allowances for tenant - furnished utilities and ... · allowances for tenant - furnished utilities...
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
24 33 42 51 65 74
69 97 124 152 193 221
53 74 94 114 144 164
77 108 139 170 217 248
3 4 5 6 8 9
8 12 15 18 23 27
7 9 12 14 17 20
0 0 0 0 0 0
37 45 53 61 72 80
11 15 20 24 29 32
21 24 27 30 35 38
22 31 40 48 61 70
21 27 34 42 53 61
0 0 0 0 0 0
26 26 31 40 52 65
18 32 40 50 63 77
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 Single 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 42 51 65 74
69 97 124 152 193 221
56 79 101 124 158 180
77 108 139 170 217 248
3 4 5 6 8 9
8 12 15 18 23 27
7 9 12 15 19 21
0 0 0 0 0 0
30 38 46 54 65 73
11 15 20 24 30 35
21 24 27 30 35 38
22 31 40 48 61 70
20 29 37 45 57 66
0 0 0 0 0 0
19 24 29 35 45 54
34 44 52 62 70 91
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 Single 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
31 42 53 64 81 92
60 84 108 133 169 193
35 48 61 74 94 107
68 95 122 149 189 216
4 6 8 9 12 13
8 12 15 18 23 27
6 7 9 10 13 15
0 0 0 0 0 0
39 46 53 59 67 73
9 12 14 17 22 25
27 31 36 40 47 51
22 31 40 48 61 70
15 21 27 32 40 45
0 0 0 0 0 0
20 21 26 33 42 51
14 21 25 30 37 45
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
56 78 100 122 155 177
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
7 9 12 15 19 21
0 0 0 0 0 0
40 49 57 65 77 85
12 16 20 24 30 35
15 17 19 21 23 25
22 31 40 48 61 70
20 29 37 45 57 64
0 0 0 0 0 0
20 23 30 39 50 59
29 39 46 54 65 77
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 Single 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
35 47 60 72 91 103
69 97 124 152 193 221
56 79 101 124 158 180
77 108 139 170 217 248
4 6 8 9 12 13
8 12 15 18 23 27
7 9 12 15 19 21
0 0 0 0 0 0
30 38 46 54 65 73
11 15 20 24 30 35
27 31 36 40 47 51
22 31 40 48 61 70
20 29 37 45 57 66
0 0 0 0 0 0
17 17 21 27 34 42
22 30 35 41 50 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
Blackford County Single 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
32 44 55 67 84 96
64 89 115 141 179 205
31 41 51 61 77 88
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
5 6 7 9 11 12
0 0 0 0 0 0
34 39 45 50 58 63
8 10 12 15 18 20
27 31 36 40 47 51
22 31 40 48 61 70
13 17 22 26 31 35
0 0 0 0 0 0
13 18 23 29 36 43
24 33 39 47 59 70
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 Single 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 36 44 55 63
60 84 108 133 169 193
36 50 62 76 96 110
68 95 122 149 189 216
3 4 5 6 7 8
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
44 51 58 64 72 78
10 13 15 18 22 26
19 22 25 27 32 34
22 31 40 48 61 70
15 21 27 33 41 46
0 0 0 0 0 0
34 42 52 66 86 106
38 51 59 70 84 99
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
41 55 70 85 108 123
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
4 4 6 7 9 10
0 0 0 0 0 0
38 45 51 57 66 71
9 12 14 17 22 25
15 17 19 21 23 25
22 31 40 48 61 70
15 21 27 32 40 45
0 0 0 0 0 0
16 23 29 36 46 56
18 27 32 39 49 59
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
76 104 126 148 184 210
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
9 13 16 20 25 29
0 0 0 0 0 0
52 63 74 84 100 111
15 21 26 32 41 47
15 17 19 21 23 25
22 31 40 48 61 70
28 39 50 61 75 81
0 0 0 0 0 0
16 20 24 30 39 48
25 32 36 41 49 56
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 Single 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 47 57 71 80
60 84 108 133 169 193
35 47 59 72 91 104
68 95 122 149 189 216
3 5 6 8 10 11
8 12 15 18 23 27
6 7 8 10 13 15
0 0 0 0 0 0
38 44 51 57 65 71
9 12 14 17 21 24
23 27 30 34 39 43
22 31 40 48 61 70
14 20 26 31 39 44
0 0 0 0 0 0
22 25 29 34 42 49
31 31 34 40 51 64
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
39 53 67 81 103 118
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
38 45 52 58 67 73
10 13 15 18 23 26
27 31 36 40 47 51
22 31 40 48 61 70
15 21 28 33 41 47
0 0 0 0 0 0
15 16 20 26 33 40
16 22 29 38 51 64
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 Single 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 31 39 48 60 68
64 89 115 141 179 205
38 51 65 78 100 114
