Questionnaire Text

2022 ACS
2021 ACS
2016 ACS
2011 ACS
2006 ACS
2000 1%
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2022 ACS
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e) Supplemental Security Income (SSI)
[ ] Yes -->$_____________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] No

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2021 ACS
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e) Supplemental Security Income (SSI)
[ ] Yes -->$_____________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] No

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2016 ACS
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e) Supplemental Security Income (SSI)
[ ] Yes -->$_____________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] No
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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.

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


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2011 ACS
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47. INCOME IN THE PAST 12 MONTHS.


Mark (X) the "Yes" box for each type of income this person received, and give your best estimate of the TOTAL AMOUNT during the PAST 12 MONTHS. (NOTE: The "past 12 months" is the period from today's date one year ago up through today.)

Mark (X) the "No" box to show types of income NOT received.

If net income was a loss, mark the "Loss" box to the right of the dollar amount.

For income received jointly, report the appropriate share for each person -- or, if that's not possible, report the whole amount for only one person and mark the "No" box for the other person.

e) Supplemental Security Income (SSI)
[ ] Yes -->$_____________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] No
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47e. Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.

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2006 ACS
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47. INCOME IN THE PAST 12 MONTHS.


Mark (X) the "Yes" box for each type of income this person received, and give your best estimate of the TOTAL AMOUNT during the PAST 12 MONTHS. (NOTE: The "past 12 months" is the period from today's date one year ago up through today.)

Mark (X) the "No" box to show types of income NOT received.

If net income was a loss, mark the "Loss" box to the right of the dollar amount.

For income received jointly, report the appropriate share for each person -- or, if that's not possible, report the whole amount for only one person and mark the "No" box for the other person.

e) Supplemental Security Income (SSI)
[ ] Yes -->$_____________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] No
Questionnaire instructions view entire document:  text  image
41e.Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.

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2000 1%
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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.

e. Supplemental Security Income (SSI)

[] Yes
Annual amount - Dollars
$[ ][ ][ ],[ ][ ][ ].00
[] No