Diary Instrument S Diary Instrument Specifications - Income Section

The Consumer Expenditure Surveys: The Quarterly Interview and the Diary

Attachment B - DIARY 2013 instrument requirements - Income Section

The Diary

OMB: 1220-0050

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1220-0050 can be found here:

Document [docx]

Download: docx | pdf

DIARY 2013 CAPI Instrument Requirements – Income section (previously 4 now 3)

Consumer Expenditure DIARY Survey 2013 Instrument Requirements

Section 4 (make it Section 3)

DIARY Section	DIARY CAPI Variable	Change Detail	2012 DIARY CAPI Wording/Specification	2013 CEQ CAPI Wording/Specification
4	Section 4 Variables	Rename the section heading from Section 4 to Section 3.	Section headings: “Section 4 Work Experience and Income Part A” “Section 4 Work Experience and Income Part B:	Section headings: “Section 3 Work Experience and Income Part A” “Section 3 Work Experience and Income Part B”

DIARY Section

DIARY CAPI Variable

Change Detail

2012 DIARY CAPI Wording/Specification

2013 CEQ CAPI Wording/Specification

Section 4 Variables

Rename the section heading from Section 4 to Section 3.

Section headings:

“Section 4 Work Experience and Income Part A”

“Section 4 Work Experience and Income Part B:

Section headings:

“Section 3 Work Experience and Income Part A”

“Section 3 Work Experience and Income Part B”

Previously Section4A, now Section 3A

DIARY Section	DIARY CAPI Variable	Change Detail	2012 DIARY CAPI Wording/Specification	2013 CEQ CAPI Wording/Specification
Prev 4A, now 3A	All variables	New question order	S4A_INTRO, WKS_WRKD, HRSPERWK, OCCULIST, EMPLTYPE, INCORP, WHYNOWRK, INCOTH, HAVEWAGE, WAGEX, WAGEB, GROSPAYX, PAYPERD, PAYPRDOT, FEDTX, FEDTXX, STATX, STATXX, PVT, PVTX, GV, GVX, RR, RRX, SSDED, SSNORM, MEDICOV, EMPLCONT, HAVEBSNS, BSNSX, BSNSLOSS, BSNSB, HAVEFARM, FARMX, FARMLOSS, FARMB, IRA, IRAX, ANYSSINC, ANYRAIL, SS_RRX, SS_RRB, MEDICARE, SS_RRQ, US_SUPP, STA_SUPP, SUPPX, SUPPB	S4A_INTRO, WKS_WRKD, HRSPERWK, OCCULIST, EMPLTYPE, WHYNOWRK, HAVEWAGE, WAGEX, WAGEB, GROSPAYX, PAYPERD, PAYPRDOT, PAYSTUB, FEDTX, FEDTXX, STATX, STATXX, DEDUCTN, MEDICOV, EMPLCONT, SEMPFRM, SEMPFRMX, SEMPFRMB, SOCRRET, SS_RRX, SS_RRB, MEDICARE, SS_RRQ, US_SUPP, SUPPX, SUPPB, IRA, IRAX
Prev 4A, now 3A	S4A_INTRO	NO CHANGE	The next few questions are about income. We know people aren’t used to discussing their income, but please be assured that, like all other information you have provided, these answers will be kept strictly confidential. Enter 1 to continue Skip instructions: <1> go to WRS_WRKD	The next few questions are about income. We know people aren’t used to discussing their income, but please be assured that, like all other information you have provided, these answers will be kept strictly confidential. Enter 1 to continue Skip instructions: <1> go to WRS_WRKD
Prev 4A, now 3A	WKS_WRKD	Add a fill at the beginning to indicate asking about the next person.	In the past 12 months, including paid vacation and sick leave, how many weeks did ^You_Name work? * If CU member did not work, enter zero. Skip instructions: <0> go to WHYNOWRK <1-52, D, R> go to HRSPERWK	[fill: Now I am going to ask about ^NAME’s work experience and income.] In the past 12 months, including paid vacation and sick leave, how many weeks did ^You_Name work? * If CU member did not work, enter zero. Fill instructions: leave blank for 1^st person asked about then fill on asking about subsequent CU members. Skip instructions: <0> go to WHYNOWRK <1-52, D, R> go to HRSPERWK
Prev 4A, now 3A	HRSPERWK	NO CHANGE	In the weeks that ^YOU_NAME worked, how many hours did [fill: you/he/she] usually work per week? Skip instructions: <1-168, D, R> go to OCCULIST	In the weeks that ^YOU_NAME worked, how many hours did [fill: you/he/she] usually work per week? Skip instructions: <1-168, D, R> go to OCCULIST
Prev 4A, now 3A	OCCULIST	Combine numbers 11 (machine operator, assembler, inspector), 12 (transportation operator), and 13 (handler, helper, laborer) together and combine numbers 14 (mechanic, repairer, precision production) and 15 (construction, mining) together Fix question wording to match CEQ Capitalize “forces” in “Armed forces”	The job in which ^YOU_NAME received the most earnings in the past 12 months fits best in which of the following categories? * Enter one code. Administrator, manager Teacher Professional Administrative support, including clerical Sales, retail Sales, business goods and services Technician Protective service Private household service Other service Machine operator, assembler, inspector Transportation operator Handler, helper, laborer Mechanic, repairer, precision production Construction, mining Farming Forestry, fishing, groundskeeping Armed forces Skip instructions: <1-18, D, R> go to EMPLTYPE	Which of the following categories best describes the job in which ^YOU_NAME received the most earnings during the last 12 months? * Enter one code. Administrator, manager Teacher Professional Administrative support, including clerical Sales, retail Sales, business goods and services Technician Protective service Private household service Other service Machine or transportation operator, laborer Construction workers, mechanics Farming Forestry, fishing, groundskeeping Armed Forces Skip instructions: <1-15, D, R> go to EMPLTYPE
Prev 4A, now 3A UPDATED	EMPLTYPE UPDATED 5/4/12	Update skip instructions due to deleting INCORP Match response options to CEQ’s (combine 5 and 6) Move to Section 3A	^WERE_WAS ^YOU_NAME: An employee of a PRIVATE company, business, or individual working for wages or salary? A FEDERAL government employee? A STATE government employee? A LOCAL government employee? Self-employed in ^YOURHISHER OWN business, partnership, or professional practice? Self-employed in ^YOURHISHER OWN farm? Working WITHOUT PAY in family business or farm? Skip instructions: <1-4, 6, 7, D, R> go to HAVEWAGE <5> go to INCORP	^WERE_WAS ^YOU_NAME: An employee of a PRIVATE company, business, or individual working for wages or salary? A FEDERAL government employee? A STATE government employee? A LOCAL government employee? Self-employed in ^YOURHISHER OWN business, partnership, professional practice, or farm? Working WITHOUT PAY in family business or farm? Skip instructions: <1-6, D, R> go to HAVEWAGE