72 100 129 158 201 230
3 4 5 6 8 9
8 12 15 18 23 27
6 7 9 11 13 15
0 0 0 0 0 0
38 45 51 57 66 71
9 12 14 17 22 25
21 24 27 30 35 38
22 31 40 48 61 70
15 21 27 32 40 45
0 0 0 0 0 0
13 15 18 24 31 39
26 37 46 57 72 87
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 Single 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 36 44 55 63
60 84 108 133 169 193
33 45 57 68 87 99
68 95 122 149 189 216
3 4 5 6 7 8
8 12 15 18 23 27
6 7 8 10 12 14
0 0 0 0 0 0
33 40 47 52 61 66
9 12 14 17 21 23
19 22 25 27 32 34
22 31 40 48 61 70
14 20 25 30 37 42
0 0 0 0 0 0
19 22 28 36 47 57
31 37 41 45 52 58
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 Single 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 39 47 59 66
60 84 108 133 169 193
36 50 63 76 97 111
68 95 122 149 189 216
3 5 6 7 9 10
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
40 47 54 60 68 74
10 13 15 18 23 26
23 27 30 34 39 42
22 31 40 48 61 70
15 21 27 33 41 46
0 0 0 0 0 0
28 28 29 35 46 57
29 38 44 53 67 80
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 Single 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
26 37 46 56 68 77
60 84 108 133 169 193
48 67 86 105 133 152
68 95 122 149 189 216
4 5 7 8 10 11
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
36 43 50 55 63 69
9 12 14 17 21 24
18 29 33 37 43 46
22 31 40 48 61 70
14 20 26 32 39 44
0 0 0 0 0 0
11 17 23 32 46 61
16 23 30 39 52 64
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 Single 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
31 42 53 64 81 92
60 84 108 133 169 193
35 48 61 73 93 107
68 95 122 149 189 216
4 6 8 9 12 13
8 12 15 18 23 27
6 7 9 10 13 15
0 0 0 0 0 0
40 47 54 59 68 73
9 12 14 17 22 25
27 31 36 40 47 51
22 31 40 48 61 70
15 21 26 32 40 45
0 0 0 0 0 0
22 23 29 37 47 57
29 39 44 52 63 73
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
44 62 80 98 124 142
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
5 7 9 11 15 17
0 0 0 0 0 0
45 52 58 64 73 79
9 12 15 19 24 27
15 17 19 21 23 25
22 31 40 48 61 70
16 23 29 35 45 52
0 0 0 0 0 0
22 23 26 31 39 46
33 41 49 61 78 96
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
52 73 94 115 146 167
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
7 9 12 15 19 21
0 0 0 0 0 0
30 38 46 54 65 73
11 15 20 24 30 35
27 31 36 40 47 51
22 31 40 48 61 70
20 29 37 45 57 66
0 0 0 0 0 0
22 26 30 36 44 50
18 26 32 41 54 66
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 Single 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 42 51 65 74
60 84 108 133 169 193
38 52 67 82 105 120
68 95 122 149 189 216
3 4 6 7 9 10
8 12 15 18 23 27
6 7 8 10 12 14
0 0 0 0 0 0
33 40 47 52 61 66
9 12 14 17 21 23
17 21 24 27 32 36
22 31 40 48 61 70
14 20 25 30 37 42
0 0 0 0 0 0
23 30 36 44 55 67
26 36 42 49 60 70
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
54 76 97 119 151 173
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 9 11 14 18 20
0 0 0 0 0 0
31 39 46 54 65 72
10 15 19 23 29 33
15 17 19 21 23 25
22 31 40 48 61 70
20 27 35 43 55 63
0 0 0 0 0 0
13 18 22 27 34 34
19 24 28 34 43 51
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 Single 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
14 19 25 30 39 44
64 89 115 141 179 205
49 69 88 108 137 157
72 100 129 158 201 230
2 3 3 4 5 6
8 12 15 18 23 27
6 9 11 14 17 20
0 0 0 0 0 0
52 59 66 74 85 92
10 14 18 22 29 33
20 21 23 25 28 30
22 31 40 48 61 70
19 27 35 42 54 62
0 0 0 0 0 0
20 20 23 28 35 41
27 30 32 35 39 43
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 Single 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 21 26 33 38
60 84 108 133 169 193
34 44 54 65 82 94
68 95 122 149 189 216
2 2 3 4 5 5
8 12 15 18 23 27
6 7 9 11 12 13
0 0 0 0 0 0
33 40 47 52 61 67
10 12 14 17 22 24
19 21 22 24 27 28
22 31 40 48 61 70
15 21 26 29 35 39
0 0 0 0 0 0
27 34 37 43 50 57
24 35 43 53 68 82
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
37 50 63 76 97 111
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
6 7 8 10 13 15
0 0 0 0 0 0
38 44 51 57 65 70
9 12 14 17 21 24
27 31 36 40 47 51
22 31 40 48 61 70
14 20 26 32 39 44
0 0 0 0 0 0
10 14 16 21 27 29
26 30 33 41 53 64
