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\listoverridecount0\ls38}{\listoverride\listid1010596376\listoverridecount0\ls39}{\listoverride\listid851341965\listoverridecount0\ls40}{\listoverride\listid1551458019\listoverridecount0\ls41}{\listoverride\listid1131943055\listoverridecount0\ls42}
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\listoverridecount0\ls47}}{\*\revtbl {Unknown;}}{\info{\title COMPREHENSIVE NEEDS STUDY}{\author D. Michael Dale}{\operator  }{\creatim\yr2002\mo8\dy5\hr14\min28}{\revtim\yr2002\mo8\dy5\hr14\min28}{\printim\yr2002\mo6\dy23\hr17\min54}{\version2}{\edmins0}{\nofpages41}
{\nofwords7257}{\nofchars41365}{\*\company Oregon Law Center}{\nofcharsws50799}{\vern8269}}\margl1440\margr1440 \facingp\widowctrl\ftnbj\aenddoc\ftnrestart\aftnnar\noxlattoyen\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\hyphcaps0\horzdoc\dghspace120
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\par }{\fs24 
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{\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl8
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\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\b\fs20 COMPREHENSIVE NEEDS STUDY
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 
\par 
\par 
\par 
\par }\pard\plain \s3\qc \li0\ri0\keep\keepn\nowidctlpar\faauto\outlinelevel2\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 City where respondent is now staying: ____________________________
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 
\par 
\par 
\par 
\par 
\par 
\par (Office Use Only \endash  Case #:  _____   _____   _____   _____   _____)
\par 
\par }{\fs24\ul 
\par }{\fs24 
\par 
\par 
\par 
\par }\pard \ql \li0\ri0\keep\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 {\fs24 Date:
\par 
\par 
\par 
\par }{\fs24\ul 
\par }{\fs24 Interviewer:    ____________________________________}{\fs24\ul                                                
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\cs57\lang1024\langfe1024\noproof 3}}}{\cs57 
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\par }}{\footerr \pard\plain \s55\ql \li0\ri0\nowidctlpar\tx0\tqc\tx4680\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\scaps\fs16 \tab }{\cs57\scaps\fs20 \chpgn }{
\scaps\fs20 
\par }}\pard\plain \qc \li0\ri0\keep\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 COMPREHENSIVE NEEDS STUDY
\par 
\par 
\par }\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\ul\highlight16 INTRODUCTION TO RESPONDENT}{\pard\plain 
\s1\qc \li0\ri0\keep\nowidctlpar\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \v\fs20\ul\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\tc {\fs20\ul }{\fs20\ul\highlight16 INTRODUCTION TO RESPONDENT}{\fs20\ul }}}{\fs20\ul 
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 
\par }\pard\plain \s58\qj \li0\ri0\keep\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 (Hello, I\rquote m ______________________________ from [your sponsoring agency].  We\rquote 
re doing a study of important issues facing Washington households today.)
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par Whatever you tell me will be completely confidential, and the study findings will only show answers from many people together, unless you specifically consent.
\par 
\par 
\par The study covers areas like housing, health care, and employment, and the findings will suggest ways to improve available services. \tab \tab \tab 
\par 
\par 
\par In this survey we\rquote re concerned with things that were happening to al
l of the people now in your household, that is, the people who live with you on a more or less regular basis as part of the same living unit, in the last twelve months, that is from (today\rquote 
s date, 2001) to the present.  As I describe each situation, please tell me whether it occurred during any part of that time period.
\par \tab \tab \tab \tab 
\par 
\par 
\par \tab \tab \tab \tab \tab \tab \tab \tab 
\par 
\par First, let\rquote s talk about housing.
\par 
\par 
\par {\listtext\pard\plain\hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \qj \fi-360\li720\ri0\keep\nowidctlpar\tx0\jclisttab\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\ls28\adjustright\rin0\lin720\itap0 {\fs24 
During any part of the last twelve months, did (any of) of you live in a place that you were renting from someone else or was provided by your employer?
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par }\trowd \trgaph108\trleft-108\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrnone \clbrdrl
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\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
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\clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd 
\trgaph108\trleft-108\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrnone \clbrdrl\brdrnone 
\clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1

\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 6)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard\plain 
\s58\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
\par 
\par {\listtext\pard\plain\s58 \fs20 \hich\af0\dbch\af0\loch\f0 2.\tab}}\pard \s58\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\jclisttab\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\ls28\adjustright\rin0\lin720\itap0 
{\fs20 Did (any of) you experience unsafe or unhealthful conditions in a place you were renting, like }{\fs20\highlight16 (READ SLOWLY:)}{\fs20 
 the landlord frequently failing to provide heat, hot water, electricity, or working plumbing; a serious problem with cockroaches, mice, or rats; or unsafe conditions, like electrical problems, broken appliances, poor security, peeling paint, leaky roof, 
broken window or other serious conditions that the landlord didn\rquote t correct?
\par }\pard \s58\qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin0\itap0 {\fs20 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
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\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par Yes
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\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24\highlight16 (RECORD FIRST INCIDENT AS INCIDENT A.  IF THERE WAS ANOTHER SEPARATE INCIDENT, ALSO MARK INCIDENT B)}{\fs24  

\par }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24    
\par }\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
Incident A             Incident B
\par 1                           2
\par }\pard\plain \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par 
\par 
\par 3\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz0\shplid1026{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8192\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q. 2
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 3)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\pard\plain \s58\qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
\par 
\par }\pard\plain \qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 3.\tab 
In the last twelve months, did (any of) you have a major problem with a landlord or public housing authority, like }{\fs24\highlight16 (READ SLOWLY}{\fs24\lang1024\langfe1024\highlight16\noproof :)}{\fs24\lang1024\langfe1024\noproof 
 a serious dispute about rent, the terms of the lease, or the security deposit; being locked out, evicted or threatened with eviction; being harassed by the landlord; or being unfairly denied public housing or transfer to another public housing unit?

\par }\pard \qr \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz1\shplid1027{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8193\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q. 3
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 4)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\pard \qr \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 4.\tab 
Did (any of) you  }{\fs20\ul own}{\fs20  any real estate during the last twelve months like a house, condo, co-op, or did you land try to buy or sell any real estate in the last twelve months, like a house, condo, co-op, or land?