Prev 4A DELETE	INCORP	Delete question	Is ^YOUR_NAMES business incorporated? Yes No Skip instructions: <1, 2, D, R> go to HAVEWAGE	Delete question.
Prev 4A, now 3A	WHYNOWRK	Update skip instructions due to deleting INCOTH	What was the main reason ^YOU_NAME did not work during the last 12 months? ^WERE_WAS [fill: you/he/she] – Retired? Taking care of home/family? Going to school? Ill, disabled, unable to work? Unable to find work? Doing something else? Skip instructions: <1-5, D, R> go to HAVEWAGE <6> go to INCOTH	What was the main reason ^YOU_NAME did not work during the last 12 months? ^WERE_WAS [fill: you/he/she] – Retired? Taking care of home/family? Going to school? Ill, disabled, unable to work? Unable to find work? Doing something else? Skip instructions: <1-6, D, R> go to HAVEWAGE
Prev 4A DELETE	INCOTH	Delete question.	* Specify: Value/skip instructions: <40 characters> go to HAVEWAGE	Delete question.
Prev 4A, now 3A	HAVEWAGE	Reword question based on ACS Update skip instructions for new questions.	During the last 12 months, did ^YOU_NAME receive any money in wages or salary? Include all wages, salaries, commissions, tips, allowances, Armed Forces pay, severance pay, teaching fellowships, etc. Yes No Skip instructions: <1> go to WAGEX <2, D, R> go to HAVEBSNS	The next few questions are about income DURING THE PAST 12 MONTHS, that is from ^DATE1 TO ^DATE2… Did ^YOU_NAME receive any wages, salary, tips, bonuses, or commissions? Yes No DATE1 fill instructions: fill date one year ago from current date.(MM/DD/YY) DATE2 fill instructions: fill yesterday’s date. (MM/DD/YY) Skip instructions: <1> go to WAGEX <2, D, R> go to SEMPFRM
Prev 4A, now 3A	WAGEX	Reword question	During the last 12 months, how much did ^YOU_NAME receive in wages and salaries for ALL JOBS before any deductions? Skip instructions: <1-99999999> go to GROSPAYX <D, R> go to WAGEB	How much did ^YOU_NAME receive before taxes? Value/skip instructions: <1-99999999> go to GROSPAYX <D, R> go to WAGEB
Prev 4A, now 3A	WAGEB	Change “last” to “past” to be consistent with new question wordings	Could you tell me which range on CARD A best reflects total wages and salaries for ALL JOBS during the last 12 months? $0-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000-$69,999 $70,000-$89,999 $90,000-$119,999 $120,000 and over Skip instructions: <1-11, D, R> go to GROSPAYX	Could you tell me which range on CARD A best reflects total wages and salaries for ALL JOBS during the PAST 12 MONTHS? $0-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000-$69,999 $70,000-$89,999 $90,000-$119,999 $120,000 and over Skip instructions: <1-11, D, R> go to GROSPAYX
Prev 4A, now 3A	GROSPAYX	NO CHANGE	What was the amount of ^YOUR_NAMES last pay before any deductions? Value/skip instructions: <1-9999999999, D, R> go to PAYPERD	What was the amount of ^YOUR_NAMES last pay before any deductions? Value/skip instructions: <1-9999999999, D, R> go to PAYPERD
Prev 4A, now 3A	PAYPERD	Update skip instructions for new FR-only PAYSTUB question	What period of time did this cover? One week Two weeks Month Quarter Year Twice a month Other Skip instructions: <1-6, D, R> go to FEDTX <7> go to PAYPRDOT	What period of time did this cover? One week Two weeks Month Quarter Year Twice a month Other Skip instructions: <1-7, D, R> go to PAYSTUB <7> go to PAYPRDOT
Prev 4A, now 3A	PAYPRDOT	Update skip instructions for new FR only PAYSTUB question	* Specify: Value/skip instructions: <40 characters> go to FEDTX	* Specify: Value/skip instructions: <40 characters> go to PAYSTUB
3A NEW	PAYSTUB	New FR question on whether the respondent has a paystub/record present	N/A	* Does the respondent have a paper or electronic pay check record present for [fill: ^Name’s/the] last paycheck? Yes No Fill instructions: If MEMBNO=the reference person (REFPER) fill “you” else fill “^NAME’s” Skip instructions: <1, 2, D, R> go to FEDTX
Prev 4A, now 3A	FEDTX	Update skip instructions based on new PAYSTUB question	Was there any money deducted from ^YOUR_NAMES pay for – Federal income tax? Yes No Skip instructions: <1> go to FEDTXX <2, D, R> go to STATX	Was there any money deducted from ^YOUR_NAMES pay for – Federal income tax? Yes No Skip instructions: <1> if PAYSTUB ne 2 go to FEDTXX else go to STATX <2, D, R> go to STATX
