Utility Allowance Information 
Updated: April 2025
Instructions: Complete this form for all properties financed by Minnesota Housing where residents are responsible for paying utilities and for applications under Minnesota Housing’s Multifamily Consolidated Request for Proposals /Housing Tax Credits (HTC) funding rounds.  
If the property consists of different building types, for example, apartments and townhomes, complete a separate form for each building type. 
Property Information
Owner Full Legal Name:      
Property Name:      	D#:      
Property Address:      
Property City, State ZIP Code:      
Building Type: 
If other, explain:      
Utility Allowance Effective Date:      
Utility Allowance applies to the following address(es) or BIN(s):      

Metering arrangements
Check the meter arrangement that best explains property.
	Units are individually metered for all tenant-paid utilities. Utility supplier(s) bill residents directly.
	At least one tenant-paid utility involves a primary meter where units are sub-metered with owner or third-party billing.  Attached is an explanation of which utilities are sub-metered and the number of primary meters for each respective utility type. 
	Other meter setup (describe)       

Note: A Ratio Utility Billing System (RUBS) is a formula that allocates a property's utility bill among its units based on the units’ relative floor space, number of occupants, or some other quantitative measure, but not based on actual consumption. All payments under a RUBS are considered rent and are not included in a utility allowance. 
Utility Allowance Source
Attach the applicable utility allowance source as supporting documentation. If the Average of Actual Consumption, HUD Utility Schedule Model or Energy Consumption Model is checked, complete the Utility Allowance Certification. If PHA, HUD or USDA is checked, attach the policy used or approval, for example, if a townhouse building is using the public housing agency (PHA) utility allowance, include the PHA’s policy to the townhouse/duplex allowance or apartment/multi allowance to support utility allowance source, as PHA policies may differ based on the number of townhouse units in a building.
	Average of Actual Consumption
	HUD Utility Schedule Model (HUSM)
	Energy Consumption Model (ECM)
	Enter Name of PHA, a local PHA that administers Housing Choice Vouchers in the area 
	As approved for HUD programs (including Section 8)
	As approved by USDA

Utility Allowance
For each size unit that applies to the building(s) identified on page 1, indicate utilities that are paid by residents by placing an X in the respective utility type.  In UA Amount, enter the amount of the Utility Allowance according to the source documentation.  Enter Totals for each unit size. If Total results in cents, round up to the next whole dollar (e.g., If the Total is $52.01, enter $53.00). 
Supporting documentation from the applicable utility source must be provided.
0BR/Efficiency/Studio		1 Bedroom	
	Gas	Elec	Oil	L.P.	Other	UA Amount			Gas	Elec	Oil	L.P.	Other	UA Amount	
Unit Heat						     		Unit Heat						     	
Water Heat						     		Water Heat						     	
Cooking						     		Cooking						     	
Unit Electric						     		Unit Electric						     	
Water Svc						     		Water Svc						     	
Sewer						     		Sewer						     	
Trash						     		Trash						     	
TOTAL:						     		TOTAL:						     	

2 Bedroom		3 Bedroom	
	Gas	Elec	Oil	L.P.	Other	UA Amount			Gas	Elec	Oil	L.P.	Other	UA Amount	
Unit Heat						     		Unit Heat						     	
Water Heat						     		Water Heat						     	
Cooking						     		Cooking						     	
Unit Electric						     		Unit Electric						     	
Water Svc						     		Water Svc						     	
Sewer						     		Sewer						     	
Trash						     		Trash						     	
TOTAL:						     		TOTAL:						     	

4 Bedroom		5 Bedroom	
	Gas	Elec	Oil	L.P.	Other	UA Amount			Gas	Elec	Oil	L.P.	Other	UA Amount	
Unit Heat						     		Unit Heat						     	
Water Heat						     		Water Heat						     	
Cooking						     		Cooking						     	
Unit Electric						     		Unit Electric						     	
Water Svc						     		Water Svc						     	
Sewer						     		Sewer						     	
Trash						     		Trash						     	
TOTAL:						     		TOTAL: