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-LC'xVM g IT <br />Utility Allowance Schedule U.S Department of Housing and OMB Approval No. 2577-0169 <br />See Public Reporting and instructions on back, Urban Development exp. 7/31/2022 <br />Office of Public and Indian Housing <br />Local dy/IPH A <br />Unit Type <br />Date (/dd/yyyy) <br />COUNTY OF HAWAI'l-,Energy <br />Star <br />Apartmient Building, <br />1/0rnm1/2021 <br />Utility or Service <br />Fuel Type <br />0 BR <br />I BR <br />2 BR <br />3 BR <br />4 1311 <br />5 BR_ <br />Heating <br />Naturat Gas <br />Bottled Gas <br />Electric <br />— - - - — ------- - - <br />Electric - Heat Pump <br />Fuel Oil <br />. .... . ..... . <br />Other <br />Cooking <br />Natural Gas <br />9 <br />10 <br />15 <br />20 <br />24 <br />29 <br />Bottled Gas <br />El:ect�ric <br />10 <br />12 <br />17 <br />24 <br />31 <br />37 <br />Other <br />Other Electric <br />38 <br />44 <br />62 <br />79 <br />98 <br />117 <br />Air Conditioning <br />Water HeatingNatural <br />Gas <br />18 <br />22 <br />1 31: <br />41 <br />50 <br />60 <br />Bottled Gas <br />Electric <br />2�2 <br />26 <br />36 <br />46 <br />54 <br />62' <br />Fuel Ofll, <br />Water <br />22 <br />9A <br />34 <br />43 <br />50 <br />57 <br />Sewer <br />40 <br />40 <br />40 <br />40, <br />40 <br />40 <br />Trash Collection <br />Other - specify <br />Range/Microwave <br />25 <br />25 <br />25 <br />25 <br />25 <br />25 <br />Refrigerator <br />25 <br />5 <br />25 <br />25 <br />25, <br />Actual Family Allowances - May be used by the famiiliy to compute allowance white <br />Utility/Service/Appliance <br />Allowance <br />,searching for a, uniit. <br />Heating <br />Head of Household Name <br />Cooking <br />Other Electric <br />Air Conditioning <br />Unit Address <br />W ater Heating <br />Water <br />....... ....... <br />Sewer <br />Trash Collection <br />Other <br />Number of Bectrooms LL <br />Range/Microwave <br />Refrigerator <br />T—otai <br />Previous versions are obsolete. 1 Form HUD -52667 (7/2019) <br />