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.
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