Relocation Assistance Parcel Check List
Route Section County
Project Job No. Parcel
Unit
Relocation Representative: General
Supplemental Housing Computation Initiation of Negotiations 90 Day Notice LAS Unit Record Initiated BRW 333 Unit Record Initiated First Relocation Contact Relocation Payments Program Explained Relocation Payment Eligibility Notification Assistance Requested 30 Day Written Notice Given
Date
Supplemental Housing Payment
Eligibility Determined/Certified DS&S Inspection Verify Replacement Dwelling Cost Verify Incidental Expenses Costs Verify Increased Mortgage Interest Costs Claim Provided to Relocatee Claim Filed Claim Processed Notice of Receipt Sent to Relocatee
Date
Payment in Lieu of Moving
Determination of Entitlement Received in District Determination Reviewed Notification of Determination Sent to Relocatee Claim Provided to Relocatee Claim Filed Claim Processed Notice of Receipt of Claim Sent to Relocatee
Date
Review
Request for review received Relocatee Notification of Hearing Date 1st Level Hearing Relocatee Notification of Hearing Findings Request for 2nd Level Review Received Relocatee Notification of 2nd Level Hearing Date 2nd Level Hearing Relocatee Notification of Hearing Findings
Date
Moving
Inventory Made Inventory Verified No. 1 Moving Bid Obtained No. 2 Moving Bid Obtained Moving Bid Approval Storage Authorization Moving Claim Provided Relocatee Moving Claim Filed Moving Claim Processed Notice of Receipt of Claim Sent to Relocatee
Date
Date file closed
Printed 5/30/2009
LA 6019B (Rev. 02/07)