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1
\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 6)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row {\listtext\pard\plain\s59 \fs20 
\hich\af0\dbch\af0\loch\f0 5.\tab}}\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\jclisttab\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\ls30\adjustright\rin0\lin720\itap0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Did (any of) you need expert advice or assistance relating to this property like}{\fs20\highlight16  (READ SLOWLY}{\fs20\lang1024\langfe1024\highlight16\noproof :)}{
\fs20\lang1024\langfe1024\noproof  help with preparing or reviewing a contract or other documents, handling a closing or settlement, a dispute with a buyer, seller, or realtor; a problem with
 title to a property; a major dispute with a lender; or a problem with property taxes or assessments?
\par }\pard \s59\qj \li360\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin360\itap0 {\fs20\lang1024\langfe1024\noproof 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz2\shplid1028{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8194\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q. 5
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 6)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24\lang1024\langfe1024\noproof 
\par 
\par }{\fs24 \sect }\sectd \marglsxn1350\margtsxn720\margbsxn720\sbknone\linex0\headery1440\footery1920\endnhere\sectdefaultcl {\headerr \pard\plain \ql \li0\ri0\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\par }}{\footerr \pard\plain \s55\ql \li0\ri0\nowidctlpar\tx0\tqc\tx4680\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\scaps\fs16 \tab }{\cs57\scaps\fs20 \chpgn }{
\scaps\fs20 
\par }}\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 6.\tab 
Did (any of) you own }{\fs24\ul or}{\fs24  live in a mobile home or trailer in the last twelve months?
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1
\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 8)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 7.\tab 
Were there any serious problems related to the mobile home or a mobile home park?  For example did you have any problems with financing, warranties, fees, new rules and restrictions, access to utilities, leases, or eviction?
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz3\shplid1029{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8195\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q. 7
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 8)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\pard \qj \fi-1260\li630\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin630\itap0 {\fs24 \tab 8.\tab }{\fs24\highlight16 (READ SLOWLY}{
\fs24\lang1024\langfe1024\highlight16\noproof :)}{\fs24\lang1024\langfe1024\noproof 
 Have there been any difficulties getting or keeping utilities like telephone, water, electricity or gas, such as an unreasonable deposit policy that made it hard to get service, a dispute over charges or payments, or a utility being improperly shut off a
ltogether?
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24\lang1024\langfe1024\noproof 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz4\shplid1030{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8196\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.8
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 9)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7938 \cellx7830\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9468\row }\pard \ql \li0\ri0\keep\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par \sect }\sectd \marglsxn1350\margtsxn720\margbsxn720\sbknone\linex0\headery1440\footery1920\endnhere\sectdefaultcl {\headerr \pard\plain \ql \li0\ri0\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {

\par }}{\footerr \pard\plain \s55\ql \li0\ri0\nowidctlpar\tx0\tqc\tx4680\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\scaps\fs16 \tab }{\cs57\scaps\fs20 \chpgn }{
\scaps\fs20 
\par }}{\*\pnseclvl1\pndec\pnstart9\pnindent630\pnhang{\pntxta .}}{\*\pnseclvl2\pndec\pnstart1\pnindent630\pnhang{\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent630\pnhang{\pntxta .}}{\*\pnseclvl4\pndec\pnstart1\pnindent630\pnhang{\pntxta .}}{\*\pnseclvl5
\pndec\pnstart1\pnindent630\pnhang{\pntxta .}}{\*\pnseclvl6\pndec\pnstart1\pnindent630\pnhang{\pntxta .}}{\*\pnseclvl7\pndec\pnstart1\pnindent630\pnhang{\pntxta .}}{\*\pnseclvl8\pndec\pnstart1\pnindent630\pnhang{\pntxta .}}{\*\pnseclvl9
\pnlcrm\pnstart1\pnindent630\pnhang}{\listtext\pard\plain\s47 \fs20 \hich\af0\dbch\af0\loch\f0 9.\tab}\pard\plain \s47\qj \fi-630\li630\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\ls1\adjustright\rin0\lin630\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
Discrimination in housing can mean a lot of things, like being denied housing, being steered to certain neighborhoods, or having trouble getting financing in certain neighborhoods.  During the previous year, did (any of) yo
u face discrimination in housing \endash  whether renting, buying, or getting financing \endash 
 because of race, sex, disability, source of income, having children, composition of the household, including issues of sexual orientation, or any other reason that you believe may be unlawful?
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \tab 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz5\shplid1031{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8197\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.9
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 10)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 10.\tab 
These days it\rquote s sometimes hard for people to get and hold on to housing.  Was there ever a time in the last twelve months when you (or anyone else in your present household) were homeless or staying in a shelter for the homeless?
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par }\pard \qr \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 Yes          1
\par 
\par No          2
\par 
\par 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
\par 11.\tab During that time did (any of) you have to move in temporarily with another household because you didn\rquote t have your own place to live?
\par }\pard\plain \qr \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 Yes          1

\par 
\par No          2
\par 
\par 
\par }\pard \ql \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin720\itap0 {\fs24 12.\tab Was there any time in the last twelve months when 
someone else had to move in temporarily with (}{\fs24\ul you}{\fs24 /}{\fs24\ul your}{\fs24  household) because they had no place to live?
