Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

21 29 39 48 61 69

60 79 108 138 177 206

48 68 89 106 130 144

73 98 131 162 211 226

2 3 4 6 7 8

7 10 13 16 21 25

5 9 10 12 16 18

0 0 0 0 0 0

37 45 53 61 72 80

9 13 17 20 27 30

21 24 27 30 35 38

19 28 36 46 59 67

19 26 33 39 50 58

0 0 0 0 0 0

22 23 27 34 43 54

18 27 35 40 48 59

13 13 13 13 13 13

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 4 4 4 4 4 4

Adams County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

21 29 39 48 61 69

60 79 108 138 177 206

51 73 96 115 143 159

73 98 131 162 211 226

2 3 4 6 7 8

7 10 13 16 21 25

5 9 10 13 17 20

0 0 0 0 0 0

30 38 46 54 65 73

9 13 17 21 28 32

21 24 27 30 35 38

19 28 36 46 59 67

19 27 36 42 54 62

0 0 0 0 0 0

16 21 25 30 37 45

34 38 45 50 52 70

9 9 9 9 9 9

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 5 5 5 5 5 5

Allen County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

27 37 49 60 76 86

52 69 94 120 154 180

32 45 57 68 85 94

64 86 114 141 184 197

3 5 6 8 10 12

7 10 13 16 21 25

5 7 8 10 12 14

0 0 0 0 0 0

39 46 53 59 67 73

8 11 13 15 20 23

27 31 36 40 47 51

19 28 36 46 59 67

14 20 26 30 37 42

0 0 0 0 0 0

17 18 23 28 34 43

14 18 22 24 28 34

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Bartholomew County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

51 73 94 113 140 156

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

6 9 10 13 17 20

0 0 0 0 0 0

40 49 57 65 77 85

10 14 17 21 28 32

15 17 19 21 23 25

19 28 36 46 59 67

19 27 36 42 53 61

0 0 0 0 0 0

17 20 26 33 41 49

29 34 40 43 49 59

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Benton County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

30 41 55 67 86 97

60 79 108 138 177 206

51 73 96 115 143 159

73 98 131 162 211 226

3 5 6 8 10 12

7 10 13 16 21 25

5 9 10 13 17 20

0 0 0 0 0 0

30 38 46 54 65 73

9 13 17 21 28 32

27 31 36 40 47 51

19 28 36 46 59 67

19 27 36 42 54 62

0 0 0 0 0 0

14 15 19 23 28 35

22 26 31 33 38 45

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Blackford County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

28 38 48 56 70 78

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

4 6 6 8 10 12

0 0 0 0 0 0

34 39 45 50 58 63

7 9 11 13 17 19

27 31 36 40 47 51

19 28 36 46 59 67

12 16 21 24 29 33

0 0 0 0 0 0

11 16 20 24 30 36

24 28 34 38 44 54

7 7 7 7 7 7

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 5 5 5 5 5 5

Boone County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

18 25 33 41 52 58

52 69 94 120 154 180

33 46 59 70 87 97

64 86 114 141 184 197

2 3 4 5 7 8

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

44 51 58 64 72 78

8 11 13 15 21 24

19 22 25 27 32 34

19 28 36 46 59 67

14 20 26 31 38 43

0 0 0 0 0 0

29 36 46 56 70 88

38 44 52 56 63 76

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Brown County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

37 51 66 79 97 108

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

3 4 5 6 8 10

0 0 0 0 0 0

38 45 51 57 66 71

8 11 13 15 20 23

15 17 19 21 23 25

19 28 36 46 59 67

14 20 26 30 38 42

0 0 0 0 0 0

13 20 25 31 38 46

18 23 28 31 37 45

10 10 10 10 10 10

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Carroll County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

70 97 119 137 166 185

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

7 13 14 18 23 27

0 0 0 0 0 0

52 63 74 84 100 111

12 18 24 28 38 44

15 17 19 21 23 25

19 28 36 46 59 67

26 37 48 57 70 77

0 0 0 0 0 0

13 17 21 25 32 40

25 27 32 33 37 43

4 4 4 4 4 4

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 7 7 7 7 7 7

Cass County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

23 32 43 53 67 75

52 69 94 120 154 180

32 44 56 67 83 92

64 86 114 141 184 197

3 4 5 6 8 10

7 10 13 16 21 25

4 7 7 9 12 14

0 0 0 0 0 0

38 44 51 57 65 71

8 10 12 15 20 23

23 27 30 34 39 43

19 28 36 46 59 67

14 19 25 29 36 41

0 0 0 0 0 0

18 22 26 29 34 41

31 31 31 32 39 49

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 5 5 5 5 5 5

Clark County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

36 49 63 76 94 104

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

38 45 52 58 67 73

8 11 13 15 21 24

27 31 36 40 47 51

19 28 36 46 59 67

14 20 27 31 39 44

0 0 0 0 0 0

12 14 18 22 27 33

16 19 25 31 38 49

11 11 11 11 11 11

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Clay County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

