Notices and Forms for Compliance with URA and Section 104(d)
The following list is not intended to be an all-inclusive list, nor does every form and notice apply to every activity; subrecipients should follow current HUD guidance and contact the Department with any questions or concerns prior to beginning any displacement activities (49 CFR 24.203 and 24 CFR 42.350).
TDHCA recommends that its subrecipients and contractors use the following forms, which will appear in the Department’s Relocation Handbook.
- Appendix 1: Relocation Time Line (PDF)
- Appendix 2: Relocation and Acquisition Disclosure (DOC)
- Appendix 3: General Information Notice (GIN) (DOC)
- Appendix 4: Total Relocation Budget Worksheet (XLS)
- Appendix 5: Move In Notice (DOC)
- Appendix 6: Relocation-Assistance-Budget-Calculator (XLS)
- Appendix 7: Notice of Non-displacement (DOC)
- Appendix 8: Notice of Eligibility for Relocation Assistance (DOC)
- Appendix 9: 90-Day Notice to Move (DOC)
- Appendix 10: Rent Roll with Relocation Benchmarks (XLS)
- Appendix 11: Decent, Safe, & Sanitary (DSS) Relocation Dwelling Certification (DOT)
- Appendix 17: Housing Quality Standards (HQS) Inspection Checklist for Housing Choice Voucher Program, form HUD-52580 (3/2001) ref Handbook 7420.8. Scroll to 52580 at bottom of list (HUD.GOV).
TDHCA staff adapted the above forms from HUD originals, described below.
HUD Handbook 1378 (portal.hud.gov) contains original instructions and templates.
General Information Notice (GIN): Informs affected persons of the project and that they may be displaced by the project. (49 CFR § 24.203 Relocation notices (a))
- GIN-Residential Tenant not Displaced (Appendix 2)
- GIN-Nonresidential Tenant not Displaced (Appendix 2A)
- GIN-Residential Tenant to be Displaced (Appendix 3)
- GIN-Nonresidential Tenant to be Displaced (Appendix 3A)
- GIN-Residential Tenant to be Displaced (104(d) included) (Appendix 3B)
Invitation to Participate: Request residents directly affected to discuss project plans. (Appendix 18)
Resident Survey: Request to determine replacement housing preference. (Appendix 18A)
Relocation Eligibility Notice: Informs persons that they will be displaced by the project and establishes their eligibility for relocation assistance and payments.
- Notice of Eligibility for Relocation Assistance-180-Day Homeowner (Involuntary Acquisition) (Appendix 5)
- Notice of Eligibility for URA Relocation Assistance-Residential Tenant (Appendix 6)
- Notice of Eligibility for URA Relocation Assistance-Nonresidential (Appendix 7)
90 Day Notice: Informs displaced persons of the earliest date by which they will be required to move. This notice may not be issued unless a comparable replacement dwelling is available and the displaced person is informed of its location and has sufficient time to lease or purchase the property. (49 CFR § 24.203 Relocation notices (c))
- General. No lawful occupant shall be required to move unless he or she has received at least 90 days advance written notice of the earliest date by which he or she may be required to move.
- Timing of notice. The displacing Agency may issue the notice 90 days or earlier before it expects the person to be displaced.
- Content of notice. The 90-day notice shall either state a specific date as the earliest date by which the occupant may be required to move, or state that the occupant will receive a further notice indicating, at least 30 days in advance, the specific date by which he or she must move. If the 90-day notice is issued before a comparable replacement dwelling is made available, the notice must state clearly that the occupant will not have to move earlier than 90 days after such a dwelling is made available. (See § 24.204(a).)
- Urgent need. In unusual circumstances, an occupant may be required to vacate the property on less than 90 days advance written notice if the displacing Agency determines that a 90-day notice is impracticable, such as when the person's continued occupancy of the property would constitute a substantial danger to health or safety. A copy of the Agency's determination shall be included in the applicable case file.
- Notice of Eligibility for Section 104(d) Relocation Assistance-Lower Income Residential Tenant * Housing Choice Voucher Assistance Available (Appendix 25)
- Notice of Eligibility for Section 104(d) Relocation Assistance-Lower Income Residential Tenant * Housing Choice Voucher Assistance NOT Available (Appendix 26)
Notice of intent to acquire establishes eligibility for relocation assistance.
- Notice to Owner - Involuntary Acquisition, Eminent Domain (Appendix 30)
- Voluntary Acquisition Informational Notice (Agency without Eminent Domain) (Appendix 31)
- Voluntary Acquisition Informational Notice (Agencies with Eminent Domain) (Appendix 32)
Non-displacement Notice to Residential Tenant for Rehabilitation (Appendix 4)
Move-In Notice to Prospective Tenant (moving into property proposed for acquisition) (Appendix 29)
- Site Occupant Record – Residential (eligibility interview) (Appendix 8)
- Site Occupant Record – Nonresidential (eligibility interview) (Appendix 9)
- Advisory Assistance and Other Contacts, Record of (facsimile) (Appendix 10)
HUD Forms: Data Collection, Expense Claim
- Data Collection Form 40061: Selection of Most Representative Comparable Replacement Dwelling for Purposes of Computing a Replacement Housing Payment (Appendix 12)
- Claim for Moving and Related Expenses – Residential, Form 40054 (Appendix 11)
- Claim for Replacement Housing Payment for 180-Day Homeowner-Occupant, Form 40057 (Appendix 13)
- Claim for Rental Assistance or Down-payment Assistance, Form 40058 (Appendix 14)
- Claim for Rental Assistance or Down-payment Assistance (English/Spanish), Form 40058-S (Appendix 14A)
- Claim for Temporary Relocation Expenses (Residential Moves), Form 40030 (Appendix 15)
- Claim for Actual Reasonable Moving and Related Expenses-Nonresidential, Form 40055 (Appendix 16)
- Claim for Fixed Payment in Lieu of Payment for Actual Moving and Related Expenses-Nonresidential, Form 40056 (Appendix 17)
- Claim for Rental or Purchase Assistance (Section 104[d]), Form 40072 (Appendix 27)
Guide for Preparing an Appraisal Scope of Work to meet requirements of 49 CFR Part 24 (Appendix 19)
Agreement for Appraisal Services (Acquisition) Suggests contract details. (Appendix 20)
Residential Relocation Management Report list of households and move status. (Appendix 21)
Nonresidential Relocation Management Report list describes households, payments. (Appendix 22)
General URA Acquisition Process Compares voluntary and involuntary. Refer to 49 CFR 24 Subpart B for detailed acquisition requirements. (Appendix 23)
Acquisition Checklist (Appendix 24)
URA Fixed Residential Moving Cost Schedule (49 CFR §24.302) background explanation. Current schedule by state -- http://www.fhwa.dot.gov/realestate/fixsch96.htm (Appendix 28)
Public Housing Demolition/Disposition, Residential Relocation Requirement Changes under Section 18 (of the United States Housing Act of 1937 as amended by QHWRA Quality Housing Work Responsibility Act of 1998 (P.L. 105-276)). Relocation Assistance for Displaced Public Housing Tenants: URA vs. Section 18. (Appendix 33)