LBCC-Single Stop 2019 Tax Self Preparation Survey Question Title * 1. Personal Information (optional): First Name Last Name ZIP/Postal Code Email Address Cell Phone Number OK Question Title * 2. How did you hear about this free tax filing opportunity? Flyer or Poster Word of mouth – professor, friend, relative or other person Texting, email or other electronic form not inclusive of social media Social media - Face Book, Twitter, etc.... College Website Single Stop Office/Staff Other Decline to answer OK Question Title * 3. Are you filing your taxes with or without dependent children? With dependent children Without dependent children Decline to answer OK Question Title * 4. What is you tax filing status? Single Married Filing Joint Married Filing Separate Head of Household Widower Decline to answer OK Question Title * 5. How many individuals are in your household (please count yourself)? 1 2 3 4 5 6 7 or more Decline to Answer OK Question Title * 6. What is your current employment status? Full Time Employed Part Time Employed Seasonal Worker Unemployed Never employed Retired Decline to answer OK Question Title * 7. What is the range of income for your entire household? Under $9999 Between $10,000 and $19,999 Between $20,000 and $29,999 Between $30,000 and $39,999 Between $40,000 and $49,999 Over $50,000 Decline to answer OK Question Title * 8. Are you interested in learning about additional public benefits or local resources for which you may be eligible such as SNAP, WIC or health insurance? Yes No Decline to Answer OK Question Title * 9. Please indicate which best describes your income for tax filing. Once you click to submit your survey, you will be directed to choose the proper filing link for your income level. I am filing with an income under $34,000. I am filing with an income between $34,001 and $66,000 My income is above $66,001 and I am not eligible for free self-file. Decline to Answer OK SUBMIT SURVEY TO ACCESS FREE FILE