allowances for tenant - furnished utilities and ...uhi +dqgerrn 12/26/2019 12 17 23 28 37 41 60 79...
TRANSCRIPT
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