Questionnaire Text

Questionnaire form view entire document:  text  image
10. Which FUEL is used MOST for heating this house, apartment or mobile home?
[ ] Gas: from underground pipes serving the neighborhood
[ ] Gas: bottled, tank or LP
[ ] Electricity
[ ] Fuel oil, kerosene, etc.
[ ] Coal or coke
[ ] Wood
[ ] Solar energy
[ ] Other fuel
[ ] No fuel used
Questionnaire instructions view entire document:  text  image
13a-13d.
If your house, apartment, or mobile home is rented, enter the costs for utilities and fuels only if you pay for them in addition to the monthly rent.
If you live in a condominium, enter the costs for utilities and fuels only if you pay for them in addition to your condominium fee.
If your fuel and utility costs are included in your rent or condominium fee, mark the "Included in rent or in condominium fee" box. DO NOT enter any dollar amounts.
For items 13a and 13b, report LAST MONTH'S COSTS. For items 13c and 13d, report total costs for the PAST 12 MONTHS.
Estimate as closely as possible if you do not know exact costs. If you have lived in this house, apartment, or mobile home less than one year, estimate the costs for the PAST 12 MONTHS in 13c and 13d.
Report amounts even if your bills are unpaid or paid by someone else. If the bills include utilities or fuel used also by another apartment or a business establishment, estimate the amounts for your house or apartment only. If gas and electricity are billed together, enter the combined amount in 13a and mark the "Included in electricity payment entered above" box in item 13b.