Control Number
Tester sequence
Tester Type
Site
Tester ID
How tester should refer to their partner/spouse
Street of Assigned Housing
City of Assigned Housing
State of Assigned Housing
Zip Code (00000) of Assigned Housing
Advertisement: Date of Publication (mm/dd/yyyy)
Household Composition
Number of Bedrooms to Request
Minimum Number of Bedrooms Willing to Accept
Move-in date to request (mm/dd/yyyy)
Maximum Rent Price
If you are pressed by the agent, you may state that you are looking in
Reason for Moving
Tester Gross Monthly Income
Tester Gross Annual Income
Person 2 relationship
Gender of second person in household
Age of second person in household
Spouse Gross Monthly Income
Person 3 relationship
Gender of third person in household
Age of third person in household
Person 4 relationship
Gender of fourth person in household
Age of fourth person in household
Person 5 relationship
Gender of fifth person in household
Age of fifth person in household
Total Gross Monthly Income of Household
Total Gross Annual Income of Household
Tester current occupation
Name of tester's current employer
Length of employment at current job
Partner/spouse's occupation at current job
Name of partner/spouse's current employer
Partner/spouse's length of employment at current job
Amount of Current Rent
Years at Current Residence
Type of Rental Agreement at Current Residence
Tester owns a car?
Advertisement: Name of source
Target date and time of first appointment call:
Target date and time for scheduling appointment:
Type of Approach
Test Type