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 Single 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 34 41 51 57
60 84 108 133 169 193
39 54 69 83 106 121
68 95 122 149 189 216
3 4 5 6 7 8
8 12 15 18 23 27
6 7 10 12 15 17
0 0 0 0 0 0
43 50 57 64 73 79
10 13 16 19 24 28
22 25 28 31 35 38
22 31 40 48 61 70
16 23 29 36 45 51
0 0 0 0 0 0
18 18 23 30 39 47
40 40 42 43 45 47
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
40 55 69 84 106 122
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 7 9 10 13 15
0 0 0 0 0 0
35 42 49 55 63 69
9 12 14 17 22 25
15 17 19 21 23 25
22 31 40 48 61 70
15 20 26 32 39 44
0 0 0 0 0 0
12 12 16 21 27 33
20 24 27 30 35 39
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 Single 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 39 47 59 66
60 84 108 133 169 193
32 43 55 67 85 97
68 95 122 149 189 216
3 5 6 8 10 11
8 12 15 18 23 27
5 6 8 9 12 14
0 0 0 0 0 0
31 37 43 48 55 60
8 11 13 15 20 22
24 28 32 35 41 45
22 31 40 48 61 70
13 18 24 29 36 40
0 0 0 0 0 0
20 22 25 31 39 46
32 41 46 53 63 73
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 Single 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
32 44 55 67 84 96
69 97 124 152 193 221
49 68 86 104 133 151
77 108 139 170 217 248
4 6 8 9 12 13
8 12 15 18 23 27
6 8 10 13 16 18
0 0 0 0 0 0
28 35 42 48 59 65
9 13 17 21 26 30
27 31 36 40 47 51
22 31 40 48 61 70
18 25 32 39 49 55
0 0 0 0 0 0
18 18 18 21 25 28
19 23 27 34 42 50
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 Single 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 24 31 38 48 54
60 84 108 133 169 193
37 50 63 77 98 111
68 95 122 149 189 216
2 3 4 5 6 7
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
38 45 52 58 67 73
10 13 15 18 23 26
19 22 24 26 30 32
22 31 40 48 61 70
15 21 28 33 41 47
0 0 0 0 0 0
20 20 23 30 39 47
27 29 31 35 50 72
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 Single 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 47 57 72 81
64 89 115 141 179 205
40 53 66 78 100 114
72 100 129 158 201 230
4 5 6 8 10 11
8 12 15 18 23 27
6 8 10 11 14 16
0 0 0 0 0 0
31 39 47 54 63 70
11 14 16 20 24 27
23 27 31 34 40 44
22 31 40 48 61 70
17 23 28 34 41 45
0 0 0 0 0 0
20 23 26 31 37 43
24 26 29 33 38 44
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
42 57 71 86 109 124
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
6 8 10 12 15 17
0 0 0 0 0 0
40 47 54 61 71 78
10 14 17 20 25 28
27 31 36 40 47 51
22 31 40 48 61 70
17 23 30 36 44 49
0 0 0 0 0 0
20 25 28 31 36 42
20 25 27 30 35 40
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 Single 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 31 39 48 59 67
60 84 108 133 169 193
34 44 54 65 82 94
68 95 122 149 189 216
3 4 5 7 9 10
8 12 15 18 23 27
6 7 9 11 12 13
0 0 0 0 0 0
33 40 47 52 61 67
10 12 14 17 22 24
21 24 27 30 35 38
22 31 40 48 61 70
15 21 26 29 35 39
0 0 0 0 0 0
34 39 45 54 65 76
21 25 31 38 48 58
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
40 54 67 81 103 117
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
37 44 51 58 67 73
10 13 16 19 23 26
27 31 36 40 47 51
22 31 40 48 61 70
17 22 28 34 41 46
0 0 0 0 0 0
12 17 21 27 34 41
23 27 29 32 37 41
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
52 72 91 110 140 160
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
7 9 12 15 19 21
0 0 0 0 0 0
45 54 63 71 82 90
12 17 20 24 30 35
27 31 36 40 47 51
22 31 40 48 61 70
20 29 37 45 56 63
0 0 0 0 0 0
19 21 24 31 38 43
26 32 36 41 48 56
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
30 39 47 56 71 82
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
5 5 6 8 10 11
0 0 0 0 0 0
25 32 39 43 49 53
9 11 11 13 16 18
15 17 19 21 23 25
22 31 40 48 61 70
11 15 20 23 27 30
0 0 0 0 0 0
29 33 39 47 59 71
31 41 48 58 71 85
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 Single 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
32 44 55 67 84 96
69 97 124 152 193 221
41 55 69 81 101 114
77 108 139 170 217 248
4 6 8 9 12 13
8 12 15 18 23 27
6 7 9 11 13 15
0 0 0 0 0 0
32 39 47 53 61 67
10 13 15 18 22 25
27 31 36 40 47 51
22 31 40 48 61 70
15 21 27 32 40 45
0 0 0 0 0 0
