Right-of-way forms & brochures

Local Public Agencies (LPA) brochures

The following generic brochures are available to local agencies for distribution to property owners and tenants that will be impacted by their federal-aid transportation projects.

• Transportation Property Needs and You (DOCX 514KB)- LPA generic – provides detailed information on the federal-aid acquisition process.
• Non- Residential Relocation Assistance Program (Business/Farm/NPO) (DOCX 32KB) - LPA generic - provides detailed information on the relocation assistance program for businesses, farms, and non-profit organizations that are displaced by a federal-aid project.
• Personal Property Only Relocation Assistance Program (DOCX 20KB) - LPA generic – provides detailed information on the relocation assistance program for the move of personal property when a residence or business is not affected by the acquisition of property and/or property rights of federal-aid projects.
• Residential Relocation Assistance Program (DOCX 24KB) - LPA generic – provides detailed information on the relocation assistance program for residential occupants who are displaced by a federal-aid project.

Another option is to disburse the Federal Highway Administration (FHWA) brochures, which can be obtained online directly from the FHWA website.

LPA general forms

Forms used by local agencies that cover general program areas.

• LPA-001: Right of Way Procedures (DOCX 32KB)
• LPA-001b: Staff Update-Right of Way Procedures (DOCX 26KB)
• LPA-004: Title Clearing for Right of Way Parcel Package (DOCX 46KB)
• LPA-005: ROW Funding Estimate Instructions (PDF 65KB)
• LPA-005b: ROW Funding Estimate (XLSX 27KB)
• LPA-006: ROW Plan Checklist (DOCX 24KB)
• LPA-007: Federal Aid Requirement Checklist (DOCX 22KB)
• LPA-008: No ROW Checklist (DOCX 33KB)
• LPA-009: Design Approval Documentation (DOCX 32KB)

LAC forms

Forms used by WSDOT’s Local Agency Coordinator (LAC) to perform the Right of Way Certification Review. Local agency staff or consultants can review the forms to understand file expectations prior to requesting a Certification Review.

• LPA-011: Project Review Worksheet (DOCX 39KB)
• LPA-012: Parcel Review Worksheet (DOCX 38KB)
• LPA-013: Residential Relocation Review Worksheet (DOCX 38KB)
• LPA-014: Non-Residential Relocation Review Worksheet (DOCX 40KB)
• LPA-015: Personal Property Only (PPO) Relocation Review Worksheet (DOCX 37KB)
• LPA-016: Certification Review Oversight Report (DOCX 28KB)
• LPA-017: Certification Review Transmittal Letter (Cert 1 and 2) (DOCX 30KB)
• LPA-017a: Certification Review Compliance Letter (Cert 1 or 2 – No Cert at this time) (DOCX 28KB)
• LPA-018: Certification Review Transmittal Letter (Cert 3) (DOCX 34KB)
• LPA-019: Spot Check & Certification Review Sample Size Determination Worksheet (XLSX 19KB)
• LPA-020: Project QA/QC Review Form (DOCX 33KB)
• LPA-021: Parcel QA/QC Review Form (DOCX 35KB)
• LPA-022: Relocation Oversight Review Form (DOCX 33KB)

LPA appraisal forms

Forms used by local agencies that pertain to the appraisal function.

• LPA-200: Appraisal Assignment Scope of Work (DOCX 36KB)
• LPA-203: Appraiser Assignment Form (DOCX 23KB)
• LPA-204: Report of Contact with Owner (DOCX 22KB)
• LPA-205: Certificate of Appraiser (DOCX 26KB)
• LPA-206: Summary of Appraisal Conclusions (DOCX 24KB)
• LPA-207: Subject Plot Plan and Photos (DOCX 22KB)
• LPA-208: Narrative Appraisal Report (DOCX 55KB)
• LPA-210: Market Data Sheet
• LPA-210b: Sale Sketch and Photographs (DOCX 22KB)
• LPA-211: Appraisal Assumptions and Limiting Conditions (DOCX 23KB)
• LPA-212: Acquisition Appraisal Salient Information> (DOCX 23KB)
• LPA-213: Abbreviated Appraisal Report (DOCX 24KB)
• LPA-214b: Local Agency Certificate of Value (DOCX 32KB)
• LPA-216: Administrative Offer Summary (AOS) (DOCX 29KB)
• LPA-217: Residential Personalty/Realty Report (XLS 29KB)
• LPA-218: Commercial/Industrial Personalty/Realty Report (XLS 31KB)
• LPA-219: Certificate of Appraiser (DOCX 34KB)
• LPA-220: Mobile Home worksheet Personal Property (DOCX 24KB)