Prev 4A, now 3A	FEDTXX	NO CHANGE	How much? Value/skip instructions: <1-999999999 > go to STATX <D, R> go to STATX	How much? Value/skip instructions: <1-999999999 > go to STATX <D, R> go to STATX
Prev 4A, now 3A	STATX	Update skip instructions based on new PAYSTUB question and new DEDUCTN question	Was there any money deducted from ^YOUR_NAMES pay for – State or local income tax? Yes No Special instructions: If FEDTAX=1 bold-black first part of question text “Was there any money deducted from ^YOUR_NAMES pay for – “ else gray out first part of question text Skip instructions: <1> go to STATXX <2, D, R> go to PVT	Was there any money deducted from ^YOUR_NAMES pay for – State or local income tax? Yes No Special instructions: If FEDTAX=1 and PAYSTUB ne 2 bold-black first part of question text “Was there any money deducted from ^YOUR_NAMES pay for – “ else gray out first part of question text Skip instructions: <1> if PAYSTUB ne 2 go to STATXX else go to DEDUCTN <2, D, R> go to DEDUCTN
Prev 4A, now 3A	STATXX	Update skip instructions based on new DEDUCTN question	How much? Value/skip instructions: <1-999999999 > go to PVT <D, R> go to PVT	How much? Value/skip instructions: <1-999999999 > go to DEDUCTN <D, R> go to DEDUCTN
Prev 4A DELETE	PVT	Delete question (replace with new DEDUCTN question)..	Was there any money deducted from ^YOUR_NAMES pay for – Private pension fund? Yes No Special instructions: If STATX=1 bold-black first part of question text “Was there any money deducted from ^YOUR_NAMES pay for – “ else gray out first part of question text Skip instructions: <1> go to PVTX <2, D, R> go to GV	Delete question.
Prev 4A DELETE	PVTX	Delete question (replace with new DEDUCTN question).	How much? Value/skip instructions: <1-999999999> go to GV <D, R> go to GV	Delete question.
Prev 4A DELETE	GV	Delete question (replace with new DEDUCTN question).	Was there any money deducted from ^YOUR_NAMES pay for – Government retirement? Yes No Special instructions: If PVT=1 bold-black first part of question text “Was there any money deducted from ^YOUR_NAMES pay for – “ else gray out first part of question text Skip instructions: <1> go to GVX <2, D, R> go to RR	Delete question.
Prev 4A DELETE	GVX	Delete question (replace with new DEDUCTN question).	How much? Value/skip instructions: <1-999999999, D, R> go to RR	Delete question.
Prev 4A DELETE	RR	Delete question (replace with new DEDUCTN question).	Was there any money deducted from ^YOUR_NAMES pay for – Railroad retirement? Yes No Special instructions: If GV=1 bold-black first part of question text “Was there any money deducted from ^YOUR_NAMES pay for – “ else gray out first part of question text Skip instructions: <1> go to RRX <2, D, R> go to SSDED	Delete question.
Prev 4A DELETE	RRX	Delete question (replace with new DEDUCTN question).	How much? Value/skip instructions: <1-99999999, D, R> go to SSDED	Delete question.
Prev 4A DELETE	SSDED	Delete question (replace with new DEDUCTN question).	Was there any money deducted from ^YOUR_NAMES pay for – Social Security including Medicare? Yes No Special instructions: If RR=1 bold-black first part of question text “Was there any money deducted from ^YOUR_NAMES pay for – “ else gray out first part of question text Skip instructions: <1> go to MEDICOV <2, D, R> go to SSNORM	Delete question.
Prev 4A DELETE	SSNORM	Delete question.	Are Social Security payments NORMALLY deducted from ^YOUR_NAMES pay? Yes No Skip instructions: <1> go to MEDICOV <2, D, R> go to EMPLCONT	Delete question.
3A NEW	DEDUCTN	New question asking if any money was deducted for Social Security, a self-directed retirement account, or any other retirement account (employer, union, or other organization)	N/A	Was there any money deducted from ^YOUR_NAMES pay for – * Read each item on list * Enter all that apply, separate with commas Social Security? A self-directed retirement account? A retirement account sponsored by an employer, union, or other organization? Skip instructions: <1-3> if entry=1 go to MEDICOV else go to EMPLCONT <D, R> go to EMPLCONT
Prev 4A, now 3A	MEDICOV	NO CHANGE	Does the money deducted for Social Security cover only the Medicare portion of Social Security? Yes No Skip instructions: <1, 2, D, R> go to EMPLCONT	Does the money deducted for Social Security cover only the Medicare portion of Social Security? Yes No Skip instructions: <1, 2, D, R> go to EMPLCONT
