Office of Planning, Environment, & Realty (HEP)
Planning • Environment • Real Estate
Personal Interview Questionnaire
Version 05/15/2009
State:
Project:
Parcel:
Name of Business:
Contact:
Old Address:
New Address:
Type of Business:
Phone Number:
(W)
(H)
(M)
Tenancy Status:
| Displacement Site: | Owner  |
Tenant |
|
| Replacement Site: | Owner |
Tenant |
Date of Move:
| Relocation Payments Received: | Yes |
No |
Moving $
Reestablishment $
In Lieu $
Search $
1.
|
b. If not, what specific items do you feel you should have been paid for but were not?
2.
| a. Did you request advisory assistance from the State? | Yes |
No |
b. In terms of advisory assistance, did the State:
| Attempt to determine your needs and preferences? | Yes |
No |
| Assist in locating replacement locations? | Yes |
No |
| Provide references, contacts and counseling to minimize hardships? | Yes |
No |
| Inform you that you could appeal disputed amounts and payments types? | Yes |
No |
| Did you specifically ask for any of the above listed services? | Yes |
No |
3. How did you locate your replacement site?
| 4. Was the payment you received for searching (the search payment) adequate? | Yes |
No |
| 5. Did you have code-related cost modifications (e.g., building codes) with the new site, building or equipment? | Yes |
No |
| 6. Approximately what was the total cost of these code-related modifications? | Yes |
No |
| 7. Do you feel you were treated fairly by the displacing agency? | Yes |
No |
8. How long did it take you to receive payment from the agency?
9.
| a. After the completion of the move, did you incur an increase or decrease in business, i.e., clients, profits, etc.? | Increase |
Decrease |
b. What do you feel caused this increase or decrease?
10.If you could design a better program, what changes would you make?
11.What additional services could the displacing agency offer to lessen the impact of business displacements?
12.What was the effect of the move on your employees?
13.Interview remarks:
Interview completed by: Date:
