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Summit County Energy Burden Survey

Please help us explore ways to assist households in paying their energy bills by completing this 4-minute survey. Your answers to this survey will remain anonymous. After completing the survey, you will have the option to enter an opportunity drawing for one of four $50 gift cards. Contact information will only be used to notify winners of the opportunity drawing. 
This survey is being conducted to collect information about the proportion of your income that goes toward paying for heat and electricity in your home, otherwise known as your energy burden.
Park City and Summit County are concerned about the energy burden of households with low incomes and seek your input regarding ways that local governments can help decrease your utility bills and increase the comfort in your home.
When filling out the questions below, it might be helpful to refer to your Rocky Mountain Power electricity and Dominion Energy natural gas bills if available. 
Thank you for your cooperation and participation! For questions or concerns about this survey, contact Lisa Yoder at 801-209-8757 or by email at lisa.yoder@comcast.net
1.Select one of the options below to fill in the blank:  I _______my primary residence.
2.Select one of the options below to fill in the blank:  My primary residence is a(n) _________.
3.What is the primary source of heat in your home?
4.If you are a renter, does your rent payment include any utility costs that are paid by the landlord?
5.If you are a renter, and your rent payment includes utility costs, which are included in the rent and paid by the landlord? (Check all that apply)
6.If you are a renter, whose rent payment includes utilities, how much does the landlord charge per month for each of the following utilities? (Enter dollar amount)
7.If you pay any of the following utility bills directly to the utility company, what is your best estimate of the highest monthly bill amount your household has paid in the past 12 months?
8.In the past 12 months, how many times have you been late or unable to pay your heat and/or electric bill(s)? (Select one)
9.In the months when the heat and/or electric bills are the highest, how much of a burden does this put on your financial resources? (Select the response that most closely aligns with your situation.)
10.Have you sought assistance for your heating and/or electric bills from any of the following?
11.If you have sought assistance to pay heating or electric bills, please indicate those you sought assistance from? (Select all that apply)
12.Is the temperature in your home too cold in the winter?  (Select one of the phrases that fits best)
13.If it’s too cold in your home in the winter, briefly explain why? (For example, ‘I cannot afford to keep the thermostat high enough to stay warm’ or ‘broken windows let in the cold.’) 
14.Is the temperature in your home too hot in the summer? (Select the one of the phrases that fits best)
15.If it’s too hot in your home in the summer, briefly explain why?  (For example, “Air conditioner is broken and landlord has not fixed it’ or ‘no curtains to keep the sun out.’)
16.What additional information would you like to tell us about your energy bills?
17.Are you at least 18 years of age or older?
18.Are you a resident of Summit County?
19.What is the zip code of your primary residence?
20.How many people live in your household (including yourself)?
21.What is the total annual household income?
22.How many people in your household contribute to the annual household income listed above? (Select one)
23.What is the predominant ethnicity of your household? (Select one)
24.Please indicate the one or more races that applies to the majority of people in your household from among the following:
Opportunity Drawing 
Having completed the survey, do you want to be entered into an opportunity drawing for one of four $50 gift cards? Your contact information will remain totally separate from your survey responses. It is needed to award the gift card to the selected recipient. Enter opportunity drawing here
Thank you for completing this survey.  Your input will be helpful to Park City and Summit County as they work to understand the energy burden of households with low income.