በቤትዎ ውስጥ ስለሚኖሩ እያንዳንዱ ግለሰብ: ስም, ከእርስዎ ጋር ያላቸው ዝምድና, የትውልድ ቀን, የማህበራዊ ዋስትና ቁጥር (አስፈላጊ ከሆነ), ዘር/ ብሔር፡
For each member of your household: name, relationship to you, date of birth, Social Security Number (if applicable), race/ethnicity