Questionnaire Text

Questionnaire form view entire document: text image

Housing
Please answer the following questions about the house, apartment, or mobile home at the address on the mailing label.

15. In the past 12 months, did anyone in this household receive Food Stamps or a Food Stamp benefit card?

Include government benefits from the Supplemental Nutrition Assistance Program (SNAP). Do NOT include WIC or the National School Lunch Program.

[] 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.

15. On October 1, 2008, the federal Food Stamp Program was renamed SNAP (Supplemental Nutrition Assistance Program). Some states may have their own specific name for this program. If you received benefits from the government to buy food for your family using a benefit card, mark the "Yes" box.