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Call <strong>Center</strong> <strong>Food</strong> <strong>Stamp</strong> <strong>Phase</strong> 2 PG October 24, 2007<br />

Financial Changes<br />

Situation H: AU LIVES IN SEPARATE DWELLING, BILLED BY<br />

LANDLORD<br />

Mary Sims lives alone in a trailer behind her landlord’s<br />

house. She pays the landlord a total of $100 monthly on all<br />

utility expenses as she has no utilities in her name. She has<br />

the following costs:<br />

• heats with gas, pays the landlord $100 for gas, electricity and water<br />

• pays $250 per month rent, verifies with landlord statement<br />

• rents from John Hill, 122 Borax Ave., Sparta, Ga. 30023, 912/994/7943<br />

INTERVIEW SHELTER EXPENSES - SHEL SHEL 01<br />

Month 11 06 3001 10 05 06<br />

Client Name MARY SIMS Client ID 934000103<br />

Primary Receive Public SUA Number Phone<br />

Heat/Cool LIHEAP Housing/Exc Type v Sharing STD<br />

Expense Type Amt V Expense Type Amt V<br />

Rent<br />

Mortgage<br />

Taxes<br />

Insurance<br />

Gas<br />

Electric<br />

Telephone<br />

Water<br />

Sewer<br />

Garbage<br />

Disaster Repair<br />

Oil<br />

Other Fuel<br />

Other Housing<br />

Landlord Name<br />

Phone<br />

Address . City ST Zip<br />

Message<br />

15-lett<br />

PG-87

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