Questionnaire Text

2017 ACS 2011 ACS 2005 ACS 1990 5%
2016 ACS 2010 ACS 2004 ACS 1980 5%
2015 ACS 2009 ACS 2003 ACS 1970 Form 2 Metro
2014 ACS 2008 ACS 2002 ACS 1970 Form 1 Metro
2013 ACS 2007 ACS 2001 ACS 1960 5%
2012 ACS 2006 ACS 2000 5% 1950 1%
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2017 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

ANSWER PERSON QUESTIONS 47 THROUGH 48 ONLY IF THIS PERSON IS 15 YEARS OLD OR OVER.

Mark the "Yes" or "No" box for each type of income, and enter the amount received IN THE PAST 12 MONTHS for each "Yes" response.

If income from any source was received jointly by household members, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark the "No" box for the other person.

When reporting income received jointly, DO NOT include the amount for a person not listed on pages 2, 3, or 4.

DO NOT include the following as income in any item:

  • Refunds or rebates of any kind
  • Withdrawals from savings of any kind
  • Capital gains or losses from the sale of homes, shares of stock, etc.
  • Inheritances or insurance settlements
  • Any type of loan
  • Pay in-kind such as food, free rent

47a. Include wages and salaries before deductions from ALL jobs. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses.

47b. Include NONFARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated businesses the person owns.

Include FARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated farm businesses you own. Also exclude amounts from land rented for cash but include amounts from land rented for shares.

47c. Include interest received or credited to checking and saving accounts, money market funds, certificates of deposit (CDs), IRAs, KEOGHs, and government bonds.

Include dividends received, credited, or reinvested from ownership of stocks or mutual funds.

Include profit (or loss) from royalties and the rental of land, buildings or real estate, or from roomers or boarders. Income received by self-employed persons whose primary source of income is from renting property or from royalties should be included in question 47b above. Include regular payments from an estate or trust fund.

47d. Include amounts, before Medicare deductions, of Social Security and/or Railroad Retirement payments to retired persons, to dependents of deceased insured workers, and to disabled workers.

47e. Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.

47f. Include any public assistance or welfare payments the person receives from the state or county welfare office. Do not include assistance received from private charities. Do not include assistance to pay heating or cooling costs.

47g. Include retirement, survivor or disability benefits received from companies and unions, Federal, state, and local governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans.

47h. Include Veterans' (VA) disability compensation and educational assistance payments (VEAP); unemployment compensation, child support or alimony; and all other regular payments such as Armed Forces transfer payments, assistance from private charities, regular contributions from persons not living in the household.


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2016 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

ANSWER PERSON QUESTIONS 47 THROUGH 48 ONLY IF THIS PERSON IS 15 YEARS OLD OR OVER.

Mark the "Yes" or "No" box for each type of income, and enter the amount received IN THE PAST 12 MONTHS for each "Yes" response.

If income from any source was received jointly by household members, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark the "No" box for the other person.

When reporting income received jointly, DO NOT include the amount for a person not listed on pages 2, 3, or 4.

DO NOT include the following as income in any item:

  • Refunds or rebates of any kind
  • Withdrawals from savings of any kind
  • Capital gains or losses from the sale of homes, shares of stock, etc.
  • Inheritances or insurance settlements
  • Any type of loan
  • Pay in-kind such as food, free rent

47a. Include wages and salaries before deductions from ALL jobs. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses.

47b. Include NONFARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated businesses the person owns.

Include FARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated farm businesses you own. Also exclude amounts from land rented for cash but include amounts from land rented for shares.

47c. Include interest received or credited to checking and saving accounts, money market funds, certificates of deposit (CDs), IRAs, KEOGHs, and government bonds.

Include dividends received, credited, or reinvested from ownership of stocks or mutual funds.

Include profit (or loss) from royalties and the rental of land, buildings or real estate, or from roomers or boarders. Income received by self-employed persons whose primary source of income is from renting property or from royalties should be included in question 47b above. Include regular payments from an estate or trust fund.

47d. Include amounts, before Medicare deductions, of Social Security and/or Railroad Retirement payments to retired persons, to dependents of deceased insured workers, and to disabled workers.