Prev 4A, now 3A	EMPLCONT	Update skip instructions due to replacing HAVEBSNS, HAVEFARM, etc. questions with SEMPFRM	Other than Social Security, did any employer or union contribute to ^YOUR_NAMES pension or retirement plan in the last 12 months? Yes No Skip instructions: <1, 2, D, R> go to HAVEBSNS	Other than Social Security, did any employer or union contribute to ^YOUR_NAMES pension or retirement plan in the last 12 months? Yes No Skip instructions: <1, 2, D, R> go to SEMPFRM
Prev 4A DELETE	HAVEBSNS	Delete question.	During the last 12 months, did ^YOUR_NAMES have any income or loss from ^YOUR_NAMES own nonfarm business, partnership, or professional practice? Yes No Skip instructions: <1> go to BSNSX <2, D, R> go to HAVEFARM	Delete question.
Prev 4A DELETE	BSNSX	Delete question.	What was the amount of income or loss after expenses? Value/skip instructions: <0-999999999> go to BSNSLOSS <D, R> go to BSNSB	Delete question.
Prev 4A DELETE	BSNSLOSS	Delete question.	Was this an income or loss? Loss Income Skip instructions: <1, 2, D, R> go to HAVEFARM	Delete question.
Prev 4A DELETE	BSNSB	Delete question.	Could you tell me which range on CARD A best reflects ^YOUR_NAMES income or loss from ^YOUR_NAMES own nonfarm business, partnership or professional practice during the last 12 months? Loss $0-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000-$69,999 $70,000-$89,999 $90,000-$119-999 $120,000 and over Skip instructions: <0-11, D, R> go to HAVEFARM	Delete question.
Prev 4A DELETE	HAVEFARM	Delete question.	During the last 12 months, did ^YOU_NAME have any income or loss from ^YOUR_NAMES own farm? Yes No Skip instructions: <1> go to FARMX <2, D, R> go to IRA	Delete question.
Prev 4A DELETE	FARMX	Delete question.	What was the amount of income or loss after expenses? Value/skip instructions: <0-99999999> go to FARMLOSS <D, R> go to FARMB	Delete question.
Prev 4A DELETE	FARMLOSS	Delete question.	Was this an income or loss? Loss Income Skip instructions: <1, 2, D, R> go to IRA	Delete question.
Prev 4A DELETE	FARMB	Delete question.	Could you tell me which range on CARD A best reflects ^YOU_NAME income or loss from ^YOUR_NAMES own farm during the last 12 months? Loss $0-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000-$69,999 $70,000-$89,999 $90,000-$119-999 $120,000 and over Skip instructions: <0-11, D, R> go to IRA	Delete question.
3A NEW	SEMPFRM	New question based on current ACS question SEMX	N/A	DURING THE PAST 12 MONTHS – Did ^YOU_NAME receive any self-employment income or have a loss? (Report income from own businesses (farm or non-farm) including proprietorships and partnerships.) Yes No Special instructions: If WAGE=1 bold-black the first line (“DURING THE PAST 12 MONTHS – “) else gray out the first line Skip instructions: <1> go to SEMPFRMX <2, D, R> go to SOCSRRET
3A NEW	SEMPFRMX	New question based on current ACS question SEM	N/A	What was the amount? (Report net income after operating expenses. Include earnings as a tenant farmer or sharecropper.) * If net income was a loss, precede amount with a ‘-‘. * Breakeven = 1. Value/skip instructions: <-999999999-999999999> go to SOCSRRET <D, R> go to SMPFRMB
3A NEW	SMPFRMB	New card question if SMPFRMX is D or R	N/A	Could you tell me which range on CARD A best reflects ^YOUR_NAMES income or loss from self-employment during the PAST 12 MONTHS? Loss $0-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000-$69,999 $70,000-$89,999 $90,000-$119-999 $120,000 and over Skip instructions: <0-11, D, R> go to SOCSRRET
Prev 4A, now 3A	IRA	Move to end of section 3A Update question pattern	During the last 12 months, did ^YOU_NAME place any money in a retirement plan such as an Individual Retirement Account (IRA) or Keogh? Do not include rollovers. Yes No Skip instructions: <1> go to IRAX <2, D, R> go to ANYSSINC	DURING THE PAST 12 MONTHS – Did ^YOU_NAME place any money in a retirement plan such as an Individual Retirement Account (IRA) or Keogh? Do not include rollovers. Yes No Special instructions: If US_SUPP =1 bold-black the first line (“DURING THE PAST 12 MONTHS – “) else gray out the first line Skip instructions: <1> go to IRAX <2, D, R> go to S04A_CHECK
Prev 4A, now 3A	IRAX	Move to end of section 3A	How much? Value/skip instructions: <1-999999999 , D, R> go to ANYSSINC	How much? Value/skip instructions: <1-999999999 , D, R> go to S04A_CHECK
Prev 4A DELETE	ANYSSINC	Delete question.	During the last 12 months, did ^YOU_NAME receive, from the US Government, any money from – Social Security checks? Yes No Skip instructions: <1, 2, D, R> go to ANYRAIL	Delete question.
