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Living at Home: Elder Economic Survey
All information is required. When entering dollar amounts, use whole numbers (no cents).
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1.
What municipality do you live in?
(Required.)
Amawalk
Ardsley
Armonk
Baldwin Place
Bedford
Bedford Hills
Briarcliff Manor
Bronxville
Buchanan
Chappaqua
Cortlandt Manor
Crestwood
Crompond
Cross River
Croton Falls
Croton-on-Hudson
Crugers
Dobbs Ferry
Eastchester
Elmsford
Goldens Bridge
Granite Springs
Greenburgh
Harrison
Hartsdale
Hastings-on-Hudson
Hawthorne
Heathcote
Irvington
Jefferson Valley
Katonah
Larchmont
Lewisboro
Lincolndale
Mamaroneck
Maryknoll
Millwood
Mohegan Lake
Montrose
Mount Kisco
Mount Vernon
New Rochelle
North Salem
Ossining
OTHER
Peekskill
Pelham
Pelham Manor
Pleasantville
Pocantico Hills
Port Chester
Pound Ridge
Purchase
Purdys
Rye
Rye Brook
Scarborough
Scarsdale
Shenorock
Shrub Oak
Sleepy Hollow
Somers
Tarrytown
Thornwood
Tuckahoe
Valhalla
Verplanck
Vista
Waccabuc
White Plains
Yonkers
Yorktown Heights
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2.
Zip Code
(Required.)
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3.
Are you responding as a single person or a couple?
(Required.)
Single
Couple
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4.
What are your ages?
(Required.)
Couple, both 60-64
Couple, both 65+
Couple, one 60-64, one 65+
Single, 60-64
Single, 65+
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5.
Monthly Income: Enter your total personal income for a calendar month or consecutive 30-day period on the "Monthly Income" line.
(Required.)
Monthly Income
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6.
Monthly Expenses: These are the total amount of bills you pay in a calendar month or consecutive 30-day period. Enter the amounts on the appropriate lines from Utilities to Miscellaneous.
(Required.)
Utilities
Telephone
Property Taxes
Transportation
Car
Health Care Insurance
Prescription not covered by Insurance
Food
Miscellaneous
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7.
Add your monthly expenses and enter that figure on the "Subtotal" line.
(Required.)
Subtotal
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8.
What is left for housing? Subtract the total of your monthly expenses from your monthly income. Enter that figure below.
(Required.)
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9.
Enter your monthly housing expense.
(Required.)
Housing Expense
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10.
Choose the one that applies to you.
(Required.)
Owner with mortgage
Owner without mortgage
Renter
Senior Housing
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11.
Add the numbers for "Subtotal" and "Housing Expense." Enter the result on the line for "Total Monthly Expenses (index)."
(Required.)
Total Monthly Expenses (index)
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12.
Subtract your total monthly expenses from your Monthly Income. Enter the result below.
(Required.)
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13.
If your expenses are less than your income, fill in the circle for the "above water" box. If your expenses are more than your income, fill in the circle for the "under water" box.
(Required.)
Above water
Under water