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~..r <br />~..i <br />CLAIM FOR EXPENSES TO SEARCH FOR REPi.ACEA~NT SITE <br />AQency: <br />P~jeul: <br />File Y: <br />I hareby apply for payment for the ezpeases incurrad in searchin~ for a rnplacement site. <br />IT IS UNDERSTOOD: <br />The owner of a dieplaced business, farm, sign or NPO may be reimbursed for the actuat re~sasonable expanse in <br />soarching for a replacemant site, not to ezcs~ed 51,000. Sueh ezpensa3 may include costs of transportation, meals, <br />lodging away from home, and tha readonabte va(ue of time actuatly spdnt in search, including the fe~,s ot' resl ~,state <br />a~ants or rral eetate brokers. <br />All expaases claimad, exeapt value of tima actuslly crp~nt in aearch, includinQ the fee.s of real estate ageats vr real <br />estata brokers must be supported by ieceipt~d biUs. Payment for milca clriven may not ezceed 20 cants par mile. <br />Payment for time actually speat ia r,earch shail be basecl on the applieable hourly wage rasa for the patson(s) <br />coaducting tha search but may not excead S30 p~r hour. <br />Dat~ Milea <br />Driven Rata par <br />Mile Daily <br />Charga Hours <br />Spcnt Rate of <br />Pay Daily <br />Charge Meals and <br />Lodgin~ <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Subtotal of Mileage Charge Subtotal of HourlY Charg~~ <br />'1~is is a eartified statemene of milns driven, hours spent and other axpeoses while searching for a teplacement site <br />'total Claim S <br />Clai <br />Add <br />9earch for Re~lacement Sia H~na, McP.3dawncy a Aaaociaica (5(T:~) 297-95H6 <br />Appraiaal • NeQolia4oR • Relocatim • SWdieb <br />