Questionnaire Text

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[Questions 19 through 32 asked of persons aged 15 and over.]


31. Income in 1999 - Mark [X] the "Yes" box for each income source received during 1999 and enter the total amount received during 1999 to a maximum of $999,999. Mark [X] the "No" box if the income source was not received. If net income was a loss, enter the amount and mark [X] the "Loss" box next to the dollar amount.
For income received jointly, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark the "No" box for the other person. If exact amount is not known, please give best estimate.


31.f. Any public assistance or welfare payments from the state or local welfare office

[] Yes
Annual amount - Dollars

$_ _ _, _ _ _ .00

[] No