Prev 4A DELETE	ANYRAIL	Delete question.	During the last 12 months, did ^YOU_NAME receive, from the US Government, any money from – Railroad Retirement checks? Yes No Special instructions: If ANYSSINC=1 bold-black first part of question text “During the last 12 months, did ^YOU_NAME receive, from the US Government, any money from – “ else gray out first part of question text Skip instructions: <1, 2, D, R> if ANYSSINC=1 or ANYRAIL=1 go to SS_RRX else go to US_SUPP	Delete question.
3A NEW	SOCSRRET	New question based on ACS SSX question (replaces ANYSSINC and ANYRAIL)	N/A	DURING THE PAST 12 MONTHS – Did ^YOU_NAME receive any Social Security or Railroad Retirement benefits? Yes No Special instructions: If SEMPFRM=1 bold-black the first line (“DURING THE PAST 12 MONTHS – “) else gray out the first line Skip instructions: <1> go to SSRRTX <2, D, R> go to
Prev 4A, now 3A	SS_RRX	NO CHANGES	What was the amount of the last Social Security or Railroad Retirement payment received? Value/skip instructions: <1-99999999> go to MEDICARE <D, R> go to SS_RRB	What was the amount of the last Social Security or Railroad Retirement payment received? Value/skip instructions: <1-99999999> go to MEDICARE <D, R> go to SS_RRB
Prev 4A, now 3A	SS_RRB	New card ranges Update question pattern (“last” to “past”)	Could you tell me which range on CARD B best reflects the amount of ^YOUR_NAMES last Social Security or Railroad Retirement payment during the last 12 months? Less than $300 $300-$399 $400-$499 $500-$599 $600-$699 $700-$799 $800-$899 $900-$999 $1,000-$1,499 $1,500 and over Skip instructions: <1-10, D, R> go to MEDICARE	Could you tell me which range on CARD B best reflects the amount of ^YOUR_NAMES last Social Security or Railroad Retirement payment during the PAST 12 MONTHS? Less than $500 $500-$699 $700-$999 $1,000-$1,299 $1,300-$1,699 $1,700 and over Skip instructions: <1-6, D, R> go to MEDICARE
Prev 4A, now 3A	MEDICARE	NO CHANGES	Is this amount AFTER the deduction for a Medicare premium? Yes No Skip instructions: <1, 2, D, R> go to SS_RRQ	Is this amount AFTER the deduction for a Medicare premium? Yes No Skip instructions: <1, 2, D, R> go to SS_RRQ
Prev 4A, now 3A	SS_RRQ	Change “last” to “past”	During the last 12 months, how many Social Security or Railroad Retirement payments did ^YOU_NAME receive? Value/skip instructions: <1-52, D, R> go to US_SUPP	During the past 12 months, how many Social Security or Railroad Retirement payments did ^YOU_NAME receive? Value/skip instructions: <1-52, D, R> go to US_SUPP
Prev 4A, now 3A	US_SUPP	Reword question based on ACS question SSIX Updated skip instructions due to deleting STA_SUPP/moving IRA questions	During the last 12 months, did ^YOU_NAME receive any – Supplemental Security Income (SSI) payments from the US Government? Yes No Skip instructions: <1, 2, D, R> go to STA_SUPP	DURING THE PAST 12 MONTHS – Did ^YOU_NAME receive any Supplemental Security Income (SSI) payments? Yes No Special instructions: If SOCSRRET =1 bold-black the first line (“DURING THE PAST 12 MONTHS – “) else gray out the first line Skip instructions <1> go to SUPPX <2, D, R> go to IRA
Prev 4A DELETE	STA_SUPP	Delete question.	During the last 12 months, did ^YOU_NAME receive any – Supplemental Security Income (SSI) payments from the STATE or LOCAL government? Yes No Special instructions: If US_SUPP=1 bold-black first part of question text “During the last 12 months, did ^YOU_NAME receive any – “ else gray out first part of question text Skip instructions: <1, 2, D, R> if US_SUPP=1 or STA_SUPP=1 go to SUPPX else go to S04A_CHECK	Delete question.
Prev 4A, now 3A	SUPPX	Reword question based on current ACS question SSI Update skip instructions to go to IRA	During the last 12 months, how much did ^YOU_NAME receive in Supplemental Security Income checks from ALL government sources? Value/skip instructions: <1-99999999> go to S04A_CHECK <D, R> go to SUPPB	What was the amount? Value/skip instructions: <1-99999999> go to IRA <D, R> go to SUPPB
Prev 4A, now 3A	SUPPB	Reword question (delete “from all government sources” and changing “last” to “past”) Update skip instructions to go to IRA	Could you tell me which range on CARD C best reflects the amount ^YOU_NAME received in Supplemental Security income from all government sources during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to S04A_CHECK	Could you tell me which range on CARD C best reflects the amount ^YOU_NAME received in Supplemental Security Income during the past 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to IRA

