CDOT Form 437 "Moving Claim (Residential)" - Colorado

What Is CDOT Form 437?

This is a legal form that was released by the Colorado Department of Transportation - a government authority operating within Colorado. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2017;
  • The latest edition provided by the Colorado Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of CDOT Form 437 by clicking the link below or browse more documents and templates provided by the Colorado Department of Transportation.

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Download CDOT Form 437 "Moving Claim (Residential)" - Colorado

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COLORADO DEPARTMENT OF TRANSPORTATION
Project Code:
Parcel No:
Project No:
MOVING CLAIM (Residential)
Location:
County:
Claimant’s name:
State acquired address or location (include apt. # or mobile home space #):
Replacement property address or location (include apt. # or mobile home space #):
ACTUAL REASONABLE MOVING AND RELATED EXPENSES:
Moves from a Dwelling/Mobile Home (based on one or a combination of the following options):
1)
Commercial Move ........................................................................................ $
2)
Self Move
a) Fixed Residential Moving Cost Schedule ................................................. $
0
Rooms in dwelling
+ rooms in storage
=
rooms
Rooms in storage include:
b) Actual Cost Move (receipted bills for labor and equipment; hourly rates should
not exceed those paid by commercial movers for labor and equipment rental) $
NOTE: A self move based on the lower of two bids or estimates is not eligible.
I certify that I have vacated, or will vacate, the State acquired property. I have not submitted
any other claim, or received any compensation for my moving expenses. I will not accept
compensation other than as specified in this claim.
I declare that statements made in this document are true and correct to the best of my
knowledge. I understand that false statements on this document may result in loss of the entire
claim.
Claimant signature
Date:
Claimant signature
Date:
I certify that to the best of my knowledge the amount of payment is correct and that this
claim conforms in all respects to the applicable provisions of State law.
Real Estate Specialist signature
Date:
Statewide ROW Program Manager (review and approval)
Date:
CDOT Form #437 05/17
cc: Project Development Branch, ROW Services (original)
Region ROW
Previous editions are obsolete and may not be used
COLORADO DEPARTMENT OF TRANSPORTATION
Project Code:
Parcel No:
Project No:
MOVING CLAIM (Residential)
Location:
County:
Claimant’s name:
State acquired address or location (include apt. # or mobile home space #):
Replacement property address or location (include apt. # or mobile home space #):
ACTUAL REASONABLE MOVING AND RELATED EXPENSES:
Moves from a Dwelling/Mobile Home (based on one or a combination of the following options):
1)
Commercial Move ........................................................................................ $
2)
Self Move
a) Fixed Residential Moving Cost Schedule ................................................. $
0
Rooms in dwelling
+ rooms in storage
=
rooms
Rooms in storage include:
b) Actual Cost Move (receipted bills for labor and equipment; hourly rates should
not exceed those paid by commercial movers for labor and equipment rental) $
NOTE: A self move based on the lower of two bids or estimates is not eligible.
I certify that I have vacated, or will vacate, the State acquired property. I have not submitted
any other claim, or received any compensation for my moving expenses. I will not accept
compensation other than as specified in this claim.
I declare that statements made in this document are true and correct to the best of my
knowledge. I understand that false statements on this document may result in loss of the entire
claim.
Claimant signature
Date:
Claimant signature
Date:
I certify that to the best of my knowledge the amount of payment is correct and that this
claim conforms in all respects to the applicable provisions of State law.
Real Estate Specialist signature
Date:
Statewide ROW Program Manager (review and approval)
Date:
CDOT Form #437 05/17
cc: Project Development Branch, ROW Services (original)
Region ROW
Previous editions are obsolete and may not be used