Relocation Assistance Program
Generic Form Revisions
WSDOT made changes to our generic relocation assistance forms August 2011. These forms are generic in nature and should be used by local public agencies instead of using the WSDOT forms.
Please contact Leslie Beaird, LPA & Consultant Relocation Reviewer at 360.705.7316 if you have any questions regarding the forms.
These forms are available in Microsoft Word (.docx)
Contents
Local Public Agency Relocation Forms List (docx 16 kb)
LPA-501 General Notice - Non-Residential (docx 24 kb)
LPA-502 General Notice - Landlord (docx 21 kb)
LPA-503 General Notice - Personal Property (docx 20 kb)
LPA-504 General Notice - Residential (docx 20 kb)
LPA-505 Notice of Eligibility - Non-Residential (docx 32 kb)
LPA-505a Non-Residential (Fixed Payment) (docx 21 kb)
LPA-507 Notice of Eligibility - Residential Owner (docx 24 kb)
LPA-507a Notice of Revised Price Differential - Residential Owner (docx 18 kb)
LPA-507b Notice of Eligibility - Non DSS Residential Owner (docx 24 kb)
LPA-507c Notice of Eligibility - Residential Owner with Carve Out Language (docx 25 kb)
LPA-508 Notice of Eligibility - Residential Tenant (docx 25 kb)
LPA-508a Notice of Eligibility - Non DSS Residential Tenant (docx 24 kb)
LPA-509 Notice of Eligibility - Landlord (docx 25 kb)
LPA-510 Notice of Eligibility - Personal Property (docx 21 kb)
LPA-511a Notice of Relocation Eligibility & 90-Day Assurance Combo Letter (Mobile Homes - Rent Site, Own Mobile Home) (docx 29 kb)
LPA-511b Notice of Relocation Eligibility & 90-Day Assurance Combo Letter (Mobile Homes - Own Site, Own Mobile Home) (docx 28 kb)
LPA-511c Notice of Relocation Eligibility & 90-Day Assurance Combo Letter (Mobile Homes - Rent Site, Rent Mobile Home) (docx 25 kb)
LPA-512 Notice of Intent to Acquire (docx 46 kb)
LPA-513 Mortgage Interest Differential Payment (MIDP) Computation (docx 55 kb)
LPA-514 Incidental Purchase Expense Worksheet (docx 63 kb)
LPA-515 Documentation of Living Expenses (docx 43 kb)
LPA-516 Price Differential Entitlement Instructions (docx 45 kb)
LPA-516a Down Payment Assistance Entitlement Instructions (docx 35 kb)
LPA-517 Vacate Inspection (docx 28 kb)
LPA-518 Agreement for Provisional Replacement Housing Payment (docx 29 kb)
LPA-519 Fixed Payment (In-Lieu) Worksheet Non-Residential (docx 33 kb)
LPA-520 Request for Moving Bid cover letter (docx 27 kb)
LPA-521 Move Bid Request and Specification (docx 46 kb)
LPA-522 Replacement Site Search Log (docx 45 kb)
LPA-523 Application for Reestablishment Expenses - Non-Residential (docx 34 kb)
LPA-524 Eligibility Report (docx 31 kb)
LPA-525 (DSS) Replacement Dwelling Inspection Report (docx 59 kb)
LPA-526 Loss of Tangibles/Substitute Personal Property Bid Form(docx 29 kb)
LPA-527 Loss of Tangibles Computation (docx 38 kb)
LPA-528 Substitute Personal Property Computation (docx 36 kb)
LPA-529 Residential Checklist (docx 68 kb)
LPA-530 Non-Residential Checklist (docx 66 kb)
LPA-531 Personal Property Checklist (docx 44 kb)
LPA-532 Residential Occupancy Survey (docx 91 kb)
LPA-533 Non-Residential Occupancy Survey (docx 66 kb)
LPA-533a Landlord Occupancy Survey (docx 77kb)
LPA-534 Personal Property Only Occupancy Survey (docx 42 kb)
LPA-535 Pre Move Inventory – Non-Residential (docx 72 kb)
LPA-536 Final Claim Letter - Non-Residential (docx 27 kb)
LPA-536a Final Claim Letter - Residential (docx 27 kb)
LPA-537 Relocation Assistance Voucher (docx 82 kb)
LPA-538 Application for Fixed Payment (docx 37 kb)
LPA-539 Monthly Income Verification (docx 47 kb)
LPA-540 Move Expense Agreement – Residential (docx 33 kb)
LPA-540a Move Expense Agreement – Non-Residential (docx 41 kb)
LPA-541 Housing Comparison Worksheet (docx 92 kb)
LPA-542 Price Differential Report (docx 53 kb)
LPA-542a Price Differential Report instructions (docx 53 kb)
LPA-543 Rent Supplement Report (docx 66 kb)
LPA-544 Notice of Relocation Non-Eligibility (docx 27 kb)
LPA-545 Non-Residential Obsolete Printed Items (docx 27 kb)
LPA-546 Mobile Home Move Cost - Personal Property (docx 39 kb)
LPA-547 Lawfully Present in the United States Certification (docx 39 kb)
LPA-548 Transfer of Ownership - Non-Residential (docx 39 kb)
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