Previously Section4B, now Section 3B

DIARY Section	DIARY CAPI Variable	Change Detail	2012 DIARY CAPI Wording/Specification	2013 CEQ CAPI Wording/Specification
Prev 4B, now 3B	All variables	New question order	INTEREST, INTX, INTB, DIVRYEST, DIVX, DIVB, PENSION, PENSIONX, PENSIONB, COMP, UNEMPX, UNEMPB, WORKCOMP, WRKRSX, WRKRSB, REC_FS, FS_MTHI, FD_STMPS, FS_AMT, PAWELFAR, WELFRX, WELFRB, RENTAL, ROOMX, ROOMLOSB, ROOMLOSS, OTHRNTX, OTHLOSSB, OTHLOSS, CHDSUP, CHDLMP, CHDLMPX, CHDLMPB, CHDSPOTH, CHDOTHX, CHDOTHB, ALIMSUP, OTHCONT, ALIOTHX, ALIOTHB, LUMP, LUMPX, LUMPB, SALE, SALEX, SALEB, OTHIN, OTHINX, OTHINB, FEDREF, FEDREFX, STATREF, STATREFX, SSREF, SSREFX, INSREF, INSREFX, PTAXREF, PTAXREFX, OTHREF, RFNDOTH, OTHREFX, ADDFED, ADDFEDX, ADDSTA, ADDSTAX, TAXPROP, TAXPROPX, ADDOTH, MISCOTH, ADDOTHX, OCCEXPN, OCCEXPNX, FREEMEAL, FREEMLX, MEALWKI, RTASPAY, RTCOMPX, RTCMPPD, RTCM_SP	INTERDIV, INTRDVX, INTRDVB, NETRENT, NETRENTX, NETRENTB, ROYALT, ROYALX, ROYALB, RETSURV, RETSURVX, RETSURVB, OTHREG, OTHREGX, OTHREGB, LUMP, LUMPX, LUMPB, OTHIN, OTHINX, OTHINB, FEDREF, FEDREFX, STATREF, STATREFX, EITC, ADDFED, ADDFEDX, ADDSTA, ADDSTAX, ADDOTH, ADDOTHX, OCCEXPN, OCCEXPNX, REC_FS, FS_MTHI, FS_AMT, PAWELFAR, WELFRX, WELFRB, FREEMEAL, FREEMLX, MEALWKI, RTASPAY, RTCOMPX, RTCMPPD, RTCM_SP
Prev 4B DELETE	INTEREST	Delete question. Move 1^st part (4B intro) to new question INTERDIV	Up until this point, we have discussed earnings for individual members. Now, I would like to talk to you about the people on your list. During the last 12 months, did ^YOU_ANY receive income from any of the following – Interest on bank accounts, money market funds, CD’s, or bonds? Yes No Skip instructions: <1> go to INTX <2, D, R> go to DIVRYEST	Delete question.
Prev 4B DELETE	INTX	Delete question.	What was the total amount received ^BY_ALL? Value/skip instructions: <1-999999999> go to DIVRYEST <D, R> go to INTB	Delete question.
Prev 4B DELETE	INTB	Delete question.	Could you tell me which range on CARD C best reflects the total amount of interest received ^BY_ALL during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to DIVRYEST	Delete question.
Prev 4B DELETE	DIVRYEST	Delete question.	During the last 12 months, did ^YOU_ANY receive any – REGULAR income from dividends, trusts, estates or royalties? Yes No Skip instructions: <1> go to DIVX <2, D, R> go to PENSION	Delete question.
Prev 4B DELETE	DIVX	Delete question.	What was the total amount received ^BY_ALL? Value/skip instructions: <1-99999999> go to PENSION <D,R> go to DIVB	Delete question.
Prev 4B DELETE	DIVB	Delete question.	Could you tell me which range on CARD C best reflects the total amount of income from dividends, trusts, estates or royalties during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to PENSION	Delete question.
3B NEW	INTERDIV	New question based on ACS field test question INTRX- Q49C1A) Contains intro sentences to Part B that were previously in INTEREST	N/A	Up until this point, we have discussed earnings for individual members. Now, I would like to talk to you about your household as a whole. DURING THE PAST 12 MONTHS – Did ^YOU_ANY receive any interest or dividends? Report even small amounts credited to an account. Yes No Skip instructions: <1> go to INTRDVX <2, D, R> go to NETRENT
3B NEW	INTRDVX	New question based on ACS field test question INTR – Q49c2a	N/A	What was the amount? Value/skip instructions: <1-999999999> go to NETRENT <D, R> go to INTRDVB
3B NEW	INTRDVB	New card question if INTRDVX is D or R	N/A	Could you tell me which range on CARD C best reflects the amount ^YOU_ANY received in interest or dividends during the PAST 12 MONTHS? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to NETRENT
3B NEW	NETRENT	New question based on ACS field test question Q49c1b (replaces RENTAL, OTHRNTX, etc. questions)	N/A	DURING THE PAST 12 MONTHS – Did ^YOU_ANY receive any net rental income or a loss? * Net rental income is the total amount after expenses. Yes No Special instructions: If INTERDIV=1 bold-black the first line (“DURING THE PAST 12 MONTHS – “) else gray out the first line Skip instructions: <1> go to NETRENTX <2, D, R> go to ROYALT
3B NEW	NETRENTX	New question based on ACS field test question Q49c2b	N/A	What was the amount? * The net amount is the total amount after expenses. * If income was a loss, precede amount with a ‘-‘. * Breakeven=1. Skip instructions: <-999999999-99999999> go to ROYALT <D, R> go to NETRENTB
