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pdfOMB No. 1121-0111: Approval Explres713112006
FoRMNCVS-s41
(5-4-2005)
U.S. DEPARTMENTOF COMMERCE
ECONOMICS
ANDSTATISTICS
ADMINISTRATION
U.S.CENSUSBUREAU
ACTINGAS COLLECTING
AGENTFORTHE
BUREAUOF JUSTICESTATISTICS
U.S,DEPARTMENT
OFJUSTICE
NOTIGE - We are conducting this suruey under the authority of Title 13,
United States Cods Section 8. Section 9 ofthis law requires usto keep
all information about you and your household strictly confidential.We
may use this information only for statistical purposes, Also, Title 42,
Section 3732, Unitsd States Code, authorizes the Bureau of Justice
Statistics,Departmsnt of Justice, to collect information using this
survey. Title 42, Sections 37899 and 3735, United States CodTe,also
requires us to keep all information about you and your household
strictlv confidential.
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itnoicator
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A. Regionalofficecode
REINTERVIEWBASIC SCREEN
OUESTIONNAIRE
NATIONALCRIME
VICTIMIZATION
SURVEY
rT--]
2o1l |
|
FieldRepresentative
status
r I Experienced
2oz l2fl Inexperienced
I
B. Original
Field epresentative
identification
Code
iName
@
G. Reinterviewer
dentification
Code
lName
4
D. Household
respondent's
name
1 Linenumber
Dateof originalinterview
@
2.,6| iu-"-.til H
person's
E. Sample
name fZozI r n SameashouseholdLinenumber
resDon0ent
zoaI
;;;r
i Dateof originalinterview
;==mmm
rzoeI
.NiontF- --Day
-Tdt-
Section I - FALSIFICATION OUESTIONS
1.
INTRODUCTION
Hello, l'm ... from the U.S. CensusBureau./shoraz soil r n
z!
badge,if .p.ersonal
visit.)May I speak
to (original
a!
householdrespondents
namd?
a!
sI
2.
- proxy
vERlFyADDRESS
Perhaps you can help me.
I need to verify that the address lhere/therel is
(sampleaddress).lsthis correct?
(Verifyaddressas of householdrespondent's
interviewdate.)
yes, this is correctperson- SKIPto item 3
No, personno longerlivesat addressI
No, personunknownat this address I Go to item2
No,personunavailable
I
Unableto reachanyonein the househ-old
after
a reasonable
numberol attempts EIUD
BEINTEBVTEWand SKIP to section VI on
pagc 2O.
Eoz
I r n Yes- SKIP to CHECK|TEMB
zD No - Iry to locatecorrect address,or)
_verify phone number
lco to CHECK
s ! Don't know- Locafecorrect address,I ITEMA
or verifyphonenumber
)
+[l Refused/unable
to complete- END BEINTEBVTEW
and SKIP to section Vt on page 20.
lfifi+i
iiar",.,
ffi
';!*r!?i
To+l rlYes-Whatistheline
f:W:yli'h"^i
1",1,?E!!l
*,
numberotthe personyou
controlcard (item I3d.
NOTE- /f necessary,makeseveralattemptsto locate
a householdmember 12yearsold or older.
Mark "No'ONLY if you are unableto locatea
householdmemberafter severalaftempts.
3.
- Correctresoondent
VERIFY
ADDRESS
According to our records,this householdwas
included in one of out lecont surueys.
l. need to verify that the address {herelthere) is
(sampleaddress).ls this correct?
USCENSUSBUREAU
Tm I r n Foundcorrectaddressor phonenumber- Go
back to item 1, eraseall previous entries,and
BEGINREINTENVEW
AGAIN
z n Unableto locatecorrectaddressor phone
number - E/UDBEIIUTEBVIEWand SKIP to
section VI on page 2O.
arespeakingto?
_)
lr*r"ro
I itemI
z ! No - Unableto locatehouseholdmember
after a reasonablenumberof attempts- EIUD
EEINTERVIEWand SKIP to section VI on
page 2O.
gosl rnYes
.
tuitem4onpage2
z n No - Explainbelow ]1n ,
s I Refused/unable
to cdmolete- END RETNTERVIEW
and 9KlP to section Vl on page 2O.
Section | - FALSIFICATION OUESTIONS Contl
4.
lt is the Census Bureau policy to recontact a
few of the households in our survey to evaluato
the quality of our work'
| 3ool r fl Yes
' I 5
fzfl No - PBOBEand expla.in
.below I Go to item
below
Explain
I
s fl Don't know
)
Did a Gensus lepre$entative call orvisit on or interviewdate)and
afoutJtrouset oId respondent's
iik qubCtions aboui crimes for the National
Crimb Vlctimizstion Suryey?
Reaskouestion14on thecontrolcard to vetifY.the
hoiseiold compositionin items 13a-c,as of the
date of the originalinterview.
Mark correctionsin REDpencilon the controlcard'
MEMBERis
(Onlv
mark box 2 if a HOIJSEHOLD
'add6d
or deleted- includeschangeof
membershipstatusin 13c.)
Exptain ANYcorrcctions to items 13a-cin the
"Explanation"section.
6a.
Did the Gensus lepresentativo interview you?
addedI
MEMBER
r n NoHoUSEHoLD
I
or deleted
addedor I Goto item6
, n ibuseioLD MEMBER
8:,,lfv
;!Fg
)
i|:i"3*E"i3l;nili
t 3 1 2 1l L - l Y e s
zlNo-ExPlainbelow
l-
s n Don't know- ExPlainbelow
6b. tf respondentis onlY perconage 12+yearsin
houdehold,mark choice4 without asking'
Did the census reprosentativo interview-or
to interview any other household
"iGmpt
members?
t,
r 3 1 3 1r L l Y e S
Exqlain below
7zJNo-
g I Don't know
I ! Onlyone Person12+
household
INSTRUCTION
REINTERVIEWER
with householdrespondentand sample
Evenif vou suspectfalsification,conductNCVScontentreinteview
personbsnecessary
Uistedon page.l)'
^6 page
naaa12'
1a
persona^^i^^
beginson
NOTE- Househou respondeniiiiginso, page3. Sampte
Section ll - SCREEN OUESTIONS FOR ORIGINAL HOUSEHOLD RESPONDENT
Name
i Line number
17. Household
resoondent
E
18. Typeof originalinterview
I r n Tel.- Selfrespondent
zn Per.- Self-respondent
slTel.-Proxvl ^
rroxY was
r n Per.- ProxvI
iis
-
19. Typeof reinterview
-Selfrespondent
-srd r n Tel.
z n Per.- Self-respondent
s n Tel. - Proxy I The only acceptableproxy is the person
+ n Per. - Proxy J who is listed in item 18
s fl Noninterview - SKIP to Check ltem I on page 10
20.
oate of reinterview
I
r-n
r-T---l rT--l
| | I I I
i3171 I | | |
Year
Day
Month
i
I
36a. l'm going to read some examptes that will give you
an idea of the kinds of crimes this study covers.
