H12. Answer this question if you pay rent for your living quarters. "Report the rent agreed to or contracted for, even if the furnishings, utilities, or services are included." a. If rent is paid by the month -- What is the monthly rent? $ (Nearest dollar) _____.00 and Fill one circle [] Less than $30 [] $30 to $39 [] $40 to $49 [] $50 to $59 [] $60 to $69 [] $70 to $79 [] $80 to $89 [] $90 to $99 [] $100 to $119 [] $120 to $149 [] $150 to $199 [] $200 to $249 [] $250 to $299 [] $300 or more "If you pay rent by the month, write in the amount of rent and fill one circle." b. If rent is not paid by the month - What is the rent, and what period of time does it cover? $ (Nearest dollar) _____.00 per (Week, half-month, year, etc.) _____ "If rent is not paid by the month, answer both parts of b. For example, $20 per week, $1,500 per year, etc."

H12. Answer this question if you pay rent for your living quarters. "Report the rent agreed to or contracted for, even if the furnishings, utilities, or services are included." a. If rent is paid by the month -- What is the monthly rent? $ (Nearest dollar) _____.00 and Fill one circle [] Less than $30 [] $30 to $39 [] $40 to $49 [] $50 to $59 [] $60 to $69 [] $70 to $79 [] $80 to $89 [] $90 to $99 [] $100 to $119 [] $120 to $149 [] $150 to $199 [] $200 to $249 [] $250 to $299 [] $300 or more "If you pay rent by the month, write in the amount of rent and fill one circle." b. If rent is not paid by the month - What is the rent, and what period of time does it cover? $ (Nearest dollar) _____.00 per (Week, half-month, year, etc.) _____ "If rent is not paid by the month, answer both parts of b. For example, $20 per week, $1,500 per year, etc."

[All] H9. Are your living quarters - [] Owned or being bought by you or by someone else in this household? Do not include cooperatives and condominiums here. [] A cooperative or condominium which is owned or being bought by you or by someone else in your household? [] Rented for cash rent? [] Occupied without payment of cash rent? "Owned or being bought means that the living quarters are owned outright or are mortgaged. Also mark Owned or being bought if the living quarters are owned but the land is rented. Mark Rented for cash rent if any money rent is paid. Rent may be paid by persons who are not members of your household. Occupied without payment of cash rent includes, for example, a parsonage, a house or apartment provided free of rent by the owner, or a house or apartment occupied by a janitor or caretaker in exchange for services."

23. When was this person born? [] Born before April 1956 - Please go on with questions 24 through 41. [] Born April 1956 or later - Please omit questions 24 through 41 and go to the next page for the next person. Questions 29 through 41 are for all persons born before April 1956 including housewives, students, or disabled persons as well as part-time or full-time workers. [All] 29a. Did this person work at any time last week? [] Yes - Fill this circle if this person did full- or part-time work. (Count part-time work such as a Saturday job, delivering papers, or helping without pay in a family business or farm; and active duty in the Armed Forces. [] No - Fill this circle if this person did not work, or did only own housework, school work, or volunteer work. Skip to 30 33. Industry a. For whom did he work? If now on active duty in the Armed Forces, print "AF" and skip to question 36. _____ (Name of company, business, organization, or other employer) "If he worked for company, business, or government agency, print the name of the company, not the name of his supervisor. If he worked for a person or a small business that has no company name, print the name of the person he worked for." b. What kind of business or industry was this? Describe activity at location where employed. _____ (For example: Junior high school, retail supermarket, dairy farm, TV and radio service, auto assembly plant, road construction) "Write two or more words to tell what the business, industry, or person named in 33a does. Write what it makes or what it sells or what service it gives. Some examples of acceptable answers are shown on the Census form and here." Acceptable Cattle ranch Wholesale grocery store Retail gas station Metal furniture manufacturing Unacceptable Ranch Grocery store Oil company Furniture company If a company does more than one thing (like make household electrical appliances and electric generators) describe only the major activity at the place where he works. If, however, he works at a warehouse, repair shop, etc., that is part of and used only by a larger organization, give the major activity of the larger organization; for example, department store warehouse - report department store." c. Is this mainly - (Fill one circle) [] Manufacturing [] Retail trade [] Wholesale trade [] Other (agriculture, construction, service, government, etc.) "Mark Manufacturing if the factory, plant, mill, etc. makes things, even if it also sells them. Mark Wholesale trade if a business does not make things but buys them to sell to stores or other companies. Mark Retail trade if the business mostly sells things (not services) to individuals. Mark Other if the main purpose of the employer is not making or selling things. Some examples of "Other" are services, such as those given by hotels, dry cleaners, repair shops, schools, and banks. Farming and building houses, bridges, roads, are also examples of "Other" kinds of businesses."

