Questionnaire Text

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1b. If everyone is staying here only temporarily and usually lives somewhere else, list the name of each person on the numbered lines above, fill this circle ? O [brackets used in this document instead] and print their usual address below. Do not print the address listed on the front cover.

____ House number
____ Street or road/Rural route and box number
____ Apartment number
____ City
____ State
____ ZIP code
____ Country or foreign country
____ Names of nearest intersecting streets or roads


[If everyone listed in questions 1a usually lives at another address(es), print the address(es) in 1b.]