\par }\pard \qr \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 Yes          1
\par 
\par No          2
\par 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 13.\tab 
At the present time, how many people including yourself now live in your household, whether they are related to you or n
ot?  Please count everyone who lives (there/here) half the time or more, including babies and small children and anyone who usually lives (there/here) but is away.  }{\fs20\highlight16 (CIRCLE NUMBER OF HOUSEHOLD MEMBERS IN CHART BELOW.)}{\fs20 
\par }\pard\plain \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par }\trowd \trgaph108\trleft-18\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4836 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell HOUSEHOLD\cell }{\fs24\highlight16 INCOME CUT-OFF FOR Q. 14
}{\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh
\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440
\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4836 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\trowd \trgaph108\trleft-18
\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell SIZE\cell ANNUAL\cell MONTHLY\cell WEEKLY\cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt
\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\pard 
\qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell 
\cell }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl
\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb
\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 1
\par \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 11075\cell 923\cell 213\cell }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 2
\par \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 14952\cell 1244\cell 288\cell }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 3
\par \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 18775\cell 1564\cell 361\cell }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 4
\par \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 22625\cell 1885\cell 401\cell }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 5
\par \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 26475\cell 2206\cell 509\cell }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 6
\par \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 30325\cell 2527\cell 583\cell }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 7
\par \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 34175\cell 2848\cell 657\cell }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 8
\par \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 38025\cell 3168\cell 731\cell }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 
\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 per extra person\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 9+
\par \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 3850\cell 321
\par \cell 74\cell }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl
\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb
\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1458 \cellx1440\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1734 \cellx3174\clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1596 \cellx4770\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1596 \cellx6366\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1644 \cellx8010\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1548 \cellx9558\row }\pard \ql \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }{\fs24\highlight16 \tab (SEE CHART IN Q. 13.  USE }{\fs24\ul\highlight16 ANNUAL}{\fs24\highlight16  INCOME FIGURE CORRESPONDING TO HOUSEHOLD SIZE IN Q. 13 FOR NEXT QUESTION)}{\fs24 
\par }\pard \ql \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin720\itap0 {\fs24 14.\tab 
Now, thinking again about all the people in your household including yourself, would you say that your total combined income from all sources is above or below}{\fs24\highlight16  (}{\fs24\ul\highlight16 ANNUAL INCOME FROM CHART IN Q. 13}{
\fs24\highlight16 )}{\fs24 ?  Please count income from all sources, like earnings from work or odd jobs, retirement income, interest and dividends, and various benefit programs.
\par }\pard \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par \sect }\sectd \marglsxn1350\margtsxn720\margbsxn720\sbknone\linex0\headery1440\footery1920\endnhere\sectdefaultcl {\headerr \pard\plain \ql \li0\ri0\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {

\par }}{\footerr \pard\plain \s55\ql \li0\ri0\nowidctlpar\tx0\tqc\tx4680\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\scaps\fs16 \tab }{\cs57\scaps\fs20 \chpgn }{
\scaps\fs20 
\par }}{\*\pnseclvl1\pndec\pnstart9\pnindent720 {\pntxta .}}{\*\pnseclvl2\pndec\pnstart1\pnindent720 {\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720 {\pntxta .}}{\*\pnseclvl4\pndec\pnstart1\pnindent720 {\pntxta .}}{\*\pnseclvl5\pndec\pnstart1\pnindent720 
{\pntxta .}}{\*\pnseclvl6\pndec\pnstart1\pnindent720 {\pntxta .}}{\*\pnseclvl7\pndec\pnstart1\pnindent720 {\pntxta .}}{\*\pnseclvl8\pndec\pnstart1\pnindent720 {\pntxta .}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720 }\pard\plain 
\s60\ql \li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 (IF REFUSED OR DON
\rquote T KNOW, REASSURE R OF CONFIDENTIALITY AND EXPLAIN THAT INFORMATION WILL BE USED ONLY TO COMPARE THE PROBLEMS AND RESOURCES AVAILABLE TO PEOPLE IN BROAD INCOME GROUPS.   IF DON\rquote T KNOW, PROBE FOR R\rquote 
S BEST GUESS AND USE CATEGORY 4, IF VOLUNTEERED.  PRESENT MONTHLY AND WEEKLY FIGURES CORRESPONDING TO HOUSEHOLD SIZE, IF HELPFUL.)}{\fs20 
\par }\pard\plain \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 
\par }\trowd \trqc\trgaph120\trrh405\trleft-120\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 
\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5086 \cellx4966\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3723 \cellx8689\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth639 \cellx9328\pard 
\ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\highlight16 (THANK R AND END INTERVIEW)}{\fs24 \cell Above\tab \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 1\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trqc\trgaph120\trrh405\trleft-120\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5086 \cellx4966\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3723 \cellx8689\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth639 \cellx9328\row }\trowd \trqc\trgaph120\trrh403\trleft-120\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 
\trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5086 \cellx4966\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3723 \cellx8689\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth639 \cellx9328\pard \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\highlight16 (CONTINUE)}{\fs24 \tab \tab \tab \tab \cell Below\cell }\pard 
\qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 2\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trqc\trgaph120\trrh403\trleft-120\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl
\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb
\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5086 \cellx4966\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3723 \cellx8689\clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth639 \cellx9328\row }\pard \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\highlight16 (CONTINUE)}{
\fs24 \cell Equal\cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 3\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trqc\trgaph120\trrh403\trleft-120\trkeep\trbrdrt
\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5086 \cellx4966\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth3723 \cellx8689\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth639 \cellx9328\row }\pard 
\ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\highlight16 (CONTINUE)}{\fs24 \cell Not sure:  right around (}{\fs24\ul INCOME}{\fs24 )\cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 4\cell 
}\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trqc\trgaph120\trrh403\trleft-120\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh
\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5086 \cellx4966
\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3723 \cellx8689\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth639 \cellx9328\row }\pard \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\highlight16 (THANK R AND END  INTERVIEW)}{\fs24 \cell Refused    \tab \tab \tab \cell }\pard 
\qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 7\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trqc\trgaph120\trrh403\trleft-120\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl
\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb
\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5086 \cellx4966\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3723 \cellx8689\clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth639 \cellx9328\row }\trowd \trqc\trgaph120\trrh403\trleft-120\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 
\trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5086 \cellx4966\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3723 \cellx8689\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth639 \cellx9328\pard \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\highlight16 (THANK R AND END INTERVIEW)}{\fs24 \cell Don
\rquote t know\cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 8\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trqc\trgaph120\trrh403\trleft-120\trkeep\trbrdrt
\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5086 \cellx4966\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth3723 \cellx8689\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth639 \cellx9328\row }\pard \qr \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par \sect }\sectd \marglsxn1350\margtsxn720\margbsxn720\sbknone\linex0\headery1440\footery1920\endnhere\sectdefaultcl {\headerr \pard\plain \ql \li0\ri0\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {

\par }}{\footerr \pard\plain \s55\ql \li0\ri0\nowidctlpar\tx0\tqc\tx4680\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\scaps\fs16 \tab }{\cs57\scaps\fs20 \chpgn }{
\scaps\fs20 
\par }}{\*\pnseclvl1\pndec\pnstart24\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl2\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl4\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl5
\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl6\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl7\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl8\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl9
\pnlcrm\pnstart1\pnindent720\pnhang}\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 15.\tab Was there a problem or disagreement about the existence of or proposal to place something in your immediate neighborhood that you objected to and wanted to oppose, like }{
\fs20\highlight16 (READ SLOWLY}{\fs20\lang1024\langfe1024\highlight16\noproof :)}{\fs20\lang1024\langfe1024\noproof 
 a prison or half-way house, adult entertainment facility, drug treatment facility, garbage dump, waste treatment plant,, or other polluter, or liquor store?
\par }\pard\plain \qr \li0\ri0\keep\nowidctlpar\tx0\tx5760\tx7110\tx8100\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang1024\langfe1024\noproof 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz6\shplid1032{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8198\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.15
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 16)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx5760\tx7110\tx8100\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {
\fs24\lang1024\langfe1024\noproof 
\par 
\par 
\par 
\par }\pard \qj \li0\ri0\nowidctlpar\tx0\tx5760\tx7110\tx8100\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24\lang1024\langfe1024\noproof 
\par {\listtext\pard\plain\s59 \fs20 \hich\af0\dbch\af0\loch\f0 16.\tab}}\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar
\tx0\jclisttab\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\ls31\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
Was there a problem near your home with seriously inadequate or inferior city or municipal services, like }{\fs20\highlight16 (READ SLOWLY}{\fs20\lang1024\langfe1024\highlight16\noproof :)}{\fs20\lang1024\langfe1024\noproof 
 garbage piling up without being collected, abandoned buildings not being closed up or torn down, dangerous holes in streets or sidewalks, inadequate or unsafe public transportation, or other serious municipal service problem?
\par }\pard \s59\qj \li360\ri0\keep\nowidctlpar\tx0\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin360\itap0 {\fs20\lang1024\langfe1024\noproof 
\par 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz7\shplid1033{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8199\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.16
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 17)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qr \li0\ri0\keep\nowidctlpar\tx0\tx5760\tx7110\tx8100\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {
\fs24\lang1024\langfe1024\noproof 
\par 
\par 
\par {\listtext\pard\plain\s59 \fs20 \hich\af0\dbch\af0\loch\f0 17.\tab}}\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar
\tx0\jclisttab\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\ls31\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
Were (any of) you living in a neighborhood in the last twelve months where you felt the police weren\rquote t doing a reasonable job at  keeping crime, drug use, or other serious problems near your home under control, such as }{\fs20\highlight16 
(READ SLOWLY}{\fs20\lang1024\langfe1024\highlight16\noproof :)}{\fs20\lang1024\langfe1024\noproof  the police didn\rquote t come when called, there weren\rquote 
t enough police in the neighborhood, the police were abusive or harrassed residents, or any other major problems with police handling of neighborhood difficulties?
\par }\pard \s59\qj \li360\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin360\itap0 {\fs20\lang1024\langfe1024\noproof 
\par 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz8\shplid1034{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8200\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.17
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 18)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \ql \fi-720\li720\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 {\fs24 
\par 
\par }\pard \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\pard \ql \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 {\fs24 18.\tab Now, I\rquote 
d like to ask you about some situations that can come up in families.  Again, I\rquote ll be asking about the last twelve months and about problems affecting anyone }{\fs24\ul now}{\fs24  living in your household.
\par }\pard \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par }\pard\plain \s60\qj \li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
Did (any of) you need legal advice or help related to the breakup of a marriage or live-in relationship or about what would happen with children or property after a breakup?
\par 
\par 
\par }\pard\plain \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1
\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 20)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard \qc \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par 
\par 
\par }\pard \qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin720\itap0 {\fs24 19.\tab 
Was that related to getting a separation, divorce, or annulment;  about who would keep what property, about alimony; about who would have custody of a child, about rights to see the child; or about something else?  }{\fs24\highlight16 (RECORD }{
\fs24\ul\highlight16 LOWEST CODE}{\fs24\highlight16  THAT APPLIES TO EACH INCIDENT)}{\fs24 
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par 
\par }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard 
\qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Incident A\cell Incident B\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 
\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\ul Child }{\fs24 custody dispute\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 01\cell 
01\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Serious dispute about }{\fs24\ul property }{\fs24 settlement or }{\fs24\ul alimony}{\fs24 \cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 02\cell 02\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 
\trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 
\trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Other }{\fs24\ul dispute about }{\fs24 
child (e.g., re: residence of parent or child, visitation, or rights of grandparents\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 03\cell 03\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\ul Separation, divorce}{\fs24 , or annulment\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {
\fs24 04\cell 04\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh
\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030
\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\ul Other}{\fs24  family law problem\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 77
\cell 77\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb
\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 
\trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 
\cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 
\clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\highlight16 
(PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE: THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.17 BEFORE CONTINUING BELOW)}{\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {
\lang1024\langfe1024\noproof {\shp{\*\shpinst\shpleft1413\shptop35\shpright2013\shpbottom635\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz10\shplid1035
{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8202\dprect\dpx1413\dpy35\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\fs24 \cell }\pard \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par 
\par 
\par 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 20.\tab }{
\fs20\highlight16 (IF RESPONDENT IS A SENIOR CITIZEN ASK:)}{\fs20 
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par }\pard \qj \li630\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin630\itap0 {\fs24 A.  Did a situation arise where you (or an elderly person in the household) }{
\fs24\highlight16 (READ SLOWLY) }{\fs24  were yelled at or hit by a caretaker or other person, had money or property items taken by a caretaker or other person, wer
e left alone by a care taker or other person when you couldn't take care of yourself or feed yourself or get yourself to the bathroom, or otherwise had someone treat you badly? 
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par \tab }{\fs24\highlight16 (OTHERWISE ASK:)}{\fs24 
\par 
\par 
\par }\pard \qj \li630\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin630\itap0 {\fs24 B.  Did a situation arise in which an elderly person in 
the household or a close elderly relative was suspected of being emotionally, physically or sexually abused, neglected or taken advantage of financially?
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz9\shplid1036{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8201\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.20
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 21)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par 
\par {\listtext\pard\plain\s15 \fs20 \hich\af0\dbch\af0\loch\f0 21.\tab}}\pard\plain \s15\qj \fi-720\li720\ri0\keep\nowidctlpar
\tx0\jclisttab\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\ls32\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
Do you live in a nursing facility, boarding home, adult family home or other group care setting?  
\par }\pard\plain \qj \li360\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin360\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1
\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 23)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard \qr \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par 
\par \sect }\sectd \marglsxn1350\margtsxn630\margbsxn720\sbknone\linex0\headery1440\footery1920\endnhere\sectdefaultcl {\headerr \pard\plain \ql \li0\ri0\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {

\par }}{\footerr \pard\plain \s55\ql \li0\ri0\nowidctlpar\tx0\tqc\tx4680\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\scaps\fs16 \tab }{\cs57\scaps\fs20 \chpgn }{
\scaps\fs20 
\par }}{\*\pnseclvl1\pndec\pnstart22\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl2\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl4\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl5
\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl6\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl7\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl8\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl9
\pnlcrm\pnstart1\pnindent720\pnhang}{\listtext\pard\plain\s47 \fs20 \hich\af0\dbch\af0\loch\f0 22.\tab}\pard\plain \s47\ql \fi-630\li630\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\ls2\adjustright\rin0\lin630\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
In the last twelve months, did you experience any of the following problems: 
\par }\pard\plain \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab      Incident
\par \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab     A          B
\par }\trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 
\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard\plain 
\s62\ql \fi-720\li720\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin720 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 a.  \tab 
Was clothing you brought into the facility lost or misplaced or your eyeglasses, hearing aids, teeth or other items misplaced or given to someone else's to wear? \cell }\pard\plain \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24     1\cell    1\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl
\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb
\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh242\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb
\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard\plain \s62\ql \fi-720\li720\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin720 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 \cell }\pard\plain \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph120\trrh242\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 
\trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 
\cellx9450\pard\plain \s62\ql \fi-720\li720\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin720 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 b.  \tab 
Did you receive the wrong medication, or not receive medical services or therapies you were supposed to?\cell }\pard\plain \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
    2     \cell    2\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh215\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard\plain \s62\ql \fi-720\li720\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin720 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 \cell }\pard\plain \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph120\trrh215\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 
\trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 
\cellx9450\pard\plain \s62\ql \fi-720\li720\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin720 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 c.  \tab 
Were you not able to see people that you wanted to see or not able to participate in activities that you wanted to?\cell }\pard\plain \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 
{\fs24     3\cell    3\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh260\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard\plain \s62\ql \fi-720\li720\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin720 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 \cell }\pard\plain \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph120\trrh260\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 
\trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 
\cellx9450\pard\plain \s62\ql \fi-720\li720\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin720 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 d.  \tab 
Were you told you couldn't do things you wanted to do unless you acted better or differently?\cell }\pard\plain \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24     4\cell    4
\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh
\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920
\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh233\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd 
\trgaph120\trrh233\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt
\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard 
\ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 e.  \tab Was your room changed or moved over your objections?\cell     5\cell    5\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd 
\trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh242\trleft810\trkeep\trbrdrt
\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard 
\ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph120\trrh242\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl
\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb
\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb
\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard\plain \s62\ql \fi-720\li720\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin720 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 f.   \tab Was there any other serious problem related to living in the group care setting?\cell }\pard\plain \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24     6\cell    6\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl
\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb
\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh287\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb
\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard\plain \s62\ql \fi-720\li720\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin720 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 \cell }\pard\plain \ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph120\trrh287\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 
\trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 
\cellx9450\pard \ql \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\highlight16 
IF YES, PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.22
\par }\pard\plain \s62\ql \fi-720\li720\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin720 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16  BEFORE CONTINUING BELOW)}{\fs20 \cell }\pard\plain 
\ql \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft471\shptop20\shpright1071\shpbottom620\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz11\shplid1037{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8203\dprect\dpx471\dpy20\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 
\trowd \trgaph120\trrh403\trleft810\trkeep\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl120\trpaddr120\trpaddfl3\trpaddfr3 
\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7110 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth810 \cellx8730\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\pard 
\ql \li1560\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin1560\itap0 {\fs24 
\par }\pard \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 \tab }{\fs24\highlight16 (IF ALL \'93NO,\'94 CONTINUE  TO Q. 23)}{\fs24 
\par 
\par 
\par {\listtext\pard\plain\s59 \fs20 \hich\af0\dbch\af0\loch\f0 23.\tab}}\pard\plain \s59\qj \fi-630\li630\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\ls2\adjustright\rin0\lin630\itap0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Did any adult, (including you) living in the household suffer physical, sexual, or emotional abuse from a spouse or intimate partner?
\par }\pard \s59\qj \li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 {\fs20 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz12\shplid1038{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8204\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.23
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 24)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qj \fi-1260\li630\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin630\itap0 {\fs24   \tab 
\par 
\par 
\par 
\par 
\par }\pard\plain \s15\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 24.
\tab (Did you/did anyone now living in your household) have a biological, adoptive, step-, or foster child who was under the age of 18 in the last twelve months, whether or not that child was living in the household?
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1
\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 27)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 25.\tab 
Was anyone in the household involved in a dispute about child support\emdash either with the other parent or a government agency\emdash about the award or payment of child support, who the child\rquote s father is, or some other matter?
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz13\shplid1039{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8205\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.25
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 26)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qr \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 26.\tab Did
 any of the following occur in the last twelve months:  the adoption or appointment of a guardian for a child, problems with the child welfare authorities, suspicions about child abuse or neglect, or a serious problem with foster care?
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz14\shplid1040{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8206\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.26
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 27)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par {\listtext\pard\plain\s62 \fs20 \hich\af0\dbch\af0\loch\f0 27.\tab}}\pard\plain \s62\ql \fi-720\li720\ri0\keep\nowidctlpar
\tx0\jclisttab\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\ls33\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
At any time during the last twelve months, did anyone in your household have a biological, adoptive, step-, or foster child who was of school age, whether or not that child was living in the household, or did your household include any children of school 
age?