19 32 38 46 57 67
24 40 50 62 80 98
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 Single 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 47 57 71 80
60 84 108 133 169 193
39 53 67 81 103 117
68 95 122 149 189 216
3 5 6 8 10 11
8 12 15 18 23 27
6 7 9 11 15 17
0 0 0 0 0 0
35 43 50 56 66 72
10 13 15 19 24 27
23 27 30 34 39 43
22 31 40 48 61 70
16 22 29 35 43 49
0 0 0 0 0 0
23 28 35 45 59 72
25 36 42 50 61 72
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 Single 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 36 44 54 62
69 97 124 152 193 221
69 97 125 152 194 221
77 108 139 170 217 248
3 4 5 6 7 8
8 12 15 18 23 27
8 11 15 18 23 26
0 0 0 0 0 0
45 54 64 73 88 97
13 19 24 29 37 43
13 16 19 21 25 28
22 31 40 48 61 70
25 35 45 55 70 81
0 0 0 0 0 0
23 26 33 42 55 69
30 39 44 51 61 71
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 Single 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 43 53 67 76
69 97 124 152 193 221
53 74 94 114 144 164
77 108 139 170 217 248
3 4 5 7 8 10
8 12 15 18 23 27
7 9 12 14 17 20
0 0 0 0 0 0
37 45 53 61 72 80
11 15 20 24 29 32
23 26 30 33 37 41
22 31 40 48 61 70
21 27 34 42 53 61
0 0 0 0 0 0
12 12 16 22 28 35
32 41 46 52 62 71
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 Single 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
31 42 53 64 81 92
60 84 108 133 169 193
39 53 67 81 103 117
68 95 122 149 189 216
4 6 8 9 12 13
8 12 15 18 23 27
6 7 9 11 15 17
0 0 0 0 0 0
35 43 50 56 66 72
10 13 15 19 24 27
27 31 36 40 47 51
22 31 40 48 61 70
16 22 29 35 43 49
0 0 0 0 0 0
11 13 15 20 25 31
20 23 27 34 43 50
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 Single 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 41 50 62 69
60 84 108 133 169 193
39 53 67 81 103 117
68 95 122 149 189 216
3 4 5 6 8 9
8 12 15 18 23 27
6 7 9 11 15 17
0 0 0 0 0 0
35 43 50 56 66 72
10 13 15 19 24 27
19 22 25 27 32 35
22 31 40 48 61 70
16 22 29 35 43 49
0 0 0 0 0 0
18 18 23 30 39 49
29 29 29 36 46 57
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
39 52 65 78 99 114
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
35 42 49 55 65 71
10 13 15 18 23 26
27 31 36 40 47 51
22 31 40 48 61 70
16 22 27 33 40 45
0 0 0 0 0 0
28 34 40 47 58 68
27 33 37 43 51 59
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 Single 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 36 44 56 64
60 84 108 133 169 193
30 41 51 62 78 90
68 95 122 149 189 216
4 5 7 8 11 12
8 12 15 18 23 27
5 6 7 9 11 13
0 0 0 0 0 0
34 40 46 51 58 63
8 11 12 15 18 21
27 32 36 40 46 50
22 31 40 48 61 70
12 17 22 27 33 37
0 0 0 0 0 0
18 21 25 30 36 43
26 37 44 53 66 78
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
41 56 70 85 108 123
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
5 7 9 11 13 15
0 0 0 0 0 0
32 36 42 48 57 62
9 12 14 17 22 25
15 17 19 21 23 25
22 31 40 48 61 70
15 21 27 32 40 45
0 0 0 0 0 0
24 29 34 39 47 54
30 33 34 36 39 42
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
40 56 72 88 112 127
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
5 7 8 10 13 15
0 0 0 0 0 0
35 40 46 51 59 65
8 11 14 17 21 25
15 17 19 21 23 25
22 31 40 48 61 70
14 20 26 32 41 46
0 0 0 0 0 0
15 18 20 23 28 34
15 21 25 31 40 47
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
52 72 93 114 145 165
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 9 11 13 17 19
0 0 0 0 0 0
32 39 46 54 64 71
10 14 18 22 28 32
15 17 19 21 23 25
22 31 40 48 61 70
19 26 34 41 53 60
0 0 0 0 0 0
20 24 28 32 40 47
17 22 25 30 36 43
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
51 72 92 112 143 164
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 8 11 13 17 19
0 0 0 0 0 0
36 43 50 57 68 75
10 14 18 22 28 31
15 17 19 21 23 25
22 31 40 48 61 70
18 25 33 40 51 58
0 0 0 0 0 0
17 18 21 26 32 38
29 29 32 39 48 58
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 Single 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
31 42 53 64 81 92
60 84 108 133 169 193
39 53 67 81 103 117
68 95 122 149 189 216
4 6 8 9 12 13
8 12 15 18 23 27
6 7 9 11 15 17
0 0 0 0 0 0
35 43 50 56 66 72
10 13 15 19 24 27
27 31 36 40 47 51
22 31 40 48 61 70
16 22 29 35 43 49
