Questionnaire Text

Questionnaire form view entire document:  text  image
Person 1
(Person 1 is the person living or staying here in whose name this house or apartment is owned, bought, or being rented. If there is no such person, start with the name of any adult living or staying here.)

3. What is Person 1's sex? Mark (X) in one box.

[] Male
[] Female

[Repeat for persons X = 2 - 5.]

3. What is Person X's sex? Mark (X) ONE box.

[] Male
[] Female

[Repeat for Persons Y = 6 - 12.]

Sex

[] Male
[] Female
Questionnaire instructions view entire document:  text  image
Answer person questions 1 through 6 for the first five people listed on pages 2,3, and 4 of the questionnaire.

3. Mark one box to indicate this person's biological sex.