I (We) Agree Tobringtheabove Described Propertyinto Compliancewithsps 367 Energystandardsno

DSPS controlnumberSTIPULATIONRentalUnitEnergy
TypeorprintusingblackinkEfficiencyStandards
Personalinformationyouprovide may be used forsecondarypurposes[PrivacyLaws. 15.04(1)(m)]
TheDepartmentof SafetyandProfessionalServicesdoes not discriminateonthe basis of disabilityin theprovision ofservices or inemployment.If you needthis printedmaterial interpretedorin adifferentformor if you need assistanceinusingthisservice, please contactus, 608-266-2112, Option 5,TTYthrough Relay.
SellersName(s): / Rental Building Location - StreetAddress:
Seller’sStreetaddress: / City: / County:
City: / State: / ZipCode: / Numberofrentalbuildingsonthisproperty: / Numberofrentalunits in building:
SellersTelephone Number(includingarea code):
Legal DescriptionofRental Unit Property. (You mayattach a separatesheet):
PARCELIDENTIFICATIONNUMBER:(PIN)
ReturnTo:
PIN:

Instructions:Informationconcerningthesellerandthepropertyshouldbefilledinabove.Informationconcerningthebuyerandthebuyer'ssignatureshouldbefilledinbelow.TheStipulationmustthenbesubmittedtothe DepartmentofSafetyandProfessionalServicesortoaDSPSagentforvalidation.AlistoftheseagentsisavailableontheWebSite Generalquestionsshouldbedirectedto608-266-1818.IfthereisnotaDSPSagentinyourarea,sendthestipulationtotheaddresslistedbelow.Thevalidatedstipulationwillbereturnedtothebuyerasnotedbelow,ortoanotherpartyasdesignatedinthe"Returnto"blockabove.

Thisdocument is validonlyif nopreviousstipulationorwaiver iscurrentlyonfile forthisproperty. / STIPULATIONAGREEMENT

I (we) agree tobringtheabove described propertyinto compliancewithSPS 367 energystandardsno laterthatoneyearfrom dateofvalidation.

PrintBuyersNames: / BuyersSignatures: / Date Signed:
BuyersStreetAddress: / Buyers City: / State: / Zip Code: / Buyer Telephone Number(inc.area code):
Validatedby:
Department of SafetyandProfessionalServices / Date Validated: / DSPSTransferAuthorization Number:
S- / Place DSPS TransferAuthorization NumberStamp here
DSPS Agent / Author TaxRev#:
Official'sSignature: / Phone Number: / Expiration Date (oneyear fromdate validated):
Print OfficialsName: / Official Title: / MunicipalityandCounty:
TRANSFER OF STIPULATION
(Use original or certified copy) / Iftheresidentialpropertydescribedaboveistransferredwithinoneyearofthevalidationdateofthisstipulationandbeforethebuilding(s)hasbeencertifiedincompliancewithDSPS367,thenewbuyermustsignbelowandforwardacopyor faxofthisdocument toDSPSattheaddresslistedbelow. *Bysigningbelowthe newbuyeracceptsresponsibilitytocomplywiththisstipulationbytheexpirationdatelistedabove.Transferofthepropertyaftertheexpirationdateisnot valid withoutconformancetotheenergystandards.Thistransfermayberecordedusingthetransferredstipulation.
Print NewBuyers Name: / NewBuyersSignature: / Date Signed:
NewBuyers StreetAddress: / NewBuyersCity,State andZipCode: / NewBuyersTelephoneNumber (includingareacode):
TRANSFEROF STIPULATION
(Useoriginalor certified copy) / Iftheresidentialpropertydescribedaboveistransferredwithinoneyearofthevalidationdateofthisstipulationandbeforethebuilding(s)hasbeencertifiedincompliancewithDSPS367,thenewbuyermustsignbelowandforwardacopyor faxofthisdocument toDSPSattheaddresslistedbelow. *Bysigningbelowthe newbuyeracceptsresponsibilitytocomplywiththisstipulationbytheexpirationdatelistedabove.Transferofthepropertyaftertheexpirationdateisnot valid withoutconformancetotheenergystandards.Thistransfermayberecordedusingthetransferredstipulation.
Print NewBuyers Name: / NewBuyersSignature: / Date Signed:
NewBuyers StreetAddress: / NewBuyersCity,State andZipCode: / NewBuyersTelephoneNumber (includingareacode):