LPA acquisition forms

Forms used by local agencies that pertain to the acquisition of real property or property rights/interests.

• LPA-300: Recording Cover Sheet (DOCX 42KB)
• LPA-301: Diary (DOCX 47KB)
• LPA-302: Warranty Deed (DOCX 51KB)
• LPA-303: Special Warranty Deed (DOCX 51KB)
• LPA-305: Warranty Deed (Access Rights Only) (DOCX 51KB)
• LPA-306: Quitclaim Deed (DOCX 51KB)
• LPA-307: Quitclaim Deed (Access Rights Only) (DOCX 52KB)
• LPA-308: Partial Release of Mortgage (DOCX 52KB)
• LPA-309: Partial Release Of Mortgage (Access Rights Only) (DOCX 52KB)
• LPA-310: Request For Partial Reconveyance (DOCX 48KB)
• LPA-311: Partial Reconveyance (DOCX 48KB)
• LPA-312: Partial Release Of Lease (DOCX 50KB)
• LPA-313: Release of Lease (DOCX 50KB)
• LPA-314: Subordination Agreement of Utility Interests (DOCX 28KB)
• LPA-315: Release of Damages (DOCX 32KB)
• LPA-316: Partial Release Of Judgment (DOCX 46KB)
• LPA-317: Possession and Use Agreement (DOCX 56KB)
• LPA-318: Early Acquisition Checklist Option 2 (XLSX 36KB)
• LPA-319: Early Acquisition Checklist Option 3 (XLSX 36KB)
• LPA-321: Real Property Voucher (Excel) (XLSX 60KB)
• LPA-323: Consent to Change of Grade (DOCX 50KB)
• LPA-324: Easement (DOCX 51KB)
• LPA-325: Temporary Easement (DOCX 51KB)
• LPA-326: Permit (DOCX 51KB)
• LPA-330: Bill of Sale (DOCX 43KB)
• LPA-333: Request to Accept Mortgage (deed of trust) Encumbrance (DOCX 30KB)
• LPA-333a: Letter to Owner-Agree to Pay Mortgage (deed of trust) Encumbrance (DOCX 30KB)
• LPA-335: Fixtures and Improvements Agreement (DOCX 27KB)
• LPA-350: Offer Letter (DOCX 58KB)
• LPA-351: Revised Offer Letter (DOCX 26KB)
• LPA-351a: Recission of Offer Letter (DOCX 35KB)
• LPA-352: Landlord/Tenant Form (DOCX 28KB)
• LPA-355: Quitclaim Deed (Release Easement) (DOCX 28KB)
• LPA-356: Quitclaim Deed (Access Use for Easement) (DOCX 24KB)
• LPA-362: Agency Payment Letter (DOCX 18KB)
• LPA-365: Individual Notary (DOCX 25KB)
• LPA-366: Corporate Notary (DOCX 25KB)
• LPA-367: Attorney In Fact Notary (DOCX 25KB)
• LPA-368: Self and Attorney In Fact Notary (DOCX 25KB)
• LPA-369: Guardian, Executor, Administrator Notary (DOCX 25KB)
• LPA-370: Mayor City Commissioners Notary (DOCX 25KB)
• LPA-371: County Commissioners Notary (DOCX 25KB)
• LPA-372: School District Notary (DOCX 25KB)
• LPA-373: Signature by Mark Notary (DOCX 25KB)
• LPA-374: Partnership Notary (DOCX 25KB)
• LPA-375: Trustee Notary (DOCX 25KB)
• LPA-376: Limited Liability Company Notary (DOCX 25KB)
• LPA-377: Agency Notary (DOCX 25KB)
• LPA-382: Relocation Eligibility Report (DOCX 26KB)
• LPA-383: Donation and Appraisal Waiver (DOCX 22KB)