47e. Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.

47f. Include any public assistance or welfare payments the person receives from the state or county welfare office. Do not include assistance received from private charities. Do not include assistance to pay heating or cooling costs.

47g. Include retirement, survivor or disability benefits received from companies and unions, Federal, state, and local governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans.

47h. Include Veterans' (VA) disability compensation and educational assistance payments (VEAP); unemployment compensation, child support or alimony; and all other regular payments such as Armed Forces transfer payments, assistance from private charities, regular contributions from persons not living in the household.


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2015 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

ANSWER PERSON QUESTIONS 47 THROUGH 48 ONLY IF THIS PERSON IS 15 YEARS OLD OR OVER.

Mark the "Yes" or "No" box for each type of income, and enter the amount received IN THE PAST 12 MONTHS for each "Yes" response.

If income from any source was received jointly by household members, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark the "No" box for the other person.

When reporting income received jointly, DO NOT include the amount for a person not listed on pages 2, 3, or 4.

DO NOT include the following as income in any item:

  • Refunds or rebates of any kind
  • Withdrawals from savings of any kind
  • Capital gains or losses from the sale of homes, shares of stock, etc.
  • Inheritances or insurance settlements
  • Any type of loan
  • Pay in-kind such as food, free rent

47a. Include wages and salaries before deductions from ALL jobs. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses.

47b. Include NONFARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated businesses the person owns.

Include FARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated farm businesses you own. Also exclude amounts from land rented for cash but include amounts from land rented for shares.

47c. Include interest received or credited to checking and saving accounts, money market funds, certificates of deposit (CDs), IRAs, KEOGHs, and government bonds.

Include dividends received, credited, or reinvested from ownership of stocks or mutual funds.

Include profit (or loss) from royalties and the rental of land, buildings or real estate, or from roomers or boarders. Income received by self-employed persons whose primary source of income is from renting property or from royalties should be included in question 47b above. Include regular payments from an estate or trust fund.

47d. Include amounts, before Medicare deductions, of Social Security and/or Railroad Retirement payments to retired persons, to dependents of deceased insured workers, and to disabled workers.

47e. Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.

47f. Include any public assistance or welfare payments the person receives from the state or county welfare office. Do not include assistance received from private charities. Do not include assistance to pay heating or cooling costs.

47g. Include retirement, survivor or disability benefits received from companies and unions, Federal, state, and local governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans.

47h. Include Veterans' (VA) disability compensation and educational assistance payments (VEAP); unemployment compensation, child support or alimony; and all other regular payments such as Armed Forces transfer payments, assistance from private charities, regular contributions from persons not living in the household.


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2014 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

ANSWER PERSON QUESTIONS 47 THROUGH 48 ONLY IF THIS PERSON IS 15 YEARS OLD OR OVER.

Mark the "Yes" or "No" box for each type of income, and enter the amount received IN THE PAST 12 MONTHS for each "Yes" response.

If income from any source was received jointly by household members, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark the "No" box for the other person.

When reporting income received jointly, DO NOT include the amount for a person not listed on pages 2, 3, or 4.

DO NOT include the following as income in any item:

  • Refunds or rebates of any kind
  • Withdrawals from savings of any kind
  • Capital gains or losses from the sale of homes, shares of stock, etc.
  • Inheritances or insurance settlements
  • Any type of loan
  • Pay in-kind such as food, free rent

47a. Include wages and salaries before deductions from ALL jobs. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses.

47b. Include NONFARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated businesses the person owns.

Include FARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated farm businesses you own. Also exclude amounts from land rented for cash but include amounts from land rented for shares.

47c. Include interest received or credited to checking and saving accounts, money market funds, certificates of deposit (CDs), IRAs, KEOGHs, and government bonds.

Include dividends received, credited, or reinvested from ownership of stocks or mutual funds.

Include profit (or loss) from royalties and the rental of land, buildings or real estate, or from roomers or boarders. Income received by self-employed persons whose primary source of income is from renting property or from royalties should be included in question 47b above. Include regular payments from an estate or trust fund.

47d. Include amounts, before Medicare deductions, of Social Security and/or Railroad Retirement payments to retired persons, to dependents of deceased insured workers, and to disabled workers.