20 27 36 44 57 64

56 73 100 128 164 191

34 48 61 73 90 100

68 91 121 150 195 209

2 3 4 6 7 8

7 10 13 16 21 25

5 7 8 10 12 14

0 0 0 0 0 0

38 45 51 57 66 71

8 11 13 15 20 23

21 24 27 30 35 38

19 28 36 46 59 67

14 20 26 30 38 42

0 0 0 0 0 0

11 13 16 20 26 33

26 32 40 46 54 67

9 9 9 9 9 9

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 5 5 5 5 5 5

Clinton County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

18 25 33 41 52 58

52 69 94 120 154 180

30 42 53 64 79 88

64 86 114 141 184 197

2 3 4 5 7 8

7 10 13 16 21 25

4 7 7 9 11 13

0 0 0 0 0 0

33 40 47 52 61 66

8 10 12 14 19 22

19 22 25 27 32 34

19 28 36 46 59 67

14 19 24 28 35 39

0 0 0 0 0 0

16 19 24 30 38 48

31 32 36 36 39 45

15 15 15 15 15 15

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Crawford County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

19 27 36 44 55 62

52 69 94 120 154 180

33 46 59 71 87 98

64 86 114 141 184 197

2 4 5 6 8 9

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

40 47 54 60 68 74

8 11 13 15 21 24

23 27 30 34 39 42

19 28 36 46 59 67

14 20 26 31 39 44

0 0 0 0 0 0

24 24 26 29 37 47

29 33 38 43 50 62

15 15 15 15 15 15

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 3 3 3 3 3 3

Daviess County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

23 32 43 52 65 72

52 69 94 120 154 180

43 62 81 97 120 134

64 86 114 141 184 197

3 4 6 7 8 10

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

36 43 50 55 63 69

8 10 12 15 20 23

18 29 33 37 43 46

19 28 36 46 59 67

14 19 25 29 37 41

0 0 0 0 0 0

9 14 20 27 37 51

16 19 26 31 39 49

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Dearborn County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

27 37 49 60 76 86

52 69 94 120 154 180

32 45 57 68 84 94

64 86 114 141 184 197

3 5 6 8 10 12

7 10 13 16 21 25

5 7 7 10 12 14

0 0 0 0 0 0

40 47 54 59 68 73

8 10 13 15 20 23

27 31 36 40 47 51

19 28 36 46 59 67

14 20 25 30 37 42

0 0 0 0 0 0

18 20 25 31 39 48

29 33 39 42 47 56

4 4 4 4 4 4

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Decatur County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

40 58 75 91 112 125

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

4 7 8 10 13 16

0 0 0 0 0 0

45 52 58 64 73 79

7 10 14 16 22 25

15 17 19 21 23 25

19 28 36 46 59 67

15 22 28 33 43 49

0 0 0 0 0 0

19 20 23 27 32 38

33 35 42 49 59 74

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 3 3 3 3 3 3

Dekalb County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

48 68 89 107 132 147

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

5 9 10 13 17 20

0 0 0 0 0 0

30 38 46 54 65 73

9 13 17 21 28 32

27 31 36 40 47 51

19 28 36 46 59 67

19 27 36 42 54 62

0 0 0 0 0 0

18 23 27 31 36 42

18 22 28 33 40 51

15 15 15 15 15 15

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Delaware County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

20 28 38 47 61 69

52 69 94 120 154 180

34 49 64 77 95 106

64 86 114 141 184 197

2 4 5 6 8 9

7 10 13 16 21 25

4 7 7 9 11 13

0 0 0 0 0 0

33 40 47 52 61 66

8 10 12 14 19 22

17 21 24 27 32 36

19 28 36 46 59 67

14 19 24 28 35 39

0 0 0 0 0 0

20 26 32 37 45 56

26 31 36 40 45 54

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 4 4 4 4 4 4

Dubois County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

49 70 92 111 137 152

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

5 9 10 13 16 19

0 0 0 0 0 0

31 39 46 54 65 72

9 12 17 20 27 31

15 17 19 21 23 25

19 28 36 46 59 67

19 26 34 40 52 59

0 0 0 0 0 0

11 16 19 23 28 28

19 20 25 27 32 40

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Elkhart County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

56 73 100 128 164 191

45 64 83 100 124 138

68 91 121 150 195 209

1 2 3 3 4 5

7 10 13 16 21 25

5 9 10 12 16 19

0 0 0 0 0 0

52 59 66 74 85 92

8 12 16 20 26 30

20 21 23 25 28 30

19 28 36 46 59 67

18 26 33 40 51 58

0 0 0 0 0 0

17 17 20 24 28 35

27 27 28 28 30 33

10 10 10 10 10 10

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 5 5 5 5 5 5

Fayette County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

10 15 20 24 31 36

52 69 94 120 154 180

31 40 50 60 74 83

64 86 114 141 184 197

1 2 2 3 4 5

7 10 13 16 21 25

5 7 8 10 11 13

0 0 0 0 0 0

33 40 47 52 61 67

8 11 13 15 20 23

19 21 22 24 27 28

19 28 36 46 59 67

14 20 25 27 33 37

0 0 0 0 0 0

23 29 33 36 41 47

24 30 38 43 51 63

15 15 15 15 15 15

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 1 1 1 1 1 1

Floyd County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

34 47 60 71 88 98

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

4 7 7 9 12 14

0 0 0 0 0 0

38 44 51 57 65 70

8 10 12 15 20 23

27 31 36 40 47 51

19 28 36 46 59 67

14 19 25 29 37 41

0 0 0 0 0 0

9 12 14 17 22 24

26 26 29 33 39 49

15 15 15 15 15 15

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Fountain County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

