Questionnaire Text

Questionnaire form view entire document:  text  image
23. LAST WEEK, did this person do ANY work for either pay or profit?

Mark (X) the "Yes" box even if the person worked only 1 hour, or helped without pay in a family business or farm for 15 hours or more, or was on active duty in the Armed Forces

[ ] Yes
[ ] No -> SKIP to question 29

36. For whom did this person work?

If now on active duty in the armed forces, mark (X) this box -> [ ] and print the branch of the Armed Forces

Name of company, business, or other employer

____________________________________

Questionnaire instructions view entire document:  text  image
23.Count as work - Mark the "Yes" box if this person performed:

  • Work for someone else for wages, salary, piece rate, commission, tips, or payments "in kind" (for example, food or lodging received as payment for work performed).
  • Work in own business, professional practice, or farm.

  • Any work in a family business or farm, paid or not.
  • Any part-time work including babysitting, paper routes, etc.
  • Active duty in the Armed Forces.
Do not count as work - Mark the "No" box if this person performed:

  • Housework or yard work at home.
  • Unpaid volunteer work.
  • School work done as a student.
  • Work done as a resident of an institution.
36.If the person worked for a company, business, or government agency, print the name of the company, not the name of the person's supervisor. If the person worked for an individual or a business that had no company name, print the name of the individual worked for. If the person worked in his or her own un-named business, print "self-employed."