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
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