Questionnaire Text

Questionnaire form view entire document: text image

4. What is this person's marital status?

[] Now Married
[] Widowed
[] Divorced
[] Separated
[] Never married

Questionnaire instructions view entire document: text image

4.Mark the "Now married" box for a married person regardless of whether his or her spouse is living in the household unless they are separated. If the person's only marriage was annulled, mark the "Never married" box.