Questionnaire Text

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E. Marital Status Information

Only for those 12 years of age and older

17. What is your current marital status?

[] 1 Single
[] 2 Married or cohabiting
[] 3 Widowed
[] 4 Divorced or separated

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d. Civil state information This question is for men and women 12 years or older.

Question 17.What is your current civil state?

Mark the box corresponding to the given response.