0 0 0 0 0 0
17 25 30 37 47 56
18 22 27 33 41 49
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
40 55 69 81 100 114
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
6 7 10 11 14 16
0 0 0 0 0 0
26 33 40 47 56 62
10 13 16 19 24 27
27 31 36 40 47 51
22 31 40 48 61 70
16 23 28 34 43 48
0 0 0 0 0 0
17 18 19 25 31 36
29 35 39 44 52 60
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 Single 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
29 39 49 59 74 84
64 89 115 141 179 205
53 71 87 104 133 152
72 100 129 158 201 230
4 5 7 8 11 12
8 12 15 18 23 27
8 11 13 15 19 22
0 0 0 0 0 0
37 46 55 64 78 86
12 17 22 26 32 35
24 28 32 36 42 46
22 31 40 48 61 70
23 30 37 45 54 60
0 0 0 0 0 0
17 22 26 30 38 46
30 30 30 32 41 50
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
57 77 96 117 148 169
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
7 9 12 15 19 21
0 0 0 0 0 0
34 42 50 58 70 78
11 15 20 24 30 35
15 17 19 21 23 25
22 31 40 48 61 70
21 29 37 45 55 62
0 0 0 0 0 0
13 14 16 20 26 32
19 25 29 33 39 46
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 Single 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 47 57 71 80
60 84 108 133 169 193
36 50 63 76 97 111
68 95 122 149 189 216
3 5 6 8 10 11
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
40 47 54 60 68 74
10 13 15 18 23 26
23 27 30 34 39 43
22 31 40 48 61 70
15 21 27 33 41 46
0 0 0 0 0 0
19 22 28 36 47 58
29 38 43 50 59 69
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 Single 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
35 47 60 72 91 103
60 84 108 133 169 193
53 71 87 102 128 146
68 95 122 149 189 216
3 4 5 6 8 9
8 12 15 18 23 27
7 9 11 14 17 20
0 0 0 0 0 0
39 47 56 64 75 82
12 16 19 22 29 33
21 24 27 30 35 38
22 31 40 48 61 70
19 27 35 42 51 56
0 0 0 0 0 0
25 25 26 31 38 44
18 18 30 40 53 65
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 Single 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
31 42 53 64 81 92
60 84 108 133 169 193
40 55 70 85 108 124
68 95 122 149 189 216
4 6 8 9 12 13
8 12 15 18 23 27
6 8 10 12 15 17
0 0 0 0 0 0
46 53 61 67 77 83
10 13 16 19 25 28
27 31 36 40 47 51
22 31 40 48 61 70
17 23 30 36 46 52
0 0 0 0 0 0
15 18 21 25 31 37
22 30 35 41 50 59
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
37 50 63 76 97 111
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
6 7 8 10 13 15
0 0 0 0 0 0
38 44 51 57 65 70
9 12 14 17 21 24
27 31 36 40 47 51
22 31 40 48 61 70
18 25 32 40 50 58
0 0 0 0 0 0
26 33 37 42 49 56
13 20 24 29 37 44
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
43 59 73 88 112 128
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
6 8 10 12 15 18
0 0 0 0 0 0
42 49 57 64 74 81
11 14 17 21 25 29
27 31 36 40 47 51
22 31 40 48 61 70
18 24 31 37 45 51
0 0 0 0 0 0
23 27 30 35 43 51
32 39 42 47 58 69
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
51 72 92 113 144 164
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 8 11 13 17 19
0 0 0 0 0 0
35 42 50 57 67 75
10 14 18 22 28 32
15 17 19 21 23 25
22 31 40 48 61 70
19 26 34 41 52 60
0 0 0 0 0 0
15 21 27 35 46 56
19 23 26 29 34 38
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
51 71 91 112 142 162
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 8 11 13 17 19
0 0 0 0 0 0
36 43 50 57 68 75
10 14 18 22 27 31
15 17 19 21 23 25
22 31 40 48 61 70
18 26 33 41 52 59
0 0 0 0 0 0
19 24 28 34 44 53
26 32 35 39 52 65
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 Single 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 46 56 68 77
60 84 108 133 169 193
48 67 86 105 133 152
68 95 122 149 189 216
4 5 7 8 10 11
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
36 43 50 55 63 69
9 12 14 17 21 24
25 29 33 37 43 46
22 31 40 48 61 70
14 20 26 32 39 44
0 0 0 0 0 0
16 21 23 27 32 37
39 42 46 49 54 58
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 Single 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
26 35 45 54 68 77
60 84 108 133 169 193
37 50 63 76 97 111
68 95 122 149 189 216
3 5 6 8 10 11
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
35 42 49 55 64 70
10 13 15 18 23 26
23 27 30 34 39 43
22 31 40 48 61 70