*This instrument was draftedby:DSPSRentalWeatherization,POBox 7302, Madison,WI 53707-7302 Telephone: 608-266-2112, Option 5

SBD-7115(R2/15)

Purpose:Section101.122(4)and(6),Wis.Stats,requiresthataproperlyauthorizedCertificateofCompliance,Stipulation,orWaiveraccompanythetransferdocumentsatthetimeofrecording.ThisprocessisfurtherexplainedinSPS367,Wis.AdminCode.ReceiptoftheCertificateofComplianceindicatesconformancewithenergyconservationstandardsofSPS

367.05.InlieuoftheCertificateofCompliance,thepurchasermayacceptresponsibilityforfutureconformancewitheitheraStipulationoraWaiverunderSPS367.08(2).

Stipulation:ThebuyerofaresidentialrentalbuildingshallpresentaproperlyvalidatedstipulationtotheRegisterofDeedsatthetimethepropertytransferisrecorded(seeinstructionsbelow).Thisindicatesthebuildingissubjecttotherentalweatherizationrules,andthatthebuyerwillbringthebuildingintocompliancewiththeenergystandardswithinoneyear.

Buildingwithexistinglease:Thebuyerofabuildingwithfourunitsorlesswhointendstoowner-occupy,butisunabletodosowithin60daysoftransferduetoanexistinglease,isrequiredtoprepareastipulation.DSPSwillsatisfythestipulationafterconfirmationthattheownerhasoccupiedaunit.Awrittennoticeandproofofowner-occupancyisrequiredtobesenttoDSPS.Requireddocumentationforproofofowner-occupancyistwoormoreofthefollowing:copyofdriver’slicense,withcurrentaddress;W-2WageStatement;incometaxreturnsfromtwoyears;ortelephonebillsfromtwoormoreconsecutivemonths.NOTE:Utilitybillsarenotacceptable.DSPSwillconfirmbyissuingaSatisfaction,whichneedstoberecordedwiththeRegisterofDeedsbytheowneroftheproperty.

PleasenoteyoumayfindParcelIdentificationNumber(PIN)informationontaxassessmentrolls,rollsfromcountypropertylister,orcountytaxrolls.

YoumayfindallRentalWeatherizationFormsandalistofunsatisfiedstipulationsandwaiversonourwebpage:

HOWTOSATISFYASTIPULATION:

1.Hireastate-certifiedRentalWeatherizationInspectortoinspectthepropertyanddeterminewhatrequirementsareneededtomeetthestatecode.Inspectorsarelistedunder“BuildingInspection”intheyellowpagesoftelephonebooks.AlistofRentalWeatherizationInspectorscanbefoundontheInternet: RW Inspectors.

Comparativeshoppingisrecommendedwhencontractingforinspectionservicessincefeesarebasedontheprivateinspector’scostsandmarketcompetition.However,themaximumfeeforinspectionandcertificationofaresidentialrentalpropertyissetbystatute.Thisfeeincludesaninitialinspection,theFieldInspectionReport,afinalinspectionforcompliance,andtheissuingoftheCertificateofComplianceandtheCertificateofComplianceStamp.Themaximumsare:

a.1or2rentalunits...... $250.00

b.3to8rentalunits...... $250.00plus$50.00foreachadditionalrentalunitover2

c. Over8rentalunits...... $500.00plus$25.00foreachadditionalrentalunitover8

2.TheinspectorwillleaveacopyofaFieldInspectionReportandwilldiscusstherequirementswithyou.

3.Ifweatherizationrequirementshavebeenidentifiedbyinspection,thenyoushouldeitherhireacontractororperformtheworkyourselftobringthebuildingintocodecompliance.

4.Aftercompletionofthework,youshouldcontacttheinspectorandrequestafinalinspection.

5.Theinspectorwillre-inspecttheproperty,thenissueaCertificateofComplianceifallrequirementsaresatisfied.

6.TheownerwillreceiveanoriginalCertificateofCompliancewhichmustberecordedatthecountyRegisterofDeedsofficesatisfythestipulation.TheinspectorwillsendacopyofthecertificatetoSafetyandBuildingsDivision.WhenSafetyandBuildingsreceivesthecertificate,thestipulationwillbesatisfied.

AllworkmustbecompletedandtheCertificateofComplianceissuedwithin12monthsoftheoriginaldateofthestipulationortheownerissubjecttoafineaccordingtoStats.101.122(7)(d).