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.

[B] - Answer questions 18a and b if this house, apartment, or mobile home is rented. Otherwise, skip to question 19.

18. a) What is the monthly rent for this house, apartment, or mobile home?

Monthly amount (USD) _________
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.

If any money rent is paid, even if the rent is paid by people who are not members of your household, or paid by a federal, state, or local government agency, mark the "Rented?" box.
If the unit is not owned or being bought by a member of this household and if money rent is not paid or contracted, mark the "Occupied without payment of rent?" box. The unit may be owned by friends or relatives who live elsewhere and who allow you to occupy this house, apartment, or mobile home without charge. A house or apartment may be provided as part of wages or salary. Examples are: caretaker's or janitor's house or apartment; parsonages; tenant farmer or sharecropper houses for which the occupants do not pay cash rent; or military housing.

18a. Report the rent agreed to or contracted for, even if the rent for your house, apartment, or mobile home is unpaid or paid by someone else.

If rent is paid: Multiply rent by:
By the day........30
By the week......4
Every other week.....2
If rent is paid: Divide rent by:
4 times a year......3
2 times a year ......6
Once a year .......12