47e. Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.

47f. Include any public assistance or welfare payments the person receives from the state or county welfare office. Do not include assistance received from private charities. Do not include assistance to pay heating or cooling costs.

47g. Include retirement, survivor or disability benefits received from companies and unions, Federal, state, and local governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans.

47h. Include Veterans' (VA) disability compensation and educational assistance payments (VEAP); unemployment compensation, child support or alimony; and all other regular payments such as Armed Forces transfer payments, assistance from private charities, regular contributions from persons not living in the household.


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2013 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

ANSWER PERSON QUESTIONS 47 THROUGH 48 ONLY IF THIS PERSON IS 15 YEARS OLD OR OVER.

Mark the "Yes" or "No" box for each type of income, and enter the amount received IN THE PAST 12 MONTHS for each "Yes" response.

If income from any source was received jointly by household members, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark the "No" box for the other person.

When reporting income received jointly, DO NOT include the amount for a person not listed on pages 2, 3, or 4.

DO NOT include the following as income in any item:

  • Refunds or rebates of any kind
  • Withdrawals from savings of any kind
  • Capital gains or losses from the sale of homes, shares of stock, etc.
  • Inheritances or insurance settlements
  • Any type of loan
  • Pay in-kind such as food, free rent

47a. Include wages and salaries before deductions from ALL jobs. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses.

47b. Include NONFARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated businesses the person owns.

Include FARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated farm businesses you own. Also exclude amounts from land rented for cash but include amounts from land rented for shares.

47c. Include interest received or credited to checking and saving accounts, money market funds, certificates of deposit (CDs), IRAs, KEOGHs, and government bonds.

Include dividends received, credited, or reinvested from ownership of stocks or mutual funds.

Include profit (or loss) from royalties and the rental of land, buildings or real estate, or from roomers or boarders. Income received by self-employed persons whose primary source of income is from renting property or from royalties should be included in question 47b above. Include regular payments from an estate or trust fund.

47d. Include amounts, before Medicare deductions, of Social Security and/or Railroad Retirement payments to retired persons, to dependents of deceased insured workers, and to disabled workers.

47e. Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.

47f. Include any public assistance or welfare payments the person receives from the state or county welfare office. Do not include assistance received from private charities. Do not include assistance to pay heating or cooling costs.

47g. Include retirement, survivor or disability benefits received from companies and unions, Federal, state, and local governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans.

47h. Include Veterans' (VA) disability compensation and educational assistance payments (VEAP); unemployment compensation, child support or alimony; and all other regular payments such as Armed Forces transfer payments, assistance from private charities, regular contributions from persons not living in the household.


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2012 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

ANSWER PERSON QUESTIONS 47 THROUGH 48 ONLY IF THIS PERSON IS 15 YEARS OLD OR OVER.

Mark the "Yes" or "No" box for each type of income, and enter the amount received IN THE PAST 12 MONTHS for each "Yes" response.

If income from any source was received jointly by household members, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark the "No" box for the other person.

When reporting income received jointly, DO NOT include the amount for a person not listed on pages 2, 3, or 4.

DO NOT include the following as income in any item:

  • Refunds or rebates of any kind
  • Withdrawals from savings of any kind
  • Capital gains or losses from the sale of homes, shares of stock, etc.
  • Inheritances or insurance settlements
  • Any type of loan
  • Pay in-kind such as food, free rent

47a. Include wages and salaries before deductions from ALL jobs. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses.

47b. Include NONFARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated businesses the person owns.

Include FARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated farm businesses you own. Also exclude amounts from land rented for cash but include amounts from land rented for shares.

47c. Include interest received or credited to checking and saving accounts, money market funds, certificates of deposit (CDs), IRAs, KEOGHs, and government bonds.

Include dividends received, credited, or reinvested from ownership of stocks or mutual funds.

Include profit (or loss) from royalties and the rental of land, buildings or real estate, or from roomers or boarders. Income received by self-employed persons whose primary source of income is from renting property or from royalties should be included in question 47b above. Include regular payments from an estate or trust fund.