23. When was this person born? [] Born before April 1956 - Please go on with questions 24 through 41. [] Born April 1956 or later - Please omit questions 24 through 41 and go to the next page for the next person. Questions 29 through 41 are for all persons born before April 1956 including housewives, students, or disabled persons as well as part-time or full-time workers. [All] 29a. Did this person work at any time last week? [] Yes - Fill this circle if this person did full- or part-time work. (Count part-time work such as a Saturday job, delivering papers, or helping without pay in a family business or farm; and active duty in the Armed Forces. [] No - Fill this circle if this person did not work, or did only own housework, school work, or volunteer work. Skip to 30 33. Industry a. For whom did he work? If now on active duty in the Armed Forces, print "AF" and skip to question 36. _____ (Name of company, business, organization, or other employer) "If he worked for company, business, or government agency, print the name of the company, not the name of his supervisor. If he worked for a person or a small business that has no company name, print the name of the person he worked for." b. What kind of business or industry was this? Describe activity at location where employed. _____ (For example: Junior high school, retail supermarket, dairy farm, TV and radio service, auto assembly plant, road construction) "Write two or more words to tell what the business, industry, or person named in 33a does. Write what it makes or what it sells or what service it gives. Some examples of acceptable answers are shown on the Census form and here." Acceptable Cattle ranch Wholesale grocery store Retail gas station Metal furniture manufacturing Unacceptable Ranch Grocery store Oil company Furniture company If a company does more than one thing (like make household electrical appliances and electric generators) describe only the major activity at the place where he works. If, however, he works at a warehouse, repair shop, etc., that is part of and used only by a larger organization, give the major activity of the larger organization; for example, department store warehouse - report department store." c. Is this mainly - (Fill one circle) [] Manufacturing [] Retail trade [] Wholesale trade [] Other (agriculture, construction, service, government, etc.) "Mark Manufacturing if the factory, plant, mill, etc. makes things, even if it also sells them. Mark Wholesale trade if a business does not make things but buys them to sell to stores or other companies. Mark Retail trade if the business mostly sells things (not services) to individuals. Mark Other if the main purpose of the employer is not making or selling things. Some examples of "Other" are services, such as those given by hotels, dry cleaners, repair shops, schools, and banks. Farming and building houses, bridges, roads, are also examples of "Other" kinds of businesses."

23. When was this person born? [] Born before April 1956 - Please go on with questions 24 through 41. [] Born April 1956 or later - Please omit questions 24 through 41 and go to the next page for the next person. Questions 29 through 41 are for all persons born before April 1956 including housewives, students, or disabled persons as well as part-time or full-time workers. [All] 29a. Did this person work at any time last week? [] Yes - Fill this circle if this person did full- or part-time work. (Count part-time work such as a Saturday job, delivering papers, or helping without pay in a family business or farm; and active duty in the Armed Forces. [] No - Fill this circle if this person did not work, or did only own housework, school work, or volunteer work. Skip to 30 [All] 39. a. Last year (1969), did this person work at all, even for a few days? [] Yes [] No - Skip to 41 b. How many weeks did he work in 1969, either full-time or part-time? Count paid vacation, paid sick leave, and military service. [] 13 weeks or less [] 14 to 26 weeks [] 27 to 39 weeks [] 40 to 47 weeks [] 48 to 49 weeks [] 50 to 52 weeks "Look at the instruction for question 29a to see what work means. Count every week in which he did any work at all, even for a few hours."

23. When was this person born? [] Born before April 1956 - Please go on with questions 24 through 41. [] Born April 1956 or later - Please omit questions 24 through 41 and go to the next page for the next person. Questions 29 through 41 are for all persons born before April 1956 including housewives, students, or disabled persons as well as part-time or full-time workers. [All] 29a. Did this person work at any time last week? [] Yes - Fill this circle if this person did full- or part-time work. (Count part-time work such as a Saturday job, delivering papers, or helping without pay in a family business or farm; and active duty in the Armed Forces. [] No - Fill this circle if this person did not work, or did only own housework, school work, or volunteer work. Skip to 30 [All] 39. a. Last year (1969), did this person work at all, even for a few days? [] Yes [] No - Skip to 41 b. How many weeks did he work in 1969, either full-time or part-time? Count paid vacation, paid sick leave, and military service. [] 13 weeks or less [] 14 to 26 weeks [] 27 to 39 weeks [] 40 to 47 weeks [] 48 to 49 weeks [] 50 to 52 weeks "Look at the instruction for question 29a to see what work means. Count every week in which he did any work at all, even for a few hours."