15 21 27 33 41 46
0 0 0 0 0 0
30 31 33 42 54 65
23 30 34 42 52 63
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 Single 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
29 40 51 62 77 86
64 89 115 141 179 205
39 53 67 81 103 118
72 100 129 158 201 230
4 5 7 8 10 12
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
38 45 52 58 67 73
10 13 15 18 23 26
24 28 32 36 41 45
22 31 40 48 61 70
15 21 28 33 41 47
0 0 0 0 0 0
20 23 26 32 41 49
28 39 46 54 67 79
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
36 48 61 74 94 107
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
5 6 8 10 13 14
0 0 0 0 0 0
37 43 50 55 63 69
9 12 13 16 21 24
27 31 36 40 47 51
22 31 40 48 61 70
14 20 25 30 37 42
0 0 0 0 0 0
19 20 24 30 37 45
22 30 34 39 47 54
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 Single 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 21 26 33 38
60 84 108 133 169 193
34 48 61 75 95 109
68 95 122 149 189 216
2 3 3 4 5 6
8 12 15 18 23 27
5 6 8 10 13 15
0 0 0 0 0 0
25 31 36 41 50 55
8 11 14 17 21 24
20 21 23 25 28 30
22 31 40 48 61 70
14 20 26 31 40 45
0 0 0 0 0 0
25 33 39 48 62 76
38 41 42 45 59 73
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 Single 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 37 45 57 65
60 84 108 133 169 193
32 43 55 67 85 97
68 95 122 149 189 216
3 4 5 7 8 10
8 12 15 18 23 27
5 6 7 9 12 13
0 0 0 0 0 0
31 31 37 42 50 54
8 11 12 15 19 22
23 26 30 33 37 41
22 31 40 48 61 70
13 18 23 28 34 38
0 0 0 0 0 0
24 28 35 46 58 69
34 42 46 53 61 70
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
49 68 87 107 136 155
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 8 10 13 16 18
0 0 0 0 0 0
39 46 52 59 69 76
9 13 17 21 26 30
15 17 19 21 23 25
22 31 40 48 61 70
18 25 32 39 49 56
0 0 0 0 0 0
23 30 34 39 47 50
32 37 42 48 56 64
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 Single 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 36 44 56 64
60 84 108 133 169 193
31 42 52 63 80 92
68 95 122 149 189 216
4 5 7 8 11 12
8 12 15 18 23 27
5 6 7 9 12 13
0 0 0 0 0 0
25 31 37 42 50 54
8 11 12 15 19 22
27 32 36 40 46 50
22 31 40 48 61 70
13 18 23 28 34 38
0 0 0 0 0 0
22 23 30 39 52 66
25 25 33 44 58 73
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
52 72 93 113 144 165
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 8 11 13 17 19
0 0 0 0 0 0
41 48 55 62 73 80
10 14 18 22 28 32
15 17 19 21 23 25
22 31 40 48 61 70
19 26 34 41 52 60
0 0 0 0 0 0
33 33 38 49 64 78
41 45 47 50 55 59
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
Single FamilyPulaski 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
32 44 55 67 84 96
64 89 115 141 179 205
40 54 67 81 103 117
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
37 44 51 58 67 73
10 13 16 19 23 26
27 31 36 40 47 51
22 31 40 48 61 70
17 22 28 34 41 46
0 0 0 0 0 0
19 22 28 35 45 54
51 57 61 65 74 83
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 Single 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 40 49 61 70
64 89 115 141 179 205
43 59 75 92 117 133
72 100 129 158 201 230
3 4 5 7 8 10
8 12 15 18 23 27
6 8 10 12 15 17
0 0 0 0 0 0
36 43 50 57 66 73
10 13 16 20 25 29
23 26 30 33 37 41
22 31 40 48 61 70
17 24 30 37 46 52
0 0 0 0 0 0
20 25 28 33 39 45
32 35 37 39 42 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
Randolph County Single 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 27 34 43 49
60 84 108 133 169 193
48 67 86 105 133 152
68 95 122 149 189 216
2 3 4 5 6 7
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
36 43 50 55 63 69
9 12 14 17 21 24
18 21 23 25 29 31
22 31 40 48 61 70
14 20 26 32 39 44
0 0 0 0 0 0
19 20 24 32 41 51
25 25 32 42 55 68
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 Single 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
26 36 46 56 70 79
64 89 115 141 179 205
38 52 65 79 100 115
72 100 129 158 201 230
3 5 6 8 10 11
8 12 15 18 23 27
6 7 9 11 13 15
0 0 0 0 0 0
39 46 53 59 67 73
10 12 14 17 22 25
22 26 30 33 39 42
22 31 40 48 61 70
15 21 27 32 40 45
0 0 0 0 0 0
30 35 44 55 70 85
38 38 42 47 54 61
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
