1525-0012-0187 US Mint Quant Consumer Research-Silver Inquiries/Kennedy Gold Rsrch&1525-0012-0188 US Mint Qual Inactive Catalog Purch Rsrch

National Analysts Worldwide 1525-0012-0188

Study #005-23-859

January 2014

RECRUITER INITIALS _______ NA INTERVIEWER: _____________

INCENTIVE $_______

PAID ( )

(Please initial upon completion.)

TDI SCREENER

US MINT INACTIVE CATALOG PURCHASERS RESEARCH

INTERVIEWER #1 (Adine Frank - AF)

INTERVIEWER #2 (Jessica Gerber - JG)

IDENTIFY (GET A MIX)

Male ( )

Female ( )

NAME:

OFFICE ADDRESS:

CITY/STATE:___________________________________________ ZIP CODE:

BUSINESS TELEPHONE #: ( ) FAX: ( )

(AREA CODE) (AREA CODE)

EMAIL ADDRESS:

APPOINTMENT: INTERVIEW PHONE #:

DAY/DATE This # is: home ( ) office ( ) other ( )

TIME ALTERNATE NUMBER

Respondent Time:_____________________

SEND HONORARIUM TO (If different from address above):

NAME:_________________________________________________________________________

ADDRESS:______________________________________________________________________

_______________________________________________ ZIP CODE:______________________

SUGGESTED INTRODUCTION: Hello, I'm __________________________ calling for National Analysts Worldwide, a marketing research firm based in Philadelphia. This is not a sales call. We are conducting a research study for The United States Mint, and are inviting people who meet certain qualifications to participate in a brief 15 minute telephone interview.

I’d like to ask you a few questions. We are also required, by law, to report to you the OMB Control Number for this public information request. That number is OMB #1525-0012-XXXX.

1. Do you, or does anyone in your household or family, own or work for? (READ)

	YES	NO
A coin dealer or a retail store that sells coins?	( )	( )
A newspaper, radio station, or television station?	( )	( )
The United States Mint?	( )	( )
An advertising agency?	( )	( )
A market research company?	( )	( )
A company that manufactures or markets collectible items (dolls, cards, memorabilia, etc.)?	( )	( )

IF "YES" TO ANY THANK AND TERMINATE

2. Have you ever purchased U.S. coins or other merchandise directly from the United States Mint?

Yes	( )
No	( )	TERMINATE

3. When was the most recent time that you purchased coins or coin related items from the United States Mint? Was it: (READ AND CHECK APPROPRIATE BOX)

Within the past two or three months, or	( )
More than two or three months ago?	( )	TERMINATE

4. Prior to this most recent purchase, when was the last time that you purchased coins or coin related items from the United States Mint? Was it: (READ AND CHECK APPROPRIATE BOX)

More than two to three months but less than a year ago, or	( )	TERMINATE
Within the past 1 to 2 years, or	( )
More than 2 years ago?	( )

5. Did you receive the United States Mint 2013 holiday catalog?

Yes	( )
No	( )	TERMINATE
Don’t Know	( )	TERMINATE

6. Which of the following items did you purchase from the United States Mint in your last order?

(READ AND CHECK ALL THAT APPLY)

	YES	NO	GET A MIX
Uncirculated Coin Sets?	( )	( )
Annual Silver Proof Sets?	( )	( )
Annual Proof Sets?	( )	( )
5-Coin Quarter Proof/Silver Proof Sets?	( )	( )
Presidential Coins/Sets?	( )	( )
Commemorative Coins?	( )	( )
Bags/Rolls?	( )	( )
American Eagle Silver, Gold, or Platinum Coins?	( )	( )
American Buffalo Gold Coins?	( )	( )
Medals	( )	( )
Other items, such as maps or holders? (Please Specify:____________________________________)	( )	( )

7. In the past year, have you sold any U.S. coins for income purposes other than to round out a personal collection? (IF NECESSARY, PROBE: Are you a coin dealer?)

Yes	( )	TERMINATE
No	( )

8. Is your age: (READ)

Under 18,	( )	TERMINATE
18 to 30,	( )	GET A MIX
31 to 40,	( )
41 to 50,	( )
51 to 60,	( )
61 to 69, or	( )
Over 70?	( )

9. The United States Mint is interested in getting the opinions of people of diverse cultural backgrounds, and we would like to ask you a few questions about your background. (READ)

Are you Latino or Hispanic? (READ)

Yes	( )
No	( )

10. What is your race? Please select one or more. (READ AND CHECK ALL THAT APPLY.)

	YES	NO
White?	( )	( )	GET A MIX
Black or African American?	( )	( )
Asian?	( )	( )
Native Hawaiian or other Pacific Islander?	( )	( )
American Indian or Alaska Native?	( )	( )
Prefer not to answer.	( )	( )

11. What is the highest level of education you’ve completed? Is it: (READ)

Less than high school	( )	TERMINATE AT END OF SCREENER
High school graduate,	( )	GET A MIX
Some college or vocational training,	( )
College graduate, or	( )
Graduate school?	( )

12. Are you employed? (READ)

Full time,	( )	GET A MIX
Part time, or	( )
Not employed or retired?	( )
In school?	( )

EXTEND INVITATION TO ELIGIBLE RESPONDENT AND RECORD INFORMATION ON FRONT. We'd like to invite you to participate in this research project.

You will receive an honorarium of $______ for your participation

Note to recruiters: As part of our ISO certification, we require that the following be read to each respondent.

Thank you for your time. We look forward to having a discussion with you regarding [TOPIC]. We want to assure you that it is National Analysts Worldwide’s policy to keep interviews anonymous and responses secured. The information you provide during the interview will be reported in aggregate and at no stage will your name or other identifying information be associated with your responses.

The interview may be recorded or viewed by others.

For further information on National Analysts Worldwide’s privacy policy, you can visit their website at www.nationalanalysts.com/privacy/domestic-global.asp

Please let us know if you have any questions or concerns about your upcoming appointment with National Analysts Worldwide.