\par }\pard\plain \ql \li360\ri0\keep\nowidctlpar\tx0\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin360\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1
\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 31)}{\fs24  \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard \qr \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 28.\tab 
Did anyone have great difficulty obtaining appropriate educational serv
ices such as enrolling a child in school, finding that the child was placed in a program below his or her level, or having a serious problem getting the kind of special classes or services the child needed?
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz15\shplid1041{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8207\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.28
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 29)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qr \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab 
\par }\pard \qj \fi-630\li630\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin630\itap0 {\fs24 29.\tab 
Was there ever a time in the last twelve months when a child in the household had truancy or disciplinary problems that you believe were handled unfairly or improperly by school officials or the police?
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz16\shplid1042{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8208\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.29
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 30)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par {\listtext\pard\plain\hich\af0\dbch\af0\loch\f0 30.\tab}}\pard \qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\jclisttab\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\ls34\adjustright\rin0\lin720\itap0 {\fs24 
Did a child from the household have serious difficulty getting an education, because, for example, }{\fs24\highlight16 (READ SLOWLY}{\fs24\lang1024\langfe1024\highlight16\noproof :)}{\fs24\lang1024\langfe1024\noproof 
 the school was dangerous and students were not adequately protected, students were treated unfairly or unequally, or the education that was offered was seriously inadequate?
\par }\pard \qj \li360\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin360\itap0 {\fs24\lang1024\langfe1024\noproof 
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24\lang1024\langfe1024\noproof 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz17\shplid1043{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8209\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.30
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 31)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qr \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24\lang1024\langfe1024\noproof 
\par 
\par }\pard \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 31.\tab Now a few more questions about things that can come up in families . . .
\par 
\par 
\par }\pard\plain \s60\qj \li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 In 
the last twelve months, did (any of) you need help with things like:  making or changing a will, estate planning, setting up a trust, becoming eligible for Medicaid coverage of nursing home care, making sure loved ones will be provided for after your deat
h or administering an estate or dealing with an inheritance problem that arose }{\fs20\ul after}{\fs20  someone died?
\par }\pard\plain \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz18\shplid1044{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8210\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.31
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 32)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 32.\tab 
At any time in the last twelve months, did (any of) you feel that you needed to get help for an adult who could not handle his or her own affairs, have a guardian appointed for that person, or change a guardianship arrangement that was already in place?

\par }\pard\plain \qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin720\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz19\shplid1045{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8211\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.32
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q.33)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \ql \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par {\listtext\pard\plain\hich\af0\dbch\af0\loch\f0 33.\tab}}\pard \ql \fi-720\li720\ri0\keep\nowidctlpar\tx0\jclisttab\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\ls35\adjustright\rin0\lin720\itap0 {\fs24 
In the last twelve months, did (any of) you find that you wanted to provide }{\fs24\ul in advance}{\fs24 
 for a time when you might not be able to make important decisions about your finances, medical treatment, or other important matters, by signing a document like a power of attorney or living will?
\par }\pard \ql \li360\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin360\itap0 {\fs24 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz20\shplid1046{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8212\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.33
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 34)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qr \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 34.\tab I
\rquote 
d like to ask about some situations that may come up concerning work and retirement.  In the previous year, do you believe (any of) you denied a job because of unfair hiring practices or discrimination based on race, national origin, sex, disability, immi
gration status, religion, sexual orientation or anything else?
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1
\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 36)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 35.\tab 
What do you believe was the basis for the unfair treatment or discrimination\emdash race, sex, age, disability, or something else?
\par 
\par }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard\plain 
\qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Incident A\cell Incident B\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
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\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 
\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Race\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 01\cell 01\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 National origin/Ethnicity\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 02\cell 02\cell 
}\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Sex\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 03\cell 03\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Marital Status\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 04\cell 04\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Parental Status\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 05\cell 05\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Age\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 06\cell 06\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Sexual orientation\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 07\cell 07\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Disability\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 09\cell 09\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Religion\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 10\cell 10\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Immigration status\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 11\cell 11\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Other (including }{\fs24\ul combination}{\fs24  of the above) (SPECIFY:)\cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 77\cell 77\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 
\trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 
\trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 
\trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 
\cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 
\clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\highlight16 
(PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE: THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.35 BEFORE CONTINUING BELOW)}{\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {
\lang1024\langfe1024\noproof {\shp{\*\shpinst\shpleft1413\shptop99\shpright2013\shpbottom699\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz44\shplid1047
{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8236\dprect\dpx1413\dpy99\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 
\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par {\listtext\pard\plain\s59 \fs20 \hich\af0\dbch\af0\loch\f0 36.\tab}}\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar
\tx0\jclisttab\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\ls36\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Do you believe (any of
) you were unfairly denied unemployment compensation benefits or were you involved in a fight to get these benefits?
\par }\pard \s59\qj \li360\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin360\itap0 {\fs20 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz21\shplid1048{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8213\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.36
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 37)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard\plain \s62\ql \li0\ri0\nowidctlpar
\tx0\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
\par {\listtext\pard\plain\s62 \fs20 \hich\af0\dbch\af0\loch\f0 37.\tab}}\pard \s62\ql \fi-720\li720\ri0\keep\nowidctlpar
\tx0\jclisttab\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\ls36\adjustright\rin0\lin720\itap0 {\fs20 
Do you believe (any of) you were unfairly denied workers compensation benefits to pay for medical costs, lost time or permanent disability caused by an injury at work, or were you involved in a fight to get these benefits?
\par }\pard\plain \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz22\shplid1049{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8214\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.37
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 38)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qr \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\pard \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\pard \ql \fi-630\li630\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin630\itap0 {\fs24 38.\tab 
Did (any of) you have a serious problem related to a pension plan or retirement benefits\emdash either while working or after retirement--such as}{\fs24\highlight16  (READ SLOWLY}{\fs24\lang1024\langfe1024\highlight16\noproof :)}{
\fs24\lang1024\langfe1024\noproof  a dispute over collecting benefits, being fired just before vesting, being unfairly excluded from the pension plan, improper administration of the plan, or cutting off health benefits for retirees?
\par 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz23\shplid1050{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8215\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.38
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 39)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qr \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24\lang1024\langfe1024\noproof 
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\pard \qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin720\itap0 {\fs24 39.\tab 
(Were you/was anyone in your household) working at a paid job or doing }{\fs24\ul any other}{\fs24  work for pay during the last twelve months?
