Questionnaire Text

Questionnaire form view entire document: text image

Housing

Please answer the following questions about the house, apartment, or mobile home at the address on the mailing label.

3. When did PERSON 1 (listed on page 2) move into this house, apartment, or mobile home?

Month [ ][ ]
Year [ ][ ][ ][ ]

[A] - Answer questions 4-6 ONLY if this is a HOUSE OR A MOBILE HOME; otherwise, SKIP to question 7a.

Questionnaire instructions view entire document: text image

ANSWER QUESTIONS 1 THROUGH 21 FOR THE HOUSE, APARTMENT, OR MOBILE HOME AT THE ADDRESS ON THE MAILING LABEL.

3. Enter the month and year that Person 1 listed on page 2 last moved into this house, apartment, or mobile home.