Questions 29 through 41 are for all persons born before April 1956 including housewives, students, or disabled persons as well as part-time or full-time workers. [All] 29a. Did this person work at any time last week? [] Yes - Fill this circle if this person did full- or part-time work. (Count part-time work such as a Saturday job, delivering papers, or helping without pay in a family business or farm; and active duty in the Armed Forces. [] No - Fill this circle if this person did not work, or did only own housework, school work, or volunteer work. Skip to 30 [All] 40. Earnings in 1969 - Fill parts a, b, and c for everyone who worked any time in 1969 even if he had no income. (If exact amount is not known, give best estimate.) a. How much did this person earn in 1969 in wages, salary, commissions, bonuses, or tips from all jobs? (Before deductions for taxes, bonds, dues, or other items.) $ (Dollars only) _____.00 or [] None b. How much did he earn in 1969 from his own nonfarm business, professional practice, or partnership? (Net after business expenses. If business lost money, write "Loss" above amount.) $ (Dollars only) _____.00 or [] None c. How much did he earn in 1969 from his own farm? (Net after operating expenses. Include earnings as a tenant farmer or sharecropper. If farm lost money, write "Loss" above amount.) $ (Dollars only) _____.00 or [] None "Enter the amount or fill the None circle in a, b, and c. Part 40a includes "sick leave" pay. Part 40a excludes military bonuses, reimbursement for business expenses, and pay "in kind." The owner of an unincorporated nonfarm business should include his net earnings in part 40b. If the business or farm is incorporated, his earnings should be included in part 40a." 41. Income other than earnings in 1969 - Fill in parts a, b, and c. (If exact amount is not known, give best estimate.) "Enter the amount or fill the None circle in a, b, and c." a. How much did this person receive in 1969 from Social Security or Railroad Retirement? $ (Dollars only) _____.00 or [] None "Social Security or Railroad Retirement - include U.S. Government payments to retired persons, to dependents of deceased insured workers, or to disabled workers. Include "Medicare" premiums; exclude receipts." b. How much did he receive in 1969 from public assistance or welfare payments? Include aid for dependent children, old age assistance, general assistance, aid to the blind or totally disabled. Exclude separate payments for hospital or other medical care. $ (Dollars only) _____.00 or [] None "Public assistance or public welfare payments - include amounts received from Federal, State, or local public programs. Exclude private welfare payments." c. How much did he receive in 1969 from all other sources? Include interest, dividends, veterans' payments, pensions, and other regular payments. (See instruction sheet.) $ (Dollars only) _____.00 or [] None "Interest, dividends - include amounts received or credited to your account. Veterans' payments - include money paid for service-connected disabilities, to survivors of deceased veterans, for education and on-the-job training subsistence allowances, and for 'refunds' on 'GI' insurance premiums. Retirement pensions - include amounts paid by former private employers and by unions, and amounts paid by Federal, State, county, or other governmental agencies. Other regular payments - include such periodic income as net rental income, unemployment insurance benefits, workmen's compensation, private welfare payments, alimony or child support, Armed Forces allotments, and regular contributions from persons who are not members of your household. Exclude receipts from the sale or personal property, capital gains, lump-sum insurance or inheritance payments, or pay 'in kind.'"