17 23 31 38 48 54

52 69 94 120 154 180

36 50 65 78 96 107

64 86 114 141 184 197

2 3 4 5 6 7

7 10 13 16 21 25

5 7 8 11 14 16

0 0 0 0 0 0

43 50 57 64 73 79

8 11 14 17 22 26

22 25 28 31 35 38

19 28 36 46 59 67

15 22 28 33 42 48

0 0 0 0 0 0

15 16 21 25 32 40

40 40 40 40 40 40

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 1 1 1 1 1 1

Franklin County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

37 51 65 78 96 107

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

4 7 7 9 12 14

0 0 0 0 0 0

35 42 49 55 63 69

8 10 12 15 20 23

15 17 19 21 23 25

19 28 36 46 59 67

14 20 25 30 37 42

0 0 0 0 0 0

10 11 14 17 22 28

20 21 23 24 26 30

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Fulton County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

19 27 36 44 55 62

52 69 94 120 154 180

29 40 52 62 77 86

64 86 114 141 184 197

3 4 5 7 9 10

7 10 13 16 21 25

4 6 7 9 11 13

0 0 0 0 0 0

31 37 43 48 55 60

7 9 11 13 18 21

24 28 32 35 41 45

19 28 36 46 59 67

12 18 23 27 34 38

0 0 0 0 0 0

17 19 22 26 32 38

32 35 40 43 47 56

6 6 6 6 6 6

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Gibson County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

60 79 108 138 177 206

45 63 81 97 120 134

73 98 131 162 211 226

3 5 6 8 10 12

7 10 13 16 21 25

5 8 9 12 15 17

0 0 0 0 0 0

28 35 42 48 59 65

8 11 15 18 25 28

27 31 36 40 47 51

19 28 36 46 59 67

17 24 31 37 46 52

0 0 0 0 0 0

15 15 16 18 20 23

19 20 24 27 31 39

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 5 5 5 5 5 5

Grant County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

15 21 29 35 45 50

52 69 94 120 154 180

34 47 60 71 88 98

64 86 114 141 184 197

2 3 3 4 6 6

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

38 45 52 58 67 73

8 11 13 15 21 24

19 22 24 26 30 32

19 28 36 46 59 67

14 20 27 31 39 44

0 0 0 0 0 0

17 18 21 25 32 39

27 27 27 28 38 56

16 16 16 16 16 16

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 5 5 5 5 5 5

Greene County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

24 33 43 53 68 76

56 73 100 128 164 191

37 50 62 73 90 100

68 91 121 150 195 209

3 4 5 7 9 10

7 10 13 16 21 25

5 8 8 10 13 15

0 0 0 0 0 0

31 39 47 54 63 70

9 12 15 17 22 25

23 27 31 34 40 44

19 28 36 46 59 67

16 22 27 32 38 42

0 0 0 0 0 0

17 20 23 26 30 36

24 24 25 26 29 34

14 14 14 14 14 14

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 4 4 4 4 4 4

Hamilton County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

38 53 67 80 98 110

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

5 8 9 11 14 16

0 0 0 0 0 0

40 47 54 61 71 78

8 12 15 17 23 26

27 31 36 40 47 51

19 28 36 46 59 67

16 22 29 34 41 46

0 0 0 0 0 0

17 22 24 26 30 35

20 21 24 24 26 31

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 2 2 2 2 2 2

Hancock County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

19 27 36 44 56 63

52 69 94 120 154 180

31 40 50 60 74 83

64 86 114 141 184 197

2 3 5 6 7 9

7 10 13 16 21 25

5 7 8 10 11 13

0 0 0 0 0 0

33 40 47 52 61 67

8 11 13 15 20 23

21 24 27 30 35 38

19 28 36 46 59 67

14 20 25 27 33 37

0 0 0 0 0 0

28 34 40 45 53 64

21 22 27 31 36 45

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Harrison County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

36 50 63 75 93 103

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

37 44 51 58 67 73

8 11 14 16 22 25

27 31 36 40 47 51

19 28 36 46 59 67

16 21 27 32 39 44

0 0 0 0 0 0

10 15 19 22 28 34

23 23 25 26 28 32

10 10 10 10 10 10

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 4 4 4 4 4 4

Hendricks County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

48 67 86 102 127 141

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

6 9 10 13 17 20

0 0 0 0 0 0

45 54 63 71 82 90

10 14 17 21 28 32

27 31 36 40 47 51

19 28 36 46 59 67

19 27 35 42 53 60

0 0 0 0 0 0

16 19 22 26 31 36

26 28 32 33 36 43

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Henry County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

27 36 45 52 65 72

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

4 5 6 7 9 10

0 0 0 0 0 0

25 32 39 43 49 53

7 9 9 11 15 17

15 17 19 21 23 25

19 28 36 46 59 67

10 15 19 22 26 28

0 0 0 0 0 0

25 28 34 40 48 59

31 35 42 46 53 65

7 7 7 7 7 7

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 3 3 3 3 3 3

Howard County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

60 79 108 138 177 206

37 51 65 76 91 101

73 98 131 162 211 226

3 5 6 8 10 12

7 10 13 16 21 25

5 7 8 10 12 14

0 0 0 0 0 0

32 39 47 53 61 67

8 11 13 15 20 23

27 31 36 40 47 51

19 28 36 46 59 67

15 20 26 30 38 42

0 0 0 0 0 0

16 27 34 39 46 56

24 34 43 50 60 75

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Huntington County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

