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One-Minute Survey
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First Name
*
Last Name
*
Email
*
ZIP Code
*
1) Do you currently own a house?
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Yes
No
2) What is your yearly household income?
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3) What are your sources of income?
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Work
Disability
Social Security
Child Support / Alimoney
Self-employed
Other
Check all that apply
4) How long have you been working at your current job?
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0-6 months
6-10 months
10 months - 1 year
1 year +
In addition to working at your current job for at least a year, have you been employed for two consecutive years?
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Yes
No
5) Have you filed for bankruptcy in the last two years?
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Yes
No
6) Will you consent to a credit and criminal background check?
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Yes
No
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