47d. Include amounts, before Medicare deductions, of Social Security and/or Railroad Retirement payments to retired persons, to dependents of deceased insured workers, and to disabled workers.

47e. Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.

47f. Include any public assistance or welfare payments the person receives from the state or county welfare office. Do not include assistance received from private charities. Do not include assistance to pay heating or cooling costs.

47g. Include retirement, survivor or disability benefits received from companies and unions, Federal, state, and local governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans.

47h. Include Veterans' (VA) disability compensation and educational assistance payments (VEAP); unemployment compensation, child support or alimony; and all other regular payments such as Armed Forces transfer payments, assistance from private charities, regular contributions from persons not living in the household.


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2011 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

ANSWER PERSON QUESTIONS 47 THROUGH 48 ONLY IF THIS PERSON IS 15 YEARS OLD OR OVER.

Mark the "Yes" or "No" box for each type of income, and enter the amount received IN THE PAST 12 MONTHS for each "Yes" response.

If income from any source was received jointly by household members, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark the "No" box for the other person.

When reporting income received jointly, DO NOT include the amount for a person not listed on pages 2, 3, or 4.

DO NOT include the following as income in any item:

  • Refunds or rebates of any kind
  • Withdrawals from savings of any kind
  • Capital gains or losses from the sale of homes, shares of stock, etc.
  • Inheritances or insurance settlements
  • Any type of loan
  • Pay in-kind such as food, free rent

47a. Include wages and salaries before deductions from ALL jobs. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses.

47b. Include NONFARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated businesses the person owns.

Include FARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated farm businesses you own. Also exclude amounts from land rented for cash but include amounts from land rented for shares.

47c. Include interest received or credited to checking and saving accounts, money market funds, certificates of deposit (CDs), IRAs, KEOGHs, and government bonds.

Include dividends received, credited, or reinvested from ownership of stocks or mutual funds.

Include profit (or loss) from royalties and the rental of land, buildings or real estate, or from roomers or boarders. Income received by self-employed persons whose primary source of income is from renting property or from royalties should be included in question 47b above. Include regular payments from an estate or trust fund.

47d. Include amounts, before Medicare deductions, of Social Security and/or Railroad Retirement payments to retired persons, to dependents of deceased insured workers, and to disabled workers.

47e. Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.

47f. Include any public assistance or welfare payments the person receives from the state or county welfare office. Do not include assistance received from private charities. Do not include assistance to pay heating or cooling costs.

47g. Include retirement, survivor or disability benefits received from companies and unions, Federal, state, and local governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans.

47h. Include Veterans' (VA) disability compensation and educational assistance payments (VEAP); unemployment compensation, child support or alimony; and all other regular payments such as Armed Forces transfer payments, assistance from private charities, regular contributions from persons not living in the household.


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2010 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

ANSWER PERSON QUESTIONS 47 THROUGH 48 ONLY IF THIS PERSON IS 15 YEARS OLD OR OVER.

Mark the "Yes" or "No" box for each type of income, and enter the amount received IN THE PAST 12 MONTHS for each "Yes" response.

If income from any source was received jointly by household members, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark the "No" box for the other person.

When reporting income received jointly, DO NOT include the amount for a person not listed on pages 2, 3, or 4.

DO NOT include the following as income in any item:

  • Refunds or rebates of any kind
  • Withdrawals from savings of any kind
  • Capital gains or losses from the sale of homes, shares of stock, etc.
  • Inheritances or insurance settlements
  • Any type of loan
  • Pay in-kind such as food, free rent

47a. Include wages and salaries before deductions from ALL jobs. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses.

47b. Include NONFARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated businesses the person owns.

Include FARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated farm businesses you own. Also exclude amounts from land rented for cash but include amounts from land rented for shares.

47c. Include interest received or credited to checking and saving accounts, money market funds, certificates of deposit (CDs), IRAs, KEOGHs, and government bonds.

Include dividends received, credited, or reinvested from ownership of stocks or mutual funds.

Include profit (or loss) from royalties and the rental of land, buildings or real estate, or from roomers or boarders. Income received by self-employed persons whose primary source of income is from renting property or from royalties should be included in question 47b above. Include regular payments from an estate or trust fund.

