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• Answer ONLY if you PAY RENT for this house, <br />apartment, or mobile home -All others skip to 47. <br />a. What is the monthly rent? <br />Aonthly amount -Dollars <br />,r <br />,J . Jai <br />b. Does the monthly rent include any meals? <br />Yes <br />No <br />Answer questions 47a-53 if you or someone <br />in this household owns or is buying this house, <br />apartment, or mobile home; otherwise, skip to <br />questions for Person 2. <br />a. Do you have a mortgage, deed of trust, contract <br />to purchase, or similar debt on THIS property? <br />Yes, mortgage, deed of trust, or similar debt <br />Yes, contrail to purchase <br />No -3 Skip to 48a <br />b. How much is your regular monthly mortgage <br />payment on THIS property? Include payment only on <br />first mortgage or contras to purchase. <br />Monthly amount -Dollars <br /> <br />OR <br />Gtl <br />~~~~'~ <br />~~.. <br />~J <br />No regular payment required -~ Skip to 48a C~''~ <br />. Does your regular monthly mortgage payment~•; <br />.nclude payments for real estate taxes o~'l;til'~ <br />property? ,~ :~. '~.~ <br />.: ~i~`,~ <br />Yes, taxes included in mortgage payment; <br />~ No, taxes paid separately or taxes'ri~t_r;~uired <br />•. ~; <br />~._~; <br />d. Does your regular monthly rrior±gage payment <br />include payments for fire,.ha~rd; or flood <br />insurance on THIS property?~~ ~:> <br />v <br />Yes, insurance included in mortgage payment <br />Q No, insurance paid separately or no insurance <br />a. Do you have a second mortgage or a home <br />equity loan on THIS property? Mark ©all boxes <br />that apply. <br />~ Yes, a second mortgage <br />Yes, a home equity loan <br />(] No -~ Skip to 49 <br />b. How much is your regular monthly payment on <br />all second or junior mortgages and all home equity <br />loans on THIS property? <br />Monthly amount -Dollars <br />5 .QQ <br />OR <br />No regular payment required <br />What were the real estate taxes on THIS property <br />last year? <br />Yearly amount -Dollars <br />,~~ <br />OR <br />None <br />What was the annual payment for fire, hazard, <br />and flood insurance on THIS property? <br />Annual amount -Dollars <br />a , i~U <br />OR ~~ <br />Q None ,~;~ ~ ~~ <br />..,\, <br />What is the value ~f this property; that is, <br />how much~d-a yc~.~ink this house and lot, <br />apartment+,`or mobile home and lot would sell <br />for if it were :or sale? <br />~;~Les~.s~t~i $10,000 ~ $90,000 to $99,999 <br />~~~;~? ~0a to $14, 999 ~ $100,000 to $124 999 <br />:~;~'?5,000 to $19,999 <br />~~ $20,000 to $24,999 <br />$25,000 to $29,999 <br />$30,000 to $34,999 <br />$35,000 to $39,999 <br />$40,000 to $49,999 <br />$50,000 to $59,999 <br />(] $60,000 to $69,999 <br />Q $70,000 to $79,999 <br />$80,000 to $89,999 <br />$125,000 to $149,999 <br />$150,000 to $174,999 <br />$175,000 to $199,999 <br />$200,000 to $249,999 <br />0 $250,000 to $299,999 <br />$300,000 to $399,999 <br />^ $400,000 to $499,999 <br />0 $500,000 to $749,999 <br />$750,000 to $999,999 <br />0 $1,000,000 or more <br />Answer ONLY if this is a CONDOMINIUM - <br />What is the monthly condominium feel <br />Monthly amount -Dollars <br />.,)~ <br />Answer ONLY if this is a MOBILE HOME - <br />a. Do you have an installment loan or contract <br />on THIS mobile home? <br />Yes <br />No <br />b. What was the total cost for installment loan <br />payments, personal property taxes, site rent, <br />registration fees, and license fees on THIS mobile <br />home and its site last year? Exclude real estate taxes. <br />Yearly amount -Dollars <br />s ~ .ao <br />Are there more people living here? If yes, <br />continue with Person 2. <br />