23. When was this person born? [] Born before April 1956 - Please go on with questions 24 through 41. [] Born April 1956 or later - Please omit questions 24 through 41 and go to the next page for the next person. Questions 29 through 41 are for all persons born before April 1956 including housewives, students, or disabled persons as well as part-time or full-time workers. [All] 29a. Did this person work at any time last week? [] Yes - Fill this circle if this person did full- or part-time work. (Count part-time work such as a Saturday job, delivering papers, or helping without pay in a family business or farm; and active duty in the Armed Forces. [] No - Fill this circle if this person did not work, or did only own housework, school work, or volunteer work. Skip to 30 [All] 40. Earnings in 1969 - Fill parts a, b, and c for everyone who worked any time in 1969 even if he had no income. (If exact amount is not known, give best estimate.) a. How much did this person earn in 1969 in wages, salary, commissions, bonuses, or tips from all jobs? (Before deductions for taxes, bonds, dues, or other items.) $ (Dollars only) _____.00 or [] None b. How much did he earn in 1969 from his own nonfarm business, professional practice, or partnership? (Net after business expenses. If business lost money, write "Loss" above amount.) $ (Dollars only) _____.00 or [] None c. How much did he earn in 1969 from his own farm? (Net after operating expenses. Include earnings as a tenant farmer or sharecropper. If farm lost money, write "Loss" above amount.) $ (Dollars only) _____.00 or [] None "Enter the amount or fill the None circle in a, b, and c. Part 40a includes "sick leave" pay. Part 40a excludes military bonuses, reimbursement for business expenses, and pay "in kind." The owner of an unincorporated nonfarm business should include his net earnings in part 40b. If the business or farm is incorporated, his earnings should be included in part 40a." 41. Income other than earnings in 1969 - Fill in parts a, b, and c. (If exact amount is not known, give best estimate.) "Enter the amount or fill the None circle in a, b, and c." a. How much did this person receive in 1969 from Social Security or Railroad Retirement? $ (Dollars only) _____.00 or [] None "Social Security or Railroad Retirement - include U.S. Government payments to retired persons, to dependents of deceased insured workers, or to disabled workers. Include "Medicare" premiums; exclude receipts." b. How much did he receive in 1969 from public assistance or welfare payments? Include aid for dependent children, old age assistance, general assistance, aid to the blind or totally disabled. Exclude separate payments for hospital or other medical care. $ (Dollars only) _____.00 or [] None "Public assistance or public welfare payments - include amounts received from Federal, State, or local public programs. Exclude private welfare payments." c. How much did he receive in 1969 from all other sources? Include interest, dividends, veterans' payments, pensions, and other regular payments. (See instruction sheet.) $ (Dollars only) _____.00 or [] None "Interest, dividends - include amounts received or credited to your account. Veterans' payments - include money paid for service-connected disabilities, to survivors of deceased veterans, for education and on-the-job training subsistence allowances, and for 'refunds' on 'GI' insurance premiums. Retirement pensions - include amounts paid by former private employers and by unions, and amounts paid by Federal, State, county, or other governmental agencies. Other regular payments - include such periodic income as net rental income, unemployment insurance benefits, workmen's compensation, private welfare payments, alimony or child support, Armed Forces allotments, and regular contributions from persons who are not members of your household. Exclude receipts from the sale or personal property, capital gains, lump-sum insurance or inheritance payments, or pay 'in kind.'"

23. When was this person born? [] Born before April 1956 - Please go on with questions 24 through 41. [] Born April 1956 or later - Please omit questions 24 through 41 and go to the next page for the next person. Questions 29 through 41 are for all persons born before April 1956 including housewives, students, or disabled persons as well as part-time or full-time workers. [All] 29a. Did this person work at any time last week? [] Yes - Fill this circle if this person did full- or part-time work. (Count part-time work such as a Saturday job, delivering papers, or helping without pay in a family business or farm; and active duty in the Armed Forces. [] No - Fill this circle if this person did not work, or did only own housework, school work, or volunteer work. Skip to 30 [All] 40. Earnings in 1969 - Fill parts a, b, and c for everyone who worked any time in 1969 even if he had no income. (If exact amount is not known, give best estimate.) a. How much did this person earn in 1969 in wages, salary, commissions, bonuses, or tips from all jobs? (Before deductions for taxes, bonds, dues, or other items.) $ (Dollars only) _____.00 or [] None b. How much did he earn in 1969 from his own nonfarm business, professional practice, or partnership? (Net after business expenses. If business lost money, write "Loss" above amount.) $ (Dollars only) _____.00 or [] None c. How much did he earn in 1969 from his own farm? (Net after operating expenses. Include earnings as a tenant farmer or sharecropper. If farm lost money, write "Loss" above amount.) $ (Dollars only) _____.00 or [] None "Enter the amount or fill the None circle in a, b, and c. Part 40a includes "sick leave" pay. Part 40a excludes military bonuses, reimbursement for business expenses, and pay "in kind." The owner of an unincorporated nonfarm business should include his net earnings in part 40b. If the business or farm is incorporated, his earnings should be included in part 40a." 41. Income other than earnings in 1969 - Fill in parts a, b, and c. (If exact amount is not known, give best estimate.) "Enter the amount or fill the None circle in a, b, and c." a. How much did this person receive in 1969 from Social Security or Railroad Retirement? $ (Dollars only) _____.00 or [] None "Social Security or Railroad Retirement - include U.S. Government payments to retired persons, to dependents of deceased insured workers, or to disabled workers. Include "Medicare" premiums; exclude receipts." b. How much did he receive in 1969 from public assistance or welfare payments? Include aid for dependent children, old age assistance, general assistance, aid to the blind or totally disabled. Exclude separate payments for hospital or other medical care. $ (Dollars only) _____.00 or [] None "Public assistance or public welfare payments - include amounts received from Federal, State, or local public programs. Exclude private welfare payments." c. How much did he receive in 1969 from all other sources? Include interest, dividends, veterans' payments, pensions, and other regular payments. (See instruction sheet.) $ (Dollars only) _____.00 or [] None "Interest, dividends - include amounts received or credited to your account. Veterans' payments - include money paid for service-connected disabilities, to survivors of deceased veterans, for education and on-the-job training subsistence allowances, and for 'refunds' on 'GI' insurance premiums. Retirement pensions - include amounts paid by former private employers and by unions, and amounts paid by Federal, State, county, or other governmental agencies. Other regular payments - include such periodic income as net rental income, unemployment insurance benefits, workmen's compensation, private welfare payments, alimony or child support, Armed Forces allotments, and regular contributions from persons who are not members of your household. Exclude receipts from the sale or personal property, capital gains, lump-sum insurance or inheritance payments, or pay 'in kind.'"

