Form LS-3 Person record
What is this person's name?
HannaFirst name
AhmadLast name
What is this person's date of birth and age?
May 17, 1990Date of birth
36Age
What is this person's sex?
- Male (selected)
- Female
What is this person's race or origin?
- White
- Black or African American
- American Indian or Alaska Native
- Asian (selected)
- Hispanic or Latino
- Two or more races
Where does this person live?
Cloverdale, INCity and state
RuralSetting
Is this home owned or rented?
- Owned (selected)
- Rented
HouseKind of home
What is the highest degree or level of school this person has finished?
No High School DegreeEducation
Does this person work?
Employed at a large companyWork status
Monday-Friday, 9:00 to 17:00Schedule
What was this person's income in the last 12 months?
$70,867Total income
Is this person now married?
- Now married (selected)
- Not married
Jun Ahmad, 35Spouse