Moving Expenses Worksheet - Residential by hmb46803


									                                                                     Moving Expenses Worksheet – Residential
                                                                                                      (49 CFR 24.301)

Airport:                                                          Project:
Sponsor:                                                          Parcel:
County:                                                           Unit:
Claimant Name:

1. Type of Payment claimed:
    Fixed payment $                        Reimbursement of Actual Expense             Supplementary Claim for Storage
                                           (complete item 2 including any              Cost (complete item 3)
                                           storage cost)

2. Actual Moving Expenses (See below for Eligible and Non-eligible Expense)         Amount Claimed      For Agency Use
  a.   Moving Costs
  b.   Transportation Costs - Families and Individuals (if any)
  c.   Cost of Insurance (Move and Storage)
  d.   Storage Costs (complete item 3)
  e.   Other: (explain under Remarks below)
               Total Amount Claimed                                                       $0.00              $0.00
         Less Amount of Advanced Payments (if any)
               Total Amount Due                                                           $0.00              $0.00

3. Storage Cost (complete only if personal property was moved to and from storage)
Type of Claim:                          Date Property Moved              Date Property Moved          Storage Location:
   Initial  Supplemental       Final    TO Storage:                      FROM Storage:                   with Mover
                                                                                                         other location

                              Eligible Moving Expenses                                       Ineligible Expenses
The actual, reasonable, and necessary expense for:                                1. Cost of moving structures or other
1. Transportation of individuals, families, and personal property from the           real property improvements.
   acquired site to the replacement site not to exceed a distance of 50 miles,    2. Interest on a loan of funds for
   (unless the 50 mile limit is waived for cause by the agency) .                    moving costs.
2. Packing and unpacking, crating and uncrating of personal property.             3. Additional expense because of
3. Disconnecting, dismantling, removing, reassembling, and reinstalling              living in a new location.
   relocated household appliances, and other personal property.                   4. Personal injury.
4. Storage of personal property as necessary intransit up to 12 months,           5. Any legal fee or other cost for
   (unless extended by the agency if necessary).                                     preparing a claim for a relocation
5. Insurance for the replacement value of the property moved and/or stored.          payment or for representing the
6. The replacement value of property lost, stolen, or damaged in the move,           claimant before the agency.
   not through the fault or negligence of the displaced person, or his/her        6. Expense to search for a
   agent or employee; where insurance coverage for such items is not                 replacement residence.
   available at reasonable cost.                                                  7. Improvement to the replacement
                                                                                     real property.


Printed on 1/13/2010                                                                                  AER 2518B (12/15/09)

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