip Code: State Number of rental buildings on this property: Number of rental units in building: Sellers Telephone Number (including area code): Legal Description of Rental Unit Property. (You may attach a separate sheet): Return To: PARCEL IDENTIFICATION NUMBER:(PIN) PIN: Instructions: Information concerning the seller and the property should be filled in above. Information concerning the buyer and the buyer's signature should be filled in below. The Stipulation must then be submitted to the Department of Commerce or to a Commerce agent for validation. A list of these agents is available on the website http://commerce.wi.gov/SB/SBRentalWeatherizationProgram.html (see #3). General questions should be directed to (608) 267-2240. If there is not a Commerce agent in your area, send the Stipulation to the address listed below. The validated Stipulation will be returned to the buyer as noted below, or to another party as designated in the "Return to" block above. SEE BACK OF THIS FORM FOR ADDITIONAL INFORMATION. This document is valid only if no previous Stipulation or Waiver is currently on file for this property. STIPULATION AGREEMENT I (we) agree to bring the above described property into compliance with Comm 67 energy standards no later that one year from date of validation. Print Buyers Names: Buyers Signatures: Date Signed: Buyers Street Address: Buyers City, State, and Zip Code: Buyer Telephone Number(inc.area code): Date Validated: Commerce Transfer Authorization Number: Expiration Date (one year from date validated): Validated by: S-___ ___ ___ ___ ___ ___ Department of Commerce Commerce Agent Auth or Tax Rev #: _______________ Official's Signature: Print Officials Name: TRANSFER OF STIPULATION (Use original or certified copy) Official Title: Municipality and County: If the residential property described above is transferred within one year of the validation date of this Stipulation and before the building(s) has been certified in compliance with Comm 67, the new buyer must sign below and forward a copy or fax of this document to Commerce at the address listed below.* By signing below the new buyer accepts responsibility to comply with this Stipulation by the expiration date listed above. Transfer of the property after the expiration date is not valid without conformance to the energy standards. This transfer may be recorded using the transferred Stipulation. Print New Buyers Name: New Buyers Street Address: TRANSFER OF STIPULATION (Use original or certified copy) Place Commerce Transfer Authorization Number Stamp here New Buyers Signature: New Buyers City, State and Zip Code: Date Signed: New Buyers Telephone Number (including area code): If the residential property described above is transferred within one year of the validation date of this Stipulation and before the building(s) has been certified in compliance with Comm. 67, the new buyer must sign below and forward a copy or fax of this document to Commerce at the address listed below.* By signing below the new buyer accepts responsibility to comply with this Stipulation by the expiration date listed above. Transfer of the property after the expiration date is not valid without conformance to the energy standards. This transfer may be recorded using the transferred Stipulation. Print New Buyers Name: New Buyers Street Address: New Buyers Signature: New Buyers City, State and Zip Code: Date Signed: New Buyers Telephone Number (including area code): *This instrument was drafted by: Wisconsin Dept of Commerce, Rental Weatherization, PO Box 7302, Madison, WI 53707-7302 Telephone: (608) 267-2240 Fax (608) 283-7413 SBD-7115 (R.11/08) Copy Distribution: 1 –Recording (original with stamp); -1- Agent; -1- Commerce American LegalNet, Inc. www.FormsWorkflow.com Purpose: Section 101.122 (4) and (6), Wis. Stats, requires that a properly authorized Certificate of Compliance, Stipulation, or Waiver accompany the transfer documents at the time of recording. This process is further explained in Chapter Comm. 67, Wis. Admin Code. Receipt of the Certificate of Compliance indicates conformance with energy conservation standards of Comm. 67.05. In lieu of the Certificate of Compliance, the purchaser may accept responsibility for future conformance with either a Stipulation or a Waiver under Comm. 67.08(2). Stipulation: The buyer of a residential rental building shall present a properly validated Stipulation to the Register of Deeds at the time the property transfer is recorded (see instructions below). This indicates the building is subject to the rental weatherization rules, and that the buyer will bring the building into compliance with the energy standards within one year. Building with existing lease: The buyer of a building with four units or less who intends to owner-occupy, but is unable to do so within 60 days of transfer due to an existing lease, is required to prepare a Stipulation. Commerce will cancel the Stipulation after confirmation that the owner has occupied a unit. A written notice and proof of owner-occupancy is required to be sent to Commerce. Required documentation for proof of owner-occupancy is two or more of the following: copy of driver’s license, with current address; W-2 Wage Statement; income tax returns from two years; or telephone bills from two or more consecutive months. NOTE: Utility bills are not acceptable. Commerce will confirm cancellation by issuing a Satisfaction, which needs to be recorded with the Register of Deeds, by the owner of the property. Please note you may find Parcel Identification Number (PIN) information on tax assessment rolls, rolls from county property lister, or county tax rolls. You may find all Rental Weatherization Forms and a list of unsatisfied stipulations and waivers on our web page: http://commerce.wi.gov/SB/SB-RentalWeatherizationProgram.html 1. HOW TO SATISFY A STIPULATION: Hire a State-Certified Rental Weatherization Inspector to inspect the property and determine what requirements are needed to meet the State code. Inspectors are listed under “Building Inspection” in the yellow pages of telephone books. A list of credentialed Rental Weatherization Inspectors can be found on our web site: http://www.commerce.wi.gov/SB/SBCredsRwi.html. Comparative shopping is recommended when contracting for inspection services since fees are based on the private inspector’s costs and market competition. However, the maximum fee for inspection and certification of a residential rental property is set by statute. This fee includes an initial inspection, the Field Inspection Report, a final inspection for compliance, and the issuing of the Certificate of Compliance and the Certificate of Compliance Stamp. The maximums are: a. 1 or 2 rental units ............................................ $200.00 b. 3 to 8 rental units............................................. $200.00 plus $50.00 for each additional rental unit over 2 c. Over 8 rental units........................................... $500.00 plus $25.00 for each additional rental unit over 8 2. The inspector will leave a copy of a Field Inspection Report and will discuss the requirements with you. 3. If weatherization requirements have been identified by inspection, then you should either hire a contractor or perform the work yourself to bring the building into code compliance. 4. After completion of the work, you should contact the inspector and request a final inspection. 5. The inspector will re-inspect the property, then issue a Certificate of Compliance if all requirements are satisfied. 6. The owner will receive an original Certificate of Compliance which must be recorded at the County Register of Deeds to negate the Stipulation. The inspector will send a copy of the certificate to Safety and Buildings Division. When Safety and Buildings receives the certificate, the stipulation will be satisfied. All work must be completed and the Certificate of Compliance issued within 12 months of the original date of the stipulation or the owner is subject to a fine according the State Statute 101.122 (7)(d). Copy Distribution: 1 –Recording (original with stamp); -1- Agent; -1- Commerce American LegalNet, Inc. www.FormsWorkflow.com