Questionnaire Text

Questionnaire form view entire document: text image

e. A sink with a faucet?

[] 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.

8e. Mark "yes" to "sink with a faucet" if the sink is inside the house, apartment, or mobile home and the water can be turned on and off.