sister [ ]
brother [ ]
aunt [ ]
uncle [ ]
cousin [ ]
mother [ ]
father [ ]
son [ ]
daughter [ ]
pet [ ]
Education: 1 2 3 4 (tick highest grade completed)
Do you own [ ] or rent [ ] your mobile home?
___ total number of vehicles you own
___ number of vehicles that still crank
___ number of vehicles in front yard
___ number of vehicles in back yard
___ number of vehicles on cement blocks
