Form LS-3 Person record
What is this person's name?
CarmelaFirst name
BurkhartLast name
What is this person's date of birth and age?
June 14, 1959Date of birth
67Age
What is this person's sex?
- Male
- Female (selected)
What is this person's race or origin?
- White (selected)
- Black or African American
- American Indian or Alaska Native
- Asian
- Hispanic or Latino
- Two or more races
Where does this person live?
Newport, RICity and state
RuralSetting
Is this home owned or rented?
- Owned
- Rented (selected)
Mobile HomeKind of home
What is the highest degree or level of school this person has finished?
Bachelor's degreeEducation
Does this person work?
Employed at a small businessWork status
Monday-Friday, 9:00 to 16:00Schedule
What was this person's income in the last 12 months?
$110,013Total income
Is this person now married?
- Now married (selected)
- Not married
Greg Burkhart, 70Spouse