NCVS-545 National Crime Victimization Survey 545

O M BN o . 1 1 2 . | - 0 1
FoRMNCVS,!45
t4.6.2005)
OF COMMERCE
U.S.OEPARTMENT
E6nmlc8 sd ShilltlcaAdmlnl8t€{o
U.g.CENSUS
BUREAU
ACTINO
ASCOLLECTING
AGENT
FORTT{E
BUREAU
OFJUSTICE
STATISTICS
U.S.DEPARTMENTOF
JUSTICE

REINTERVIEWOUESTIONNAIRE
FOR ORIGINAL SURVEY
NONINTERVIEWS(Type B and Gl
NATIONAL GRIME
VIGTIMIZATIONSURVEY

Explre37/31/2006

- Yourfeportto tha CenaugBureauls confldontlal
by lav (U.S'
llotlct
wlllD€
informallon
Code42, sactlons37899and 3735),All ldentlflebla
uieo onti OypersonserigagedIn ahdfor the puDoeesot the suley' and
purpoges.
tof
any
mav not bs disclo8edor releesedlo olhe's

=r Gonlrol numb.l
I SoriaY tHH No.lSpinofl
lsegm6nusuffixrSamole
[ | esu
Ml
idesldnatiorr'Suflixisufilx
i
ilndlcatot
I
I
I
rl
I
status
FieldRepresentative
A. Regionalotficecod€

TT-I

2oll |

|

r E Experienced
?9?lzfj Inexp€rienced

|

identltication
B. OriginalFi€ldR(rpresontatlv€
Name
Code

@
idBntification
G. Reinterviewer
I Name
Code

@
codsanddescription
D. Originalsuryeynoninterview

E. Dateof originalnonint€rview

-T_-l
TT]
| |

2ool I

@

Month

G. fype of reinterview

F. Date of reintervi€w

@ munl
Month

Day

Day

Y€ar

d tEl:',::Hli'.-

Sectlon | - FALSIFICATION OUESTIONS

E
l.

2.

3.

p€'son'n
,'em t 3 o r l r !
: iSgrxiyj:J.?"Jt?fi
!'r'3ffi
z il
rNTRooucroN
Hello, I'm ... lrom the U.3. Gensur Butsau.
(Showbadge,il personalus,t) ilay I speak to
(typeB/C contactperson'snamel?

vEBtFycoNTAcr pERsoN'sADDRESSi
PHONENUMBER
fs this (addressORphonenumberfromcontrol
carditem 331?

VERIFYcoNTAcr - Proxy
Perhaps you can help me. Our rccords show
thal one of our Censuc rep?e3ontatives recently
visited or called.
outcome
Was {sarnp,eaddress) (o-rigin-al.noninteuiew
and desciption)on or about (dateof otiginal
nonintewiewl?

Yes,contactpersonlisted- Go to item1
No, contactporsonnoi listed- SKIP to CHECKITEMB

- 9f(P to item4
person
Soil r ! Yes,thisiscorrect
unavailable \ grre- ro
temporarily
r n No,p€rson
i-thereI item3
livesiworks
nolonger
. tr No,person
i
|
unknownGoto item2
+E Person
aftera reasonable
to reachanyone
s tr Unable
i
I
- SKiPto CHECK
ITEMI
of attempts
number

t gof,i r ! Yes- Goto item3
'l
I
zlNo
----trEMB
j srtP toOHECK
.otpt.t.
to
;;rsed/unabte
;
D
I
I
I
I
I
@
f
I

r D Yes
lE,ffntenW*W
z E No- probe andexptainOetow t'{iii'6'section
s tr oon't know- SKIP to CHE1KITEMI

I

I
I
l

4.

- Correctcontactperson
VERIFYCONTACT
According to oul lecolds, one ol our Gensus
representatives rDcently vicited or called you.
Did a Gensus reprtsentative vislt or call
rugarding (sampleaddressl?

I
l3-ot r EYes
I
I
I

IISCENSUSBUR

Go to iten 5
below
eI No- Explain
g! Don'tknow- Explain
below

,na
ll

FALSIFICATIOI{ OUESTTONS- Gonrinued
W.. (sample address) (oiginat noninteNiew outcome
and description) on or about (date of originat
noninteruiewn

oorillEyes

lgnonelryrsnylsw

z ! No - PROBEand explainbetowt anclSKIPto sectionll
g D Don'l know- Go to CHECKITEMB

Verifythe noninterview
statusof thesamole
'
addresson or aboutthe dateol original
noninterview
by contacting
a know6dgeable
person(l-e.rentalagent,landlord,
etc.)or by
o0servalron.

g D Unableto verifystatus- Exptainbetow

section |I - NoNtlttrERvtEwvEBtFtcATtoN/FALstFtcATtolt
assessuenr
NONINTERVIEWVERIFICATION
Mark (X) one box

@
j

t D Originalnoninterview
classification
correct
z n Origirialnoninterview
classification
inconect
L--| Whatis thecorrectclassification?
g

eE Unableto verifyoriginalnoninterview
- Go to itemR2
classification
PERSONAL
VISITATTEMPTED
Wasa porsonalvisitattempted
for thiscase?
2 ! No,notcostefiective- Explainbelow
3 fl No, anotherreason- Explainbelow

FALSIFICATION
ASSESSMENT
Basedon the reinterview,
do yoususpectfalsification I ros I r D Yes,talsitication
- Explainbelow and
suspected
by lhe originalfieldrepresentitive?
REFERTOA SUPERVISOF

NpJE:J{y_ou
wereunableto veify thenoninteruiew
youllavenootherreeson
A.ryD
to suspect
?tltu_?
tatsfircation,
maft(X)box2.

2 D No,falsification
notsuspecled