HUD Utility Schedule Model (HUSM)
U.S. Department of Housing and Urban Development
Allowances Model for Tenant-Furnished Utilities and Other Services
(Based on Form 52667)

Location

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Unit Information

Energy Savings Design
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Include A/C Allowance
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Actual Allowance

  Sewer
 
  Range/Microwave
  Refrigerator
 
 

Standard Electric Utility Tariff

Use Electric Heat Tariff  
    Previous Current
Utility Name  
Rate Name  
Effective Date    
First Month of Summer   Select January if rate is not seasonal
Last Month of Summer   Select December if rate is not seasonal
Monthly Charge   $/month
Floor    
Ceiling    
Summer  
Size of First Block   kWh
Size of Second Block   kWh
Size of Third Block   kWh
Size of Fourth Block   kWh
Cost of First Block   $/kWh
Cost of Second Block   $/kWh
Cost of Third Block   $/kWh
Cost of Fourth Block   $/kWh
Winter  
Size of First Block   kWh
Size of Second Block   kWh
Size of Third Block   kWh
Size of Fourth Block   kWh
Cost of First Block   $/kWh
Cost of Second Block   $/kWh
Cost of Third Block   $/kWh
Cost of Fourth Block   $/kWh
Extra Charges   $/kWh
Taxes   %

Special Electric Heating / All Electric Tariff

Use Electric Heat Tariff  
    Previous Current
Utility Name  
Rate Name  
Effective Date    
First Month of Summer   Select January if rate is not seasonal
Last Month of Summer   Select December if rate is not seasonal
Monthly Charge   $/month
Floor    
Ceiling    
Summer  
Size of First Block   kWh
Size of Second Block   kWh
Size of Third Block   kWh
Size of Fourth Block   kWh
Cost of First Block   $/kWh
Cost of Second Block   $/kWh
Cost of Third Block   $/kWh
Cost of Fourth Block   $/kWh
Winter  
Size of First Block   kWh
Size of Second Block   kWh
Size of Third Block   kWh
Size of Fourth Block   kWh
Cost of First Block   $/kWh
Cost of Second Block   $/kWh
Cost of Third Block   $/kWh
Cost of Fourth Block   $/kWh
Extra Charges   $/kWh
Taxes   %

Standard Natural Gas Utility Tariff

    Previous Current
Utility Name  
Rate Name  
Effective Date    
Measurement Units  
First Month of Summer   Select January if rate is not seasonal
Last Month of Summer   Select December if rate is not seasonal
Monthly Charge   $/month
Floor    
Ceiling    
Summer  
Size of First Block   Therms
Size of Second Block   Therms
Size of Third Block   Therms
Size of Fourth Block   Therms
Cost of First Block   $/Therm
Cost of Second Block   $/Therm
Cost of Third Block   $/Therm
Cost of Fourth Block   $/Therm
Winter  
Size of First Block   Therms
Size of Second Block   Therms
Size of Third Block   Therms
Size of Fourth Block   Therms
Cost of First Block   $/Therm
Cost of Second Block   $/Therm
Cost of Third Block   $/Therm
Cost of Fourth Block   $/Therm
Extra Charges   $/Therm
Taxes   %

Fuel Oil Delivery Contract

    Previous Current
Supplier Name  
Effective Date    
Monthly Charge   $/month
Floor    
Ceiling    
Size of First Block   Gallons
Size of Second Block   Gallons
Size of Third Block   Gallons
Size of Fourth Block   Gallons
Cost of First Block   $/Gallon
Cost of Second Block   $/Gallon
Cost of Third Block   $/Gallon
Cost of Fourth Block   $/Gallon
Extra Charges   $/Gallon
Taxes   %

Liquified Petroleum Gas (Bottle Gas) Delivery Contract

    Previous Current
Supplier Name  
Effective Date    
Monthly Charge   $/month
Floor    
Ceiling    
Size of First Block   lbs
Size of Second Block   lbs
Size of Third Block   lbs
Size of Fourth Block   lbs
Cost of First Block   $/lb
Cost of Second Block   $/lb
Cost of Third Block   $/lb
Cost of Fourth Block   $/lb
Extra Charges   $/lb
Taxes   %

Water Supply Tariff

    Previous Current
Supplier Name  
Effective Date    
 
Monthly Charge   $/month
Floor    
Ceiling    
Size of First Block   Cubic Feet
Size of Second Block   Cubic Feet
Size of Third Block   Cubic Feet
Size of Fourth Block   Cubic Feet
Cost of First Block   $/Cubic Foot
Cost of Second Block   $/Cubic Foot
Cost of Third Block   $/Cubic Foot
Cost of Fourth Block   $/Cubic Foot
Extra Charges   $/Cubic Foot
Taxes   %

Sewer Tariff

    Previous Current
Sewer Service Name  
Effective Date    
 
Monthly Charge   $/month
Floor    
Ceiling    
Size of First Block   Cubic Feet
Size of Second Block   Cubic Feet
Size of Third Block   Cubic Feet
Size of Fourth Block   Cubic Feet
Cost of First Block   $/Cubic Foot
Cost of Second Block   $/Cubic Foot
Cost of Third Block   $/Cubic Foot
Cost of Fourth Block   $/Cubic Foot
Extra Charges   $/Cubic Foot
Taxes   %

Trash Collection Fees

    Previous Current
Studio  
1 Bedroom  
2 Bedroom  
3 Bedroom  
4 Bedroom  
5 Bedroom  

Range/Microwave Fees

    Previous Current
Studio  
1 Bedroom  
2 Bedroom  
3 Bedroom  
4 Bedroom  
5 Bedroom  

Refrigerator Fees

    Previous Current
Studio  
1 Bedroom  
2 Bedroom  
3 Bedroom  
4 Bedroom  
5 Bedroom  

Other Fees

    Previous Current
Studio  
1 Bedroom  
2 Bedroom  
3 Bedroom  
4 Bedroom  
5 Bedroom  

Climate Data

PHA Code:
Typical Low Temp:

Months HDDCDD
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Annual