12. HOUSEHOLD CHARACTERISTICS Monthly Rent (including Tenant Paid Income Data Household Data Utilities)* *Monthly Race of Head of Household *Tenant Gross Unit No. of *Subsidy % of Area Size of Type of Rental No Bedrooms Occupant Amount Total Rent Income* Median Household Household Assistance 0-efficiency 1-Tenant 1-0-30% 11-White 1-1 Person 1-Section 8 Hispanic, Disabled Female than 1-1Bdrm 2-Owner 2-31-50% 12-Black/African American 2-2 Persons 2-HOME 2-2 Bdrms 9-Vacant 3-51-60% 13-Asian one, 3-3 Persons 2-Elderly TBRA Headed 3-3 Bdrms 4-61-80% 14-American Indian / 4-4 Persons 3-Related/1 3-Other Household Check input parent 4-4 Bdrms 9-Vacant Alaskan Native 5-5 Persons 4-None 4-Related/2 5-5 or 15-Native Hawaiian / Other 6-6 Persons 9-Vacant number) Household, if parent Unit more Pacific Islander 7-7 Persons "Yes" Member, 5-Other Bdrms 16-American Indian / 8-or more Alaskan Native & White 9-Vacant Unit Persons 17-Asian & White Check 9-Vacant Check 18-Black/African American & White 19-American Indian/Alaskan Native & black/African (if American more 20-Balance/Other 09-Vacant unit $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ *Round to the nearest dollar ATTACHMENT C
12. HOUSEHOLD CHARACTERISTICS Unit No No. of Bedrooms Occupant Monthly Rent (including Tenant Paid Utilities)* Income Data Household Data *Tenant *Subsidy Amount Total Rent *Monthly Gross Income* % of Area Median Race of Head of Household Size of Household Type of Household Rental Assistance 0-efficiency 1-1Bdrm 2-2 Bdrms 3-3 Bdrms 4-4 Bdrms 5-5 or more Bdrms 1-Tenant 2-Owner 9-Vacant 1-0-30% 2-31-50% 3-51-60% 4-61-80% 9-Vacant Hispanic, Check if "Yes" 11-White 12-Black/African American 13-Asian 14-American Indian / Alaskan Native 15-Native Hawaiian / Other Pacific Islander 16-American Indian / Alaskan Native & White 17-Asian & White 18-Black/African American & White 19-American Indian/Alaskan Native & black/African American 20-Balance/Other 09-Vacant unit Disabled Household Member, Check (if more than one, input number) Female Headed Household, Check 1-1 Person 2-2 Persons 3-3 Persons 4-4 Persons 5-5 Persons 6-6 Persons 7-7 Persons 8-or more Persons 9-Vacant 2-Elderly 3-Related/1 parent 4-Related/2 parent 5-Other 9-Vacant Unit 1-Section 8 2-HOME TBRA 3-Other 4-None 9-Vacant Unit $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ *Round to the nearest dollar ATTACHMENT C
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