Include Do NOT Include
Foster childeren, roomers, or housemates College students living away from home
People staying here today who have no other permanent place to stay People currently in correctional facility, nursing home, or mental hospital
People living here most of the time while working, even if they have another place to live People in the Armed Forces who live somewhere else
People temporarily away on a business trip, on vacation, etc. People who live or stay at another place most of the time

a. What is the race, gender, and age of EACH person indicated above? Please tell us if each household member identifies themselves as American Indian or Alaska Native (AIAN) either alone or in combination with other races. Add ONE for each person in household.

Add Person

8. What was your household income last year, before taxes, from all sources - include all sources for all household members; sources include:

1) All wages, salary, commissions, bonuses, or tips from all jobs

2) Self-employment income from own farm or non-farm business, including proprietorships and partnerships

3) Interest, dividends, net rental income, royalty income, or income from estates and trusts

4) Social Security or railroad retirement

5) Supplemental Security Income (SSI)

6) Any public assistance or welfare payments from the state, local or tribal welfare office

7) Any other sources of income received regularly such as Veteran payment, unemployment compensation, child support or alimony

9. What is the highest level of education you or someone in your household have completed?
10. Are you Employed?
a. Employment type
a. Are you abel and willing to work?
b. Did you actively seek job this year but were unable to find one?