Questionnaire Text

Questionnaire form view entire document: text image

Housing (continued)

B Answer questions 18a and b if this house, apartment, or mobile home is rented. Otherwise, skip to question 19.

18.

a. What is the monthly rent for this house, apartment, or mobile home?

Monthly amount - dollars
_ _ , _ _ _ _

b. Does the monthly rent include any meals?

[] Yes
[] No

Questionnaire instructions view entire document: text image

Answer questions 1 through 21 for the house, apartment, or mobile home at the address on the mailing label.

18b. If meals are included in the monthly rent payment, or you must contract for meals or a meal plan in order to live in this house, apartment, or mobile home, mark the "Yes" box.