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Res16 15550
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Res16 15550
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Last modified
2/14/2017 7:48:45 AM
Creation date
12/14/2016 3:28:12 PM
Metadata
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Template:
CC Index
CC Index - Document Type
Resolution
Meeting Type
Joint
Agency Type
City Council and Successor Agency and Public Financing Authority
Date
12/12/2016
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<br />37 | Page <br />Docktown Plan <br /> <br />OAK #4823-0464-7229 v3 <br />INTERVIEW FORM <br /> <br />Tenant Name: <br /> <br />Phone Number: <br /> <br />Berth #: Registration #: Other Identification #: <br /> <br /> <br />Resident/Age/Primary Language (Record Additional Persons on Separate Page: <br />1. <br />2. <br />3. <br />4. <br /> <br />Household Composition Questions: <br /> <br />1. How long have you resided at Docktown? <br /> <br />2. What is the address of your primary home? <br /> <br />3. What is your annual gross household income (include all members below by <br />name with income)? <br /> Member 1: <br /> Member 2: <br /> Additional: <br /> <br />4. Do all persons occupying the property reside at Docktown year round? <br /> <br />5. Do you or anybody in your household have any disabilities? <br /> <br />6. Do you or anybody in your Household attend school? If yes, where? <br /> <br />7. What is your primary method of transportation? <br /> <br />Property Information: <br /> <br />1. Would you describe the property as a vessel? <br /> <br />2. When did you purchase the property? <br /> <br />3. How much did you purchase the property for?
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