Property Intake Form & Model Request

Intake Form
Property Information
Property Name
Occupancy Type
Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Ownership Entity
Program Type
2nd Program Type
Program 1 # (if known)
Program 2 # (if applicable/known)
Your Contact Information
Name

First NameLast Name
Company Name
Does your company currently have a master services agreement with Plummer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Billing Information
Is Billing Contact Same as Above
Name

First NameLast Name
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Which Service are you Requesting?
ECM (Energy Consumption Model) Utility Allowance
A detailed analysis of projected energy and water consumption based on building design, systems, equipment, and utility responsibilities. Typically used for LIHTC, underwriting, utility allowances, and agency submissions.

HUSM (HUD Utility Schedule Model)
A HUD-approved utility allowance methodology used to develop utility allowances based on location, utility rates, unit characteristics, and utility responsibilities.

Utility Allowance Estimate
A preliminary utility allowance estimate used for budgeting, underwriting, planning, or early project feasibility before a final utility allowance methodology is selected.

Common Area Analysis
An evaluation of owner-paid and common-area utility usage, including common spaces, site lighting, laundry facilities, offices, elevators, and other non-residential loads.
Service Requested

Other
Not sure which service you need?

Select the option that seems most appropriate and provide additional details in the Notes section. Our team will review the request and contact you if a different service would be more appropriate.
How did you learn about Plummer services?
Anything else you'd like us to know?

Rows	Proposed Flow Rate
Kitchen Faucet (gpm)
Lavatory Faucet (gpm)
Showerhead (gpm)
Toilet (gpf):

Rows	Utility Provider
Natural Gas
Electricity
Water
Sewer
Trash

Rows	Model #	2nd Model # (If Appicable)
HVAC Outdoor
HVAC Indoor

HUSM Questions
Utility Information

Please specify the fuel type and payment responsibility for each of the end uses below.

Rows	Fuel Type	Paid By
Space Heating
Cooking
Water Heating

Please specify payment responsibility for each the end uses below.

Rows	Paid By
Cooling
Other Electric
Water
Sewer
Trash

Please specify the utility providers and meter arrangement.

Rows	Utility Provider	Unit Meter Type
Natural Gas
Electricity
Water
Sewer
Trash

Building Characteristics
What is the HUD unit type?
Will the building qualify for Green Discounts? If so, select applicable discount below.
HUSM - Continue to Final Review

Utility Allowance Estimate Questions
Unit Mix and Types

Provide a Summary of Unit Types on the Property

Rows	Bedrooms	Bathrooms	Unit Type	# of Units	Square Ft.	Current UA (in $)
Type 1
Type 2
Type 3
Type 4
Type 5
Type 6

Enter any notes about unit types here
Utility Information

Please specify the fuel type and payment responsibility for each of the end uses below.

Rows	Fuel Type	Paid By
Space Heating
Cooking
Water Heating

Please specify payment responsibility for each the end uses below.

Rows	Paid By
Cooling
Other Electric
Water
Sewer
Trash

Please specify the energy utility providers and meter arrangement.

Rows	Utility Provider	Unit Meter Type
Natural Gas
Electricity
Water
Sewer
Trash

Final Review & Submit

Please review your information before submitting.
By signing below, I certify that the information provided in this intake form is accurate to the best of my knowledge
Should be Empty:

Rows	Model #	2nd Model # (If Appicable)
Refrigerator
Dishwasher
Clothes Dryer
Clothes Washer
Water Heater
HVAC Outdoor Model #
HVAC Indoor Model #

Intake Form

Property Information

Your Contact Information

Billing Information

Which Service are you Requesting?

ECM Questions

Project Snapshot

Energy/Code Information

Building Certifications

Unit Mix and Types

Documents & Access

Procore Access

Current Utility Allowance Information

Utility Information

Building Systems

Renewable/Alternative Energy

Additional Utility Information

Common Area Analysis Questions

Energy/Code Information

Building Certifications

Documents & Access

Procore Access

Utility Information

Building Systems

Renewable/Alternative Energy

HUSM Questions

Utility Information

Building Characteristics

Utility Allowance Estimate Questions

Unit Mix and Types

Utility Information

Final Review & Submit

Rows	# Beds	# Baths	Unit Type	# of Units	Square Ft.	Current UA (in $)
Type 1
Type 2
Type 3
Type 4
Type 5
Type 6