Household Information

• The older of your age or your spouse’s age :

• Are you or your spouse disabled?

• Is any member of your household in a wheelchair ?

• Is at least one member of your house a US citizen or have qualified immigration status?

• Number household members 18 or older :

• Number of household members younger than 18 :

• Household Income

• Press “yes” if one or more of these apply to your household:
  
  1. homeless, staying in a shelter or lacking a fixed, adequate nighttime living situation ;
  2. in danger due to providing testimony or information regarding criminal activity;
  3. a victim of Domestic Violence or stalking that places in you imminent danger;
  4. subject to a no-fault, court ordered eviction;
  5. without housing due to natural disaster or condemnation;
  6. disabled and unable to use your current housing due to inaccessibility; or
  7. a victim of a hate crime;