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HUD-40061 Selection of Most Representative Comparable Replacement Dwelling

In the case of wanting to decide on the most suitable replacement dwelling for a displaced person, the following form has to be completed and submitted along with all the necessary information to make a well-informed decision.

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form HUD-40061   (	4/2005	)	Page 1 of 2	Previous editions are obsolete.
Address
Type of Unit
Stories / Style
Lot Size
Type of Construction
Age (in years)
Condition
Area of Living Space (sq. ft.)
No.Rooms/Bedrooms  /Baths                /                /
            /                /           /                /          /                 /
Basement
Parking/No. of Cars
Type of Heating /Fuel              /             /               /       /
Type of Air Conditioning
Neighborhood
Transportation (distance)
Current Work (distance)
High School/Grade School (distance)                /            /               /      /
Neighborhood Shopping (distance)
Religious Facility (distance)
Sale Price or Rent/Utility Costs       $           $             $   $
Other
Date of Inspection
Date Available
Most Representative Comparable Replacement Dwelling
(Check "Comparable no.1, 2, or 3" and complete Comments)
Prepared By Date (mm/dd/yyyy) Approved by Date (mm/dd/yyyy)
Factors (see back of page) Displacement Dwelling Comparable No.1 Comparable No.2 Comparable No.3
1. Agency
2. Project 3. Household 4. Select One 5.Case Number
Owner
Tenant
Privacy Act Notice:  This information is needed to determine whether you are eligible to receive a payment to help you rent or buy a new home.  You are not
required by law to furnish this information, but if you do not provide it, you may not receive any payment for these expenses or it may take longer to pay you.
This information is being collected under the authority of the Uniform Relocation Assistance and Real Property Acquisition Poli cies Act of 1970.  The information
may be made available to a Federal agency for review.
Comments : Include appropriate analysis and correlation of data.  If Agency makes adjustment to the asking price for a comparable replacement dwelling
to reflect the anticipated sale price, indicate the basis for the adjustment.  For rental units, indicate utilities included in rent and provide estimates for other
utility costs.  Indicate availability of any housing subsidy.  If condominium or cooperative, indicate required fees.  (Continue on back of page)
Comments continued on back of page   	
  Yes	     No	
Selection of Most Representative
Comparable Replacement Dwelling
for Computing a Replacement Housing Payment	
U.S. Department of Housing
and Urban Development
Office of of Community Planning
and Developmemt	OMB Approval No. 2506-0016 (exp.	04 /30/201	8)	
Public reporting burden	 for this collection of information is estimated to average 1.0 hour.  This includes the time for collecting, reviewing, and re	porting	the data.  The information is being collected under the authority of the Uniform Relocation Assistance and Real Property Acquis	ition Policies Act of 1970,	and implementing regulations at 49 CFR Part 24 and will be used for determining the most comparable and available replacement h	ousing and its cost to be	used by Agencies in computing a replacement housing payment for displaced persons.	  Response to this request for information is required in order to	receive the benefits to be derived.  This agency may not collect this information, and you are not required to complete this fo	rm unless it displays a currently	valid OMB control number.

form HUD-40061   (	4/2005	)	Page 2 of 2	Previous editions are obsolete.
Factors Examples
Type of Unit Detached,Row, End Row, Townhouse, Highrise Apartment, Mobile Home  (Indicate whether this is subsidized housing)
Stories 1,  11/2, 2, 21/2, Split Level, Split Foyer
Style Colonial, Cape, Ranch, Contemporary, Tudor, Mediterranean
Type of Frame, Masonry, Pre-Fab, Stone, Concrete Block, Concrete, Veneer (wood, brick, or aluminum siding)
Construction
Condition Poor, Fair, Good, Very Good, Excellent
Basement Full, Partial (1/2), None;  Finished or Unfinished
Parking Attached, Built-In, Detached, Carport Paved Open Area, Unpaved Open Area, None
Type of Forced Air, Hot Water, Electric, Heat Pump, Steam, Space Heater, Solar, None
Heating
Type of Fuel Natural Gas, Propane Gas, Oil, Electric, Coal, Solar
Type of Air Central, Wall, Window, None
Conditioning
Neighborhood Poor, Fair, Good, Very Good, Excellent.  (Based on characteristics such as vacancy levels, quality and maintenance  of dwellings,
landscaping, Street Maintenance, Trash Pickup, and Nonconforming land uses)
Other Swimming Pool, Fireplace, Patio, Porch, Greenhouse
Comments Continued:
Comments continued on a separate page  	
  Yes	  No
Next: Homestead Designation Affidavit (Wise County) Previous: HUD-40058 Claim for Rental Assistance or Downpayment Assistance
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