Brieflydescribeincident(s)
7
As I go through them, tell me if any of these
happened to you in the last 6 months, that is
between
20_and
20 _.
Was something belonging to YOU stolen, such as (a) Things that you carry, like luggage, a wallet,
purse, briefease, book (bl Glothing,jewelry, or cellphone(c) Bicycle or sports equipment (dl Things in your home - like a TV, stereo, or tools (el Things outside your home such as a
garden hose or lawn furniture (f) Things belonging to children in the household(gl Things.from a vehicle,^sJch as a package,
groceriec, camera, or GDs OR
(hl Did anyone ATTEMPTto steal anything
belonging to you?
MARKOR ASK36b.Did any incidents of this type happento you?
I
I
rsi6-l r n Yes- Whathappened?Describe
above
z [ ruo- SrQPto item37a
l-
36c. How many times?
E
37a. {Ottrer ttran any incidents already mentioned,l has
anyone(al Broken in or ATTEMPTEDto break into
your home by forcing a door or
window, pushing past someone,
jimmying a lock, cutting a screen,ol
entering through an open door or
window?
(bl Has anyone illegally gotten in or tried to
get into a g6rage, shed or storage room?
OR
(cl lllegally gotten in or tried to get into a
hotel or motel room or vacataonhome
where you were staying?
MARKOR ASK.
37b. Did any incidents of this type happento you?
37c. How many times?
Numberof times(36c)
Brieflydescribeincident(sl
;'
r--...-.--."=.=Eiol
I-
r ! Yes- What happened? Describeabove
z n No - SKfP to lfem 38
.ttl l
Numberof times(37c)
Page 3
Section ll - SGREEN OUESTIONS FOR ORIGINAL HOUSEHOLD RESPONDENT- Continued
38.
Wtrat was th6 TOTAL number of car., vans,
truoks, motolcycles, ot other motol v6hicles
owned by you or any other member of this
household during the Iast 6 months, that is
between
2o_and
20 _?
Includo those you no longer
own.
TNSTRUCTION
below
e'dl o n None- sKtP to REINTERVIEWER
rL-11
zJ2
sn3
+[4ormore
Brieflydescribeincident(s)
7
39a. During the la.t 6 months, that is betwoen
2O_and_
20 _, (oth6r than any incidents already
mention6d,) (was the vehiclelwere any of the
vehicles) {a} Stolen or used without permission?
lbl Did anyone steal any parts such as a tire,
. car steneo,hubcap or battery?
lcl Did anyone steal any gas from {itfitheml?
OR
(dl Did anyone ATTEMPTto steal any vehicle or
parts attached to (iUtheml?
MARKOR ASK39b. Did any incidents of this type happen to you?
t
@
I
r !Yes-What happened?Describeabove
INSTRUCTION
below
z n No - SKIP to REINTERVIEWEB
I
I
39c. How many times?
13241
Numberof times(39c)
I
REINTERVIEWER
INSTRUCTION
)
Wasthe originalhouseholdrespondent
selectedas
the sampleperson?(Referto item E on page1.)
riz6l
i-
r E Yes- Continuewith item 40a
z D No - SKIP to item 46aon page 7
I
40a. (Other than any incidents already mentioned,)
Brieflydescribeincident(s)
7
between--20-and
20 _, were you attacked or
threatened OR did you have something stolon
from you la) At home including the porch or yard lb) At or near a friend's, relative's, or
neighbor's home lcl At work or school (dl In places such as a storage shed or
laundry room, a shopping mall,
restaurant, bank, or airport lel While riding in any vehicle lfl On the street or in a parking lot lg) At such places as a party, theater, gym,
picnic area, bowling lanes,or while fishing
or hunting OR
(h) Did anyone ATTEMPTto attack or
ATTEMPTto steal anything belonging to
you from any of these places?
MARKORASK40b. Did any incidents of this type happen to you?
I
I
rsze I r n Yes- What happened?Describe
above
z[] No- sKlPto item41a
I
I
.tuc. How -"n
t3u-l
Numberof times(40c)
(
Soction ll - SCREEN OUESTTONSFOR ORIGINAL HOUSEHOLD RESPONDENT- Gontinued
Brieflydescribeincident(s)7
has anyone a'ttaoked or throatened you in any of
thore ways (Excludetelephone threatt) -
41a. l(Xher than any incidentc already mentioned,)
(a) With any weapon, for instance, a gun or
knife (b) With anything like a baseball bat, frying
pan, ecissors, or stick lcl By something thrown, such as a rock or
bo(tle (dl Include any grabbing, punching, or
choking,
(el Any rapc, attempted rape or other type of
sexual attack Any
face to face threats {f}
OR
(Sl Any attack or threat or u36 of force by
anyone at all? Please montaon it even if
you aro not certain it was a crime.
MARKOR ASK-
41b. Did any incidentsof this type happento you?
4lc. How many times?
t s28I r n Yes- Whathappened?Describe
above
z n No- SKIPro item42a
T
I
t32el
Numberof times(41c)
I
42a. People often don't think of incidents committed
by romeone they know, (Other than any
incidents already mentioned,l did you liave
something stolen from you OR weie you
aftacked or threatened bV Exclude telephone
threatd -
Brieflydescribeincident(s)
;'
(al Someone at work or school {bl A neighbor or friend (c) A relative or family member ld) Any othor peFon you've met or known?
MARKORASK42b. Did any incidents of this type happen to you?
I
I 33o I r n Yes- What happened? Describeabove
zZ No - SK/Pfo item 43a
l-
42c. How many times?
I
I33il
Numberof times(42c)
r
43a. Incidents involving forced or unwanted sexual
acts aro often difficult to talk about. (Other than
any incidents already mentioned,l have you been
forced or coerced to engage in unwanteil sexual
activity by -
Brieflydescribeincident(s)
;'
la) Someone you didn't know before (bl A casual acquaintance OR
(cl Someone you know well?
MARKORASK/tilb. Did any incidents of this type happen to you?
-lsrl
r nYes-What happened?
Describe
above
zJ No- Sl(fPro item 44a
llilc. How many times?
E
Numberof times(43c)
SqGtig.NI! - SCREEN OUESTIONS FOR ORIGINAL HOUSEHOLD RESPONDENTC;;iN;;44a. During tho last 6 months, that is between
I Brieflydescribeincident(s)y
2o-and_
I
(other.ttan any in-cidenE a|ready
?9_mentioned,l-did-you
- .-
.- v_dnq
call the police to reiort
sometfring that h_apponed to yOU whichyou
thought was a crime?
