Act of Sale Date Executed Comments: Issue Type Issue Type N/A N/A Finding Finding Concern Concern Based on the available evidence, did the Grantee/ Recipient/ Yes No Yes No Subrecipient carry out the acquisition process in a manner that minimized hardships to the owners? Issue Type Issue Type Comments: N/A N/A Finding Finding Concern Concern Residential Relocation File Review ONSITE ONLY Property 3 Property 4 – For each residential relocation claim, does the Grantee/ Recipient/ DEPENDENT ON RESPONSES DEPENDENT ON RESPONSES TO SUBQUESTIONS TO SUBQUESTIONS Relocation File contain the following: Subrecipient’s Type Type Comments: UUIssue UUIssue N/A N/A Finding Finding Concern Concern Evidence and dates of personal contacts; and description of Yes No Yes No services provided? Identification of person, displacement property, racial/ethnic group classification, age and sex of all members of household, monthly rent and utility costs for displacement Yes No Yes No and replacement housing, type of enterprise, and relocation needs and preferences? Recipient Interview and Survey (Household Case Record Yes No Yes No form for replacement-housing needs? Identification of referrals to replacement properties, date of referral, sale price or rent/utility costs (if dwelling), date of Yes No Yes No availability, and reason(s) for declining referral? Identification of actual replacement property, sale price or Yes No Yes No rent/utility costs (if dwelling), and date of relocation? Replacement dwelling inspection report; and date of Yes No Yes No inspection? A copy of each approved claim form and related Yes No Yes No documentation; evidence that the person received payment? Copy of any appeal or complaint filed and recipient's Yes No Yes No response? Copy of deferred loan lien agreement that has been filed with Yes No Yes No the clerk of courts office? Acknowledgement of Receipt of Relocation Payments? Yes No Yes No
Act of Sale Date Executed Comments: Issue Type N/A Finding Concern Issue Type N/A Finding Concern Based on the available evidence, did the Grantee/ Recipient/ Subrecipient carry out the acquisition process in a manner that minimized hardships to the owners? Comments: Yes No Yes No Issue Type N/A Finding Concern Issue Type N/A Finding Concern Residential Relocation File Review – ONSITE ONLY Property 3 Property 4 For each residential relocation claim, does the Grantee/ Recipient/ Subrecipient’s Relocation File contain the following: Comments: DEPENDENT ON RESPONSES TO SUBQUESTIONS DEPENDENT ON RESPONSES TO SUBQUESTIONS UUIssue Type N/A Finding Concern UUIssue Type N/A Finding Concern Evidence and dates of personal contacts; and description of services provided? Yes No Yes No Identification of person, displacement property, racial/ethnic group classification, age and sex of all members of household, monthly rent and utility costs for displacement and replacement housing, type of enterprise, and relocation needs and preferences? Yes No Yes No Recipient Interview and Survey (Household Case Record form for replacement-housing needs? Yes No Yes No Identification of referrals to replacement properties, date of referral, sale price or rent/utility costs (if dwelling), date of availability, and reason(s) for declining referral? Yes No Yes No Identification of actual replacement property, sale price or rent/utility costs (if dwelling), and date of relocation? Yes No Yes No Replacement dwelling inspection report; and date of inspection? Yes No Yes No A copy of each approved claim form and related documentation; evidence that the person received payment? Yes No Yes No Copy of any appeal or complaint filed and recipient's response? Yes No Yes No Copy of deferred loan lien agreement that has been filed with the clerk of courts office? Yes No Yes No Acknowledgement of Receipt of Relocation Payments? Yes No Yes No
Exhibit%2012-4.docx