41. Income in the past 12 months.
Mark (X) in the "Yes" box for each type of income this person received. Give your best estimate of the total amount during the past 12 months. (Note: The "past 12 months" is the period from today's date one year ago up through today.)
Mark (X) in the "No" box to show types of income not received.
If net income was a loss, mark the "Loss" box to the right of the dollar amount.
For income received jointly, report the appropriate share for each person, or, if that's not possible, report the whole amount for only one person and mark in the "No" box for the other person.
41a. Wages, salary, commissions, bonuses, or tips from all jobs.
Report amount before deductions for taxes, bonds, dues, or other items
[] Yes, $____.00 (total amount for past 12 months)
[] No
41b. Self-employment income from own non-farm businesses or farm businesses, including proprietorships and partnerships.
Report net income after business expenses.
[] Yes, $____.00 (total amount for past 12 months)
[] No
[] Loss
41c. 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
41d. Social Security or Railroad Retirement
[] Yes, $____.00 (total amount for past 12 months)
[] No
41e. Supplemental Security Income (SSI)
[] Yes, $____.00 (total amount for past 12 months)
[] No
41f. Any public assistance or welfare payments from the state or local welfare office.
[] Yes, $____.00 (total amount for past 12 months)
[] No
41g. Retirement, survivor, or disability pensions. Do not include Social Security.
[] Yes, $____.00 (total amount for past 12 months)
[] No
41h. Any such other sources of income received regularly such as Veterans' (VA) payments, unemployment compensation, child support or alimony. Do not include lump sum payments such as money from an inheritance or the sale of a home
[] Yes, $____.00 (total amount for past 12 months)
[] No
42. What was this person's total income during the past 12 months?
Add entries in questions 41a to 41h; subtract any losses. If net income was a loss, enter the amount and mark (X) in the "Loss" box next to the dollar amount.
[] None
or
$____.00 (total amount for past 12 months)
[] Loss
[Answer Person Questions 41-42 only if this person is 15 years old and over.]
Mark the "Yes" or "No" box for each part, and enter the amount received in the past 12 months for each "Yes" response.
If the income from any source was received jointly by household members, 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.
When reporting income received jointly, do not include the amount for a person not listed on the List of Residents.
41.
41a. Include wages and salaries before deductions from all jobs. Be sure to include any tips, commissions, or bonuses. Owners of incorporated businesses should enter their salary here. Military personnel should include base pay plus cash housing and/or subsistence allowance, flight pay, uniform allotments, reenlistment bonuses.
41b. Include nonfarm profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated businesses you own.
Include farm profit (or loss) from self-employment in sole proprietorships and partnerships. Exclude profit (or loss) of incorporated farm businesses you own. Also exclude amounts from land rented for cash but include amounts from land rented for shares.
41c. 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 41b above. Include regular payments from an estate or trust fund.
41d. Include amounts, before Medicare deductions, of Social Security and/or Railroad Retirement payments to retired persons, to dependents of deceased insured workers, and to disabled workers.
41e. Include Supplemental Security Income (SSI) received by elderly, blind, or disabled persons.
41f. Include any public assistance or welfare payments the person receives from the Puerto Rico government or the municipio welfare office. Do not include assistance received from private charities. Do not include assistance to pay heating or cooling costs.
41g. Include retirement, survivor or disability benefits received from companies and unions, Federal, state, Puerto Rico and municipio governments, and the U.S. military. Include regular income from annuities and IRA or KEOGH retirement plans.
41h. Include Veterans (VA) disability compensation and educational assistance payments (VEAP), unemployment compensation, child support or alimony, and all other regular payments such as Armed Forces transfer payments, assistance from private charities, regular contributions from persons not living in the household.
Do not include the following as income in any item:
Refunds or rebates of any kind
Withdrawals from savings of any kind
Capital gains or losses from the sale of homes, shares of stock, etc.
Inheritances or insurance settlements
Any type of loan
Pay in-kind such as food, free rent
42.
Add the total entries (subtracting losses) for 41a. through 41h. for the past 12 months and enter that number in the space provided.