Name (first, last) Do not enter your name or spouse’s name below (a) | Date of Birth (mm/dd/yy) (b) | Relationship to you (for example: son, daughter, parent, none, etc) (c) | Number of months lived in your home last year (d) | US Citizen (yes/no) (e) | Resident of US, Canada, or Mexico last year (yes/no) (f) | Single or Married as of 2020 (S/M) (g) | Full-time Student last year (yes/no) (h) | Totally and Permanently Disabled (yes/no) (i) |