Questionnaire Text

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H11.


[Answer this question if you pay rent for your housing unit.]


a. If you pay rent by the month --
What is the monthly rent?

Write the amount here _____.00
and
Fill one circle here

[] Less than $10
[] $10 to $19
[] $20 to $29
[] $30 to $39
[] $40 to $49
[] $50 to $59
[] $60 to $69
[] $70 to $79
[] $80 to $89
[] $90 to $99
[] $100 to $119
[] $120 to $149
[] $150 to $199
[] $200 or more


b.
[If you do not pay monthly rent]
What is your rent, and what period of time does it cover?

$ (Nearest dollar) _____.00 per (Week, half-month, year, etc.) _____


[For a vacant unit, also fill D, E, A, H2 to H7, and H9 to H11]