ST. JOSEPH COUNTY HOUSING CONSORTIUM - CONFIDENTIAL RESIDENT QUESTIONNAIRE FY 2025-2029 Five Year Consolidated Plan, FY 2025 Annual Action Plan, and Analysis of Impediments to Fair Housing Choice Question Title * 1. What street do you live on in St. Joseph County? Question Title * 2. What is the name of the neighborhood you live in St. Joseph County? Question Title * 3. What is your gender? Male Female Prefer Not to Say Other (please specify) Question Title * 4. What is your race? Please choose all that apply. White Black or African American Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Some Other Race Prefer Not to Say Other (please specify) Question Title * 5. What is your Ethnicity? Hispanic or Latino Not Hispanic or Latino Prefer Not to Say Other (please specify) Question Title * 6. What is your age group? 17 or younger 18-20 21-29 30-39 40-49 50-59 60 or older Question Title * 7. How many people are living in your household? One Two Three Four Five Six or More Question Title * 8. Based on the number of persons living in your household, mark whether your household income is more or less than the listed income: More Less N/A 1-Person Household - $49,850 1-Person Household - $49,850 More 1-Person Household - $49,850 Less 1-Person Household - $49,850 N/A 2-Person Household - $57,000 2-Person Household - $57,000 More 2-Person Household - $57,000 Less 2-Person Household - $57,000 N/A 3-Person Household - $64,100 3-Person Household - $64,100 More 3-Person Household - $64,100 Less 3-Person Household - $64,100 N/A 4-Person Household - $71,200 4-Person Household - $71,200 More 4-Person Household - $71,200 Less 4-Person Household - $71,200 N/A 5-Person Household - $76,900 5-Person Household - $76,900 More 5-Person Household - $76,900 Less 5-Person Household - $76,900 N/A 6-Person Household - $82,600 6-Person Household - $82,600 More 6-Person Household - $82,600 Less 6-Person Household - $82,600 N/A Question Title * 9. What is your current housing status? Homeowner Renter Homeless Living with friends/relatives Temporary Shelter Hotel/Motel Mobile Home Vehicle Other (please specify) Question Title * 10. Identify housing/rental issues you have observed in St. Joseph County (Check all that apply): Lack of Affordability Minor Rehabilitations Needed Major Rehabilitations Needed Housing Options/Inventory ADA Accessibility Historic Preservation Negligent Landlords Asbestos Lead Paint/Pipes Other (please specify) Next
