HUD
Area Survey of Rental Housing Costs
23. |
Is the cost of lighting included in the rent, or do you pay separately for the cost of lighting? |
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24. |
Do you pay a separate monthly rental fee for a range or refrigerator? |
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25. |
Is a sewage fee included in the rent, or do you pay separately for sewage? |
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26. |
Is trash collection included in the rent, or do you pay separately for trash collection? |
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27. |
How many different residential landline telephone numbers, not extension phones, ring into your household? |
Total number of landline telephone numbers |
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28. |
Do you or does anyone in your family have a working cell phone? |
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28a. |
(If you have a cell phone) How many cell phones do you or the people in your family have? |
Total number of cell phones |
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28b. |
(If you have a cell phone) Of all the telephone calls that you or your family receives are… |
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29. |
What is your town’s or city’s name?
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Town or City Name |
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30. |
What is your ZIP code? |
ZIP code |
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Thank you! We appreciate your help!
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 2528-0142. Public reporting burden for this collection of information is estimated to average 10 minutes including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Any personally identifiable information will be kept confidential. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the HUD Reports Clearance Officer, 451 Seventh ST, SW, Room4160, Washington, DC 20410. If you have any questions or concerns about this study, please contact ICF Macro, the company HUD hired to collect this information at 1-800-xxx-xxxx or [email protected] |
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1. |
Is this house, apartment, or mobile home –
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If you checked “Rented” please continue to QUESTION 2. If you checked any other box, you’re done! Please return the survey in the envelope provided. |
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2. |
How long have you lived at this house, apartment or mobile home? |
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3. |
If this house, apartment, or mobile home were on the market for sale or rent, how many bedrooms would you say it has? |
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4 |
Which best describes this building? |
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5. |
Was this house, apartment or mobile home built within the last two years? |
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6. |
Do you or any member of this household live or stay at this address year round?
If this is your vacation or seasonal home, apartment, or mobile home where you do not live year round, please select “No”. |
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7. |
Is this house, apartment, or mobile home owned by a relative?
If this home, apartment, or mobile home is owned by your spouse or another individual living at this address then please select “No.””. |
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8. |
Do you do any work for your landlord so you can pay less rent? |
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9. |
Apart from utility costs, does this house, apartment, or mobile home rent for the same amount every month of the year? |
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9a. |
(If the rent changes month-to-month) Why does the rent change during the year?
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10. |
As part of your rental agreement, do you have to recertify your income every year to determine how much rent you pay? |
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11. |
Is your rent amount lower because you are in a government-housing program? |
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12. |
Is the housing authority your landlord? |
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13. |
Does a local housing authority own this house, apartment, or mobile home? |
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14. |
Does your household have a housing voucher that allows you to choose where you live and pays for rent? |
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15. |
How much do YOU or does YOUR FAMILY pay for rent each month for this house, apartment, or mobile home?
Do not include separate parking fees or utility costs. |
Total amount paid for rent each month |
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15a. |
Do you have any roommates or housemates that pay part of the rent who are not members of your household? |
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16. |
How much is the TOTAL monthly rent for this house, apartment, or mobile home?
This should be how much you pay (Q15), what all other roommates pay, and any assistance you might receive. Do not include separate parking fees or utility costs. |
Total monthly amount paid for rent per month |
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17. |
Are utilities included in your rent, or do you pay for them separately?
Utilities are heat, air conditioning, lights, water, sewage, cooking fuel, or trash collection. |
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If you checked “Yes, utilities are included in the rent,” go to QUESTION 28.
If you checked “No”, please continue to QUESTION 18. |
18. |
Is the cost of heating included in the rent, or do you pay separately for heat? |
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18a. |
Which FUEL is used MOST for heating this house, apartment, or mobile home? (check one) |
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19. |
Is air conditioning included in the rent, or do you pay separately for air conditioning? |
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19a. |
Which FUEL is used MOST for air conditioning this house, apartment, or mobile home? (check one)
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20. |
Is cooking fuel included in the rent, or do you pay separately for cooking fuel? |
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20a. |
Which FUEL is used MOST for cooking fuel in this house, apartment, or mobile home? (check one)
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21. |
Is hot water included in the rent, or do you pay separately for cooking fuel? |
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21a. |
Which FUEL is used MOST for cooking in this house, apartment, or mobile home? (check one)
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22. |
Is water included in the rent, or do you pay separately for water? |
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***BARCODE**** ADD OMB # EXPIRATION DATE>
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Martino, Paul |
File Modified | 0000-00-00 |
File Created | 2021-01-31 |