23 32 43 53 67 75

52 69 94 120 154 180

35 49 63 75 93 103

64 86 114 141 184 197

3 4 5 6 8 10

7 10 13 16 21 25

5 7 8 10 13 16

0 0 0 0 0 0

35 43 50 56 66 72

8 11 14 16 22 25

23 27 30 34 39 43

19 28 36 46 59 67

15 22 28 33 41 46

0 0 0 0 0 0

19 24 31 38 48 60

25 31 36 40 46 56

8 8 8 8 8 8

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Jackson County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

18 25 33 41 51 58

60 79 108 138 177 206

63 90 117 142 175 195

73 98 131 162 211 226

2 3 4 5 6 7

7 10 13 16 21 25

7 11 13 16 21 24

0 0 0 0 0 0

45 54 64 73 88 97

11 16 21 25 35 40

13 16 19 21 25 28

19 28 36 46 59 67

24 34 44 52 66 76

0 0 0 0 0 0

20 22 29 35 45 57

30 33 39 41 46 55

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 5 5 5 5 5 5

Jasper County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

22 30 40 49 63 71

60 79 108 138 177 206

48 68 89 106 130 144

73 98 131 162 211 226

2 3 5 6 7 9

7 10 13 16 21 25

5 9 10 12 16 18

0 0 0 0 0 0

37 45 53 61 72 80

9 13 17 20 27 30

23 26 30 33 37 41

19 28 36 46 59 67

19 26 33 39 50 58

0 0 0 0 0 0

10 11 14 18 23 29

32 35 40 42 46 54

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Jay County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

27 37 49 60 76 86

52 69 94 120 154 180

35 49 63 75 93 103

64 86 114 141 184 197

3 5 6 8 10 12

7 10 13 16 21 25

5 7 8 10 13 16

0 0 0 0 0 0

35 43 50 56 66 72

8 11 14 16 22 25

27 31 36 40 47 51

19 28 36 46 59 67

15 22 28 33 41 46

0 0 0 0 0 0

9 11 13 16 21 26

20 20 23 28 32 39

11 11 11 11 11 11

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Jefferson County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

20 28 38 47 58 65

52 69 94 120 154 180

35 49 63 75 93 103

64 86 114 141 184 197

2 3 4 5 7 8

7 10 13 16 21 25

5 7 8 10 13 16

0 0 0 0 0 0

35 43 50 56 66 72

8 11 14 16 22 25

19 22 25 27 32 35

19 28 36 46 59 67

15 22 28 33 41 46

0 0 0 0 0 0

15 16 20 25 32 41

29 29 29 29 35 44

5 5 5 5 5 5

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 4 4 4 4 4 4

Jennings County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

35 48 61 73 90 100

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

35 42 49 55 65 71

8 11 14 16 21 24

27 31 36 40 47 51

19 28 36 46 59 67

15 21 26 31 38 42

0 0 0 0 0 0

23 30 35 40 47 56

27 28 33 34 38 46

13 13 13 13 13 13

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 6 6 6 6 6 6

Johnson County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

18 25 34 41 53 59

52 69 94 120 154 180

27 38 48 57 71 79

64 86 114 141 184 197

3 4 6 7 9 11

7 10 13 16 21 25

4 6 6 8 10 12

0 0 0 0 0 0

34 40 46 51 58 63

7 9 11 13 17 20

27 32 36 40 46 50

19 28 36 46 59 67

12 17 22 25 31 35

0 0 0 0 0 0

15 18 22 25 30 36

26 32 39 43 49 60

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 3 3 3 3 3 3

Knox County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

37 52 66 79 98 109

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

4 7 8 10 12 14

0 0 0 0 0 0

32 36 42 48 57 62

7 11 13 15 20 23

15 17 19 21 23 25

19 28 36 46 59 67

14 20 26 30 38 43

0 0 0 0 0 0

20 26 30 33 38 45

30 30 30 30 30 32

5 5 5 5 5 5

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 3 3 3 3 3 3

Kosciusko County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

36 52 68 82 101 112

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

4 7 7 9 12 14

0 0 0 0 0 0

35 40 46 51 59 65

6 9 12 15 20 23

15 17 19 21 23 25

19 28 36 46 59 67

14 19 25 30 38 44

0 0 0 0 0 0

12 15 18 20 23 28

15 18 22 25 30 36

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 8 8 8 8 8 8

LaGrange County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

47 67 88 106 131 146

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

5 9 10 12 16 18

0 0 0 0 0 0

32 39 46 54 64 71

8 12 16 19 26 30

15 17 19 21 23 25

19 28 36 46 59 67

18 25 33 39 50 57

0 0 0 0 0 0

17 21 24 27 33 39

17 19 22 24 27 33

14 14 14 14 14 14

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 7 7 7 7 7 7

Lake County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

47 66 87 105 129 144

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

5 8 9 12 16 18

0 0 0 0 0 0

36 43 50 57 68 75

8 12 16 19 26 29

15 17 19 21 23 25

19 28 36 46 59 67

17 24 31 37 48 55

0 0 0 0 0 0

14 16 19 22 26 32

29 29 29 31 36 44

11 11 11 11 11 11

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

LaPorte County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

27 37 49 60 76 86

52 69 94 120 154 180

35 49 63 75 93 103

64 86 114 141 184 197

3 5 6 8 10 12

7 10 13 16 21 25

5 7 8 10 13 16

0 0 0 0 0 0

35 43 50 56 66 72

8 11 14 16 22 25

27 31 36 40 47 51

19 28 36 46 59 67

15 22 28 33 41 46

0 0 0 0 0 0

15 22 27 31 38 46

18 19 23 26 31 38

9 9 9 9 9 9

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Lawrence County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