\par 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1
\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 50)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard \qr \li0\ri0\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 40.\tab 
Did (you/anyone) have any serious difficulties with pay or withholding, for example, problems with pay rates (minimum wage or promised pay), collecting pay, or withholding for taxes, or garnished wages?
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz24\shplid1051{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8216\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.40
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 41)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 41.\tab 
Did (any of) you have a major problem with fringe benefits, like vacation, sick leave, or health insurance, either because the benefits were not what the employer promised or the employer made it very difficult to use them?
\par }\pard\plain \qr \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz25\shplid1052{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8217\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.41
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 42)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 42.\tab 
(Were you/was anyone) denied a promotion or raise at work, or disciplined, fired, or given undesirable work assignments because the employer discriminated or treated people unfairly?
\par }\pard\plain \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1
\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 44)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard\plain 
\s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 
\par 43.\tab What do you believe was the basis for the discrimination or unfair treatment\emdash race, sex, age, disability, or something else?
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard 
\qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Incident A\cell Incident B\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 
\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Race\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 01\cell 01\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 National origin/Ethnicity\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 02\cell 02\cell 
}\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Sex\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 03\cell 03\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Race/ethnicity }{\fs24\ul and}{\fs24  sex\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 
04\cell 04\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh
\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030
\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Marital Status\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 05\cell 05\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Parental Status\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 06\cell 06\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Age\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 07\cell 07\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Sexual orientation\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 09\cell 09\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Disability\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 10\cell 10\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Religion\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 11\cell 11\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Immigration status\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 12\cell 12\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Other (including }{\fs24\ul combination}{\fs24  of the above) (SPECIFY:)\cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 77\cell 77\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 
\trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 
\trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 
\trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 
\cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 
\clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\highlight16 
(PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.43 BEFORE CONTINUING BELOW)}{\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {
\lang1024\langfe1024\noproof {\shp{\*\shpinst\shpleft1413\shptop81\shpright2013\shpbottom681\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz45\shplid1053
{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8237\dprect\dpx1413\dpy81\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 
\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \ql \fi-720\li720\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin720\itap0 {\fs24 
\par 44.\tab Did (any of) you experience serious threats to your privacy on the job to which you objected, }{\fs24\highlight16 (READ SLOWLY}{\fs24\lang1024\langfe1024\highlight16\noproof :)}{\fs24\lang1024\langfe1024\noproof 
 such as having to take a lie detector test, medical examination or AIDS test, not being allowed to find out what\rquote s in your personnel file, or other invasion of your privacy on the job?
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz26\shplid1054{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8218\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.44
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 45)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qj \fi-1260\li630\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin630\itap0 {\fs24 \tab 45.\tab Did (any of) you experience any other major difficulties on the job, like }{\fs24\highlight16 
(READ SLOWLY}{\fs24\lang1024\langfe1024\highlight16\noproof :)}{\fs24\lang1024\langfe1024\noproof 
 sexual harassment, unhealthy or unsafe working conditions, serious union problems, or the employer trying to get back at you for organizing other workers or reporting violations of employment law?
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24\lang1024\langfe1024\noproof 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard\plain \s1\qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\outlinelevel0\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 Incident A             Incident B
\par 1                           2\cell }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 
\par 
\par 3
\par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\pard \ql \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
{\shp{\*\shpinst\shpleft6981\shptop134\shpright7581\shpbottom734\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz27\shplid1055{\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}
{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8219\dprect\dpx6981\dpy134\dpxsize600\dpysize600
\dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat1\dplinew15\dplinecor0\dplinecog0\dplinecob0}}}}{\highlight16 (PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE:
\par  THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.45
\par  BEFORE CONTINUING BELOW)}{\fs24\highlight16 \cell }\pard\plain \s66\qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20\highlight16 
\par (GO TO Q. 46)}{\fs20\ul 
\par }\pard\plain \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7848 \cellx7740\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1728 \cellx9468\row }\pard \qj \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24\ul 
\par }{\fs24 46.\tab Did (any of) you work as a seasonal farm worker at any time in the last twelve months?
\par 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1
\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 50)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard \ql \li0\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\pard \ql \fi-1260\li630\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin630\itap0 {\fs24 \tab 47.\tab 
Was this work done in the local area or did the farm worker leave the area to look for work?
\par }\trowd \trgaph108\trleft5670\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060 \cellx8730\clvertalt\clbrdrt\brdrnone \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Worked in the local area\cell }\pard 
\qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 1\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft5670\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 
\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060 \cellx8730\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450
\row }\trowd \trgaph108\trleft5670\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060 \cellx8730\clvertalt\clbrdrt\brdrnone \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 
\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft5670\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr
\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060 \cellx8730\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\pard 
\qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 Migrated\cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 2\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {
\fs24 \trowd \trgaph108\trleft5670\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060 \cellx8730\clvertalt\clbrdrt\brdrnone \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\trowd \trgaph108\trleft5670\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr
\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060 \cellx8730\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {
\fs24 \cell }\pard \qr \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd 
\trgaph108\trleft5670\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060 \cellx8730\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone 
\clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth720 \cellx9450\row }\pard \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {
\fs24 
\par }\pard\plain \s59\qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs20 48.\tab 
Did (you/the farm worker(s)) experience problems related to being (a) (migrant) farm worker(s), for instance }{\fs20\highlight16 (READ SLOWLY}{\fs20\lang1024\langfe1024\highlight16\noproof :)}{\fs20\lang1024\langfe1024\noproof 
 with working conditions, pay, taxes, housing, health care, schooling for the children, unfair rules and restrictions imposed by your employer or a labor contractor, or getting documents needed to work?
