Transcription of Form LC-142 *1914211WW* Vermont Landlord Certificate ...
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Page 2 Form LC-142 Rev. 10/19 Section A: Landlord and Rental Unit Information (Please complete all fields)Section C: SignatureI certify the rental information on this Landlord Certificate is, to the best of my knowledge and belief, true, correct, and : Remember to enter your Social Security Number when you file the rebate s Last Name First Name MI Claimant s Social Security NumberVermont Department of Taxes Form LC-142 Vermont Landlord CertificateName of Owner or LandlordLandlord s Mailing Address City State ZIPL ocation of Rental Unit (number, street/road name) Unit Number SPAN (from property tax bill)City/Town Number of Units in this BuildingRental Unit is (check one)Items Included in Rent (check all that apply)
Mobile home owners: Enter on Form HS-122, Homestead Declaration and Property Tax Credit Claim, Line B10 . Created Date: 9/12/2019 10:53:09 AM ...
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