37 51 65 75 91 100

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

26 33 40 47 56 62

8 11 14 17 22 25

27 31 36 40 47 51

19 28 36 46 59 67

15 22 27 32 40 45

0 0 0 0 0 0

14 15 16 21 25 30

29 30 34 36 39 46

9 9 9 9 9 9

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Madison County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

25 34 45 55 70 79

56 73 100 128 164 191

49 66 82 97 120 134

68 91 121 150 195 209

3 4 6 7 9 11

7 10 13 16 21 25

6 11 11 13 17 20

0 0 0 0 0 0

37 46 55 64 78 86

10 15 20 23 29 33

24 28 32 36 42 46

19 28 36 46 59 67

22 29 36 42 51 57

0 0 0 0 0 0

14 19 23 26 31 38

30 30 30 30 31 39

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 9 9 9 9 9 9

Marion County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

52 71 91 108 134 149

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

5 9 10 13 17 20

0 0 0 0 0 0

34 42 50 58 70 78

9 13 17 21 28 33

15 17 19 21 23 25

19 28 36 46 59 67

19 28 36 42 52 58

0 0 0 0 0 0

11 12 14 17 22 27

19 22 25 26 30 35

16 16 16 16 16 16

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 2 2 2 2 2 2

Marshall County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

23 32 43 53 67 75

52 69 94 120 154 180

33 46 59 71 87 98

64 86 114 141 184 197

3 4 5 6 8 10

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

40 47 54 60 68 74

8 11 13 15 21 24

23 27 30 34 39 43

19 28 36 46 59 67

14 20 26 31 39 44

0 0 0 0 0 0

16 19 24 30 39 49

29 33 38 40 45 53

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Martin County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

30 41 55 67 86 97

52 69 94 120 154 180

48 66 82 95 115 128

64 86 114 141 184 197

2 3 4 6 7 8

7 10 13 16 21 25

6 9 10 12 16 19

0 0 0 0 0 0

39 47 56 64 75 82

10 13 16 20 27 31

21 24 27 30 35 38

19 28 36 46 59 67

18 26 33 40 48 53

0 0 0 0 0 0

21 21 23 26 31 37

18 18 27 32 39 50

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 4 4 4 4 4 4

Miami County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

27 37 49 60 76 86

52 69 94 120 154 180

36 51 66 79 98 109

64 86 114 141 184 197

3 5 6 8 10 12

7 10 13 16 21 25

5 8 8 11 14 16

0 0 0 0 0 0

46 53 61 67 77 83

8 11 14 17 23 26

27 31 36 40 47 51

19 28 36 46 59 67

16 22 29 34 43 49

0 0 0 0 0 0

13 16 18 21 25 31

22 26 31 33 38 46

4 4 4 4 4 4

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 3 3 3 3 3 3

Monroe County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

34 47 60 71 88 98

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

4 7 7 9 12 14

0 0 0 0 0 0

38 44 51 57 65 70

8 10 12 15 20 23

27 31 36 40 47 51

19 28 36 46 59 67

17 24 31 37 48 55

0 0 0 0 0 0

22 28 32 35 40 47

13 17 21 24 28 34

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Montgomery County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

40 54 69 82 102 113

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

5 8 9 11 14 16

0 0 0 0 0 0

42 49 57 64 74 81

9 12 15 18 24 27

27 31 36 40 47 51

19 28 36 46 59 67

17 23 29 35 43 48

0 0 0 0 0 0

19 23 26 30 35 42

32 33 36 38 44 53

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 5 5 5 5 5 5

Morgan County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

47 67 87 105 130 145

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

5 8 10 12 16 18

0 0 0 0 0 0

35 42 50 57 67 75

8 12 16 19 26 30

15 17 19 21 23 25

19 28 36 46 59 67

18 25 32 38 49 56

0 0 0 0 0 0

12 18 24 30 37 47

19 20 23 23 25 29

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Newton County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

46 66 86 104 128 143

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

5 8 9 12 15 18

0 0 0 0 0 0

36 43 50 57 68 75

8 12 16 19 25 29

15 17 19 21 23 25

19 28 36 46 59 67

17 25 32 38 49 56

0 0 0 0 0 0

16 20 24 29 36 44

26 27 30 31 39 50

14 14 14 14 14 14

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Noble County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

24 32 43 52 65 72

52 69 94 120 154 180

43 62 81 97 120 134

64 86 114 141 184 197

3 4 6 7 8 10

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

36 43 50 55 63 69

8 10 12 15 20 23

25 29 33 37 43 46

19 28 36 46 59 67

14 19 25 29 37 41

0 0 0 0 0 0

14 18 21 23 26 31

39 39 40 40 40 45

10 10 10 10 10 10

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Ohio County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

23 31 41 50 64 72

52 69 94 120 154 180

33 47 60 71 88 98

64 86 114 141 184 197

3 4 5 6 8 10

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

35 42 49 55 64 70

8 11 13 15 21 24

23 27 30 34 39 43

19 28 36 46 59 67

14 20 26 31 39 44

0 0 0 0 0 0

25 27 29 35 44 55

23 25 30 34 39 48

10 10 10 10 10 10

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Orange County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

