Questionnaire Text

Questionnaire form view entire document:  text  image
c) Interest, dividends, net rental income, royalty income, or income from estates and trusts. Report even small amounts credited to an account
[ ] Yes -->$_____________________.00 (TOTAL AMOUNT for past 12 MONTHS)
[ ] No
[ ] Loss
Questionnaire instructions view entire document:  text  image
47c. Include interest received or credited to checking and saving accounts, money market funds, certificates of deposit (CDs), IRAs, KEOGHs, and government bonds.

Include dividends received, credited, or reinvested from ownership of stocks or mutual funds.

Include profit (or loss) from royalties and the rental of land, buildings or real estate, or from roomers or boarders. Income received by self-employed persons whose primary source of income is from renting property or from royalties should be included in question 47b above. Include regular payments from an estate or trust fund.