Fair Market Rent (FMR) Reevaluation Survey Question Title * 1. Is this house, apartment or mobile home ___________. Note: If this is a mobile home, answer in terms of whether or not you own or rent the mobile home, and NOT the pad it is located on. Rented - skip to 2 Occupied without payment of rent - complete, please submit Owned by you or someone in this household with a mortgage or loan - complete, please submit Owned by you or someone in this household free and clear (without a mortgage or loan) - complete, please submit This is NOT a residential house, apartment or mobile home. - complete, please submit Question Title * 2. How long have you lived at this house, apartment or mobile home Less than 2 years 2 years or more Question Title * 3. If this house, apartment or mobile home were on the market for sale or rent, how many bedrooms would you say it has? No bedrooms; it is an efficiency or studio 1 bedroom 2 bedrooms 3 bedrooms 4 or more bedrooms Question Title * 4. Which best describes this building? A mobile home A one-family house detached from any other house A one-family house attached to one or more houses - for example, a duplex, townhouse or rowhouse A building with 2 or more apartments Other (please specify) Question Title * 5. Was this house, apartment or mobile home built with the last two years? Yes, it was built within the last two years No, it is more than two years old Question Title * 6. Do you or does any member of this household live or stay at this address year round? Yes No Question Title * 7. Is this house, apartment or mobile home owned by a relative? Yes No Question Title * 8. Do you do any work for your landlord so you can pay less rent? Yes No Question Title * 9. Apart from utility costs, does this house, apartment or mobile home rent for the same amount every month of the year. Yes - Skip to 11 No Question Title * 10. If you answered No to question 9 - Why does the rent change during the year? The owners' charge different rents during the summer and winter seasons The owners' charge a different rent during the school year The owners' costs - like heating and air conditioning - change during the year so they charge different rent Some other reason - please specify __________________________________________________________________________________________________________________ Question Title * 11. As part of your rental agreement, do you have to recertify your income every year to determine how much rent you pay? Yes No Question Title * 12. Is your rent amount lower because you are in a government-housing program? Yes No Question Title * 13. Does your household have a voucher that allows you to choose where you live and pays for part of your rent? Yes No Question Title * 14. 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. Question Title * 15. Do you have any roommates or housemates that pay part of the rent who are not members of your household? Yes No - Skip to 17 Question Title * 16. How much is the TOTAL monthly rent for this house, apartment or mobile home? This should be how much you pay, what all other roommates pay, and any assistance you might receive. Do not include separate parking fees or utility costs. Question Title * 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. Yes, utilities are included in the rent - Skip to 23 No Question Title * 18. Do you pay separately for heat? Yes No Question Title * 19. Do you pay separately for electricity? Yes No Question Title * 20. Do you pay separately for water? Yes No Question Title * 21. Do you pay separately for sewage? Yes No Question Title * 22. Do you pay separately for trash collection? Yes No Question Title * 23. In case we have questions or there is a problem, could you please provide a ten-digit telephone number where we can reach you? Done