23. When was this person born? [] Born before April 1956 - Please go on with questions 24 through 41. [] Born April 1956 or later - Please omit questions 24 through 41 and go to the next page for the next person. Questions 29 through 41 are for all persons born before April 1956 including housewives, students, or disabled persons as well as part-time or full-time workers. [All] 29a. Did this person work at any time last week? [] Yes - Fill this circle if this person did full- or part-time work. (Count part-time work such as a Saturday job, delivering papers, or helping without pay in a family business or farm; and active duty in the Armed Forces. [] No - Fill this circle if this person did not work, or did only own housework, school work, or volunteer work. Skip to 30 [All] 40. Earnings in 1969 - Fill parts a, b, and c for everyone who worked any time in 1969 even if he had no income. (If exact amount is not known, give best estimate.) a. How much did this person earn in 1969 in wages, salary, commissions, bonuses, or tips from all jobs? (Before deductions for taxes, bonds, dues, or other items.) $ (Dollars only) _____.00 or [] None b. How much did he earn in 1969 from his own nonfarm business, professional practice, or partnership? (Net after business expenses. If business lost money, write "Loss" above amount.) $ (Dollars only) _____.00 or [] None c. How much did he earn in 1969 from his own farm? (Net after operating expenses. Include earnings as a tenant farmer or sharecropper. If farm lost money, write "Loss" above amount.) $ (Dollars only) _____.00 or [] None "Enter the amount or fill the None circle in a, b, and c. Part 40a includes "sick leave" pay. Part 40a excludes military bonuses, reimbursement for business expenses, and pay "in kind." The owner of an unincorporated nonfarm business should include his net earnings in part 40b. If the business or farm is incorporated, his earnings should be included in part 40a." 41. Income other than earnings in 1969 - Fill in parts a, b, and c. (If exact amount is not known, give best estimate.) "Enter the amount or fill the None circle in a, b, and c." a. How much did this person receive in 1969 from Social Security or Railroad Retirement? $ (Dollars only) _____.00 or [] None "Social Security or Railroad Retirement - include U.S. Government payments to retired persons, to dependents of deceased insured workers, or to disabled workers. Include "Medicare" premiums; exclude receipts." b. How much did he receive in 1969 from public assistance or welfare payments? Include aid for dependent children, old age assistance, general assistance, aid to the blind or totally disabled. Exclude separate payments for hospital or other medical care. $ (Dollars only) _____.00 or [] None "Public assistance or public welfare payments - include amounts received from Federal, State, or local public programs. Exclude private welfare payments." c. How much did he receive in 1969 from all other sources? Include interest, dividends, veterans' payments, pensions, and other regular payments. (See instruction sheet.) $ (Dollars only) _____.00 or [] None "Interest, dividends - include amounts received or credited to your account. Veterans' payments - include money paid for service-connected disabilities, to survivors of deceased veterans, for education and on-the-job training subsistence allowances, and for 'refunds' on 'GI' insurance premiums. Retirement pensions - include amounts paid by former private employers and by unions, and amounts paid by Federal, State, county, or other governmental agencies. Other regular payments - include such periodic income as net rental income, unemployment insurance benefits, workmen's compensation, private welfare payments, alimony or child support, Armed Forces allotments, and regular contributions from persons who are not members of your household. Exclude receipts from the sale or personal property, capital gains, lump-sum insurance or inheritance payments, or pay 'in kind.'"

