Questionnaire Text

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43. 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 date 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 for the other person.

44. What was this person's total income during the past 12 months?

Add entries in questions 43a to 43h; 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
Questionnaire instructions view entire document:  text  image
Person questions 43-44

P44. Add the total entries (subtracting losses) for 43a through 43h for the past 12 months and enter that number in the space provided. Mark the "loss" box if there is a loss. Print the total amount in dollars.

Include:

  • Recurring payments such as income from unemployment compensation or unemployment insurance cash benefits

Do not include:

  • Noncash benefits such as food stamps or benefits from SNAP or rental assistance.