Homeowner Survey for Brentwood Residents

All information well be kept confidential.

1. Are you a homeowner?: Yes No
2. What is the size of your family (number of family members)?:
   1 2 3 4 5 6 7 8 More than 8
3. What is your annual household income?:
   Under $25,000
   $25,001-$34,999
   $35,000-$44,999
   $45,000-$55,000
   Over $55,000
4. What is your monthly mortgage payment?:
   Less than $1,500
   $1,500-$2,000
   $2,000-$2,500
   More than $2,500
5. Are you having difficulty with any of the following?
   (check all that apply):
   Mortgage payment
   Pending foreclosure
   High interest rates
   Brokers/contractors
   Budget & Finances
   Other:
6. As a homeowner, what are some of the concerns in your neighborhood?
   (check all that apply):
   Garbage collection
   Broken pavement, roads, street lights
   Flooding streets/home
   Abandoned houses
   High crime incidence
   Gang activity
   Lack of police or neighborhood watch program
   Other:
7. Do you know who to contact to resolve the concerns you identified in question #6?
   Yes No
8. What was the condition of your home at the time of purchase?
   Excellent
   Good
   Fair
   In need of repair
9. If you're leasing your home, are you having any difficulty with the following?
   (check all that apply):
   Late rental payments
   Maintenance and cleanliness
   Noise/complaints from neighbors
   Vandalism
   Eviction
   Other:
10. Are you having difficulty making basic home mainteneance repairs?
    Yes No
11. If yes, would you be interested in attending a home maintenance repair class?
    Yes No
12. Are you interested in finding information on who to call if you have any of the problems/concerns listed in this survey?
    Yes No
13. Are you interested in housing counseling?
    Yes No

Your Name:

Your full Mailing Address (required to receive free gift):

Your email address: