Allowances for Tenant- OMB Approval No. 2577 …

1 0 BR1 BR2 BR3 BR4 BR5 BR6 Gas (avg)$ $ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ $ (avg)$ $ $ $ $ $ $ Heat Pump (avg)$ $ $ $ $ $ $ / other $ $ $ $ $ $ $ Gas (avg)$ $ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ $ (avg)$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Gas (avg)$ $ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ $ (avg)$ $ $ $ $ $ $ / other $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ of BedroomsName of FamilyAddress of UnitRange / MicrowaveRefrigeratorTotalOtherOther$$$$ $Air ConditioningWater HeatingWaterSewerTrash Collection$$$$$To be used by the family to compute allowance . Complete below for the actual unit Family AllowancesUtility or ServiceHeatingCookingOther Electricper month cost$$$Trash Collection (avg)Range / Microwave Tenant- suppliedRefrigerator Tenant- suppliedWater (avg) other --specify:Monthly Electric Fee $ Gas Fee $ Electric (Lights & Appliances) (avg)Air Conditioning (avg)Sewer (avg)Utility or Service: Monthly Dollar AllowancesAllowances for Tenant- furnished utilities and other ServicesLocality: Housing Authority of the County of Chester, PAUnit Type: High- Department of Housing and Urban Development Office of Public and Indian HousingDate (mm/dd/yyyy)OMB Approval No.

2 2577-0169 (exp. 04/30/2018)The Nelrod Company 7/2017 Updateform HUD-52667 (04/15)ref. Handbook BR1 BR2 BR3 BR4 BR5 BR6 Gas (avg)$ $ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ $ (avg)$ $ $ $ $ $ $ Heat Pump (avg)$ $ $ $ $ $ $ / other $ $ $ $ $ $ $ Gas (avg)$ $ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ $ (avg)$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Gas (avg)$ $ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ $ (avg)$ $ $ $ $ $ $ / other $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ of BedroomsName of FamilyAddress of UnitRefrigeratorTotalOtherOther$$$$$Air ConditioningWater HeatingWaterRange / MicrowaveSewerTrash Collection$$$$$per month cost$$$Refrigerator Tenant- suppliedCookingOther--specify:Mon thly Electric Fee $ Gas Fee $ be used by the family to compute allowance .

3 Complete below for the actual unit Family AllowancesUtility or ServiceHeatingOther ElectricSewer (avg)Trash Collection (avg)Range / Microwave Tenant- suppliedAllowances for Tenant- furnished utilities and other ServicesMonthly Dollar AllowancesUtility or Service: Water (avg) other Electric (Lights & Appliances) (avg)Locality: Housing Authority of the County of Chester, PAUnit Type: Row House/ Townhouse/Semi-Detached/ Department of Housing and Urban Development Office of Public and Indian HousingAir Conditioning (avg)OMB Approval No. 2577-0169 (exp. 04/30/2018)Date (mm/dd/yyyy)The Nelrod Company 7/2017 Updateform HUD-52667 (04/15)ref. Handbook BR1 BR2 BR3 BR4 BR5 BR6 Gas (avg)$ $ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ $ (avg)$ $ $ $ $ $ $ Heat Pump (avg)$ $ $ $ $ $ $ / other $ $ $ $ $ $ $ Gas(avg)$ $ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ $ (avg)$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Gas (avg)$ $ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ $ (avg)$ $ $ $ $ $ $ / other $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ of BedroomsName of FamilyAddress of UnitRefrigeratorTotalOtherOther$$$$$Air ConditioningWater HeatingWaterRange / MicrowaveSewerTrash Collection$$$$$per month cost$$$Refrigerator Tenant- suppliedCookingOther--specify:Mon thly Electric Fee $ Gas Fee $ be used by the family to compute allowance .

4 Complete below for the actual unit Family AllowancesUtility or ServiceHeatingOther ElectricUnit Type: Detached Department of Housing and Urban Development Office of Public and Indian HousingAir Conditioning (avg)Date (mm/dd/yyyy)OMB Approval No. 2577-0169 (exp. 04/30/2018)Monthly Dollar AllowancesSewer (avg)Trash Collection (avg)Range / Microwave Tenant- suppliedAllowances for Tenant- furnished utilities and other ServicesUtility or Service: Water (avg) other Electric (Lights & Appliances) (avg)Locality: Housing Authority of the County of Chester, PAThe Nelrod Company 7/2017 Updateform HUD-52667 (04/15)ref. Handbook BR1 BR2 BR3 BR4 BR5 BR6 Gas (avg)$ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ (avg)$ $ $ $ $ $ Heat Pump (avg)$ $ $ $ $ $ / other $ $ $ $ $ $ Gas (avg)$ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ (avg)$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Gas (avg)$ $ $ $ $ $ Gas/Propane$ $ $ $ $ $ (avg)$ $ $ $ $ $ / other $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ for Tenant- furnished utilities and other ServicesLocality: Housing Authority of the County of Chester, PAUnit Type: Mobile Department of Housing and Urban Development Office of Public and Indian HousingDate (mm/dd/yyyy)OMB Approval No.

5 2577-0169 (exp. 04/30/2018) other Electric (Lights & Appliances) (avg)Air Conditioning (avg)Sewer (avg)Utility or Service: Monthly Dollar AllowancesTrash Collection (avg)Range / Microwave Tenant- suppliedRefrigerator Tenant- suppliedWater (avg) other --specify:Monthly Electric Fee $ Gas Fee $ Family AllowancesUtility or ServiceHeatingCookingOther ElectricRange / MicrowaveRefrigeratorTo be used by the family to compute allowance . Complete below for the actual unit rented.$$$$$$Air ConditioningWater HeatingWaterSewerTrash CollectionTotalOtherOther$$$Number of BedroomsName of FamilyAddress of Unitper month cost$$$$The Nelrod Company 7/2017 Updateform HUD-52667 (04/15)ref. Handbook