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RELOCATION NEEDS ASSESSMENT FORM <br />PAGE 4 <br />4. Have you been served an Eviction Notice to vacate the unit in which you now <br />occupy? [ ] If so, what was the reason the Eviction Notice was served? <br />5. Do you have to vacate the unit which you currently occupy for any of the following <br />reasons? (Please check the appropriate responses.) <br />[ ] Must move due to road construction or other federal or state government <br />action. <br />[ ] Must move because of Non Residential Development. Current unit to be <br />demolished. <br />[ ] Must move due to any other government action not listed above, i.e., <br />Zoning requirement, unit not a legal dwelling unit. <br />[ ] Must move because there are too many people and not enough bedrooms <br />in the present unit. <br />6. Current monthly rent: If you are sharing rent with another family, <br />what is your portion of the monthly rent? <br />Whose name is on the rental lease or occupancy agreement? <br />(ATTACH COPY OF RENTAL LEASE OR <br />OCCUPANCY AGREEMENT AND RENT RECEIPTS IF YOU ARE APPLYING <br />FOR A RELOCATION ASSISTANCE PAYMENT.) <br />What type of utilities do you pay for? <br />Are you receiving assistance under any utility assistance program? <br />s <br />