Local Agency Forms & Brochures



Local Agency Forms & BrochuresLPA BrochuresTransportation Property Needs LPA GenericNon-Residential Relocation LPA GenericPersonal Property Only Relocation LPA GenericResidential Relocation LPA GenericLPA Agreement Forms (for WSDOT use)224-075 EFGovernment Agreement for Aid224-076 EFGovernment Agreement for Aid (For Highway, Road, and Street Purposes Only)130-020 EFTask Assignment224-102 EFProject Review Reimbursable Agreement (“J” Agreement)LPA General FormsLPA-001Right of Way ProceduresLPA-002 ROW Phase QuestionnaireLPA-003Waiver of Appraisal ProcedureLAC Forms (for WSDOT use)LPA-011Project Review WorksheetLPA-012Parcel Review WorksheetLPA-013Residential Relocation Review WorksheetLPA-014Non-Residential Relocation Review WorksheetLPA-015Personal Property Only (PPO) Review WorksheetLPA-016Certification Review Oversight ReportLPA-017Certification Review Transmittal Letter (Cert 1 and 2)LPA-018Certification Review Transmittal Letter (Cert 3)LPA-019Sample Size Determination FormLPA-020Project Oversight Review FormLPA-021Parcel Oversight Review FormLPA-022Relocation Oversight Review FormLPA Appraisal FormsLPA-205Certificate of AppraisalLPA-210Market Data SheetLPA-214bCertificate of ValueLPA-215PFE Parcel WorksheetLPA-215bTrue Cost Estimate Parcel WorksheetLPA-215cPFE & True Cost Estimate Summary WorksheetsLPA-216Administrative Offer Summary (AOS)LPA-217Residential Realty/Personalty ReportLPA-218Commercial or Industrial Realty/Personalty ReportLPA Acquisition FormsLPA-300Recording Cover SheetLPA-301DiaryLPA-302Warranty DeedLPA-303Special Warranty DeedLPA-305Warranty Deed (Access Rights Only)LPA-306Quitclaim DeedLPA-307Quitclaim Deed (Access Rights Only)LPA-308Partial Release of MortgageLPA-309Partial Release of Mortgage (Access Rights Only)LPA-310Request for Partial ReconveyanceLPA-311Partial ReconveyanceLPA-312Partial Release of LeaseLPA-313Release of LeaseLPA-316Partial Release of JudgmentLPA-317Possession and Use AgreementLPA-321Real Property Voucher (Excel)LPA-323Consent to Change of GradeLPA-324EasementLPA-325Temporary EasementLPA-326PermitLPA-330Bill of SaleLPA-333Request to Accept Mortgage (deed of trust) EncumbranceLPA-333aLetter to Owner-Agree to Pay Mortgage (deed of trust) EncumbranceLPA-350Offer LetterLPA-351Revised Offer LetterLPA-355Quitclaim Deed (Release Easement)LPA-356Quitclaim Deed (Access Use for Easement)LPA-362Agency Payment LetterLPA-365Individual NotaryLPA-366Corporate NotaryLPA-367Attorney in Fact NotaryLPA-368Self and Attorney in Fact NotaryLPA-369Guardian, Executor, Administrator NotaryLPA-370Mayor City Commissioners NotaryLPA-371County Commissioners NotaryLPA-372School District NotaryLPA-373Signature by Mark NotaryLPA-374Partnership NotaryLPA-375Trustee NotaryLPA 376Limited Liability Company NotaryLPA-377Agency NotaryLPA-382 Relocation Eligibility ReportLPA Certification FormsLPA-383No Right of Way CertificateLPA-384Certificate 1, No RelocationLPA-385Certificate 1, Residential RelocationLPA-386Certificate 1, Non-Residential RelocationLPA-387Certificate 1, Combination of Relocation TypesLPA-388Certificate 2, No RelocationLPA-389Certificate 2, Residential RelocationLPA-390Certificate 2, Non-Residential RelocationLPA-391Certificate 2, Combination of Relocation TypesLPA-392Certificate 3, No RelocationLPA-393Certificate 3, Residential RelocationLPA-394Certificate 3, Non-Residential RelocationLPA-395Certificate 3, Combination of Relocation TypesLPA-396Certificate 3, Design Build Phased – Under ConstructionLPA-397Certification WorksheetLPA-398Certification Worksheet – Design BuildLPA-399WSDOT Local Agency Certification Concurrence