(SAMPLE) Replacement Housing Payment Eligibility Determination

(SAMPLE) Replacement Housing Payment Eligibility Determination ------180 Day Owner Occupant ------Summary and Justification of Selection of "Most" Comparable Property 49 CFR 24.401

Project: AIP #: Parcel : Displaced Person: , # in Household: Displacement Dwelling DSS? Y N

I. Market Data Source: (mark all applicable) MLS Project Data Newspaper/Published Realtors Private Listings Other: Listings Current To: II. Justification for Selection of Comparable (#) as the "Most " comparable replacement property available:. (Note: The following grid will supplement file documentation to provide justification to support the sponsor's selection of the comparable dwelling judged to be the most comparable of those identified. File documentation must also be maintained on the other comparable properties evaluated. )

Comparison of the Selected Explanation: If inferior, relate to compensating Comparable Criteria: Comparable to the Acquired trade-off. If significantly superior provide (49 CFR 24.2(d)) Dwelling/Displacee Needs justification, i.e. DSS need, compensates inferior Equal(=), feature at reasonable cost, no lesser cost alternative Superior(+),Inferior(-) acceptable. 1. Location: (Neighborhood, =, + access to employment, community services, etc.) (*must be equal or better)_ 2. Number of Rooms: =, +, - (total/bedrooms/baths) 3. Size of Habitable living Area: (sq. ft. measured interior, =, +, - excluding halls, bathrooms, and closets) 4. Condition: =, +, (*must be equal or better) 5. Age: =, +, - 6. Style/Floor Plan: =, +, - 7. Quality of Construction: ( market perception) =, +, - 8. Other Amenities: (standard features such as fireplace, upgrade carpets or cabinetry, workshop, extra storage space used; and typically available on the market. =, +, - Trade-off consideration is common where feature is not available at reasonable cost on available properties.) 9. Other features: =, +, - 10. Major Exterior Attributes: *Attribute considered only if available at reasonable ( Site attributes such as swimming cost on comparable properties. Otherwise comparable pool, excess land, major =, +, - without the attribute is used and a " Carve-out" outbuildings, etc.) procedure is used to calculate payment eligibility. *N/A (49 CFR 24.403(a)(2))

III. Required Adjustments: 1. Access for Disabled Displaced Persons: Cost Estimate:$ , (contractor bids attached) N/A Items required: 2. Sales to List Price Adjustment: The subject real estate market currently indicates a sales to list price adjustment of % that is/ is not applicable to the selected comparable. Explain if not applicable:(prior listing adjustments made, unique property, neighborhood sales experience, etc.

Adjusted price of selected comparable dwelling: $ .

IV. Summary of Housing Availability: (Note: All available properties considered must be indicated below. File documentation must evidence that adequate consideration was given lesser cost properties in order to evidence program economy had been secured in the search process. Listing inventories are to be retained in project records identifying the properties considered in selecting the most comparable property for payment calculation.)

Total available listed properties identified as comparable: Price Range of Identified Properties: From $ (address/listing#:_ ), To $ (address/listing#:_ ). Selected comparable listed/adjusted price at $ , represents (#) replacement housing opportunities currently available to the displaced person at reasonable cost. (Note: If less than 3 currently available the availability of the comparable properties must be verified prior to requiring vacation of the acquired dwelling. If the selected property is unavailable at displacement recalculation of the payment eligibility will be required.) Comments: V. Replacement Housing Payment Eligibility Calculation:

Selected Comparable Property List Price (Adjusted)

less Acquisition Cost of Displacement Dwelling : (as necessary, deduct (Carve-out) the acquisition cost of Major Exterior Attributes) -

Replacement Housing Payment Eligibility:

Plus estimated cost to make property accessible for disabled displaced persons, . (Note: Displacee must be advised that actual payment for necessary modifications will be the lesser of the estimated cost or the actual reasonable cost of installation. A replacement housing payment may only be made following DSS certification and verification that required modifications are in place. The installation of modifications necessary should be included in the sales contract to facilitate timely payment.)

VI. Certification: Relying on the above referenced market information and analysis of the comparable replacement housing requirements for the displacement property and the displaced persons, comparable (#) is selected as the most comparable property available at reasonable cost. This property is to be offered as the available replacement housing for the subject displaced persons with an anticipated displacement from the acquired property to occur by . As of the date of this determination this property is available and is considered to be decent, safe, and sanitary for purposes of providing replacement housing to the subject displacee. The offer of the selected property requires a replacement housing payment eligibility as calculated above in the amount of . The undersigned has made (approved of) the required determinations and calculation of the replacement housing payment eligibility in accordance with applicable regulations and approved procedures conforming to the requirements of the Uniform Act (49 CFR 24 Subpart C &D) and FAA directives..

Signed:______, Title:______Date:__/__/______

Prepared by:______,Title:______Date:__/__/__