Financial- Cromwell, Samuel (Previous Tenant)

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- Relocat~ee's Names: `'~-~' :~~~~~ ~~[~Occupant over 180 days ^ Occupant under 180 days ' p Owner Occupant p- Renter Occupant ^ Other DETERMINATION OF BASE MONTHLY RENT 1. Family gross monthly income from all sources $ (Tenants and owner occupants under 180 days) ,~, Replacement Housing Worksheet File No: p Occupant under 90 days ~~- Date of Occupany~____ ~OC~. c~C~ 2. 30 percent of line 1 $ ~~~; , ~, ~ 3. Monthly rent of displacement dwelling $ ~; ~ ~ ~ ~~ 4. Average monthly cost of utilities $ ,-~~, .~, ~, 5. Rent plus utilities (line 3 plus line 4) $ ~ 1~ ~, ~, 6. Base monthly rental amount (lesser of lines 2 or 5) .................................................................... $ i~C% . ~~ C% MAXIMUM RENTAL ASSISTANCE 7. Monthly rent of comparable dwelling (from housing report) $ ~"~ y~ z> `~ 8. Average mo~thiy cost or all utilities (comparable) ~ ~ 9. Maximum replacement rent (line 7 plus line 8) $ ~~~ 5- ~~, 10. Base monthly rental amount (line 6) $ /~~, . ~~• v 11. Rent differential (line 9 minus line 10) ~ /~,~, ~ ~~ 12. Maximum rent supplement (42 times line 11) $ `~ ~3 U: c> O 13. Non-refundabie fees required at comparable g ~ ~ 14. Maximum rental assistance payment (line 12 + 13) .......................................!.............................$ /, ~3L'< <-> C~ ~ DOWN PAYMENT An eligible displaced person who purchases a replacement dwelling is entitled to a down payment assistance payment in the amount the person would receive as a rent benefit payment calculated above if the person rented a comparable replacement dwelling. However, the payment to a displaced homeowner shall not exceed 55,250 or the amount of the price differential the owners would receive as determined below if they met the 180-day occupancy requirement, whichever is less. PRICE DIFFERENTIAL DETERMINATION - TOTAL ACQUISITION 13. Adjusted asking price or comparable # $ (from replacement housing worksheet) 14. Market value of dwelling to be acquired $ 15. Maximum price differential (line 13 minus line 14) .........................................................$ PRICE DIFFERENTIAL DETERMINATION - BASED ON CARVE OUT - - 16. Adjusted listing price or comparable # $ (from replacement housing worksheet) - 17. Appraised value of land and improvements to be acquired contributing to the $ - residential use of the subject (dwelling, well, garage, on-site, etc..) 18. Amount of damages to the residential portion of the remaining property g (from Appraisal Report) -_ 19. Carved out residential value of subject (sum of lines 17 and 18) g 20. Maximum rice differential line 16 minus line 19 P ~ ) ..................................................$ ~=' ~ f'; ____________ __ ~~_~~~~___~~~__~~~__~~~~~~~_~~~~~~~~~~_~~~~~~_~_~~~~~_~~~~~~_~__~_~~__~__~_~~~_~~~~~~~_____~_ BASED ON THE ABOVE INFORMATION THIS RELOCATEE IS ELIGIBLE TO RECEIVE: `~ w y .` 6`~i ''. * Rental Assistance $ `7~ ,~,~~~, ~ U Housing of ~ast Resort ~ t.=~ ~y; Down Payment ~ $ ~ ^ Yes ^ No Price Differential $ y~ ~3 0. v v if'yes", please include , ~.~;:~~ti~~~ ':~:;~~` "~" justification ,, ~..;~ -y .. _ _. ..; ,= u~~~~~ The above payment is my determination of retocation assistance. I understand that these may be used in connection with a Federal-Aid project. I have no direct or indirect present or contemplated personal interest in this transaction. Nor will I derive ::::~~ any benefits from any supplemental payment. I have inspected the interior and exterior of the above comparable. To the best ~:"~:;:. of my knowledge, the dwelling meets applicable housing and occupancy codes and is decent, safe, and sanitary according to federal and st t l i ~~.;~; a e regu at ons. . w,~r .. .~~.: ~:~~ », _, _~_~ ~• .-', ;yry "~;: