Allowances for Tenant Furnished Utilities and other Services   OMB Approval No. 2577-0169
Locality: Casper Housing Authority Unit Type: Detached House/

Single-Family

 Date (mm/dd/yyyy)
Utility or Service Inside City Limit Monthly Dollar Allowances
0 BR 1 BR 2 BR 3 BR 4 BR 5 BR
Heating a. Natural Gas $75.00 $107.00 $135.00 $166.00 $211.00 $243.00
b. Bottle Gas            
c. Electric $43.00 $60.00 $77.00 $94.00 $120.00 $137.00
  d. Oil / Other            
Cooking a. Natural Gas $4.00 $7.00 $8.00 $10.00 $12.00 $15.00
b. Bottle Gas            
c. Electric $3.00 $5.00 $6.00 $7.00 $9.00 $11.00
  d. Coal / Other            
Other Electric $8.00 $11.00 $14.00 $17.00 $22.00 $25.00
Air Conditioning $2.00 $3.00 $4.00 $5.00 $7.00 $8.00
Water Heating a. Natural Gas $12.00 $17.00 $21.00 $26.00 $33.00 $38.00
b. Bottle Gas            
c. Electric $10.00 $14.00 $19.00 $23.00 $29.00 $33.00
  d. Oil / Other            
Water $14.00 $19.00 $24.00 $28.00 $35.00 $40.00
Sewer $9.00 $12.00 $15.00 $18.00 $23.00 $26.00
Trash Collection $10.00 $10.00 $10.00 $10.00 $10.00 $10.00
Range / Microwave $7.00 $7.00 $7.00 $7.00 $7.00 $7.00
Refrigerator $9.00 $9.00 $9.00 $9.00 $9.00 $9.00
Other--specify: Electric Customer Charge:
Natural Gas Customer Charge:
$9.00
$5.00
$9.00
$5.00
$9.00
$5.00
$9.00
$5.00
$9.00
$5.00
$9.00
$5.00
Actual Family Allowances Utility or Service per month cost
To be used by the family to compute allowance. Complete below for the actual unit rented. Heating $
Cooking $
Name of Family Other Electric $
Air Conditioning $
Water Heating $
Address of Unit Water $
Sewer $
Trash Collection $
Range / Microwave $
Refrigerator $
Other $
Number of Bedrooms    
Total $
2/2006 Update