METRO HRA
Allowances for Tenant –Paid Utilities and Appliances
Effective 11/1/16
Implemented December 1, 2016 New and Port; March 1, 2017 Recertifications
Tenant Name ________________________________ Address ____________________________________
To calculate the utility allowance, circle the amount of the allowance listed for all utilities you must pay. Be sure to use
the proper column for the bedroom size (BR) and circle the amount for the proper unit type. The “Range and
Refrigerato”r column is only for tenants who own those appliances. DO NOT circle them if provided by the owner.
UNIT TYPE:
A = Apartment/Multiple Dwelling
T/D = Townhouse/Duplex
H = Single Family Home
(3 or more units attached)
(2 units attached)
(1 unit)
Heating
Natural Gas
Electric
Bottle Gas
Oil
Cooking
Natural Gas
Electric
Bottle Gas
Oil
Water Heating
Natural Gas
Electric
Bottle Gas
Oil
Other Electric
Water
Sewer
Trash
Range
Refrigerator
Total Utility
Allowance
+ Rent
= Gross Rent
Page - 1
A
0
TH
SF
A
1
TH
SF
A
UNIT SIZE AND TYPE
2
3
TH SF
A
TH
30
27
44
48
37
39
55
60
39
65
62
68
34
32
51
56
40
46
64
70
45
76
73
80
38
43
60
66
51
60
75
82
34
54
89
86
94
43
55
69
76
62
75
86
94
SF
A
66
47
67
78
85
103
99
108
4
TH
SF
A
77
51
79
87
95
74
89
97
116
105
122
112
5
TH
85
89
104
129
107
125
117
136
3
5
4
NA
4
7
5
NA
5
10
7
NA
6
13
9
NA
7
16
11
NA
8
18
13
NA
7
19
10
11
8
22
12
13
11
28
18
19
14
35
23
25
17
41
29
31
21
47
34
37
40
9
12
24
4
4
43
37
45
13
17
24
4
4
48
47
57
16
22
27
4
4
62
57
70
20
27
28
4
4
77
67
82
25
35
28
4
4
91
77
SF
95
29
39
28
4
4
105