Survey Text

Survey form view entire document:  text  image

b. Is this payment through Social Security Disability Insurance, called "SSDI"; through Supplemental Security Income, called "SSI"; through the Veteran's Administration; or through some other program?
Mark all that apply.

1[] SSDI (Check Item 1 for NP)
2[] SSI (Check Item 1 for NP)
3[] VA (Check Item 1 for NP)
4[] Other (Check Item 1 for NP)