LPA certification forms

Forms used by local agencies to request a Right of Way Certificate so their federal-aid project can be authorized for construction.

• LPA-384: Right of Way Certificate 1, No Relocation (DOCX 17KB)
• LPA-385: Right of Way Certificate 1, Residential Relocation (DOCX 17KB)
• LPA-386: Right of Way Certificate 1, Non-Residential Relocation (DOCX 18KB)
• LPA-387: Right of Way Certificate 1, Combination of Relocation Types (DOCX 17KB)
• LPA-388: Right of Way Certificate 2, No Relocation (DOCX 17KB)
• LPA-389: Certificate 2, Residential Relocation (DOCX 17KB)
• LPA-390: Right of Way Certificate 2, Non-Residential Relocation (DOCX 18KB)
• LPA-391: Right of Way Certificate 2, Residential and Non-Residential Relocation (DOCX 17KB)
• LPA-392: Right of Way Certificate 3, No Relocation (DOCX 22KB)
• LPA-393: Right of Way Certificate 3, Residential Relocation (DOCX 22KB)
• LPA-394: Right of Way Certificate 3, Non-Residential Relocation (DOCX 22KB)
• LPA-395: Right of Way Certificate 3, Residential and Non-Residential Relocation (DOCX 22KB)
• LPA-396: Right of Way Certificate 3, Design Build Phased – Under Construction
• LPA-397: Certification Worksheet (XLSX 32KB)
• LPA-398: Certification Worksheet – Design Build (XLSX 33KB)
• LPA-399: WSDOT Local Agency Certification Concurrence Letter (DOCX 27KB)
• LPA-400: Preliminary Certification Statement for Design Build Projects (DOCX 22KB)

LPA property management forms

Forms used by local agencies that pertain to the management of property purchased that is no longer needed for their federal-aid project.

• LPA-407: Disposal Approval Request (DOCX 29KB)
• LPA-407b: Request to Sell/Lease at Less than Market Value (DOCX 30KB)

LPA relocation forms

Forms used by local agencies that pertain to providing a variety of relocation assistance activities for residential, non-residential, and personal property only displacements.