;
I
I
I
I
I
I
'' Yes- What happened?
Describeabove
,riga I
2 L-l No - SKIP to item 4Sa
|
cffil
l
I
Lookat 44a.lf unsure,ASK,otherwise,
mark
withoutasking.Were you (wasthe
respondent)attacked-or threatened, or
war.somothing stolen or an attompt
made.to lteal something that belohged to
you (tnerespondentl
or another household
member?
| 335 | 1L)Yes- ASKitem 44b
|
2 LJ No - SKIP ro item 4sa
I
i
I
44b. ttow manytimes?
I
F"6-l
Numberof times(44b)
r
Durang the last 6 months, that as between
.2oand__
20 ---- (other_tian any inciderrts already-'
mentaoned,, did anything which you thought
waa a cfame happen to you, but you did NoT
report to tho police?
Brieflydescribeincident(s)
7
Fs7-l r E Yes- What happened? Describeabove
2 Ll No - SKIP to item 46a
1
I
86il
I
Lookat 45a.lf unsure,ASK,otherwise,
mark
withoutasking.Were you (wasthe (respondent)
,riis I r lYes- ASKitem4Sb
attacked or threatened, or (was soniethinq 7z! No- Sf(lPto item46a
stolen or an attempt (made to steal
something that beionged to lyou (the
I
respondent)
or another houceholdmember? I
I
I
a5b. ttowmanyrimes?
I
Page 6
I
itar'l
r
Numberof times(45b)
Sectio! ll - SCREEN OUESTIONS FOR ORIGINAL HOUSEHOLD RESPONDENT- Continued
46a. Now l'd like to ask about ALL acts of vandatism
that may have been committod during the tast 6
months against YOUR houeehold. Vandatism is
the doliberate, intentional damage to or
destructaon of household property. Exampleaare
breaking windows, slashing tires, and paanting
graffiti on walls.
,34o I i LlYes
|
2 Ll No - SKIP to CHECK ITEM G
Between_
-2O
_and
_
20 _, has anyone intentionallv
damaged o,r destroyed froperty owned by you or
someoneelse in your household?
(EXCLUDE any damage done in coniunction with
i nci dents a tready menti oned.)
Lookat 46a,lf unsure,ASK,otherwise,mark
withoutasking.In the vandalismjust
montionod,were you (wasthe respondent)
attacked or threatened, or was something
stolen o1 an attompt made to steat
something that belonged to you (the
respondentl
or another householdmember?
(other than-any incident(s) already
mentionedl
Brieflydescribeincident(s)
7
T+Tl
r n Ves- What happened? Describeabove
zJ No - ST(IPIo cHEcKITEMG
46f. Howmanytames?
I:
'1342
|
t
Effiil
Transcribe
"numberof times"entrvfor
eachof the following:
Numberof times(46f)
I None- SKIPto CHECK\TEMI on page 10
161ScreenQuestion,ltem36c,page3
161ScreenOuestion,ltem37c,page3
Numberof times(36c)
16;ScreenOuestion.ltem39c,page4
141ScreenQuestion,ltem 40c,page4
Numberof times(39c)
(el Screen.Ouestion,
ltem 41c,page5
Numberof times(41c)
g1ScreenOuestion,ltem 42c,pages
Numberof times(42c)
(gl ScreenOuestion,
ltem 43c,page5
Numberof times(43c)
ltem 44b,page6
lhl ScreenOuestion,
Numberof times(44b)
1;1ScreenOuestion,ltem 45b,page6
ltem 46t page7
11;VandalismScreenOuestion,
Numberof times(45b)
Numberof times(37c)
Numberof times(40c)
Numberof times(46f)
lf entry of 1 or more in any of the above,FILL
Sectionlll beginningon page8.
lf "none' marked,SKiP to CHECKITEMI on page
NOTES
Page7
l. REINTERVIEWER
INSTRUCTION:Filla columnfor each
screen
questionwith an entryin CHECK
ITEMG on pige Z.
Screenquestionnumber
2. Numberof times in reinterview(Transcribeentryfrom CHECK
|TEMG).
3. ANY reportsof this type of crimein originarinterviewfor this enumeration
pet|o0 (Controtcard item 32.
r n Yes- Fill item 4
z n No - SKIPto item t1
O'
r flYes - SKIPto itein 7
z I No - Fill item5
5,
;:il?i#
originalinterview
for thisenumeration
period(controtcard
typlof crim^e
was reportedin originatinterviewfor
[y1!er
9!timesthis.
tnrs
period(ControlCarditem32).
enumeration
6. fs the_entryin .item2 abovegreaterthan the entry in item 5? (More times
repofted in reinterview than-in original.)
r n Yes- SKIP to item 10
z ! No - SKIP to item 14
7. ls the entryin item 2 above1-5timesor 6+times?
r n 1-5- SKiPto item 9
z!6+-Fiilitemg
8. ls this a "series"in reinterv,iew?
(fncidents
aresimilarAND respondent
cannotrecallenoughdetailsto distinguish
themfrom eachotfier.)
r I Yes- SKIP to item 12
z n No - SKiPto item 13
Ask9.
to ask you some que_stionsabout crimes you reporrod
ll-lry-liq_I!€
roday
vetsus crimss you reported previousty.
I have recorded from the pr-evioucinteruiew that (descriptionof
crime)occuned O or morstimes in the Iast e moni[i. idd"v if,"u.
ORIGINAL
CORRECT
r [J Respondent
saysorigina
crime reportcorrect- SK|P
to item 12
recorded that thas crime occurred only
(entryfrom item 2l
times. Gan you tel! me which is corredt ana whvi
Mark (X one.
