hud form rent reasonableness

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					                                            Erie County Department of Mental Health
                                                HUD SHP & S+C Grant Programs
                                                Rent Reasonableness Worksheet

Tenant Name:                                                                                   Date Rented:

Apt. Address:                                                                                 # of bedrooms:


Published FMR:                                                          Contract Rent:               Utilities:

Meets HQS Standards:             ( ) Yes     ( ) No                           Unit Type:

Amenities:

Mgt. & Maintenance:

Comments:


Rent Comparison                            Unit #1                  Unit #2                             Unit #3
Address

Square Feet

# of bedrooms

Accessibility (ex. Bus routes,
drug/grocery stores,
laundromats, etc.)
Unit Type (1,2,or 3 bdrm,
etc.)
Amenities (ex. Wall to wall
carpeting, air condit, etc.)
Mgt. & Maint Service

Gross Rent (including
utilities)
Utility Allowance


In accordance with 24 CFR 882.106, I certify that based on the information available to this office, the requested Contract
Rent ( ) is ( ) is not     reasonable.

Person Completing
Form:                                                                                                   Date:

Title:

				
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posted:6/29/2012
language:English
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