22. In total, how many years of active-duty military service has this person had? [] Less than 2 years [] 2 years or more

Flag for years of active-duty military service

Flag for veteran status and various periods of military service

Flag for veteran status and various periods of military service

K. Answer questions 35-40 only if this person worked in the past 5 years. Otherwise, skip to question 41. 35-40 Current or most recent job activity. Describe clearly this person's chief job activity or business last week. If this person had more than one job, describe the one at which this person worked the most hours. If this person had no job or business last week, give information for his/her last job or business. 35. Was this person? Mark (X) one box [] An employee of a private for profit company or business, or of an individual, for wages, salary, or commissions? [] An employee of a private not for profit, tax-exempt, or charitable organization? [] A local government employee (city, county, etc.)? [] A state government employee? [] A Federal government employee? [] Self-employed in own not incorporated business, professional practice, or farm? [] Self-employed in own incorporated business, professional practice, or farm? [] Working without pay in family business or farm? 36. For whom did this person work? If now on active duty in the armed forces, mark (X) this box --> [] and print the branch of the Armed Forces Name of company, business, or other employer ____ 37. What kind of business or industry was this? Describe the activity at the location where employed. (For example: hospital, newspaper publishing, mail order house, auto engine manufacturing, bank) ____ 38. Is this mainly? Mark (X) one box [] Manufacturing? [] Wholesale trade? [] Retail trade? [] Other (agriculture, service, government, etc.)? 39. What kind of work was this person doing? (For example: registered nurse, personal manager, supervisor of order department, secretary, accountant) ____ 40. What were this person's most important activities or duties? (For example: patient care, directing hiring policies, supervising order clerks, typing and filing, reconciling financial records) ____

K. Answer questions 35-40 only if this person worked in the past 5 years. Otherwise, skip to question 41. 35-40 Current or most recent job activity. Describe clearly this person's chief job activity or business last week. If this person had more than one job, describe the one at which this person worked the most hours. If this person had no job or business last week, give information for his/her last job or business. 35. Was this person? Mark (X) one box [] An employee of a private for profit company or business, or of an individual, for wages, salary, or commissions? [] An employee of a private not for profit, tax-exempt, or charitable organization? [] A local government employee (city, county, etc.)? [] A state government employee? [] A Federal government employee? [] Self-employed in own not incorporated business, professional practice, or farm? [] Self-employed in own incorporated business, professional practice, or farm? [] Working without pay in family business or farm? 36. For whom did this person work? If now on active duty in the armed forces, mark (X) this box --> [] and print the branch of the Armed Forces Name of company, business, or other employer ____ 37. What kind of business or industry was this? Describe the activity at the location where employed. (For example: hospital, newspaper publishing, mail order house, auto engine manufacturing, bank) ____ 38. Is this mainly? Mark (X) one box [] Manufacturing? [] Wholesale trade? [] Retail trade? [] Other (agriculture, service, government, etc.)? 39. What kind of work was this person doing? (For example: registered nurse, personal manager, supervisor of order department, secretary, accountant) ____ 40. What were this person's most important activities or duties? (For example: patient care, directing hiring policies, supervising order clerks, typing and filing, reconciling financial records) ____

K. Answer questions 35-40 only if this person worked in the past 5 years. Otherwise, skip to question 41. 35-40 Current or most recent job activity. Describe clearly this person's chief job activity or business last week. If this person had more than one job, describe the one at which this person worked the most hours. If this person had no job or business last week, give information for his/her last job or business. 35. Was this person? Mark (X) one box [] An employee of a private for profit company or business, or of an individual, for wages, salary, or commissions? [] An employee of a private not for profit, tax-exempt, or charitable organization? [] A local government employee (city, county, etc.)? [] A state government employee? [] A Federal government employee? [] Self-employed in own not incorporated business, professional practice, or farm? [] Self-employed in own incorporated business, professional practice, or farm? [] Working without pay in family business or farm? 36. For whom did this person work? If now on active duty in the armed forces, mark (X) this box --> [] and print the branch of the Armed Forces Name of company, business, or other employer ____ 37. What kind of business or industry was this? Describe the activity at the location where employed. (For example: hospital, newspaper publishing, mail order house, auto engine manufacturing, bank) ____ 38. Is this mainly? Mark (X) one box [] Manufacturing? [] Wholesale trade? [] Retail trade? [] Other (agriculture, service, government, etc.)? 39. What kind of work was this person doing? (For example: registered nurse, personal manager, supervisor of order department, secretary, accountant) ____ 40. What were this person's most important activities or duties? (For example: patient care, directing hiring policies, supervising order clerks, typing and filing, reconciling financial records) ____

8. Does this house, apartment, or mobile home have: g) Telephone service from which you can both make and receive calls? Include cell phones. [] Yes [] No

b) How many weeks did this person work, even for a few hours, including paid vacation, paid sick leave, and military service? [] 50 to 52 weeks [] 48 to 49 weeks [] 40 to 47 weeks [] 27 to 39 weeks [] 14 to 26 weeks [] 13 weeks or less 40. During the past 12 months (52 weeks), in the weeks worked, how many hours did this person usually work each week? Usual hours worked each week: _____

b) How many weeks did this person work, even for a few hours, including paid vacation, paid sick leave, and military service? [] 50 to 52 weeks [] 48 to 49 weeks [] 40 to 47 weeks [] 27 to 39 weeks [] 14 to 26 weeks [] 13 weeks or less 40. During the past 12 months (52 weeks), in the weeks worked, how many hours did this person usually work each week? Usual hours worked each week: _____

16. Is this person currently covered by any of the following types of health insurance or health coverage plans? Mark "Yes" or "No" for each type of coverage in items a - h. Yes No g) Indian Health Service [] Yes [] No

28. a) Does this person have a VA service-connected disability rating? [] Yes (such as 0%, 10%, 20%, ... , 100%) [] No SKIP to question 29a b) What is this person's service-connected disability rating? [] 0 percent [] 10 or 20 percent [] 30 or 40 percent [] 50 or 60 percent [] 70 percent or higher