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

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

(exp. 04/30/2018)

and Urban Development

Office of Public and Indian Housing

Locality Unit Type Date (mm/dd/yyyy)

Utility or Service Monthly Dollar Allowances

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

Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Cooking a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Other Electric

Air Conditioning

Water Heating a. Natural Gas

b. Bottle Gas

c. Oil / Electric

d. Coal / Other

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Other -- specify

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

Complete below for the actual unit rented. Heating $

Cooking

Name of Family

Other Electric

Air Conditioning

Address of Unit Water Heating

Water

Sewer

Trash Collection

Range/Microwave

Refrigerator

Number 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