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\r ~ Oregon Depariment o( T~ansporiation
<br />~ Relocation
<br />REPLACEMENT HOUSING WORKSHEET
<br />Relocatees' Names: _____ ~~ ~^~ i ~ p n ~ ~~ File Number
<br />
<br />Rent Supplement`(Tl Down Payment Q Housing Additive 0 Market Rent Q Site only for MH ~ No Land, only MH ^
<br />1~
<br /> SUBJECT COMPAR. #1 COMPAR. #2 COMPAR. #3
<br />Complete Address
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<br />actured home /
<br />Condition (]Excellent QGood ~Excellent Good ~Excelient ^Good ^Excellent QGood
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<br />Lot size
<br />Garage /Carport/#of
<br />cars
<br />Special Amenities
<br />Public Transportation Yes ^ No Yes 0 No ^ Yes 0 No Yes 0 No
<br />Distance to / / ~% /
<br />EmploymenUShopping
<br />Type of Heat
<br />Listing Price
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<br />Adjusted Price
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<br />Electricity ~ D
<br />Heat
<br />Water
<br />Sewer
<br />Total Mo. utility cost
<br />Total housing cost
<br />~ ~
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<br />~~/ `~"
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<br />(rent + utilities) ~
<br />Non-refundable Fees ~
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<br />0 ~
<br />(
<br />Paid by Tenant `
<br />/ 0
<br />Information on the average monthly utility costs was verified from ~C ~
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<br />Comparable #~
<br />___ was selected because:
<br />/ v
<br />Form 103 (6/95) Page 1 of 4 RELOCATION
<br />REPLACEMENT HOUSING WORKSHEET
<br />
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