51 72 92 113 144 164
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 9 11 13 17 19
0 0 0 0 0 0
29 36 43 51 62 69
10 14 18 22 28 32
15 17 19 21 23 25
22 31 40 48 61 70
19 26 34 41 52 60
0 0 0 0 0 0
15 18 19 22 26 31
50 54 56 59 63 67
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 Single 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 41 50 62 69
60 84 108 133 169 193
39 53 67 81 103 117
68 95 122 149 189 216
3 4 5 6 8 9
8 12 15 18 23 27
6 7 9 11 15 17
0 0 0 0 0 0
35 43 50 56 66 72
10 13 15 19 24 27
19 22 25 27 32 35
22 31 40 48 61 70
16 22 29 35 43 49
0 0 0 0 0 0
20 29 34 42 53 64
30 44 53 64 80 96
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 Single 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
26 36 46 56 70 79
64 89 115 141 179 205
38 52 65 79 100 115
72 100 129 158 201 230
3 5 6 8 10 11
8 12 15 18 23 27
6 7 9 11 13 15
0 0 0 0 0 0
39 46 53 59 67 73
10 12 14 17 22 25
22 26 30 33 39 42
22 31 40 48 61 70
15 21 27 32 40 45
0 0 0 0 0 0
26 33 37 42 49 56
21 25 27 30 34 39
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 Single 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 33 40 50 57
60 84 108 133 169 193
38 53 68 83 106 121
68 95 122 149 189 216
3 4 5 6 8 9
8 12 15 18 23 27
5 7 9 12 15 17
0 0 0 0 0 0
36 43 50 55 63 69
9 12 14 17 21 24
23 26 29 32 37 40
22 31 40 48 61 70
14 20 26 32 39 44
0 0 0 0 0 0
27 33 38 46 55 65
29 34 43 54 68 83
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
Single FamilySpencer 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
14 19 25 30 39 44
69 97 124 152 193 221
49 68 87 107 136 155
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 8 10 13 16 18
0 0 0 0 0 0
39 46 52 59 69 76
9 13 17 21 26 30
15 17 19 21 23 25
22 31 40 48 61 70
18 25 32 39 49 56
0 0 0 0 0 0
23 23 23 27 35 41
34 34 35 38 46 57
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
48 66 83 101 129 147
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 8 10 12 16 18
0 0 0 0 0 0
34 41 47 54 64 71
10 13 17 20 26 29
15 17 19 21 23 25
22 31 40 48 61 70
17 24 31 38 47 54
0 0 0 0 0 0
17 26 34 42 48 54
22 25 30 39 52 65
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 Single 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 21 26 33 38
60 84 108 133 169 193
30 41 51 62 78 90
68 95 122 149 189 216
2 3 3 4 5 6
8 12 15 18 23 27
5 6 7 9 11 13
0 0 0 0 0 0
34 40 46 51 58 63
8 11 12 15 18 21
20 21 23 25 28 30
22 31 40 48 61 70
12 17 22 27 33 37
0 0 0 0 0 0
24 29 32 35 40 45
19 29 35 43 54 66
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 Single 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 33 41 51 57
60 84 108 133 169 193
48 67 86 105 133 152
68 95 122 149 189 216
17 23 30 37 47 53
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
36 43 50 55 63 69
9 12 14 17 21 24
57 74 92 109 135 153
22 31 40 48 61 70
14 20 26 32 39 44
0 0 0 0 0 0
25 28 34 41 50 59
16 18 24 30 40 50
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 Single 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
32 44 55 67 84 96
69 97 124 152 193 221
37 50 63 76 97 111
77 108 139 170 217 248
4 6 8 9 12 13
8 12 15 18 23 27
6 7 8 10 13 15
0 0 0 0 0 0
38 44 51 57 65 70
9 12 14 17 21 24
27 31 36 40 47 51
22 31 40 48 61 70
14 20 26 32 39 44
0 0 0 0 0 0
16 22 25 29 36 42
20 24 28 35 44 53
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
Tippecanoe County Single 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 31 39 48 60 68
64 89 115 141 179 205
28 36 44 52 66 76
72 100 129 158 201 230
3 4 5 6 8 9
8 12 15 18 23 27
5 5 6 8 10 11
0 0 0 0 0 0
25 32 39 43 49 53
9 11 11 13 16 18
21 24 27 30 35 38
22 31 40 48 61 70
11 15 20 23 27 30
0 0 0 0 0 0
23 24 27 33 40 47
41 45 48 51 56 61
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 Single 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
14 19 25 30 39 44
64 89 115 141 179 205
38 52 66 80 102 116
72 100 129 158 201 230
2 3 3 4 5 6
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
38 45 52 58 67 73
10 13 14 18 22 26
20 21 23 25 28 30
22 31 40 48 61 70
15 21 27 33 41 46
0 0 0 0 0 0
12 15 19 22 28 33
54 56 62 77 97 117
