07 CDBG Beneficiary SURVEY FORM.doc
American Indian/Alaskan Native Native Hawaiian/Other Pacific Islander Am. Indian/Alaskan Native and White Asian and White Black/African American and White Am. Indian/Alaskan Native and Black Other Multi-Racial Household Size 1 person 2 person 3 person 4 person 5 person 6 person 7 person 8 person Very Low-Income $0 to. $____ $0 to ................
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