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Generic Relocation Assistance Forms

Relocation Assistance Program
Generic Form Revisions

WSDOT made changes to our generic relocation assistance forms August 2013. These forms are generic in nature and should be used by local public agencies instead of using the WSDOT forms

Please contact Danny Johnson, State Relocation Reviewer, at 360.705.7317 if you have any questions regarding the forms.

These forms are available in Microsoft Word (.docx)


Local Public Agency Relocation Forms List  (docx 21kb)

LPA-501 General Notice - Non-Residential  (docx 29kb

LPA-502 General Notice - Landlord  (docx 21kb)

LPA-503 General Notice - Personal Property (docx 20kb)

LPA-504 General Notice - Residential  (docx 20kb)

LPA-505 Notice of Eligibility - Non-Residential  (docx 38kb)

LPA-505a Non-Residential (Fixed Payment)  (docx 20kb)

LPA-507 Notice of Eligibility - 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 - Residential Owner with Carve Out Language (docx 30kb)

LPA-508 Notice of Eligibility - Residential Tenant  (docx 30kb)

LPA-508a Notice of Eligibility - Non DSS Residential Tenant  (docx 29kb)

LPA-509 Notice of Eligibility - Landlord  (docx 25kb)

LPA-510 Notice of Eligibility - Personal Property  (docx 28kb)

LPA-511a Notice of Relocation Eligibility & 90-Day Assurance Combo Letter (Mobile Homes - Rent Site, Own Mobile Home)  (docx 34kb)

LPA-511b Notice of Relocation Eligibility & 90-Day Assurance Combo Letter (Mobile Homes - Own Site, Own Mobile Home)  (docx 33kb)

LPA-511c Notice of Relocation Eligibility & 90-Day Assurance Combo Letter (Mobile Homes - Rent Site, Rent Mobile Home)  (docx 31kb)

LPA-512 Notice of Intent to Acquire  (docx 16kb)

LPA-513 Mortgage Interest Differential Payment (MIDP) Computation  (docx 19kb)

LPA-514 Incidental Purchase Expense Worksheet  (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) Worksheet Non-Residential  (docx 19kb)

LPA-520 Request for Moving Bid cover letter  (docx 15kb)

LPA-521 Move Bid Request and Specification  (docx 38kb)

LPA-522 Replacement Site Search Log  (docx 17kb)

LPA-523 Application for Reestablishment Expenses - Non-Residential  (docx 21kb)

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 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  (docx 18kb)

LPA-539 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 Worksheet  (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-544 Notice of Relocation Non-Eligibility  (docx 17kb)

LPA-545 Non-Residential Obsolete Printed Items  (docx 16kb)

LPA-546 Mobile Home Move Cost - Personal Property  (docx 24kb)

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)

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