47d. Include amounts, before Medicare deductions, of Social Security and/or Railroad Retirement payments to retired persons, to dependents of deceased insured workers, and to disabled workers.

47e. Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.

47f. Include any public assistance or welfare payments the person receives from the state or county welfare office. Do not include assistance received from private charities. Do not include assistance to pay heating or cooling costs.

47g. Include retirement, survivor or disability benefits received from companies and unions, Federal, state, and local governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans.

47h. Include Veterans' (VA) disability compensation and educational assistance payments (VEAP); unemployment compensation, child support or alimony; and all other regular payments such as Armed Forces transfer payments, assistance from private charities, regular contributions from persons not living in the household.


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2009 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

48.Add the total entries (subtracting losses) for 47a through 47h for the PAST 12 MONTHS and enter that number in the space provided. Mark the "Loss" box if there is a loss. Print the total amount in dollars.

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2008 ACS

No questionnaire text is available for this sample.


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2007 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

48.Add the total entries (subtracting losses) for 47a through 47h for the PAST 12 MONTHS and enter that number in the space provided. Mark the "Loss" box if there is a loss. Print the total amount in dollars.

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2006 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

42.Add the total entries (subtracting losses) for 41a through 41h for the past 12 months and enter that number in the space provided.

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2005 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

42.Add the total entries (subtracting losses) for 41a through 41h for the past 12 months and enter that number in the space provided.

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2004 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

42.Add the total entries (subtracting losses) for 41a through 41h for the past 12 months and enter that number in the space provided.

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2003 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

48.Add the total entries (subtracting losses) for 47a through 47h for the PAST 12 MONTHS and enter that number in the space provided. Mark the "Loss" box if there is a loss. Print the total amount in dollars.

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2002 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

41a.Include wages and salaries before deductions from ALL jobs. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses.

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2001 ACS
Questionnaire form view entire document:  text  image

48. What was this person's total income during the PAST 12 MONTHS? Add entries in questions 47a to 47h; subtract any losses. If net income was a loss, enter the amount and mark (X) the "Loss" box next to the dollar amount.
[ ] None OR $_______________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] Loss
Questionnaire instructions view entire document:  text  image

41a.Include wages and salaries before deductions from ALL jobs. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses.

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2000 5%
Questionnaire form view entire document:  text  image

31. INCOME IN 1999 - Mark [X] the “Yes” box for each income source received during 1999 and enter the total amount received during 1999 to a maximum of $999,999. Mark [X] the “No” box if the income source was not received. If net income was a loss, enter the amount and mark [X] the “Loss” box next to the dollar amount.

For income received jointly, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark the “No” box for the other person. If exact amount is not known, please give best estimate.

a. Wages, salary, commissions, bonuses, or tips from all jobs - Report amount before deductions for taxes, bonds, dues, or other items.

[] Yes
Annual amount - Dollars
$[ ][ ][ ],[ ][ ][ ].00
[] No
b. Self-employment income from own nonfarm businesses or farm businesses, including proprietorships and partnerships - Report NET income after business expenses.
[] Yes
Annual amount - Dollars
$[ ][ ][ ],[ ][ ][ ].00
[] No
[] Loss
c. Interest, dividends, net rental income, royalty income, or income from estates and trusts - Report even small amounts credited to an account.
[] Yes
Annual amount - Dollars
$[ ][ ][ ],[ ][ ][ ].00
[] No
d. Social Security or Railroad Retirement
[] Yes
Annual amount - Dollars
$[ ][ ][ ],[ ][ ][ ].00
[] No
e. Supplemental Security Income (SSI)
[] Yes
Annual amount - Dollars
$[ ][ ][ ],[ ][ ][ ].00
[] No
f. Any public assistance or welfare payments from the state or local welfare office
[] Yes
Annual amount - Dollars
$[ ][ ][ ],[ ][ ][ ].00
[] No
g. Retirement, survivor, or disability pensions - Do NOT include Social Security.
[] Yes
Annual amount - Dollars
$[ ][ ][ ],[ ][ ][ ].00
[] No
h. Any other sources of income received regularly such as Veterans' (VA) payments, unemployment compensation, child support, or alimony - Do NOT include lump-sum payments such as money from an inheritance or sale of a home.
[] Yes
Annual amount - Dollars
$[ ][ ][ ],[ ][ ][ ].00
[] No
32. What was this person's total income in 1999? Add entries in questions 31 a-31 h; subtract any losses. If net income was a loss, enter the amount and mark [X] the “Loss” box next to the dollar amount.

