Form LS-3 Person record
What is this person's name?
IreneFirst name
ChavezLast name
What is this person's date of birth and age?
August 8, 1963Date of birth
63Age
What is this person's sex?
- Male
- Female (selected)
What is this person's race or origin?
- White
- Black or African American
- American Indian or Alaska Native
- Asian
- Hispanic or Latino (selected)
- Two or more races
Where does this person live?
Lake Odessa, MICity and state
RuralSetting
Is this home owned or rented?
- Owned (selected)
- Rented
Mobile HomeKind of home
What is the highest degree or level of school this person has finished?
High School GraduateEducation
Does this person work?
Employed at a small businessWork status
Monday-Friday, 7:00 to 16:00Schedule
What was this person's income in the last 12 months?
$40,040Total income
Is this person now married?
- Now married
- Not married (selected)
NoneChildren