Form FR 1375 FR 1375 Survey of Financial Management Behaviors of Military Per

FR 1375 SAMPLE SURVEY

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DOD FINANCIAL LITERACY SURVEY
Questions

1

Responses

Basic Household Information
ID/case number to link records
SHADED AREAS
ARE ONE-TIME
ONLY
QUESTIONS

2

Military ID [may not be necessary to ask] or MOS (military
occupational specialty)
Grade level

3

Gender

Male
Female

4

Year of Birth (four digits)
Month of Birth (Jan=01, Dec=12)

Year: ____
Month (01-12)

5

Race (can choose more than one)

White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or Pacific Islander
Other

Ethnicity: Hispanic/Latino?

Yes
No

Were you born in the United States
If No, year arrived in U.S.: ____

Yes / No

6b
6c

Were your parents/guardians born in the U.S.

Both/All of them
At least one but not all of them
None of them

4b

5b

6

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7

What is your marital status?

8

How many children do you have:
Under age 5
Ages 5 up to 18
Ages 18 up to 24
Age 24 and over

#
#
#
#

Including yourself, how many people:
Live in your household (includes spouse, dependents, roommates,
etc.)
in your household are adults (age 18 and over)
in your household work full- or part-time

#
#
#

8a
8b
8c
8d
9
9a
9b
9c
10
11a
11b

Single
Married
Divorced
Separated
Widowed

Rand question

What is your household's Zip Code?
Do you live on base?
If you live off base, do you rent or own your residence?

Yes / No
Rent / Own

12

Deployment status

Currently deployed overseas
~ Rand question
Currently deployed in the U.S. but not at my usual station
Currently deployed at my usual station
Not deployed

13

Do you have a spouse in the military?

I have no spouse
Yes
No

Rand question

14

Does your spouse have a full-time civilian

I have no spouse

Rand question

2

Rand question

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job?

Yes
No

15

Do you also hold a civilian job?

Yes
No

16

How much total time in the past 6 months
have you spent away from your dependents?

I have no dependents
Less than 1 month
More than 1 month but less than 3 months
3 months or more

17

What is your highest level of formal education?

High School diploma
GED
some college or any technical certification(s)
Two-year college degree
Four year college degree
Other (Fill in)

Rand question

Pre-Military History

18

What was your ASVAB score or AFQT
score, in %?

I did not take the ASVAB
Don't remember
Percentage (for example, enter 85
for 85%)

19

How would you classify the saving behavior of your
parents/guardians?

Above average savers
Average savers
Below average savers
Did not save

20

How would you classify the saving behavior of your
spouse’s parents/guardians?

I have no spouse
Above average savers
Average savers

3

http://usmilitary.about.com/
library/milinfo/blafqtscore.htm

From Bernheim, Garrett and Maki

FR 1375 SAMPLE SURVEY

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Below average savers
Did not save

21
21a
21b
21c
21d
21e

21k

While growing up:
My parents/guardians talked to me about their finances
My parents/guardians talked to me about how to manage money
My parents/guardians were good at managing their finances
I was aware of my parent’s/guardian’s financial situation
I regularly set aside money for savings
I took a class in Consumer Education or Personal Finance in High
School
I had a savings account while in high school
I had a checking account while in high school
I had a debit card while in high school
I had a credit card while in high school
My spouse took a class in Consumer Education or Personal
Finance in High School

21l

My spouse had a savings account while in high school

21m

My spouse had a checking account while in high school

21n

My spouse had a debit card while in high school

21o

My spouse had a credit card while in high school

21f
21g
21h
21i
21j

22
22a
22b
22c
22d
22e
22f

Financial Product Ownership and Financial Awareness
Do you or your spouse own or have:
Checking account
Savings account
Certificates of deposit (CDs)
Debit cards
Credit cards
Mutual funds, such as money market mutual funds, stock or bond
mutual funds

4

Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No / Don't Know / No
Spouse
Yes / No / Don't Know / No
Spouse
Yes / No / Don't Know / No
Spouse
Yes / No / Don't Know / No
Spouse
Yes / No / Don't Know / No
Spouse

Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No

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22g
22h
22i
22j

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22k

Individual retirement accounts, that is, IRA or Keogh accounts
Thrift savings account
401 k retirement plan account
Publicly traded stock in individual companies
Bonds (corporate, municipal, government, or other type of bonds
or bills)

Yes / No

25
25b

Do you have any outstanding auto loans
If yes, how many?

