[All]
H12.
Answer this question if you pay rent for your living quarters.
"Report the rent agreed to or contracted for, even if the furnishings, utilities, or services are included."
a. If rent is paid by the month --
What is the monthly rent?
Write amount here $ ____________.00 (Nearest dollar)
and Fill one circle
[] Less than $30
[] $30 to $39
[] $40 to $49
[] $50 to $59
[] $60 to $69
[] $70 to $79
[] $80 to $89
[] $90 to $99
[] $100 to $119
[] $120 to $149
[] $150 to $199
[] $200 to $249
[] $250 to $299
[] $300 or more
"If you pay rent by the month, write in the amount of rent and fill one circle."
b. If rent is not paid by the month -
What is the rent, and what period of time does it cover?
$ ____________.00 per ______________________________
(Nearest dollar) (Week, half-month, year, etc.)