23. When was this person born? [] Born before April 1956 - Please go on with questions 24 through 41. [] Born April 1956 or later - Please omit questions 24 through 41 and go to the next page for the next person. [15%] 26. If this is a man - a. Has he ever served in the Army, Navy, or other Armed Forces of the United States? [] Yes [] No "Mark Yes if he was ever on active duty in the Army, Navy, Air Force, Marine Corps, or Coast Guard, no matter how short a time he served. Count only active duty in National Guard or Reserves. Mark No if he had only civilian duty in the Armed Forces or merchant marine. Mark No if he was in the National Guard or Reserves, but was not called to active duty. Mark No if his only military service in the Armed Forces of another country." b. Was it during - (Fill the circle for each period of service.) [] Vietnam Conflict (Since Aug. 1964) [] Korean War (June 1950 to Jan. 1955) [] World War II (Sept. 1940 to July 1947) [] World War I (April 1917 to Nov. 1918) [] Any other time

23. When was this person born? [] Born before April 1956 - Please go on with questions 24 through 41. [] Born April 1956 or later - Please omit questions 24 through 41 and go to the next page for the next person. [15%] 26. If this is a man - a. Has he ever served in the Army, Navy, or other Armed Forces of the United States? [] Yes [] No "Mark Yes if he was ever on active duty in the Army, Navy, Air Force, Marine Corps, or Coast Guard, no matter how short a time he served. Count only active duty in National Guard or Reserves. Mark No if he had only civilian duty in the Armed Forces or merchant marine. Mark No if he was in the National Guard or Reserves, but was not called to active duty. Mark No if his only military service in the Armed Forces of another country." b. Was it during - (Fill the circle for each period of service.) [] Vietnam Conflict (Since Aug. 1964) [] Korean War (June 1950 to Jan. 1955) [] World War II (Sept. 1940 to July 1947) [] World War I (April 1917 to Nov. 1918) [] Any other time

23. When was this person born? [] Born before April 1956 - Please go on with questions 24 through 41. [] Born April 1956 or later - Please omit questions 24 through 41 and go to the next page for the next person. [15%] 26. If this is a man - a. Has he ever served in the Army, Navy, or other Armed Forces of the United States? [] Yes [] No "Mark Yes if he was ever on active duty in the Army, Navy, Air Force, Marine Corps, or Coast Guard, no matter how short a time he served. Count only active duty in National Guard or Reserves. Mark No if he had only civilian duty in the Armed Forces or merchant marine. Mark No if he was in the National Guard or Reserves, but was not called to active duty. Mark No if his only military service in the Armed Forces of another country." b. Was it during - (Fill the circle for each period of service.) [] Vietnam Conflict (Since Aug. 1964) [] Korean War (June 1950 to Jan. 1955) [] World War II (Sept. 1940 to July 1947) [] World War I (April 1917 to Nov. 1918) [] Any other time

23. When was this person born? [] Born before April 1956 - Please go on with questions 24 through 41. [] Born April 1956 or later - Please omit questions 24 through 41 and go to the next page for the next person. [15%] 26. If this is a man - a. Has he ever served in the Army, Navy, or other Armed Forces of the United States? [] Yes [] No "Mark Yes if he was ever on active duty in the Army, Navy, Air Force, Marine Corps, or Coast Guard, no matter how short a time he served. Count only active duty in National Guard or Reserves. Mark No if he had only civilian duty in the Armed Forces or merchant marine. Mark No if he was in the National Guard or Reserves, but was not called to active duty. Mark No if his only military service in the Armed Forces of another country." b. Was it during - (Fill the circle for each period of service.) [] Vietnam Conflict (Since Aug. 1964) [] Korean War (June 1950 to Jan. 1955) [] World War II (Sept. 1940 to July 1947) [] World War I (April 1917 to Nov. 1918) [] Any other time