Letter (WSDOT Use Only)LPA Property Management FormsLPA-407Disposal Approval RequestLPA Relocation FormsLPA-501General Notice of Relocation Rights (Non-Residential)LPA-502General Notice of Relocation Rights (Landlord)LPA-503General Notice of Relocation Rights (Personal Property)LPA-504General Notice of Relocation Rights (Residential)LPA-505Notice of Eligibility, Entitlements, and 90-Day Assurance (Non-Residential)LPA-505aNotice of Eligibility, Entitlements, and 90-Day Assurance (Non-Residential Fixed Payment) DELETED September 2019LPA-507Notice of Eligibility, Entitlements, and 90-Day Assurance (Residential Owner)LPA-507aNotice of Revised Price Differential (Residential Owner)LPA-507bNotice of Eligibility – Non DSS (Residential Owner)LPA-507cNotice of Eligibility w/Carve Out Language (Residential Owner)LPA-508Notice of Eligibility, Entitlements, and 90-Day Assurance (Residential Tenant)LPA-508aNotice of Eligibility – Non DSS (Residential Tenant)LPA-509Notice of Eligibility, Entitlements, and 90-Day Assurance (Landlord)LPA-510Notice of Eligibility, Entitlements, and 90-Day Assurance (Personal Property)LPA-511Notice of Eligibility, Entitlements, and 90-/Day Assurance (Mobile Homes – Own Mobile Home, Rent Site)LPA-511bNotice of Eligibility, Entitlements, and 90-/Day Assurance (Mobile Homes – Own Mobile Home, Own Site) DELETED September 2019LPA-511cNotice of Eligibility, Entitlements, and 90-/Day Assurance (Mobile Homes – Rent Mobile Home, Rent Site) DELETED September 2019LPA-512Notice of Intent to AcquireLPA-513Mortgage Interest Differential Payment (MIDP)LPA-514Incidental Purchase Expense Work SheetLPA-515Documentation of Living ExpensesLPA-516Price Differential Entitlement InstructionsLPA-516aDown Payment Assistance Entitlement InstructionsLPA-517Vacate InspectionLPA-518Agreement for Provisional Replacement Housing PaymentLPA-519Fixed Payment (In-Lieu) Work Sheet – Non-ResidentialLPA-520Request for Moving Bid Cover LetterLPA-521Request for Proposal and Moving Specification FormatLPA-522Replacement Site Search LogLPA-523Application for Reestablishment Expenses – Non-Residential DELETED September 2019LPA-524Eligibility ReportLPA-525(DSS) Replacement Dwelling Inspection ReportLPA-526Loss of Tangibles/Substitute Personal Property Bid FormLPA-527Loss of Tangibles ComputationLPA-528Substitute Personal Property ComputationLPA-529Residential ChecklistLPA-530Non-Residential ChecklistLPA-531Personal Property ChecklistLPA-532Residential Occupancy SurveyLPA-533Non-Residential Occupancy SurveyLPA-533aNon-Residential (Landlord) Occupancy SurveyLPA-534Personal Property Only Occupancy SurveyLPA-535Pre Move Inventory – Non-ResidentialLPA-536Final Claim Letter – Non-ResidentialLPA-536aFinal Claim Letter – ResidentialLPA-537Relocation Assistance VoucherLPA-538Application for Fixed Payment – Non-ResidentialLPA-539Monthly Income VerificationLPA-540Move Expense Agreement – ResidentialLPA-540aMove Expense Agreement – Non-ResidentialLPA-541Housing Comparison Work SheetLPA-542Price Differential ReportLPA-542aInstructions for Price Differential ReportLPA-543Rent Supplement ReportLPA-543aInstructions for Rent Supplement ReportLPA-544Notice of Relocation Non-eligibilityLPA-545Non-Residential Obsolete Printed ItemsLPA-546Mobile Home Move Cost – Personal Property DELETED September 2019LPA-547Lawfully Present in the United States CertificationLPA-548Transfer of Ownership – Non-ResidentialLPA-549Claim Determination LetterLPA-550Notification of Professional Home InspectionLPA-551NEW Personal Property Only Relocation Plan (September 2019) ................
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