Sample Official DOB Determination Request
(Print on community’s official letterhead)
September 3, 1998
Adrienne Meyers
Assistant State Hazard Mitigation Officer
1532 Governor’s Way, Suite 450
Capitol City, AS 41295
Dear Ms. Meyers:
The City of Adversity, AS, requests an official duplication of benefits determination for the following properties scheduled for acquisition during the month of October 1998.
Property Address
Property Owner Name
Estimated FMV
1375 Hurricane Way, Adversity, AS  40241
Mr. Jerome Cress
$54, 630
1385 Hurricane Way, Adversity, AS  40241
Ms. Patrice Brome
$60,012
1387 Hurricane Way, Adversity, AS  40241
Richard Turkanis
$256,104
1400 Hurricane Way, Adversity, AS  40241
Dario and Pilar Garcia
$74,448
1901 Water Street, Adversity, AS  40241
Mr. Daniel DeSilva
$65,196
Any disaster assistance award information given in response to this request will be used for the sole purpose to avoid duplicating benefits to participants in the City’s property acquisition project.  At the close of the project, the information will be maintained for three years and then destroyed.  During the time that it is maintained, it will be considered confidential information and safeguarded as such.
Sincerely,
Taylor Gilmour
Director of City Services

Tool III-10, Sample Official DOB Determination Request

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