Head of Household Person 2 Person 3 Person 4 Person 5 Are you Hispanic Yes Yes Yes Yes Yes ⃝ ⃝ ⃝ ⃝ ⃝ or Latino? No No No No No ⃝ ⃝ ⃝ ⃝ ⃝ Doesn’t Know Know Doesn’t Know Doesn’t Know Doesn’t Know ⃝ ⃝ ⃝ ⃝ ⃝ Refused ⃝ Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ Person 5 Head of Household Person 2 Person 3 Person 4 Which gender do Male Male Male Male Male ⃝ ⃝ ⃝ ⃝ ⃝ you most identify Female Female Female Female Female ⃝ ⃝ ⃝ ⃝ ⃝ with? Trans Male to Female Trans Male to Female Male to Female Trans Male to Female Trans Male to Female ⃝ ⃝ ⃝ ⃝ ⃝ Trans Female to Male Female to Male Trans Female to Male Trans Female to Male Trans Female to Male ⃝ ⃝ ⃝ ⃝ ⃝ Gender Non- Gender Non- Gender Non- Gender Non- Gender Non- ⃝ ⃝ ⃝ ⃝ ⃝ Conforming Conforming Conforming Conforming Conforming Doesn’t Know Doesn’t Know Doesn’t Know Know Know ⃝ ⃝ ⃝ ⃝ ⃝ Refused Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ ⃝ Head of Household Person 2 Person 3 Person 4 Person 5 Are you currently Yes Yes Yes Yes Yes ⃝ ⃝ ⃝ ⃝ ⃝ experiencing No No No No No ⃝ ⃝ ⃝ ⃝ ⃝ domestic Doesn’t Know Doesn’t Know Doesn’t Know Doesn’t Know Doesn’t Know ⃝ ⃝ ⃝ ⃝ ⃝ violence? Refused ⃝ Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ Head of Household Person 2 Person 3 Person 4 Person 5 Do you receive Yes Yes Yes Yes Yes ⃝ ⃝ ⃝ ⃝ ⃝ any Social No No No No No ⃝ ⃝ ⃝ ⃝ ⃝ Security Income? Doesn’t Know Know Doesn’t Know Doesn’t Know Know ⃝ ⃝ ⃝ ⃝ ⃝ Refused Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ ⃝ Head of Household Person 2 Person 3 Person 4 Person 5 Are you currently Currently Employed Currently Employed Currently Employed Currently Employed Currently Employed ⃝ ⃝ ⃝ ⃝ ⃝
Head of Household Person 2 Person 3 Person 4 Person 5 Are you Hispanic or Latino? ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused Head of Household Person 2 Person 3 Person 4 Person 5 Which gender do you most identify with? ⃝ Male ⃝ Female ⃝ Trans Male to Female ⃝ Trans Female to Male ⃝ Gender Non- Conforming ⃝ Doesn’t Know ⃝ Refused ⃝ Male ⃝ Female ⃝ Trans Male to Female ⃝ Female to Male ⃝ Gender Non- Conforming ⃝ Doesn’t Know ⃝ Refused ⃝ Male ⃝ Female ⃝ Male to Female ⃝ Trans Female to Male ⃝ Gender Non- Conforming ⃝ Doesn’t Know ⃝ Refused ⃝ Male ⃝ Female ⃝ Trans Male to Female ⃝ Trans Female to Male ⃝ Gender Non- Conforming ⃝ Know ⃝ Refused ⃝ Male ⃝ Female ⃝ Trans Male to Female ⃝ Trans Female to Male ⃝ Gender Non- Conforming ⃝ Know ⃝ Refused Head of Household Person 2 Person 3 Person 4 Person 5 Are you currently experiencing domestic violence? ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused Head of Household Person 2 Person 3 Person 4 Person 5 Do you receive any Social Security Income? ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Know ⃝ Refused Head of Household Person 2 Person 3 Person 4 Person 5 Are you currently ⃝ Currently Employed ⃝ Currently Employed ⃝ Currently Employed ⃝ Currently Employed ⃝ Currently Employed
2018-Working-Survey-1.docx