25 35 47 58 72 81

56 73 100 128 164 191

36 49 63 76 94 104

68 91 121 150 195 209

3 4 5 7 9 10

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

38 45 52 58 67 73

8 11 13 15 21 24

24 28 32 36 41 45

19 28 36 46 59 67

14 20 27 31 39 44

0 0 0 0 0 0

17 20 23 27 33 41

28 33 40 43 50 61

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Owen County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

32 45 57 69 85 94

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

4 6 7 9 12 13

0 0 0 0 0 0

37 43 50 55 63 69

7 10 12 14 19 22

27 31 36 40 47 51

19 28 36 46 59 67

13 19 24 28 35 40

0 0 0 0 0 0

16 17 22 25 31 37

22 26 30 32 35 42

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 6 6 6 6 6 6

Parke County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

10 15 20 24 31 36

52 69 94 120 154 180

31 44 58 70 86 96

64 86 114 141 184 197

1 2 3 3 4 5

7 10 13 16 21 25

4 6 7 9 12 14

0 0 0 0 0 0

25 31 36 41 50 55

6 9 12 14 19 22

20 21 23 25 28 30

19 28 36 46 59 67

13 19 25 29 37 43

0 0 0 0 0 0

21 29 34 41 51 63

38 38 38 38 44 56

11 11 11 11 11 11

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 2 2 2 2 2 2

Perry County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

19 26 34 42 54 61

52 69 94 120 154 180

29 40 52 62 77 86

64 86 114 141 184 197

2 3 5 6 7 9

7 10 13 16 21 25

4 6 6 8 11 12

0 0 0 0 0 0

31 31 37 42 50 54

7 9 11 13 17 20

23 26 30 33 37 41

19 28 36 46 59 67

12 17 22 26 32 36

0 0 0 0 0 0

21 24 31 38 48 58

34 36 41 42 46 54

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Pike County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

44 63 82 99 123 137

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

5 8 9 11 15 17

0 0 0 0 0 0

39 46 52 59 69 76

8 11 15 18 24 28

15 17 19 21 23 25

19 28 36 46 59 67

17 24 31 36 47 53

0 0 0 0 0 0

19 26 30 33 38 42

32 32 37 38 42 50

16 16 16 16 16 16

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 10 10 10 10 10 10

Porter County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

18 25 34 41 53 59

52 69 94 120 154 180

28 39 49 59 72 81

64 86 114 141 184 197

3 4 6 7 9 11

7 10 13 16 21 25

4 6 6 8 11 12

0 0 0 0 0 0

25 31 37 42 50 54

7 9 11 13 17 20

27 32 36 40 46 50

19 28 36 46 59 67

12 17 22 26 32 36

0 0 0 0 0 0

19 20 26 33 43 55

25 25 29 35 44 56

10 10 10 10 10 10

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Posey County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

47 67 87 105 130 145

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

5 8 10 12 16 18

0 0 0 0 0 0

41 48 55 62 73 80

8 12 16 19 26 30

15 17 19 21 23 25

19 28 36 46 59 67

18 25 32 39 49 57

0 0 0 0 0 0

28 29 34 42 52 65

41 41 41 41 41 46

13 13 13 13 13 13

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Pulaski County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

36 50 63 75 93 103

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

37 44 51 58 67 73

8 11 14 16 22 25

27 31 36 40 47 51

19 28 36 46 59 67

16 21 27 32 39 44

0 0 0 0 0 0

16 19 25 30 37 45

51 51 53 53 55 64

10 10 10 10 10 10

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Putnam County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

20 28 37 45 58 65

56 73 100 128 164 191

39 55 71 85 105 117

68 91 121 150 195 209

2 3 5 6 7 9

7 10 13 16 21 25

5 8 9 11 14 16

0 0 0 0 0 0

36 43 50 57 66 73

8 11 14 17 23 27

23 26 30 33 37 41

19 28 36 46 59 67

16 23 29 35 44 50

0 0 0 0 0 0

17 21 25 27 32 38

32 32 32 32 32 35

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Randolph County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

13 19 25 31 40 46

52 69 94 120 154 180

43 62 81 97 120 134

64 86 114 141 184 197

2 3 3 4 5 6

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

36 43 50 55 63 69

8 10 12 15 20 23

18 21 23 25 29 31

19 28 36 46 59 67

14 19 25 29 37 41

0 0 0 0 0 0

16 17 21 27 34 43

25 25 28 34 42 53

10 10 10 10 10 10

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 4 4 4 4 4 4

Ripley County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

23 32 43 52 66 74

56 73 100 128 164 191

35 48 61 73 91 101

68 91 121 150 195 209

3 4 5 7 8 10

7 10 13 16 21 25

5 7 8 10 12 14

0 0 0 0 0 0

39 46 53 59 67 73

8 11 13 15 20 23

22 26 30 33 39 42

19 28 36 46 59 67

14 20 26 30 38 43

0 0 0 0 0 0

25 30 38 46 57 71

38 38 38 38 40 47

9 9 9 9 9 9

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Rush County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

47 67 87 105 130 145

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

5 9 10 12 16 18

0 0 0 0 0 0

29 36 43 51 62 69

8 12 16 19 26 30

15 17 19 21 23 25

19 28 36 46 59 67

18 25 32 38 49 57

0 0 0 0 0 0

13 15 17 19 22 26

50 50 50 50 50 52

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

St. Joseph County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

20 28 38 47 58 65

52 69 94 120 154 180

35 49 63 75 93 103

64 86 114 141 184 197

2 3 4 5 7 8

7 10 13 16 21 25

5 7 8 10 13 16

0 0 0 0 0 0

35 43 50 56 66 72

8 11 14 16 22 25

19 22 25 27 32 35

19 28 36 46 59 67

15 22 28 33 41 46

0 0 0 0 0 0

17 25 30 36 43 53

30 38 46 51 60 74

10 10 10 10 10 10

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Scott County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