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 Single 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 36 44 56 64
60 84 108 133 169 193
35 49 63 77 98 112
68 95 122 149 189 216
4 5 7 8 11 12
8 12 15 18 23 27
5 7 8 10 13 15
0 0 0 0 0 0
25 31 36 42 50 56
8 11 14 17 22 25
27 32 36 40 46 50
22 31 40 48 61 70
15 20 26 32 41 47
0 0 0 0 0 0
15 22 26 32 39 47
21 34 42 53 67 81
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
28 36 44 52 66 76
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
5 5 6 8 10 11
0 0 0 0 0 0
25 32 39 43 49 53
9 11 11 13 16 18
27 31 36 40 47 51
22 31 40 48 61 70
11 15 20 23 27 30
0 0 0 0 0 0
24 24 25 26 28 30
37 42 49 59 73 86
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
28 36 44 52 66 76
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
5 5 6 8 10 11
0 0 0 0 0 0
25 32 39 43 49 53
9 11 11 13 16 18
27 31 36 40 47 51
22 31 40 48 61 70
11 15 20 23 27 30
0 0 0 0 0 0
20 25 27 31 36 41
28 31 40 53 70 88
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
Single FamilyVigo 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
24 33 42 51 65 74
69 97 124 152 193 221
41 55 69 81 101 114
77 108 139 170 217 248
3 4 5 6 8 9
8 12 15 18 23 27
6 7 9 11 13 15
0 0 0 0 0 0
32 39 47 53 61 67
10 13 15 18 22 25
21 24 27 30 35 38
22 31 40 48 61 70
15 21 27 32 40 45
0 0 0 0 0 0
15 16 18 21 26 30
24 24 27 35 46 56
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 Single 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
32 44 55 67 84 96
64 89 115 141 179 205
57 78 99 121 153 175
72 100 129 158 201 230
4 6 8 9 12 13
8 12 15 18 23 27
8 10 13 16 20 23
0 0 0 0 0 0
45 55 65 73 86 95
13 18 21 26 33 38
27 31 36 40 47 51
22 31 40 48 61 70
22 31 40 49 61 69
0 0 0 0 0 0
10 17 21 27 48 54
20 28 32 38 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
Single FamilyWarren 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
23 32 41 50 63 71
60 84 108 133 169 193
34 47 59 72 91 104
68 95 122 149 189 216
3 5 6 7 9 11
8 12 15 18 23 27
5 7 8 10 13 15
0 0 0 0 0 0
32 39 45 51 59 65
9 12 14 17 21 25
25 28 31 35 40 44
22 31 40 48 61 70
14 20 26 32 40 45
0 0 0 0 0 0
22 24 28 33 40 47
34 34 39 51 66 82
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 Single 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 41 50 62 69
60 84 108 133 169 193
39 53 67 81 103 117
68 95 122 149 189 216
3 4 5 6 8 9
8 12 15 18 23 27
6 7 9 11 15 17
0 0 0 0 0 0
35 43 50 56 66 72
10 13 15 19 24 27
19 22 25 27 32 35
22 31 40 48 61 70
16 22 29 35 43 49
0 0 0 0 0 0
23 24 28 36 48 59
19 24 29 36 47 57
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 Single 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 40 49 61 70
64 89 115 141 179 205
38 52 66 80 102 116
72 100 129 158 201 230
3 4 5 7 8 10
8 12 15 18 23 27
6 7 9 11 14 16
0 0 0 0 0 0
38 45 52 58 67 73
10 13 14 18 22 26
23 26 30 33 37 41
22 31 40 48 61 70
15 21 27 33 41 46
0 0 0 0 0 0
18 21 23 29 36 43
38 42 44 47 52 56
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 Single 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 42 51 65 74
69 97 124 152 193 221
54 75 96 115 144 163
77 108 139 170 217 248
3 4 5 6 8 9
8 12 15 18 23 27
7 9 12 14 18 20
0 0 0 0 0 0
35 42 50 58 70 77
11 15 19 23 29 33
21 24 27 30 35 38
22 31 40 48 61 70
20 28 35 43 55 63
0 0 0 0 0 0
16 19 24 31 41 51
24 25 31 40 53 65
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 Single 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 42 51 65 74
69 97 124 152 193 221
52 72 93 113 144 165
77 108 139 170 217 248
3 4 5 6 8 9
8 12 15 18 23 27
6 8 11 13 17 19
0 0 0 0 0 0
41 48 55 62 73 80
10 14 18 22 28 32
21 24 27 30 35 38
22 31 40 48 61 70
19 26 34 41 52 60
0 0 0 0 0 0
28 31 34 39 47 55
30 42 48 57 70 82
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 Single 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
14 19 25 30 39 44
69 97 124 152 193 221
48 67 86 105 133 152
77 108 139 170 217 248
2 2 3 4 5 5
8 12 15 18 23 27
6 8 10 12 16 18
0 0 0 0 0 0
34 41 48 55 66 73
10 14 18 21 26 29
15 17 19 21 23 25
22 31 40 48 61 70
18 25 31 38 48 55
0 0 0 0 0 0
25 26 29 36 45 55
41 51 57 70 86 102
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 Single Family