z n Originalcorrect- otherExplain then SKiP to item 12
ORIGINAL
NOTCORRECT
: n OriginalFRtookcrimefrom
outsidereference
oeriodSK;P to item 13
+I OriginalFRput multiple
incidentson one incident
report- SKIP to item 13
s ! Originalnotcorrect- otherExplain then SKIP to item 13
Page
Section lll - RECONCILIATION OUESTIONS FOR ORIGINAL HOUSEHOLD RESPONDENT- Conrinued
RETNTERVTEW
question
Screen
number
@
!1-9-I REINTERVIEW
question
Screen
number
d
411 I
4
d
-rzil r n Yes- Fillitem4
z [l No SKIPto item11
-rSol r n Yes Fillitem4
z n No- SKiPto item11
rzz
- I r D Yes SKIPto item7
zJNo- Fillitem5
rsl
- l r ! Yes SKIPto item7
iiil
-
r n Yes- Filtitem4
zZNo - SKIPto item11
-rrTl r n Yes SKIPto item7
z n N o - F i l li t e m S
RETNTERVTEW
question
Screen
number
zZNo
- Fitl item 5
@
d
r n Yes- SKIPto item10
+is-l
zlNo- SKtPtoitem14
-az+l r flYes SKiPto item 10
z n No - SKIPto item 14
retl r Yes- SKIPto item10
z U No- SKIPto item 14
g
+re
- r n I6 r+n- FF5
i l l SKIPto item
itemS
F5i l -l SKIPto item9
rzil
- z n 6r+n- F
itemS
rsa
- I r I 1-5 SKIP to item I
z[6+ -FillitemB
r ! Yes- SKIPto item 12
rr-71
z n No- SKiPto item13
+zeI r n Yes- SKiPto item12
z Ll No- SK;Pto item 13
r D Yes- SKiPto item12
rs;l
z I No- SKIPto item13
414 |
ORIGINAL
CORRECT
r n Respondent
saysoriginal
cramereportcorrect- sKlP
to item 12
ORIGINAL
CORRECT
r ! Respondent
saysorigina
crime reportcorrect- SK|P
to item 12
ORIGINAL
CORRECT
r D Respondent
saysoriginal
crime reportcorrect* Sr(rP
to item 12
z n Originalcorrect- otherExplain then SKIP to item 12
z n Originalcorrect- otherExplainthen SKIP to item 12
z n Originalcorrect- otherExolain then SKIP to item 12
ORIGINAL
NOTCORRECT
: n Orig'roal
FRtookcrimefrom
periodoutsidereference
SKIPto item 13
ORIGINAL
NOTCORRECT
s n OriginalFRtookcrimefrom
periodoutsidereference
SKIP to item 13
ORIGINAL
NOTCORRECT
: n OriginalFRtookcrimefrom
periodoutsidereference
SKIP to item 13
+E OriginalFRput multiple
incidentson one incident
report- SKIP to item 13
+n Original
FRput muhiple
incidentson one incident
reoort- sKtP to item 13
+n OriginalFRput multiple
incidents
on oneincident
reooft- SKIPto item 13
s n Originalnot correct- otherExplain then SKIP to item 13
s n originalnot correct- otherExplainthen SKIP to item 13
s E Originalnot correct- otherExplain then SKIP to item 13
FoR OnfCfrunl HOUSEHOLD RESPONDENT- Continu
REINTERVIEW
l9:|
Askquestion
number
Screen
Now I'd like to ask you some questions about crimes you leported
today versus crimei you reported previously.
CORRECT
ORIGINAL
reportedto reinterviewer
r
Crime
fl
(desuiption
crime)
of
that
previous
interview
I have recorded from the
outsidereference
PeriodSKIP to item 12
(entryfrom item 5, times in the last 6 months' Today I
occurred z ! Oriqinalcorrect- other(entryfrom item 2)
have recorded that this crime occurred only Exptainthen SKIP to item 12
timer. Can you tell me which is correct and why?
Mark (X) one.
Tr.tN r|llFsTloNs
10.
NOTCORRECT
ORIGINAL
: n FRput multipleincidents
on one incidentreportSKIP to item 13
n D HHtriedto reportit, original
FRdid not recordit SKIP to item 13
5 n HHdid not tell originalFR,
not importantenougnSKIP to item 13
o ! Utt diOnot tell originalFR'
forgotduringoriginal
interview- SKIP to item 13
; n Oriqinalnot correctotherExilain then SKIP to item 13
Ask-
1 1 . We aro interested in finding out more about the crime incidents
ttrit weie reoorted at ono t-imebut not at anothel. Today, youlJo6tteilttii
?aesJription of crime)happened in the last 6 months'
bin viru t-liirr'oiinii exptanation foi idescriptionof crime)having
not 6een reponed ii thd previous intewiew?
Mark (X) one.
CORRECT
ORIGINAL
r n Crimereportedto
outside
reinterviewer
referencePeriod- SKIP
to item 12
z D Oriqinalcorrect- otherExotainthen SKIP to item 12
NOTCORRECT
ORIGINAL
3 n FRput multipleincidents
on one incidentreportSKIPto item 13
c n HHtriedto reportit. original
FRdid not recordit - SKIP
to item 13
s n HHdid nottell originalFR'
not importantenoughSKIP to item 13
o n HHdia nottell originalFR'
forgotduringoriginal
interview- SKIP to item 13
z n Oriqinalnot correct- otherExolainthen SKIP to item 13
+rol r n Originalcorrect- Sf(lP
to item 15
12. Originalis correct.
Mark (X) box.
rc-r-.lr D Originalnot correctSKIP to item 15
13. Originalis not correct.
Mark X) box.
Sameor fewercrimesin reinterview'
accepted'
14. Reconciliation
Mark N) box.
G1t tJ Sameor fewercrimesin
- Go to item 15
reinterview
ITEMG for this
15. ls this the lastscreenquestionwith an entryin CHECK
G on page 7)
respondent?(Beferto CHECKITEM
ITEMI
-r+s I r ! Yes Go to CHECK
zJ No - Go backto PagesI and
9 and fill items1-14for
next screenquestion'
ffi;f
o'* hoIdmembertobe
.l,lls,.,l,1i',n
I
SKIP to SectionVl on
1444) r n Yes- ENDREINTERVIEW.
I
Page10
page20
z n No - Reinterviewsamplepersonon page 12
Section III - RECONCILIATION OUESTIONS FOR ORIGINAL HOUSEHOLD RESPONDENT- GONtiNUEd
d
RETNTERVTEW
question
Screen
number
d
RETNTERVTEW
d
number
Screen
ouestion
RETNTERVTEW
question
number
Screen
ORIGINAL
CORRECT
r n Crimereportedto reinterviewer
outsidereference
oeriod9KlP to item 12
z n Originalcorrect- otherExplainthen SKIP to item 12
ORIGINAL
CORRECT
r fl Crimereportedto reinterviewer
periodoutsidereference
SKIP to item 12
z n Originalcorrect- otherExolainthen SKIPto item 12
CORRECT
ORIGINAL
r n Crimereportedto reinterviewer
periodoutsidereference
SKIP to item 12
z n Originalcorrect- otherExplain then SKIP to item 12
NOTCORRECT
ORIGINAL
: I FRput multipleincidents
on one incidentreportSKiPto item 13
+n HHtriedto reportit, original
FRdid not recordit SKIP to item 13
s I HHdid not tell originalFR.
