Form RW-02-04 "Federal Statistical Report Form" - California

What Is Form RW-02-04?

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

Form Details:

  • Released on August 1, 2018;
  • The latest edition provided by the California 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 Form RW-02-04 by clicking the link below or browse more documents and templates provided by the California Department of Transportation.

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Download Form RW-02-04 "Federal Statistical Report Form" - California

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STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
FEDERAL STATISTICAL REPORT FORM
RW-02-04 (NEW 08/2018)
49 CFR Part 24 Appendix B - Statistical Report
Federal Highway Administration as Lead Agency
INSTRUCTION
Report coverage. This report covers all relocation and real property acquisition activities under a Federal or a federally-assisted project or
program subject to the provisions of the Uniform Act. If the exact numbers are not easily available, an Agency may provide what it believes to
be a reasonable estimate.
Report period. Activities shall be reported on a Federal fiscal year basis, i.e., October 1 through September 30.
When to submit report. Submit a copy of this report to the lead Agency as soon as possible after September 30, but NOT LATER THAN
NOVEMBER 15.
How to report relocation payments. The full amount of a relocation payment shall be reported as if disbursed in the year during which the
claim was approved, regardless of whether the payment is to be paid in installments.
How to report dollar amounts. Round off all money entries in Parts of this section A, B and C to the nearest dollar.
Regulatory references. The references in Parts A, B, C and D of this section indicate the subpart of the regulations pertaining to the requested
information.
Month
Year
From
October
To
September
PART A. REAL PROPERTY ACQUISITION UNDER THE UNIFORM ACT
Line 1. Report all parcels acquired during the report year where title or possession was vested in the Agency during the
reporting period. The parcel count reported should relate to ownerships and not to the number of parcels of different
property interests (such as fee, perpetual easement, temporary easement, etc.) that may have been part of an acquisition
from one owner. For example, an acquisition from a property that includes a fee simple parcel, a perpetual easement
parcel, and a temporary easement parcel should be reported as 1 parcel not 3 parcels. (Include parcels acquired without
Federal financial assistance, if there was or will be Federal financial assistance in other phases of the project or program.)
Line 2. Report the number of parcels reported on Line 1 that were acquired by condemnation. Include those parcels where
compensation for the property was paid, deposited in court, or otherwise made available to a property owner pursuant to
applicable law in order to vest title or possession in the Agency through condemnation authority.
Line 3. Report the number of parcels in Line 1 acquired through administrative settlement where the purchase price for the
property exceeded the amount offered as just compensation and efforts to negotiate an agreement at that amount have
failed.
Line 4. Report the total of the amounts paid, deposited in court, or otherwise made available to a property owner pursuant
to applicable law in order to vest title or possession in the Agency in Line 1.
PART B. RESIDENTIAL RELOCATION UNDER THE UNIFORM ACT
Line 5. Report the number of households who were permanently displaced during the fiscal year by project or program
activities and moved to their replacement dwelling. The term "households" includes all families and individuals. A family
shall be reported as "one" household, not by the number of people in the family unit.
Line 6. Report the total amount paid for residential moving expenses (actual expense and fixed payment).
Line 7. Report the total amount paid for residential replacement housing payments including payments for replacement
housing of last resort provided pursuant to §24.404 of this part.
Line 8. Report the number of households in Line 5 who were permanently displaced during the fiscal year by project or
program activities and moved to their replacement dwelling as part of last resort housing assistance.
Line 9. Report the number of tenant households in Line 5 who were permanently displaced during the fiscal year by project
or program activities, and who purchased and moved to their replacement dwelling using a down payment assistance
payment under this part.
Line 10. Report the total sum costs of residential relocation expenses and payments (excluding Agency administrative
expenses) in Lines 6 and 7. (Amount automatically calculated.)
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
FEDERAL STATISTICAL REPORT FORM
RW-02-04 (NEW 08/2018)
49 CFR Part 24 Appendix B - Statistical Report
Federal Highway Administration as Lead Agency
INSTRUCTION
Report coverage. This report covers all relocation and real property acquisition activities under a Federal or a federally-assisted project or
