The Household Information Form asks for the head of household's name and email, the number of residents, an optional list of other members and relationships, the primary income source, and housing status. A final choice asks whether the respondent understands the requesting organization's separately supplied information-use notice. Six of the seven questions are required, but the information-use choice accepts a request for the notice or clarification. It is an understanding check rather than permission to use data. The form gathers a household overview without calculating income, verifying household membership, or determining eligibility for a program.
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Household size and optional member relationships provide context for a staff-led needs review.
The housing-status choice separates owners, renters, people living with family or friends, and other arrangements.
The information-use question lets respondents indicate that they need the notice or an explanation before staff continue their review.
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