not importantenoughSKiPto item 13
e I HHdid not tell originalFR,
forgotduringoriginal
interview- SKIP to item 13
z E Originalnot correct- otherExplainthen SKIP to item 13
NOTCORRECT
ORIGINAL
a n FRput multipleincidents
on one incidentreportSKiP to item 13
+[ HHtriedto reportit, original
FBdid not recordit SKIP to item 13
s I HHdid not tell originalFR,
not importantenoughSKIP to item 13
6 [] HHdid nottell originalFR,
forgotduringoriginal
interview- SKIP to item 13
r n Originalnot correct- otherExolainthen SKiP to item 13
NOTCORRECT
ORIGINAL
s n FRput multipleincidents
on one incidentreportSKIP to item 13
a n HHtriedto reportit, original
FRdid not recordit SKfiPto item 13
5 [ HHdid not tell originalFR,
not importantenoughSKIP to item 13
6 n HHdid not tell originalFR,
forgotduringoriginal
interview- SKIP to item 13
I n Originalnot correct- otherExplainthen SKIP to item 13
ORIGINAL
CORRECT
r fl Crimereportedto
reinterviewer
outside
referenceperiod- SKIP
to item 12
z E Originalcorrect- otherExplain then 9KlP to item 12
ORIGINAL
NOTCORRECT
a n FRput multipleincidents
on one incidentreDortSKIP to item 13
I n HHtriedto reportit, original
FRdid not recordit - SfffP
to item 13
s n HHdid nottelloriginalFR,
not importantenoughSKIP to item 13
o n HUdid nottell originalFR,
forgotduringoriginal
interview- SKiP to item 13
z I Originalnot correct- otherExplbinthen SKIP to item 13
ORIGINAL
CORRECT
r n Crimereportedto
reinterviewer
outside
referenceperiod- SI(P
12
to item
z E Originalcorrect- otherExplain then SKIP to item 12
CS+
CORRECT
I ORIGINAL
r n Crimereportedto
reinterviewer
outside
referenceperiod- SKIP
to item 12
z I Originalcorrect- otherExplain then SKIP to item
NOTCORRECT
ORIGINAL
o n FRput multipleincidents
on one incidentreportSKIP to item 13
+[J HHtriedto reportit, original
FRdid not recordit - SK,P
to item 13
5 n HHdid nottell originalFR,
not importantenoughSKIP to item 13
o ! HHdid nottell originalFR,
forgotduringoriginal
interview- SKIP to item 13
r n Originalnot correct- otherExplain then SKIP to item 13
ORIGINAL
NOTCORRECT
r I FRput multipleincidents
on oneincidentreoortSKiP to item 13
En HHtriedto reportit, original
FRdid not recordit - St(rP
to item 13
5E HHdid nottelloriginalFR,
enoughnotimportant
SKIP to item 13
6[] HHdid nottelloriginalFR,
forgotduringoriginal
interview- SKIP to item 13
r n Originalnot correct- otherExolain then SKIP to item 13
- SKIP
+asI r n Original
correct
to item 15
lss-l r n Originalcorrect- SK|P
to item 15
c+9] r n Orisinal
notcorrect
SK;Pto item15
notcorrect
rsel r n Original
SKIPto item15
cstil r ! Sameor fewercrimesin
reinterview- Go to item 15
rsil r n Sameor fewercrimesin
- Goto item15
reinterview
rsTl
r n Yes- Go to CHECKTTEMI
zA No - Go backto pages8 and
9 and fill items 1-14for
next screenquestion.
+iCl
r nYes - Goto CHECKTTEMI
zJ No - Go backto pagesI and
9 and fill items 1-14for
nert screenquestion.
loz I r n Originalcorrect- END
and SKIP
RECONCILIATION
to CHECKITEMI on page 10
G-l r E Originalnot correct- END
RECONCILIATION
and SKIP
to CHECKITEMI on page 10
tod
r n Sameor fewercrimesin
- END
reinterview
RECONCILIATION
and SKIP
to CHECKITEMI on page 10
Page 11
Section IV. SCREEN OUESTIoNS FoR SAMPLE PERsoN
17. Household
memberselectedfor reinterview
(if other
I Name
than householdrespondent)
I
I
18. Typeof originalinterview
,Eoz I r n Tel.- Self-respondent
rnPer.-Self-respondent
i
s L l T e l . - P r o x vI
,
onPer.- ProxvI ProxYwas
i
19.
Typeof reinterview
j Linenumber
@
iios I r n tet. - Self-responoent
lz n Per.- Self-resoonoent
s n T e l . - P r o x v lz . onlyacceptable
proxyistheperson
_
!.,:4 Li per.- proxy I whois listedin item lg.
s n Nonintervieiu- SKIPto CHECKITEMI on page18.
I
2O. Dateof reinterview
lltlttT--r-l
, 5 o 4 t -;;----:| | | | I | | | I
Month
Day
Year
I
36a. l'm going to read some examples that will qive
you an idea of the kinds of cimes this studTy
covets.
Brieflydescribeincident(s)
7
As I go through them, tell me if anv of these
happened to you in the last 6 monihs, that is
between
20 _ arid
Was something belonging to yOU stolen,
such a3 (al Things-thtt you c_arry,like luggage, a waltet,
purre, Drretcase,book _
(bl Clothing, jewelry, or cellphone (cl Bicycle or sports equipment ldl Things in your home - like a TV, ster€o, ol
tools le) Things.from a vehicle, such as a package,
groceries, camela, or GDs OR
{f) Did anyone ATTEMPTto steal anything
belonging to youi
I
36b' Did any incidents of this type happen to you?
I ."tl
|
r fl ves - what happened? Describeabove
2 L_lNo - SKIP to item 40a
36c. Howmanytimes?
t506l
I
Numberof times(36c)
NOTES
Page 12
FORMNCVS-541(5-4-2005)
t:
Section lV - SGREEN OUESTIONS FOR SAMPLE PERSON - Gontinued
40a. tOther than any incidents already mentioned,l
r Brieflydescribeincident(s)
7
I
betweon
20_and
I
20 were you attacked or
threatened OR did you have something stolon
from you
la) At home including the porch or yard (bl At or near a friend's, relative's, or
neighbor's home (c) At work or school (dl In places such as a storage shed or
laundry room, a shopping mall,
restaurant, banlc or airport (el While riding in any vehicle(fl On the street or in a parking lot (9) A1 such places as a party, theator, gym,
picnic area, bowling lanes, or while
fishing or hunting OR
lhl Did anyone ATTEMPTto attack ot
ATTEMPTto steal anything belonging to
you from any of these placer?
MARKOR ASK40b. Did any incidents of this type happen to you?
r nYes-What happened?Describeabove
z n No - SKIPto item 41a
40c. How manytimes?