[] None OR Annual amount - Dollars
$[ ][ ][ ],[ ][ ][ ].00
[] Loss

Are there more people living here? If yes, continue with Person 2.

Person 2

1. What is this person's name? Print the name of person 2 from page 2.

Last Name
[ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ]

First Name MI
[ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ] [ ]

2. How is this person related to person 1?Mark [X] one box.
[] Husband/Wife
[] Natural-born son/daughter
[] Adopted son/daughter
[] Stepson/stepdaughter
[] Brother/sister
[] Father/mother
[] Grandchild
[] Parent-in-law
[] Son-in-law/daughter-in-law
[] Other relative - Print exact relationship
[ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ]

If NOT RELATED to Person 1:
[] Roomer, boarder
[] Housemate, roommate
[] Unmarried partner
[] Foster child
[] Other nonrelative


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1990 5%
Questionnaire form view entire document:  text  image

32. INCOME IN 1989 -

Fill the "Yes" circle below for each income source received during 1989. Otherwise, fill the "No" circle. If "Yes," enter the total amount received during 1989. For income received jointly, see instruction guide. If exact amount is not known, please give best estimate. If net income was a loss, write "Loss" above the dollar amount.

"Fill the Yes or No circle for each part and enter the amount received during 1989. If income from any source was received jointly by household members, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and fill the No circle for the other person."

a. Wages, salary, commissions, bonuses, or tips from all jobs - Report amount before deductions for taxes, bonds, dues, or other items.
[] Yes
[] No $________________ .00
Annual amount - Dollars
"Include wages and salaries from all jobs before deductions. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses, etc."
b. Self-employment income from own nonfarm business, including proprietorship and partnership -

Report NET income after business expenses.
[] Yes
[] No $________________ .00
Annual amount - Dollars
"Include NONFARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated businesses you own."
c. Farm self-employment income - Report NET income after operating expenses. Include earnings as a tenant farmer or sharecropper.
[] Yes
[] No $________________ .00
Annual amount - Dollars
"Include FARM profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated farm businesses you own. Also exclude amounts from land rented for cash but include amounts from land rented for shares."
d. Interest, dividends, net rental income or royalty income, or income from estates and trusts -
Report even small amounts credited to an account.
[] Yes
[] No $________________ .00
Annual amount - Dollars
"Include interest received or credited to checking and savings accounts, money market funds, certificates of deposit (CDS), IRAs, KEOGHs, and government bonds. Include dividends received, credited, or reinvested from ownership of stocks or mutual funds. Include profit (or loss) from royalties and the rental of land, buildings or real estate, or from roomers or boarders. Income received by self-employed persons whose primary source of income is from renting property or from royalties should be included in questions 32b or 32c above. Include regular payments from an estate or trust fund."
e. Social Security or Railroad Retirement
[] Yes
[] No $________________ .00
Annual amount - Dollars
"Include Social Security (and/or Railroad Retirement) payments to retired persons, to dependents of deceased insured workers, and to disabled workers before Medicare deductions."
f. Supplemental Security Income (SSI), Aid to Families with Dependent Children (AFDC), or other public assistance or public welfare payments.
[] Yes
[] No $________________ .00
Annual amount - Dollars
"Include Supplemental Security Income received by aged, blind, or disabled persons, Aid to Families with Dependent Children, or income from other government programs such as general or emergency assistance. Do not include assistance received from private charities. Exclude assistance to pay for heating (cooling) costs."
g. Retirement, survivor, or disability pensions - Do NOT include Social Security.
[] Yes
[] No $________________ .00
Annual amount - Dollars
"Include retirement, disability, or survivor benefits received from companies and unions; Federal, State, and local governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans."
h. Any other sources of income received regularly such as Veterans' (VA) payments, unemployment compensation, child support, or alimony - Do NOT include lump-sum payments such as money from an inheritance or the sale of a home.
[] Yes
[] No $________________ .00
Annual amount - Dollars
"Include Veterans' (VA) disability compensation and educational assistance payments (VEAP), unemployment compensation, child support or alimony, and all other regular payments such as Armed Forces transfer payments; assistance from private charities; regular contributions from persons not living in the household, etc.

