DI-382 Claim for Relocation Payments - Nonresidential - Schedul

OMB Control Number: 1084-0010
Expiration Date: 12/31/2021

DI-382 (03 -2019)
Department of the Interior

Schedule C
Search Expenses – Nonresidential
(Under Sec. 202, P.L. 91-646, as amended)

Section 1 – To Be Completed By Claimant
1. NAME:

2. PROJECT/TRACT:

3. ACTUAL EXPENSES:

AMOUNT CLAIMED

FOR AGENCY USE ONLY

(hours) at ______ (rate) ................................... $

0.00

$

TRANSPORTATION ....... ______ (miles) at ______ (rate) ................................... $

0.00

$

LODGING ...................... ______ (nights) at ______ (rate) ................................... $

0.00

$

SEARCHING TIME ........ ______

COST OF MEALS ....................................................................................................... $

$

TIME SPENT IN OBTAINING PERMITS
AND ATTENDING ZONING HEARINGS. ....... _____ (hours) at ______ (rate) ...... $

0.00

TIME SPENT NEGOTIATING THE
PURCHASE OF A REPLACEMENT SITE ..... _____ (hours) at ______ (rate) ...... $

0.00

$

$

FEES PAID TO REAL ESTATE AGENTS OR BROKERS (excluding commissions) . $

$

OTHER (list) ............................................................................................................... $

$

.................................................................................................................................... $

$

0.00

TOTAL ......................................................................................................................... $

0.00

$

4. REMARKS:

5. SIGNATURE:

SIGNATURE:
___________________________________________

DATE: ___________________________________________

___________________________________________
DATE:

___________________________________________

Section 2 – To Be Completed By Agency

PAYMENT

AMOUNT

SIGNATURE

TITLE

DATE

RECOMMENDED:

_________________

________________________________________

_________________

______________

APPROVED:

_________________

________________________________________

_________________

______________

FBMS INVOICE NO.:_________________

DI-382 Schedule C - Page 1 of 1