Numberof times(40c)
Bri.fly dr*rib. ir,.ldr.t(.) Z
41a. ((Nherthan any incidents alreadymontioned,l
h_aranyono attackod or threatonod you in any of
these ways (Excludetelephonethreati)lal With any weapon, for instance, a gun or
knife (bl With anything like a baseball bat, frying
pan, scissors, or stick (cl By something thrown, such as a rock or
bottle (dl Include any grabbing, punching, or
choking,
(e) Any rape, attemptod rape or other type of
sexual attack(f) Any face to face threats OR
(Sl Any attack or throat or use of force by
anyone at all? Please mention it even if
you aro not certain it was a crime,
MARKORASK41 b. Did any incidents of this type happen to you?
I
r 5 o e lr IYes-What happened?Desuibeabove
I
I
41c. How many times?
z [l No - 9KIP to item 42a
I
t5lol
I
I
FORMNCVS-541(5-#2005)
Numberof times(41c)
P a g e1 3
a..t,on ,U- S""aa* OU="t,O"atO* iffi
42a.Peode-oftEn.gg[t-tq*-._f
reopro orren oon't thank of incidents
incidents"o-rni*frf
committed -' I
someone
theyknow.l(Xhertrin i-ni indiJlii,iii-by
,
atteady
Brieflydescribeincident(s)g
,;:filiili!'"qi":i.1iii'::,l;iff
3fH:[ffi,,.,1""1
mentioned,l
did you have sohethina
rrerrr t/uu v|I were yOU anl
(EXCluCte
telenhnnc fhra.tcl
lExctucte
telephone
threatd -
qtntan I
--'------
-t
I
I
I
I
I
I
I
I
I
la) Someone at work or school (b)A neighbor or friend (cl A relative or family member (dl Any other porson you've met
or known?
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
MARKORASK4i2b' Did anv,ncidents of this type happen
to you?
]
.,! yes - what happened
? Describeabove
z n No - SKlp to item 43a
,brl
i
42c. How many times?
rsltl
I
Numberof times(42c)
43a.|ncidentsinvo|vingforced.o.runwantedsexua|@
to tak iuoui. I&[-d]iian
::::,:l?.of1_difficutt
atready
il"i6;il;1;J;b:i
l:-v_llcilems
rol-c-ego.rcoerced to engage
activity by -
I
;:H
I
in uiwanteit seiuii-
|
(al Someone you didn,t know
before _
(b)A casual acquaintance-
;
OR
(cl Someone you know well?
j
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
MARKOR,ASK
43b' Did any incidents of this type happen you?
to
iE
,,
r n yes - what happened? Describeabove
t ! No - SKlp to item 44a
43c. How many times?
;
Numberof times(43c)
Page 1 4
FORt\4NCVS-541(5-d-2005)
Section lV - SCREENOUESTIONSFORSAMPLE PERSON- Continued
Brieflydescribeincident(s)
;'
44a. During the tast 6 monthi, that is between
2O_and_
(other than any incidents already
20 montioned,l did you call the police to report
something that happonod to YOU which you
thought was a crime?
Frs-l r n Yes- Whathappened?Desuibeabove
zn No- sKrPro itemAga
i-
Gffi |
erwise,
mark
i,:,il:fl[
ilft
,lf
:iliJJ:',A'fi,,9::
respondent)attacked
r 516 | r L)Yes- Askitem 44b
or threatened, or was t
z L-.1
No - $f(P fo item 45a
something stolen or an attempt made to
steal eomething that belongoii to you (the
respondent)or another household member?
44b. How many times?
r5171
Numberof times(44b)
I
I
Brieflydescribeincident(sl
7
45a. Ouring the.last 6 months, that as betweon
2O_and_
(other than any incidonts already
20 mentioned,l did anything which you thought
was a crime happen to YOU, but you did NOT
roport to the police?
srdl r EVes-What happened?Desuibeabove
z U No - SKIP to CHECKITEM G
,S.,]'if::erwise,mark
ff ilnitl h:fi
Edl r U Yes['J,::?i,ii:ili:f
-
Askitem 45b
z Ll No SKIPto CHECK
ITEMG
respondent)attacked or threatened, or was
romothing rtolen or an attempt made to
stoal somothangthat belonged to you (the
respondent)or another household member?
45b. How manytimes?
r52ol
I
I
liEil
"ly.mbgr
Transcnbe
oftimes"
entry
for
eacnot tne toilowtng:
.{alScreenOuestion,ltem36c.page12
Numberof times(45b)
n None- Go to CHECKITEMI on page 18
Numberof times(36c)
(b)ScreenOuestion,ltem 40c,page13
Numberof times(40c)
(cl ScreenQuestion.ltem 41c,page13
Numberof times(41c)
(dl ScreenOuestion,ltem 42c,page14
Numberof times(42c)
lel ScreenOuestion,ltem 43c,page14
Numberof times(43c)
(fl ScreenOuestion,ltem 44b,page15
Numberof times(44b)
(gl ScreenOuestion,ltem 45b,page15
Numberof times(45b)
If entry of 1 or more in any of the above,FILL
SectionV beginningon page 16.
If nonemarked,go to CHECKITEMI on page 18.
NOTES
Page
Seciion v - REcoNclLlATlON OUESTIONS FOB SAMPLE PERSON
INSTRUCTION:Filla columnfor eachscreen
1. REINTERVIEWER
questionwith an entryin GHECK
ITEMG on page15.
REINTERVIEW
U
question
number
Screen
2. Number.oftimes in reinterview(Transcribeentry from CHECKITEM@.
q
3, ANY reportsof this type of crimein originalinterviewfor this enumeration
oeriod (Controlcard item 32).
-ooCl r n Yes- Fillitem4
z n No SKIPto item11
period(Controlcard
4. "Series"in originalinterviewfor this enumeration
item 32d.
r n Yes- SKIPto item7
6o-+-l
zZNo - Fillitem5
5. Numberof timesthis type of crimewas reportedin originalinterviewfor
period(ControlCarditem32).
this enumeration
6. ls the entry in item 2 abovegreaterthan the entry in item 5? (Moretimes
repottedin reinterviewthan in original.)
-eoeI r D Yes SKiPto item 10
zDNo- SKlPtoitem14
7. ls the entrvin item 2 above1-5timesor 6+ times?
r tr 1-5-9KIPto itemI
soTl
zn6+- FillitemS
(lncidents
aresimilarAND respondent
8. ls this a "series'in reinterview?
cannotrecallenoughdetailsto distinguish
themfrom eachother.)
-ioel r n Yes SKiPto item12
zZNo-SKlPtoitem13
Askask you some questions about Grimesyou reported
today versus crimes you reported previously.