program subject to the provisions of the Uniform Act. If the exact numbers are not easily available, an Agency may provide what it believes to
be a reasonable estimate.
Report period. Activities shall be reported on a Federal fiscal year basis, i.e., October 1 through September 30.
When to submit report. Submit a copy of this report to the lead Agency as soon as possible after September 30, but NOT LATER THAN
NOVEMBER 15.
How to report relocation payments. The full amount of a relocation payment shall be reported as if disbursed in the year during which the
claim was approved, regardless of whether the payment is to be paid in installments.
How to report dollar amounts. Round off all money entries in Parts of this section A, B and C to the nearest dollar.
Regulatory references. The references in Parts A, B, C and D of this section indicate the subpart of the regulations pertaining to the requested
information.
Month
Year
From
October
To
September
PART A. REAL PROPERTY ACQUISITION UNDER THE UNIFORM ACT
Line 1. Report all parcels acquired during the report year where title or possession was vested in the Agency during the
reporting period. The parcel count reported should relate to ownerships and not to the number of parcels of different
property interests (such as fee, perpetual easement, temporary easement, etc.) that may have been part of an acquisition
from one owner. For example, an acquisition from a property that includes a fee simple parcel, a perpetual easement
parcel, and a temporary easement parcel should be reported as 1 parcel not 3 parcels. (Include parcels acquired without
Federal financial assistance, if there was or will be Federal financial assistance in other phases of the project or program.)
Line 2. Report the number of parcels reported on Line 1 that were acquired by condemnation. Include those parcels where
compensation for the property was paid, deposited in court, or otherwise made available to a property owner pursuant to
applicable law in order to vest title or possession in the Agency through condemnation authority.
Line 3. Report the number of parcels in Line 1 acquired through administrative settlement where the purchase price for the
property exceeded the amount offered as just compensation and efforts to negotiate an agreement at that amount have
failed.
Line 4. Report the total of the amounts paid, deposited in court, or otherwise made available to a property owner pursuant
to applicable law in order to vest title or possession in the Agency in Line 1.
PART B. RESIDENTIAL RELOCATION UNDER THE UNIFORM ACT
Line 5. Report the number of households who were permanently displaced during the fiscal year by project or program
activities and moved to their replacement dwelling. The term "households" includes all families and individuals. A family
shall be reported as "one" household, not by the number of people in the family unit.
Line 6. Report the total amount paid for residential moving expenses (actual expense and fixed payment).
Line 7. Report the total amount paid for residential replacement housing payments including payments for replacement
housing of last resort provided pursuant to §24.404 of this part.
Line 8. Report the number of households in Line 5 who were permanently displaced during the fiscal year by project or
program activities and moved to their replacement dwelling as part of last resort housing assistance.
Line 9. Report the number of tenant households in Line 5 who were permanently displaced during the fiscal year by project
or program activities, and who purchased and moved to their replacement dwelling using a down payment assistance
payment under this part.
Line 10. Report the total sum costs of residential relocation expenses and payments (excluding Agency administrative
expenses) in Lines 6 and 7. (Amount automatically calculated.)
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
FEDERAL STATISTICAL REPORT FORM
RW-02-04 (NEW 08/2018)
PART C. NONRESIDENTIAL RELOCATION UNDER THE UNIFORM ACT
Line 11. Report the number of businesses, nonprofit organizations, and farms who were permanently displaced during the
fiscal year by project or program activities and moved to their replacement location. This includes businesses, nonprofit
organizations, and farms, that upon displacement, discontinued operations.
Line 12. Report the total amount paid for nonresidential moving expenses (actual expense and fixed payment.)
Line 13. Report the total amount paid for nonresidential reestablishment expenses.
Line 14. Report the total sum costs of nonresidential relocation expenses and payments (excluding Agency administrative
expenses) in Lines 12 and 13. (Amount automatically calculated.)
PART D. RELOCATION APPEALS
Line 15. Report the total number of relocation appeals filed during the fiscal year by aggrieved persons (residential and
nonresidential).
For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms
ADA Notice
Management Unit at (916) 445-1233, TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
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