Rent/Mortgage Survey

Catholic Charities is gathering information on how COVID-19 is affecting our region in regards to maintaining housing during this time. All information collected is anonymous. Taking this survey does not guarantee any financial support, but gives Catholic Charities real time information to help advocate about the current needs in the counties we serve.

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* 1. Are you still receiving your usual income during COVID-19?

Yes

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* 2. What is your monthly rent amount?

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* 3. Are you behind in your rent?

Yes (If you answer YES continue with questions 4)

No (If NO, skip to Question #10)

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* 4. How many months’ rent do you owe?

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* 5. What is the total amount owed?

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* 6. Is your past due rent due to the impact of the COVID-19 pandemic?

Yes (If you answer YES continue with Question 7)

No (If NO skip to Question #7)

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* 7. If the answer to question 6 was yes, please indicate how you have been impacted by COVID-19

I was laid off or furloughed form my job due to COVID-19

I am unable to work due to care for a sick family member

I am unable to work due to care for children who are learning remotely

I am unable to work due to underlying medical conditions that make contracting COVID-19 dangerous

Other (please specify)

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* 8. Do you have an eviction notice or have you been informed that you are subject to eviction?

Yes, I have received a court ordered eviction

Yes, I have received an eviction letter from my landlord

Other (please specify)

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* 9. If yes to question 8, please share the following

Reason for eviction

Date need to vacate the property

Number of people in the household

Total household income (gross)

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* 10. How has COVID-19 affected you and your family?

Laid off

Caring for kids at home

Physical/Dental Health

Mental Health

Financially

Other (please specify)