I have recorded from the previous intewiew that (descriptionof
crime)occuwed 6 or more times in the last 6 months. Today I have
ORIGINAL
CORRECT
r n Respondent
saysoriginal
crimereoortcorrect- SKIP
to item 12
(entryfrom item 2)
recorded that this crime occurred only times. Can you tell me which is correct and why?
Mark (X) one,
z ! Orioinalcorrect- otherExitain then SKiP to item 12
9. Now I'd like to
NOTCORRECT
ORIGINAL
s I OriginalFRtookcrimefrom
periodoutsidereference
SKiP to item 13
+D OriginalFRput multiple
incidents
on oneincident
report- SKIP to item 13
s I Oriqinalnotcorrect- otherExitain then SKIPto item 13
Page16
FORM
Section V - RECONCILIATION OUESTIONS FOR SAMPLE PERSON - Conrinued
RETNTERVTEW
llil
question
Screen
number
RETNTERVTEW
d
question
Screen
number
RETNTERVTEW
d
question
Screen
number
@
d
-dTzl ' E Yes Filtitem4
znNo-SKIPtoitemil
ezil r n Yes- Fillitem4
z L-lNo- SKiPto item11
65ol r n Yes- Fillitem4
z L-.1
No- SKIPto item11
ersI r n Yes- SKIPto item7
z U No- Fillitem5
ozzl r n Yes- SKIPto item7
z Ll No- Fill item5
-oeil r ! Yes- SKIPto item 7
zJNo Fillitem5
1l
@
d
@
ors I r E Yes- SKiPto item10
z U No- SKiPtoitem14
izn-l r n Yes- SKiPto item10
z Ll No- SKIPto item 14
r n Yes- SKIPto item10
sstl
z fl No- SKlPtoitem14
r D 1-5- SKIPto item 9
arril
2D6+ - Filtitem I
-rzs
z EI 6r+! - F1-5
i t l SKIPto item9
itemB
-oj+
z nI6r+tr- F1-5
i l l SKiPto item9
itemS
r D Yes- SKIPto item 12
oz6l
zZNo - SKiPto item 13
odl r n Yes- SKIPto item 12
z U No- SKiPto item 13
oiil
r D Yes- SKiPto item 12
z U No- SKIPto item 13
9_lO RIGINAL
CORRECT
r ! Respondent
saysoriginal
crime reportcorrect- SKrP
to item i2
ORIGINAL
CORRECT
r E Respondent
saysoriginal
crime reportcorrect- SKIP
to item 12
ORIGINAL
CORRECT
r -I Respondent
saysorigina
z n Originalcorrect- otherExplainthen SKiP to item 12
z E Originalcorrect- otherExplainthen SKiP to item 12
z ! Originalcorrect- otherExplain then SKIP to item 12
ORIGINAL
NOTCORRECT
e [J OriginalFRtookcrimefrom
outsidereference
oeriodSKIP to item 13
ORIGINAL
NOTCORRECT
: n OriginalFRtookcrimefrom
periodoutsidereference
SKIP to item 13
ORIGINAL
NOTCORRECT
a n OriginalFRtook crimefrom
outsidereference
oeriodSKIP to item 13
n ! Original
FRput multiple
incidentson one incident
reporl- SKIP to item 13
s n Originalnot correct- otherExplain then SKIP to item 13
+n Original
FRput multiple
incidents
on oneincident
report SKIP to item 13
s n Originalnot correct- otherExplainthen SKIP to item 13
a n OriginalFRput multiple
incidents
on oneincident
rcoott- SKiP to item 13
s n Originalnot correct- otherExplainthen SKIP to item 13
criniJrepo.tco'rieci':
siilp
to item 12
Page 17
Section V - RECONCILIATION OUESTIONS FOR SAMPLE PERSON - Continued
RETNTERVTEW
d
question
Screen
number-
10.
AskNow l'd like to ask you some questions about crimes you reported
today vorsus crimes you reported previously.
I have rocorded from the previous interview that (descriptionof
(entryfrom item 5/ times in the last 6 months,
crime)occuned _
Today I have recorded that this crimo occurred onlY_
bntry
from item 2)times. Can you t6ll me which is correct and why?
Mark (X) one.
CORRECT
ORIGINAL
r ! Crimereoortedto reintervrewer
outsidereference
oeriodSKIPto item 12
z n Originalcorrect- otherExplainthen SKIP to item 12
ORIGINAL
NOTCORRECT
a n FRput multipleincidents
on one incidentreoortSKIP to item 13
+f] HHtriedto reportit, original
FRdid not recordit SKIPto item 13
5 n HHdid nottelloriginalFR.
not importantenoughSKIP to item 13
s I HHdid nottelloriginalFR,
forgotduringoriginal
interview- SKIP to item 13
r n Originalnot correct- otherExplainthen SKIP to item 13
Ask-
1 1 . We are interested in finding
out more about the crime
incidents that were reported at one timo but not at another.
Today, you reported lhal (descriptionof crime)happened in the
last 6 months. Gan you think of any explanation for
(descriptionof crime)having not been reported in the previous
intewiew?
Ma* X) one.
639 I ORIGINAL
CORRECT
r n CrimereDorted
to
reinterviewer
outside
referenceperiod- SKIP
to item 12
z n Originalcorrect- otherExplain then SKIP to item 12
ORIGINAL
NOTCORRECT
e n FRput multipleincidents
on one incidentreDortSK;P to item 13
+n HHtriedto reportit, original
FRdid not recordit - SKIP
to item 13
s n HHdid nottell originalFR.
not importantenoughSKIP to item 13
6 n HHdid nottell originalFR,
forgotduringoriginal
interview- SKIP to item 13
z n Originalnot correct- otherExplainthen SKIP to item 13
12. Originalis correct.
Mark (X) box.
oiol r n Originalcorrect- Sl(lP
to item 15
13. Originalis not correct.
Mark (X) box.
aiil
r [] Originalnot correctSKIP to item 15
14. Reconciliation
accepted.
Sameor fewercrimesin
reinterview.
Mark (X) box.
olil
r n Sameor fewercrimesin
- Go to item 15
reinterview
15. ls this the lastscreenquestionwith an entrvin CHECK
ITEMG
for this respondent?(Refetto CHECKITEM'Gon page 15)
-ils-l r flYes Go to cHEcKITEMI
z n No - Go backtopages16and
17and fill items 1-14for
next screenquestion.
Effi|
Page
I
ls this the lasthousehold
Gr+ I r ! Yes- ENDRE\NTERVIEW.
