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* 1. In what state or U.S. territory do you live?

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* 2. Are your living quarters owned or being bought by you or someone in your household, rented for cash, or occupied without payment of cash rent?

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* 3. Are you male or female?

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* 4. Which category below includes your age?

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* 5. Are you now married, widowed, divorced, separated, or never married?

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* 6. What is the highest level of school you have completed or the highest degree you have received?

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* 7. Are you Mexican, Mexican-American, Chicano, Puerto Rican, Cuban, Cuban-American, or some other Spanish, Hispanic, or Latino group?

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* 8. Are you White, Black or African-American, American Indian or Alaskan Native, Asian, Native Hawaiian or other Pacific islander, or some other race?

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* 9. Does anyone in your household own a business or a farm?

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* 10. Which of the following categories best describes your employment status?

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* 11. How much total combined money did all members of your HOUSEHOLD earn in 2010? This includes money from jobs; net income from business, farm, or rent; pensions; dividends; interest; social security payments; and any other money income received by members of your HOUSEHOLD that are EIGHTEEN (18) years of age or older. Please report the total amount of money earned - do not subtract the amount you paid in taxes or any deductions listed on your tax return.

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* 12. How much money did YOU personally earn in 2010? This includes money from jobs; net income from business, farm, or rent; pensions; dividends; interest; social security payments; and any other money income received by YOU. Please report the total amount of money you earned - do not subtract the amount you paid in taxes or any deductions listed on your tax return.

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