• LPA-501: General Notice of Relocation Rights (Non-Residential) (DOCX 29KB)
• LPA-502: General Notice of Relocation Rights (Landlord) (DOCX 21KB)
• LPA-503: General Notice of Relocation Rights (Personal Property) (DOCX 20KB)
• LPA-504: General Notice of Relocation Rights (Residential) (DOCX 20KB)
• LPA-505: Notice of Eligibility, Entitlements, and 90-Day Assurance (Non-Residential) (DOCX 38KB)
• LPA-506; Notice of Eligibility, Entitlements, and 90-Day Assurance (Non-Residential Fixed Payment) (DOCX 32KB)
• LPA-507: Notice of Eligibility, Entitlements, and 90-Day Assurance (Residential Owner) (DOCX 29KB)
• LPA-507a: Notice of Revised Price Differential (Residential Owner) (DOCX 29KB)
• LPA-507b: Notice of Eligibility – Non DSS (Residential Owner) (DOCX 29KB)
• LPA-507c: Notice of Eligibility w/Carve Out Language (Residential Owner) (DOCX 30KB)
• LPA-508: Notice of Eligibility, Entitlements, and 90-Day Assurance (Residential Tenant) (DOCX 30KB)
• LPA-508a: Notice of Eligibility – Non DSS (Residential Tenant) (DOCX 29KB)
• LPA-509: Notice of Eligibility, Entitlements, and 90-Day Assurance (Landlord) (DOCX 25KB)
• LPA-510: Notice of Eligibility, Entitlements, and 90-Day Assurance (Personal Property) (DOCX 28KB)
• LPA-511: Notice of Relocation Eligibility, Entitlements, and 90-/Day Assurance (Mobile Homes) (DOCX 34KB)
• LPA-512: Notice of Intent to Acquire (DOCX 16KB)
• LPA-513: Mortgage Interest Differential Payment (MIDP) (PDF 1.37MB)
• LPA-514: Incidental Purchase Expense Work Sheet (DOCX 27KB)
• LPA-515: Documentation of Living Expenses (DOCX 21KB)
• LPA-516: Price Differential Entitlement Instructions (DOCX 20KB)
• LPA-516a: Down Payment Assistance Entitlement Instructions (DOCX 19KB)
• LPA-517: Vacate Inspection (DOCX 17KB)
• LPA-518: Agreement for Provisional Replacement Housing Payment (DOCX 18KB)
• LPA-519: Fixed Payment (In-Lieu) Work Sheet – Non-Residential (DOCX 19KB)
• LPA-520: Request for Moving Bid Cover Letter (DOCX 15KB)
• LPA-521: Request for Proposal and Moving Specification Format (DOCX 38KB)
• LPA-522: Replacement Site Search Log (DOCX 17KB)
• LPA-525: (DSS) Replacement Dwelling Inspection Report (DOCX 21KB)
• LPA-526: Loss of Tangibles/Substitute Personal Property Bid Form (DOCX 15KB)
• LPA-527: Loss of Tangibles Computation (DOCX 19KB)
• LPA-528: Substitute Personal Property Computation (DOCX 19KB)
• LPA-529: Residential Checklist (DOCX 22KB)
• LPA-530: Non-Residential Checklist (DOCX 28KB)
• LPA-531: Personal Property Checklist (DOCX 18KB)
• LPA-532: Residential Occupancy Survey (DOCX 34KB)
• LPA-533: Non-Residential Occupancy Survey (DOCX 30KB)
• LPA-533a: Non-Residential (Landlord) Occupancy Survey (DOCX 24KB)
• LPA-534: Personal Property Only Occupancy Survey (DOCX 28KB)
• LPA-535: Pre Move Inventory – Non-Residential (DOCX 25KB)
• LPA-536: Final Claim Letter – Non-Residential (DOCX 16KB)
• LPA-536a: Final Claim Letter – Residential (DOCX 16KB)
• LPA-537: Relocation Assistance Voucher (DOCX 31KB)
• LPA-538: Application for Fixed Payment – Non-Residential (DOCX 18KB)
• LPA-539: Residential Tenants Monthly Income Verification (DOCX 19KB)
• LPA-540: Move Expense Agreement – Residential (DOCX 25KB)
• LPA-540a: Move Expense Agreement – Non-Residential (DOCX 20KB)
• LPA-541: Housing Comparison Work Sheet (DOCX 25KB)
• LPA-542: Price Differential Report (DOCX 19KB)
• LPA-542a: Price Differential Report instructions (DOCX 25KB)
• LPA-543: Rent Supplement Report (DOCX 21KB)
• LPA-543a: Rent Supplement Report instructions (DOCX 21KB)
• LPA-544: Notice of Relocation Non-eligibility (DOCX 17KB)
• LPA-545: Non-Residential Obsolete Printed Items (DOCX 16KB)
• LPA-547: Lawfully Present in the United States Certification (DOCX 23KB)
• LPA-548: Transfer of Ownership – Non-Residential (DOCX 23KB)
• LPA-549: Claim Determination Letter (DOCX 22KB)
• LPA-550: Notification of Professional Home Inspection (DOCX 26KB)
• LPA-551: Personal Property Only Relocation Plan (DOCX 27KB)
• LPA-552: Relocation Diary (DOCX 38KB)