SKIPto SectionVl on page20
memberto be
I
reinterviewed?
z n No - Ask Secfionl, falsificationquestionsand SectionIl, screenquestions,
I
of the householdrespondent.Arrangefor callbackif necessary.
Section V - RECONCILIATION OUESTIONS FOR SAMPLE PERSON - Gontinued
RETNTERVTEW
d
question
Screen
number-
RETNTERVTEW
question
Screen
number
q
RETNTERVTEW
d
question
Screen
number
ORIGINAL
CORRECT
se I onrcrNnlcoRREcr
eol
oRtotnn coBREcr
r n Crimereportedto reinterviewer
r I Crimereoorted
r n Crimereoorted
to reinterviewer
to reinterviewer
periodperiod
periodoutsidereference
outside
reference
outside
reference
SKiPto item 12
SKIPto item12
SKIPto item 12
- other- otherz ! Originalcorrect- otherz n Original
z n Original
correct
correct
Explainthen SKiP to item 12
ExplainthenSKIPto item 12
ExplainthenSKiPto item12
ORIGINAL
NOTCORRECT
3 D FRput multipleincidents
on one incidentrepoftSKIP to item 13
r n HHtriedto reportit, original
FRdid not recordit SKIP to item 13
s n HHdid not tell originalFR,
not importantenoughSKIPto item 13
o n HHdid nottelloriginalFR,
forgotduringoriginal
interview- SKIP to item 13
z n Originalnot correct- otherExplain then SKIP to item 13
ORIGINAL
NOTCORRECT
g n FRput multipleincidents
on one incidentreoortSKIP to item 13
I n HHtriedto reportit, original
FRdid not recordit SKIP to item 13
5 n HHdid nottelloriginalFR,
not importantenoughSKIP to item 13
o E HHdid nottelloriginalFR,
forgotduringoriginal
interview- SKIP to item 13
; D Originalnot correct- otherExolainthen SKIP to item 13
ORIGINAL
NOTCORRECT
: n FRput multipleincidents
on one incidentreDortSKIP to item 13
r E HHtriedto reportit, original
FRdid not recordit SKiP to item 13
s ! nH diAnottell originalFR,
not importantenoughSKIP to item 13
o n UUdiOnottelloriginalFR,
forgotduringoriginal
interview- SKIP to item 13
z n Originalnot correct- otherExplainthen SKIP to item 13
ORIGINAL
CORRECT
r n Crimereportedto
reinterviewer
outside
referenceperiod- SlflP
to item 12
z n Originalcorrect- otherExplainthen SKIP to item
ORIGINAL
CORRECT
r n Crimereportedto
reinterviewer
outside
referenceperiod- SKIP
to item 12
z ! Originalcorrect- otherExplainthen SKIP to item 12
ORIGINAL
CORRECT
r n Crimereportedto
reinterviewer
outside
referenceperiod- SKIP
to item 12
z n Originalcorrect- otherExplain then SRIP to item 12
ORIGINAL
NOTCORRECT
3 n FRput multipleincidents
on one incidentreportSKIP to item 13
I n HHtriedto reportit, oriqinal
FRdid not reiord it - SfttP
to item 13
s fl HHdiCnottelloriginalFR,
not importantenouohSKIPio item 13
6 [ HHdid not tell originalFR,
forgotduringoriginal
interview- SKIP to item 13
z n Originalnot correct- otherExplain then SKIP to item 13
ORIGINAL
NOTCORRECT
a ! FRput multipleincidents
on one incidentreoortSKiP to item 13
+E HHtriedto reportit, original
FRdid not recordit - SK,P
to item 13
s n HHdid nottelloriginalFR,
not importantenoughSKIP to item 13
6[] HHdid nottelloriginalFR,
forgotduringoriginal
interview- SKiP to item 13
r n Originalnot correct- otherExolainthen SKIP to item 13
ORIGINAL
NOTCORRECT
3 E FRput multipleincidents
on one incidentreportSKIP to item 13
+[1 HHtriedto reportit, original
FRdid not recordit - SK|P
to item 13
s n HHdid nottelloriginalFR,
not importantenoughSKIP to item 13
e I nu did nottell originalFR,
forgotduringoriginal
interview- SKiP to item 13
z n Originalnot correct- otherExplain then SKIP to item 13
- SKIP
xe-l r ! Original
correct
to item 15
aei'l r n Originalcorrect- SKIP
to item15
- END
aoz'lr tr Original
correct
RECONCILIATION
andSKIP
to CHECK
ITEMIon paoe18
ocsl r n Original
notcorrect
osd-l r [1 Originalnot correctSKIP to item 15
oes-l r n Originalnot correct- END
RECONCI
LIATIONand SKIP
to CHECKITEMI on page 18
eso I r ! Sameor fewercrimesin
reinterview- Go to item Is
esTl r n Sameor fewercrimesin
- Goto item15
reinterview
ooaI r E Sameor fewercrimesin
- END
reinterview
RECONCILIATION
and SKIP
to CHECKITEMI on page 18
esil r nYes- cotoCHECK\TEMl
z U No - Go backtopages16and
17and fill items 1-14for
next screenquestion.
osgl r nYes- Go to CHECK\TEMI
z Ll No - Go backto pages 16and
17and fill items 1-14for
next screenouestion,
SKiP to item 15
NCVS-54
Page 19
Section Vl - REINTERVIEW STATUS
Rl.
REINTERVIEW
STATUS
ls this reinterview
complete?
NOTE- Considera reinteryiew
completelF you
talkedto someonein the household
ANDcompleted
(i.e.,got responses
questions1
for)the falsification
through6.
Mark X) one box
VISIT
ATTEMPTED
R2. PERSoNAL
visitattemoted
Wasa oersonal
forthiscase?
zof
- SKiPto itemR3
COMPLETE
r n REINTERVIEW
INCOMPLETE
REINTERVIEW
z D Refused- Explainbelow and SKIP to item R3
: n Originalhouseholdmoved- SKIPto itemR3
r n Unableto contact- Explainbelow and go to item R2
s n Other- Explainbelowand go to item R2
'l
7oE rflYes
- Explainbelow
z n No,notcosteffective
gI No,anotherreason- Explainbelow I
no,o
nem
Rs
ASSESSMENT
R3. FALSIFICATION
- Explainbelow
suspected
Basedon the reinterview,
do you suspectfalsification r zosl r nYes, falsification
TOA SUPERVISOR
and REFER
by the originalfield representative?
t.
not suspected
zn No.falsification
NOTE: /fyou were unable to contact anyone
you
have no other reason to suspect
AND
falsification, mark (X) box 2.
NOTES
Page 20
| File Type | application/pdf |
| File Modified | 0000-00-00 |
| File Created | 2006-05-02 |