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"'~rr' ``~ Oregon Departmenf of TransNoRation
<br />Relocation
<br />REPLACEMENT HOUSING WORKSHEET
<br />~ ryti,~ File Number -----
<br />Relocatees' Names: ____ /1,~C'i /r~~~
<br />Rent Supplement`~1 Down Payment ^ Housing Additive Q Market Rent ~ Site only for MH ~ No Land, only MH 0
<br />1C
<br /> SUBJECT COMPAR. #1 COMPAR. #2 COMPAR. #3
<br />Complete Address
<br />and
<br />town/neighborhood
<br />,~(o ~ ~r-~ ~
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<br />~~~1 ~in.~~
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<br /># Bed/bath/total Rms / ~ / 2 / / / 2 / / .2 / i l a2,
<br />Total Area
<br />Year Built
<br />House/apt/duplex/site/
<br />manufactured home n ~ ~
<br />~ -~ ~ ~ f ~~ ~~
<br />Condition QExcellent ~Good
<br />[~Fair
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<br />^Non-Dss because
<br />Lot size
<br />Garage /Carport/#of
<br />cars
<br />Speciai Amenities
<br />Pubiic Transportation Yes ^ No Yes ~ No ~ Yes D No Yes ~ No
<br />Distance to
<br />EmploymenUShopping I l ~l l
<br />Type of Heat
<br />Listing Price -
<br />Adjustment and
<br />Source:
<br />Adjusted Price
<br />Rent
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<br />Heat
<br />Water
<br />Sewer
<br />Total Mo. utility cost
<br />Total housing cost
<br />(rent + utilities) ~
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<br />~7 ~ ~
<br />~ ~
<br />i Non-refundable Fees
<br />Paid by Tenant ~C, ~ O~
<br />~ ~ ~
<br />Information on the average monthly utility costs was verified from ~~ V
<br />Comparable #Y_ ____ was selected because:
<br />
<br />Form 103 (6/95) Page 1 of 4 RELOCATION
<br />REPLACEMENT HOUSING WORKSHEET
<br />
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