Yes / No
#

25c
25c1
25c2
25c3
25c4

For the most recent car you bought, what is the: [Fill in 0 if you have no car loan]
Original size of loan
$
Length of loan in months
#
Approximate number of months remaining on loan
#
Monthly payment amount
$

25d1
25d
25d2
25d3
25d4

If you have a loan on another car, what is the:
Original size of loan
Length of loan in months
Approximate number of months remaining on loan
Monthly payment amount

26

26a

Yes / No
Yes / No
Yes / No
Yes / No

$
#
#
$

What is the outstanding balance on your home mortgage?
What is the outstanding balance on any home equity loans on your
house?

I have no such loans
$
I have no such loans
$

Current Financial Standing
35
35b
35c

Regarding you and/or your spouse:
How many credit cards do you use in an average month?
How many of your credit cards were not paid off in full after the

5

# I/We don't have credit cards
#

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most recent due date?
[that is, how many carried a balance to the next month.]
23

After the last payments were made on your credit cards,
roughly what was the balance still owed on these accounts?

I/We have no credit cards
$0

24

Thinking only about Visa, Mastercard,
Discover, Optima and store cards, do you
almost always, sometimes, or hardly ever
pay off the total balance owed on the
account each month?

I/We have no credit cards
Always or almost always
Sometimes
Hardly ever

35d

Do you know - approximately - the interest rate(s) on the credit
card you use
most often?

29
29a
29b
29c
29d
29e
29f
29g

Approximately what is your family's monthly gross household income (before taxes) from:
Your military salary
$
Your additional wage income from other jobs
$
Wage earned by your spouse
$
Interest and dividends
$
Rental Income
$
Child support and/or alimony
$
Other
$

30
30a
30b
30c
30d
30e
30f

About how much do you spend on these items each month:
Rent or mortgage payment
Car loan or lease payments
Child support payments and/or alimony
Credit card payments
Savings for retirement
Other savings (for car, house, education, wedding, etc.)

6

I have no credit cards
%
don’t recall

$
$
$
$
$
$

Rand question

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30g
30h
30i
30j

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30k

Student loans
Furniture and or appliance loans
Payments on other personal loans
Food eaten at home
Food eaten away from home (restaurants, fast food, drinks at bars,
etc.)

$
$
$
$

31
31a
31b
31c
31d
31e
31f

How much do you think each of the following is worth:
Your house and property (if you own it)
Your home furnishings
Your cars
financial/liquid securities (banks accounts, bonds, shares of stock, mutual funds, etc.)
Others - list
Others - list

32
32a
32b
32c
32d
32e
32f

Approximately how much do you still owe on
Your mortgage and other home loan
Your home furnishings
Your cars
Any credit card debt
Student loans outstanding
Others - list 1

$

$

33

What is the interest rate on your home mortgage?

I have no home loan
%
Don't recall

34

What is the interest rate on your most recent auto loan?

I have no auto loan
%
Don't recall

35

How many credit cards do you have?

#

7

FR 1375 SAMPLE SURVEY
35b
35c
35d

36

INTERNAL FR

How many credit cards do you use in an average month?
How many of your credit cards were not paid off after the most
recent due date?

#
#

Do you know - approximately - the interest rate(s) on your credit
card(s)?

I have no credit cards
Yes
No

How much are you charged
when using an ATM machine to access your
bank accounts?

I don't use ATMs machines
I only use ATMs without fees
$
Don't recall

Financial Self-Assessment
27

How would you classify yourself in terms of
savings habits?

Above average saver
Average saver
Below average saver

28

How would you classify your spouse in terms of
savings habits?

I have no spouse
Above average saver
Average saver
Below average saver

37

Did you have serious bill problems in the past 6
months?

Yes
No

Rand question

38

How do you feel about your family's financial
condition over the past 6 months?

Comfortable and secure
Able to make ends meet
Occasional difficulties
Tough to make ends meet
In over your head

Rand question

8

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39

40
40a
40b
40c
40d
40e

41

42

43
43a
43b
43i
43j
43c

INTERNAL FR

In planning your saving and spending, which of the following time
periods is most
important to you (and your spouse)?

The next few months
the next year
the next few years
At least 5 years from now

On a scale of 0 to 10 where 0 is very dissatisfied, 5 is neither satisfied nor dissatisfied
and 10 is very satisfied, how satisfied are you with:
the amount of money you have saved
0 - 10
your ability to meet short-term financial goals
0 - 10
your ability to meet long-term financial goals
0 - 10
your financial management skills
0 - 10
your current overall financial situation
0 - 10

Which of the following statements on this page comes closest to
describing
your (and your spouse's) saving habits?

