Manufactured Home Community Redevelopment Program Tenant Questionnaire
Please answer the following questions to the best of your knowledge. You can choose not to answer all the questions. When completed, please return to the Community Owner/Manager/Co-op Leader.
Tenant Name (optional): 	     
Manufactured Home Park Name: 	     	City: 	     
1.	Is any member of your household over the age of 65? 
 Yes
 No
2.	Is any member of your household under the age of 18? 
 Yes
 No
3.	Which annual income category most closely represents your household? 
 Below $30,000
 Between $30,000 and $50,000
 Between $50,000 and $80,000
 Over $80,000
4.	Which race do you identify with?  Check all that apply.
 Hispanic
 Black/African American
 American Indian/Alaska Native
 Native Hawaiian/Pacific Islander
 Asian
 White
 Prefer not to answer

Thank you! Minnesota Housing will use this information to aid in assessing qualifications for the acquisition of a manufactured home park or infrastructure improvement grant through the Minnesota Housing Manufactured Home Community Redevelopment Program. 
Contact Information
General inquiries and technical assistance needs can be emailed to MNHousing.ManufacturedHomes@state.mn.us.