Questionnaire Text

Questionnaire form view entire document:  text  image
48. What was this person's total income during the past 12 months?

Add entries in questions 47a to 47h; 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 total amount for past 12 months (USD)________
[] Loss
Questionnaire instructions view entire document:  text  image
Answer person questions 47 through 48 only if this person is 15 years old or over.

Mark the "Yes" or "No" box for each type of income, and enter the amount received in the past 12 months for each "Yes" response.
If income from any source was received jointly by household members, report, if possible, the appropriate share for each person; otherwise, report the whole amount for only one person and mark the "No" box for the other person.
When reporting income received jointly, do not include the amount for a person not listed on pages 2, 3, or 4.
do not include the following as income in any item:

Refunds or rebates of any kind
Withdrawals from savings of any kind
Capital gains or losses from the sale of homes, shares of stock, etc.
Inheritances or insurance settlements
Any type of loan
Pay in-kind such as food, free rent

48. Add the total entries (subtracting losses) for 47a through 47h 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.