47. Income in the past 12 months
Mark (x) the "yes" box for each type of income this person received and give your best estimate of the total amount during the past 12 months (note: the past 12 months is the period from today's d dta one year ago up through today.)
Mark (x) 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 the "no" box the other person.
a. 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
b. Self-employment income from own nonfarm businesses or farm businesses, including propietirships and partnerships. Report net income after business expenses.
[] Yes
- _ , _ _ _ , _ _ _ .00 (total amount for past 12 months)
[] Loss
[] No
c. 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)
[] Loss
[] No
d. Social Security or Railroad Retirement
[] Yes
- _ , _ _ _ , _ _ _ .00 (total amount for past 12 months)
[] No
e. Supplemental Security Income (SSI)
[] Yes
- _ , _ _ _ , _ _ _ .00 (total amount for past 12 months)
[] No
f. Any public assistance or welfare payments from the state or local welfare office.
[] Yes
- _ , _ _ _ , _ _ _ .00 (total amount for past 12 months)
[] No
g. Retirement, survivor, or disability pensions.
Do not include Social Security.
[] Yes
- _ , _ _ _ , _ _ _ .00 (total amount for past 12 months)
[] No
h. Any 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
48. What was this person's total income during the past 12 months? Add entries in questions 47a 47h; subtract any losses. If net income was a loss, enter the amount and mark (x) the "loss" box next to the dollar amount.
[] None or _ _ , _ _ _ , _ _ _ .00 (total amount for past 12 months)
[] Loss
Questions 7-48 are a continuation of the questions for each person. Questions 7-48 are a continuation of the questions for each person. (Questions 1-6 appear on pages 2, 3, and 4 of the questionnaire.)
Answer person questions 19 through 48 if this person is 15 years old or over.
Answer person questions 47 through 48 only if this person is 15 years old or over.
Mark the "yes" or "no" box for each type of income, and enter the amount received in the past 12 months for each "Yes" response.
If 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 pages 2, 3, or 4.
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
47a. 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.