"Do not include the following as income in any item:

- Refunds or rebates of any kind
- Withdrawals from savings of any kind
- Capital gains or losses from the sale of homes, shares of stock, etc.
- Inheritances or insurance settlements
- Any type of loan
- Pay in-kind such as food, free rent, etc."
33. What was this person's total income in 1989?

Add entries in questions 32a through 32h; subtract any losses. If total amount was a loss, write "Loss" above amount.

[] None OR $_________________ .00
Annual amount - Dollars

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1980 5%
Questionnaire form view entire document:  text  image


32. Income in 1979 -
Fill circles and print dollar amounts.
If net income was a loss, write "Loss" above the dollar amount.
If exact amount is not known, give best estimate.
For income received jointly by household members, see instruction guide.

During 1979 did this person receive any income from the following sources?
If "Yes" to any of the sources below - How much did this person receive for the entire year?

"Fill the Yes or No circle for each part and enter the appropriate amount. If income from any source was received jointly by household members, report if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark No for the other person, unless the other person has additional income of the same type."

a. Wages, salary, commissions, bonuses, or tips from all jobs . . .

Report amount before deductions for taxes, bonds, dues, or other items.
[] Yes - $____________________.00
(Annual amount - Dollars)
[] No

"Include sick leave pay. Do not include reimbursement for business expenses and pay "in kind," (for example, food, lodging received as payment for work performed)."

b. Own nonfarm business, partnership, or professional practice . . .

Report net income after business expenses.
[] Yes - $____________________.00
(Annual amount - Dollars)
[] No

"Include net earnings (gross receipts minus operating expenses) from a nonfarm business. If business lost money, write "Loss" above the amount."

c. Own farm . . .

Report net income after operating expenses. Include earnings as a tenant farmer or sharecropper.
[] Yes - $____________________.00
(Annual amount - Dollars)
[] No

"Include net earnings (gross receipts minus operating expenses) from a farm. If farm lost money, write "Loss" above the amount."

d. Interest, dividends, royalties, or net rental income . . .

Report even small amounts credited to an account.
[] Yes - $____________________.00
(Annual amount - Dollars)
[] No

"Include interest and dividends credited to the person's account (for example, from savings accounts and stock shares), net royalties, and net income from rental property."

e. Social Security or Railroad Retirement . . .

[] Yes - $____________________.00
(Annual amount - Dollars)
[] No

"Include Social Security or Railroad Retirement payments to retired persons, to dependents of deceased insured workers and to disabled workers."

f. Supplemental Security (SSI), Aid to Families with Dependent Children (AFDC), or other public assistance or public welfare payments . . .

[] Yes - $____________________.00
(Annual amount - Dollars)
[] No

"Include public assistance or welfare payments received from Federal, State, or local agencies. Do not include private welfare payments."

g. Unemployment compensation, veterans' payments, pensions, alimony or child support, or any other sources of income received regularly . …

Exclude lump-sum payments such as money from an inheritance or the sale of a home.
[] Yes - $____________________.00
(Annual amount - Dollars)
[] No

"Include all other regular payments, such as government employee retirement, union or private pensions and annuities; unemployment benefits; worker's compensation; Armed Forces allotments; private welfare payments; regular contributions from persons not living in the household; etc. Do not include lump-sum payments received from the sale of property (capital gains), insurance policies, inheritances, etc."


33. What was this person's total income in 1979?

Add entries in questions 32a through g; subtract any losses.
If total amount was a loss, write "Loss" above amount.
$____________________.00 OR [] None
(Annual amount - Dollars)
"If no income was received in 1979, fill the None circle. If total income was a loss, write "Loss" above the amount."

