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Culpeper Town and County government agencies are collecting information about housing from residents as part of a community-wide affordable housing needs assessment. Thank you for taking the time to complete this survey.

There is no identifiable information on this survey and all answers are confidential.

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* 1. Which type of housing best describes your current living situation?

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* 2. How many persons are with you in your current living situation at least 5 nights per week?
(Include all adults and children)

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* 3. How many adults over age 60 (include yourself) are with you in your current living situation at least 5 nights per week?

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* 4. How many persons under age 18 are with you in your current living situation at least 5 nights per week?

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* 5. What is your estimated average gross household income per month?

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* 6. How much do you pay in rent or mortgage for your current living situation?

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* 7. How many times have you moved in the last 12 months due to eviction, foreclosure or the costs of housing where you lived were too high, forcing you to move?

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* 8. Please tell us how you heard about the survey?

Thank you for taking time to complete the survey. If you would like more information, please contact Jenny Biche' at (540) 829-7450 or at jkbiche@rrregion.org or visit www.rrregion.org.

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