23 32 43 52 66 74

56 73 100 128 164 191

35 48 61 73 91 101

68 91 121 150 195 209

3 4 5 7 8 10

7 10 13 16 21 25

5 7 8 10 12 14

0 0 0 0 0 0

39 46 53 59 67 73

8 11 13 15 20 23

22 26 30 33 39 42

19 28 36 46 59 67

14 20 26 30 38 43

0 0 0 0 0 0

22 28 32 35 40 47

21 21 24 24 26 30

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 6 6 6 6 6 6

Shelby County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

16 23 30 38 47 53

52 69 94 120 154 180

34 49 64 77 96 106

64 86 114 141 184 197

2 3 4 6 7 8

7 10 13 16 21 25

4 7 8 11 14 16

0 0 0 0 0 0

36 43 50 55 63 69

8 10 12 15 20 23

23 26 29 32 37 40

19 28 36 46 59 67

14 19 25 29 37 41

0 0 0 0 0 0

22 29 34 38 45 54

29 30 37 43 51 63

15 15 15 15 15 15

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Spencer County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

44 63 82 99 123 137

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

5 8 9 11 15 17

0 0 0 0 0 0

39 46 52 59 69 76

8 11 15 18 24 28

15 17 19 21 23 25

19 28 36 46 59 67

17 24 31 36 47 53

0 0 0 0 0 0

19 20 20 23 28 35

34 34 34 34 35 44

11 11 11 11 11 11

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Starke County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

44 61 78 94 116 130

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

4 8 9 11 15 17

0 0 0 0 0 0

34 41 47 54 64 71

8 11 15 18 24 27

15 17 19 21 23 25

19 28 36 46 59 67

16 23 30 36 45 51

0 0 0 0 0 0

15 23 30 36 39 45

22 22 26 31 39 50

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 2 2 2 2 2 2

Steuben County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

10 15 20 24 31 36

52 69 94 120 154 180

27 38 48 57 71 79

64 86 114 141 184 197

1 2 3 3 4 5

7 10 13 16 21 25

4 6 6 8 10 12

0 0 0 0 0 0

34 40 46 51 58 63

7 9 11 13 17 20

20 21 23 25 28 30

19 28 36 46 59 67

12 17 22 25 31 35

0 0 0 0 0 0

20 25 28 30 33 38

19 25 31 35 41 50

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Sullivan County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

16 23 31 38 48 54

52 69 94 120 154 180

43 62 81 97 120 134

64 86 114 141 184 197

12 19 25 31 41 47

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

36 43 50 55 63 69

8 10 12 15 20 23

57 74 92 109 135 153

19 28 36 46 59 67

14 19 25 29 37 41

0 0 0 0 0 0

21 24 30 34 41 49

16 16 21 24 30 38

13 13 13 13 13 13

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 1 1 1 1 1 1

Switzerland County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

60 79 108 138 177 206

34 47 60 71 88 98

73 98 131 162 211 226

3 5 6 8 10 12

7 10 13 16 21 25

4 7 7 9 12 14

0 0 0 0 0 0

38 44 51 57 65 70

8 10 12 15 20 23

27 31 36 40 47 51

19 28 36 46 59 67

14 19 25 29 37 41

0 0 0 0 0 0

13 19 22 25 29 35

20 21 24 28 33 41

13 13 13 13 13 13

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 8 8 8 8 8 8

Multi FamilyTippecanoe County

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

20 27 36 44 57 64

56 73 100 128 164 191

25 34 41 48 60 67

68 91 121 150 195 209

2 3 4 6 7 8

7 10 13 16 21 25

4 5 6 7 9 10

0 0 0 0 0 0

25 32 39 43 49 53

7 9 9 11 15 17

21 24 27 30 35 38

19 28 36 46 59 67

10 15 19 22 26 28

0 0 0 0 0 0

20 21 24 27 33 39

41 41 42 42 42 47

13 13 13 13 13 13

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Tipton County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

56 73 100 128 164 191

35 49 62 74 92 103

68 91 121 150 195 209

1 2 3 3 4 5

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

38 45 52 58 67 73

8 11 13 15 21 24

20 21 23 25 28 30

19 28 36 46 59 67

14 20 26 31 38 43

0 0 0 0 0 0

10 13 17 19 23 27

54 54 55 62 73 90

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Union County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

18 25 34 41 53 59

52 69 94 120 154 180

32 45 59 72 89 99

64 86 114 141 184 197

3 4 6 7 9 11

7 10 13 16 21 25

4 7 7 9 12 14

0 0 0 0 0 0

25 31 36 42 50 56

6 9 12 15 20 23

27 32 36 40 46 50

19 28 36 46 59 67

14 20 25 30 38 44

0 0 0 0 0 0

13 19 23 27 32 39

21 30 37 42 50 63

11 11 11 11 11 11

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Vanderburgh County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

25 34 41 48 60 67

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

4 5 6 7 9 10

0 0 0 0 0 0

25 32 39 43 49 53

7 9 9 11 15 17

27 31 36 40 47 51

19 28 36 46 59 67

10 15 19 22 26 28

0 0 0 0 0 0

20 21 22 22 23 25

37 37 43 47 54 66

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Vermillion County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