\par }\pard\plain \qr \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\fs24\lang1024\langfe1024\noproof 
\par }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 
\par Yes
\par \cell No\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard \qc \li0\ri0\keep\nowidctlpar\intbl
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0 {\fs24 1
\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 50)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalc\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard \qj \fi-720\li720\ri0\keep\nowidctlpar
\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin720\itap0 {\fs24\lang1024\langfe1024\noproof 49.\tab 
Was the problem with working conditions, pay, taxes, housing, schooling, rules and restrictions, or something else?  }{\fs24\lang1024\langfe1024\highlight16\noproof (IF MULTIPLE PROBLEMS }{\fs24\ul\lang1024\langfe1024\highlight16\noproof 
RELATED TO A SINGLE INCIDENT}{\fs24\lang1024\langfe1024\highlight16\noproof , PROBE FOR THE ONE R CONSIDERS }{\fs24\ul\lang1024\langfe1024\highlight16\noproof MOST SERIOUS}{\fs24\lang1024\langfe1024\highlight16\noproof )}{
\fs24\lang1024\langfe1024\noproof 
\par 
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24\lang1024\langfe1024\noproof 
\par }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard 
\qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof Incident A}{\fs24 \cell }{\fs24\lang1024\langfe1024\noproof Incident B
}{\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 
\trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\ul\lang1024\langfe1024\noproof Working conditions}{\fs24\lang1024\langfe1024\noproof 
 (e.g., pesticide exposure, unavailability of drinking water or toilets)}{\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof 01}{\fs24 \cell }{\fs24\lang1024\langfe1024\noproof 01}{\fs24 
\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof Not receiving proper }{\fs24\ul\lang1024\langfe1024\noproof pay}{\fs24 \cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof 02}{\fs24 \cell }{\fs24\lang1024\langfe1024\noproof 02}{\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {
\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard 
\qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {
\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard 
\qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof Forced to buy things from your employer}{\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {
\fs24\lang1024\langfe1024\noproof 03}{\fs24 \cell }{\fs24\lang1024\langfe1024\noproof 03}{\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl
\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb
\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 
\trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof Employer not paying }{
\fs24\ul\lang1024\langfe1024\noproof social security}{\fs24\lang1024\langfe1024\noproof  taxes}{\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof 04}{\fs24 \cell }{
\fs24\lang1024\langfe1024\noproof 04}{\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl
\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 
\trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 
\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof 
Unsafe or seriously inadequate }{\fs24\ul\lang1024\langfe1024\noproof housing}{\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof 05}{\fs24 \cell }{\fs24\lang1024\langfe1024\noproof 05}{
\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 
\trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof Inadequate }{\fs24\ul\lang1024\langfe1024\noproof health care}{\fs24 \cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof 06}{\fs24 \cell }{\fs24\lang1024\langfe1024\noproof 06}{\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {
\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard 
\qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {
\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt
\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard 
\qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof Inadequate }{\fs24\ul\lang1024\langfe1024\noproof schools}{\fs24\lang1024\langfe1024\noproof   or schools that are hard for children to get to}{\fs24 
\cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof 07}{\fs24 \cell }{\fs24\lang1024\langfe1024\noproof 07}{\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6048 \cellx6030\clvertalt\clbrdrt
\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1890 \cellx7920\clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof Unreasonable rules and }{\fs24\ul\lang1024\langfe1024\noproof restrictions}{
\fs24\lang1024\langfe1024\noproof  proposed by an employer, labor contract or housing provider}{\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof 08}{\fs24 \cell }{
\fs24\lang1024\langfe1024\noproof 08}{\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 
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\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof Getting }{
\fs24\ul\lang1024\langfe1024\noproof documents}{\fs24\lang1024\langfe1024\noproof  needed to work}{\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof 09}{\fs24 \cell }{
\fs24\lang1024\langfe1024\noproof 09}{\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
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\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard 
\qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 
\trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrdot\brdrw10 \clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr
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\clbrdrl\brdrdot\brdrw10 \clbrdrb\brdrdot\brdrw10 \clbrdrr\brdrdot\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof Other (SPECIFY:)}{
\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24\lang1024\langfe1024\noproof 77}{\fs24 \cell }{\fs24\lang1024\langfe1024\noproof 77}{\fs24 \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv
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\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\fs24 \cell \cell }\pard 
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\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\row }\trowd \trgaph108\trleft-18\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr\brdrdot\brdrw10 \trbrdrh\brdrdot\brdrw10 \trbrdrv\brdrdot\brdrw10 
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\cltxlrtb\clftsWidth3\clwWidth1638 \cellx9558\pard \qj \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\highlight16 
(PLACE A CHECK IN THE BOX AT THE RIGHT TO MARK YOUR PLACE THEN COMPLETE SUPPLEMENT, PART I, FOR INCIDENT(S) IN Q.49BEFORE CONTINUING BELOW)}{\fs24 \cell }\pard \qc \li0\ri0\keep\nowidctlpar\intbl\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\noproof 
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\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin0\itap0 {\fs24 \tab \tab \tab \tab 
\par }\pard \qj \fi-720\li720\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\faauto\adjustright\rin0\lin720\itap0 {\fs24 50.\tab During the last twelve months, did (any of) you experience a }{
\fs24\ul disability or serious health condition}{\fs24 ?
\par }\pard \qj \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24 
\par }\pard \ql \li0\ri0\keep\nowidctlpar\tx0\tx720\tx1440\tx2160\tx2880\tx3600\tx4320\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 {\fs24\highlight16 (ACCEPT R\rquote 
s ANSWER WITHOUT PROBING, BUT IF R STATES A CONDITION THAT YOU ARE UNSURE WOULD QUALIFY AS A DISABILITY OR SERIOUS HEALTH CONDITION, MARK YES, AND MAKE NOTE OF THE CONDITION SPECIFIED IN THE MARGIN.)}{\fs24 
\par 
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\par Yes
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\par 
\par }{\fs24\highlight16 (CONTINUE)}{\fs24 \cell 2
\par 
\par }{\fs24\highlight16 (SKIP TO Q. 53)}{\fs24   \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrdot\brdrw10 \trbrdrl\brdrdot\brdrw10 \trbrdrb\brdrdot\brdrw10 \trbrdrr
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\par }}{\footerr \pard\plain \s55\ql \li0\ri0\nowidctlpar\tx0\tqc\tx4680\tx5040\tx5760\tx6480\tx7200\tx7920\tx8640\tx9360\faauto\adjustright\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\scaps\fs16 \tab }{\cs57\scaps\fs20 \chpgn }{
\scaps\fs20 
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