I don't save because I usually spend all my income
I have no regular saving plan, save whatever is left over at the end of the month
I spend my work income, save other income
I save regularly by putting money aside each month

Have you or anyone in your household ever filed
for bankruptcy?

Yes
No

In the past 6 months, have you or your spouse:
got a title loan
got a payday loan
gone to a pawn shop to get cash
got food stamps
leased a car

Yes / No / Don't know
Yes / No
Yes / No
Yes / No
Yes / No

9

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43d
43e
43f
43g
43h
43u
43k
43l
43m
43n
43o
43p
43q
43r
43s
43t

leased furniture or a major appliance
bought credit insurance
bought Renters or Homeowners Insurance
bought supplemental life Insurance
borrowed against a life insurance policy
been turned down for credit
fallen behind in rent payments
bounced 1 or 2 checks
bounced 3 or more checks
made 1 or 2 late payments on credit cards
made 3 or more late payments on credit cards
been called by a debt collector
had utilities shut off for reasons of nonpayment
returned from deployment for financial reasons
been denied or lost security clearance for financial reasons
filed for bankruptcy

Yes / No
Yes / No / Don't know
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No

43z

On a scale of 1 to 10, with 1 being not at all stressed and 10 being
extremely stressed,
how would you rate your financial stress level?

1 - 10

44
44a
44b
44c
44d
44e
44f
44g
44h
44i
44j

Financial Behavior
Do you and/or your spouse:
use a formal budget for spending in your household
use an informal budget for spending in your household
have a debt reduction plan
have a specific plan for saving for retirement
have a specific plan for saving for the purchase of a home
have a specific plan for saving for other short-term purchases
understand the distinction between discretionary and nondiscretionary spending
Comparison shop for credit alternatives
Comparison shop for investment alternatives
Comparison shop for major purchases (items > $250)

10

Yes / No
Yes / No
Yes / No / Have little to no debt
Yes / No
Yes / No
Yes / No
Yes / No
Never / Seldom / Moderately / A lot
Never / Seldom / Moderately / A lot
Never / Seldom / Moderately / A lot

FR 1375 SAMPLE SURVEY
44k
44l
44m
44n
44o
44p

45
45a
45b
45c
45d
45d1

INTERNAL FR

Review magazines like Consumer Reports before a major
purchase (item > $250)
Read about money management through magazines and
newsletters like Kiplingers, Money, etc.
Use discount coupons when shopping for household items and
food
Shop at the base PX
Do you or your spouse currently have a checking account?
If yes, for how long have you had an account?

Do you and/or your spouse:
balance your checkbook on a monthly basis
check your checking account during the month either by phone or
on-line
track retirement investments periodically
have an emergency fund (for meeting unforeseen spending needs)
If so, how large is it?

Never / Seldom / Moderately / A lot
Never / Seldom / Moderately / A lot
Never / Seldom / Moderately / A lot
Never / Seldom / Moderately / A lot
Yes / No
less than 6 months
between 6 months and 1 year
for 1 to two years
longer than 2 years

Yes / No / Not applicable
Yes / No / Not applicable
Yes / No / Not applicable
Yes / No
Actual amount
$1 to $1,000
$1,001 to $2,000
$2,001 to $3,000
$3,001 to $4,000
$4,001 to $5,000
$5,001 and above

Educational programs
Over time, you and/or your spouse might be exposed to various efforts to provide economic
or
consumer education. These can be work, school, or community based. They might be
formal or
informal. Examples might include work-related saving and retirement seminars, school
classes in

11

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46a
46a1
46a2
46a3
46a4
47a
47a1
47a2
47a3
47a4
48

INTERNAL FR

personal finance, church-affiliated home-buying seminars, or peer counseling sessions. We would like
to
know what experience you have had with such activities in the past six months: when you might have attended,
what the topic was, and how useful the activity, and whether or not it improved your financial
behavior
Better than avg / Avg / Worse than avg
Formal/
Program Likelihood of
Course Description
Date MM/YY
Informal Rating
Change in Behavior
For you -

For spouse -

Rate the AIT Financial Management Training Course:

49
49a

Which of the following best describes your experience with the AIT
course:
Before the course, I knew

49b

Through the course, I learned

mm/yy

Very little about the subject
Something about the subject
A lot about the subject
Nothing more
A little more
A lot more

12

formal

???

???