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Wayne County Resident’s Fair Housing Survey Form

  1. It is illegal to discriminate in housing provision or transactions based on a person’s race, national origin, color, religion, sex, familial status, or a disability. The County of Wayne is surveying its residents on fair housing issues in preparation of a plan to affirmatively further fair housing, as required by the HUD Community Development Block Grant (CDBG) program.
  2. 1. Before reading the statement above, were you aware of the seven protected classes in cases of housing discrimination?
  3. 2. Do you think Mount Olive residents need more information on housing discrimination?
  4. 3. Have you experienced or witnessed housing discrimination in Mount Olive?
  5. 4. If you were to feel you were discriminated against in a housing transaction (buying, selling, renting, financing, or improving a residence), who would you notify?
  6. 5. Are there affordable housing options for everyone who wants to live in Mount Olive?
  7. 6. Do you own or rent your residence in Mount Olive? *
  8. 7. How long have you lived in Mount Olive?
  9. 8. What is your race/ethnicity?
  10. 9. Is a language other than English spoken in your house?
  11. 10. Is anyone in your household disabled, a senior citizen, or a veteran of the US military?
  12. The County of Wayne is an Equal Opportunity Employer and Service Provider.
  13. Leave This Blank:

  14. This field is not part of the form submission.