25 34 41 48 60 67

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

4 5 6 7 9 10

0 0 0 0 0 0

25 32 39 43 49 53

7 9 9 11 15 17

27 31 36 40 47 51

19 28 36 46 59 67

10 15 19 22 26 28

0 0 0 0 0 0

17 21 24 26 29 34

28 28 35 42 53 68

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Vigo County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

21 29 39 48 61 69

60 79 108 138 177 206

37 51 65 76 91 101

73 98 131 162 211 226

2 3 4 6 7 8

7 10 13 16 21 25

5 7 8 10 12 14

0 0 0 0 0 0

32 39 47 53 61 67

8 11 13 15 20 23

21 24 27 30 35 38

19 28 36 46 59 67

15 20 26 30 38 42

0 0 0 0 0 0

13 14 16 18 21 25

24 24 24 28 34 43

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 4 4 4 4 4 4

Wabash County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

28 38 51 62 79 89

56 73 100 128 164 191

52 73 94 112 139 155

68 91 121 150 195 209

3 5 6 8 10 12

7 10 13 16 21 25

6 10 11 14 19 22

0 0 0 0 0 0

45 55 65 73 86 95

11 15 19 23 31 35

27 31 36 40 47 51

19 28 36 46 59 67

21 30 39 46 57 65

0 0 0 0 0 0

9 15 19 23 39 45

20 24 28 30 34 42

0 0 0 0 0 0

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Warren County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

20 28 38 47 59 66

52 69 94 120 154 180

31 43 56 67 82 92

64 86 114 141 184 197

3 4 5 6 8 10

7 10 13 16 21 25

4 7 7 9 12 14

0 0 0 0 0 0

32 39 45 51 59 65

7 10 12 15 20 23

25 28 31 35 40 44

19 28 36 46 59 67

14 19 25 30 37 42

0 0 0 0 0 0

18 21 25 28 33 39

34 34 35 41 50 63

10 10 10 10 10 10

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 8 8 8 8 8 8

Warrick County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

20 28 38 47 58 65

52 69 94 120 154 180

35 49 63 75 93 103

64 86 114 141 184 197

2 3 4 5 7 8

7 10 13 16 21 25

5 7 8 10 13 16

0 0 0 0 0 0

35 43 50 56 66 72

8 11 14 16 22 25

19 22 25 27 32 35

19 28 36 46 59 67

15 22 28 33 41 46

0 0 0 0 0 0

19 21 25 31 39 49

19 20 26 29 35 44

7 7 7 7 7 7

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Washington County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

20 28 37 45 58 65

56 73 100 128 164 191

35 49 62 74 92 103

68 91 121 150 195 209

2 3 5 6 7 9

7 10 13 16 21 25

5 7 8 10 13 15

0 0 0 0 0 0

38 45 52 58 67 73

8 11 13 15 21 24

23 26 30 33 37 41

19 28 36 46 59 67

14 20 26 31 38 43

0 0 0 0 0 0

16 18 21 24 29 36

38 38 39 39 39 43

12 12 12 12 12 12

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 0 0 0 0 0 0

Wayne County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

21 29 39 48 61 69

60 79 108 138 177 206

49 70 90 107 130 144

73 98 131 162 211 226

2 3 4 6 7 8

7 10 13 16 21 25

5 9 10 13 16 19

0 0 0 0 0 0

35 42 50 58 70 77

9 13 17 20 27 31

21 24 27 30 35 38

19 28 36 46 59 67

19 27 34 40 52 59

0 0 0 0 0 0

13 17 21 26 34 42

24 24 27 32 40 50

15 15 15 15 15 15

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 8 8 8 8 8 8

Wells County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

21 29 39 48 61 69

60 79 108 138 177 206

47 67 87 105 130 145

73 98 131 162 211 226

2 3 4 6 7 8

7 10 13 16 21 25

5 8 10 12 16 18

0 0 0 0 0 0

41 48 55 62 73 80

8 12 16 19 26 30

21 24 27 30 35 38

19 28 36 46 59 67

18 25 32 39 49 57

0 0 0 0 0 0

23 27 30 33 38 46

30 36 42 46 52 63

8 8 8 8 8 8

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 2 2 2 2 2 2

White County Multi Family

Allowances for Tenant-Furnished Utilities and Other Services See Public Reporting Statement and Instructions on back

U.S. Department of Housing OMB Approval No. 2577-0169

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

Actual Family Allowances To be used by the family to compute allowance. Utility or Service per month cost

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number of Bedrooms Other

Total $

form HUD-52667 (04/15)

Previous editions are obsolete Page 1 of 1

ref. Handbook 7420.8

12/26/2019

12 17 23 28 37 41

60 79 108 138 177 206

44 62 81 97 120 134

73 98 131 162 211 226

1 2 3 3 4 5

7 10 13 16 21 25

5 8 9 11 14 17

0 0 0 0 0 0

34 41 48 55 66 73

8 12 16 18 24 27

15 17 19 21 23 25

19 28 36 46 59 67

17 24 30 36 46 52

0 0 0 0 0 0

21 23 26 30 37 45

41 44 50 56 64 78

9 9 9 9 9 9

7 7 7 7 7 7

6 6 6 6 6 6

Stormwater 9 9 9 9 9 9

Whitley County Multi Family