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1970 Form 2 Metro
Questionnaire form view entire document:  text  image

[All]
40. Earnings in 1969 - Fill parts a, b, and c for everyone who worked any time in 1969 even if he had no income. (If exact amount is not known, give best estimate.)

a. How much did this person earn in 1969 in wages, salary, commissions, bonuses, or tips from all jobs? (Before deductions for taxes, bonds, dues, or other items.)
$ ____________.00
(Dollars only)

OR
[] None
b. How much did he earn in 1969 from his own nonfarm business, professional practice, or partnership? (Net after business expenses. If business lost money, write "Loss" above amount.)
$ ____________.00
(Dollars only)

OR
[] None
c. How much did he earn in 1969 from his own farm? (Net after operating expenses. Include earnings as a tenant farmer or sharecropper. If farm lost money, write "Loss" above amount.)
$ ____________.00
(Dollars only)

OR
[] None
"Enter the amount or fill the None circle in a, b, and c. Part 40a includes "sick leave" pay. Part 40a excludes military bonuses, reimbursement for business expenses, and pay "in kind." The owner of an unincorporated nonfarm business should include his net earnings in part 40b. If the business or farm is incorporated, his earnings should be included in part 40a."
[All]
41. Income other than earnings in 1969 - Fill in parts a, b, and c. (If exact amount is not known, give best estimate.) "Enter the amount or fill the None circle in a, b, and c."

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1970 Form 1 Metro
Questionnaire form view entire document:  text  image

[All]
40. Earnings in 1969 - Fill parts a, b, and c for everyone who worked any time in 1969 even if he had no income. (If exact amount is not known, give best estimate.)

a. How much did this person earn in 1969 in wages, salary, commissions, bonuses, or tips from all jobs? (Before deductions for taxes, bonds, dues, or other items.)
$ ____________.00
(Dollars only)

OR
[] None
b. How much did he earn in 1969 from his own nonfarm business, professional practice, or partnership? (Net after business expenses. If business lost money, write "Loss" above amount.)
$ ____________.00
(Dollars only)

OR
[] None
c. How much did he earn in 1969 from his own farm? (Net after operating expenses. Include earnings as a tenant farmer or sharecropper. If farm lost money, write "Loss" above amount.)
$ ____________.00
(Dollars only)

OR
[] None
"Enter the amount or fill the None circle in a, b, and c. Part 40a includes "sick leave" pay. Part 40a excludes military bonuses, reimbursement for business expenses, and pay "in kind." The owner of an unincorporated nonfarm business should include his net earnings in part 40b. If the business or farm is incorporated, his earnings should be included in part 40a."
[All]
41. Income other than earnings in 1969 - Fill in parts a, b, and c. (If exact amount is not known, give best estimate.) "Enter the amount or fill the None circle in a, b, and c."

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1960 5%

No questionnaire text is available for this sample.


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1950 1%
Questionnaire form view entire document:  text  image
31. Income received by this person in 1949:
31a. Last year (1949), how much money did he earn working as an employee for wages or salary?
(Enter amount before deductions for taxes, etc. or None)

31b. Last year, how much money did he earn working in his own business, professional practice, or farm? (Enter net income or None)
31c. Last year, how much money did he receive from interest, dividends, veteran's allowances, pensions, rents, or other income (aside from earnings)? ($ or None)
Questionnaire instructions view entire document:  text  image

Item 31a. Wages or salary

229. Item 31a. Entry for each sample person 14 years old or over.-There must be an entry of an amount or a check in the "None" box for each person 14 years of age or over who is on a sample line. The amount must be entered to the nearest whole dollar, not in dollars and cents. Enter " 10,000 + " if amount received was more than $10,000. Accept the respondent's best estimate if he does not know the exact amount.

230. Time period covered by item 31a.-January 1, 1949, through December 31, 1949.

231. General definition of wages or salary.-The total amount of money earned by a person for all work done as an employee. This may have been earned on more than one job during the year. X age and salary income includes "take-home" pay plus all deductions and contributions such as deductions for withholding tax, Social Security, etc. It also includes receipts from the following sources-tips, piece-rate payments, nonmilitary cash bonuses, a share of the profits if received by an employee in addition to wages or salary, armed forces pay. National Guard pay, and cash pay received by a farm laborer or manager.