3B NEW	NETRENTB	New card question if NETRENTX is D or R	N/A	Could you tell me which range on CARD C best reflects the total net rental income or loss during the PAST 12 MONTHS? Loss $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <0-12, D, R> go to ROYALT
3B NEW	ROYALT	New question based on ACS field test question Q49c1c	N/A	DURING THE PAST 12 MONTHS – Did ^YOU_ANY receive any royalty income or income from estates and trusts? Yes No Special instructions: If NETRENT=1 bold-black the first line (“DURING THE PAST 12 MONTHS – “) else gray out the first line Skip instructions: <1> go to ROYALX <2, D, R> go to RETSURV
3B NEW	ROYALX	New question based on ACS field test question Q49c2c	N/A	What was the amount? <1-99999999> go to RETSURV <D, R> go to ROYALB
3B NEW	ROYALB	New card question if ROYALX is D or R	N/A	Could you tell me which range on CARD C best reflects the total amount received in royalty income or income from estates and trusts during PAST 12 MONTHS? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to RETSURV
Prev 4B DELETE	PENSION	Delete question.	During the last 12 months, did ^YOU_ANY receive income from – Retirement, disability and survivor pensions or annuities from private companies, military, Government, IRA or Keogh? Yes No Skip instructions: <1> go to PENSIONX <2, D, R> go to COMP	Delete question.
Prev 4B DELETE	PENSIONX	Delete question.	What was the total amount received ^BY_ALL? Value/skip instructions: <1-999999999> go to COMP <D, R> go to PENSIONB	Delete question.
Prev 4B DELETE	PENSIONB	Delete question.	Could you tell me which range on CARD C best reflects the total amount of retirement pensions and annuities during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to COMP	Delete question.
03B NEW	RETSURV	New question based on current ACS question RETX	N/A	DURING THE PAST 12 MONTHS – Did ^YOU_ANY receive any retirement, survivor, or disability pensions? Yes No Special instructions: If ROYALT=1 bold-black the first line (“DURING THE PAST 12 MONTHS – “) else gray out the first line Skip instructions: <1> go to RETSURVX <2> go to OTHREG
03B NEW	RETSURVX	New question based on current ACS question RET	N/A	What was the amount? (Do not include Social Security.) Value/skip instructions: <1-9999999> go to OTHREG <D, R> go to RETSURVB
03B NEW	RETSURVB	New card question if RETSURVX is D or R	N/A	Could you tell me which range on CARD C best reflects the total amount received in retirement, survivor, or disability pensions during the PAST 12 MONTHS? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to OTHREG
Prev 4B DELETE	COMP	Delete question.	During the last 12 months, did ^YOU_ANY receive any income from – Unemployment compensation or supplemental unemployment compensation? Yes No Skip instructions: <1> go to UNEMPX <2, D, R> go to WORKCOMP	Delete question.
Prev 4B DELETE	UNEMPX	Delete question.	What was the total amount received ^BY_ALL? Value/skip instructions: <1-999999999> go to WORKCOMP <D, R> go to UNEMPB	Delete question.
Prev 4B DELETE	UNEMPB	Delete question.	Could you tell me which range on CARD C best reflects the total amount received in unemployment compensation during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to WORKCOMP	Delete question.
Prev 4B DELETE	WORKCOMP	Delete question.	During the last 12 months, did ^YOU_ANY receive any income from – Worker’s compensation or veteran’s benefits including the GI Bill but not including military retirement? Yes No Special instructions: If COMP=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY receive any income from – “ else gray out first part of question text Skip instructions: <1> go to WRKRSX <2, D, R> go to REC_FS	Delete question.
Prev 4B DELETE	WRKRSX	Delete question.	What was the total amount received ^BY_ALL? Value/skip instructions: <1-999999999> go to REC_FS <D, R> go to WRKRSB	Delete question.
Prev 4B DELETE	WRKRSB	Delete question.	Could you tell me which range on CARD C best reflects the total amount of income from worker’s compensation during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to REC_FS	Delete question.
3B NEW	OTHREG	New question based on current ACS question OIX	N/A	DURING THE PAST 12 MONTHS – Did ^YOU_ANY receive income on a REGULAR basis f rom any other source such as Veteran’s Administration (VA) payments, unemployment compensation, child support, or alimony? Yes No Special instructions: If RETSURV=1 bold-black the first line (“DURING THE PAST 12 MONTHS – “) else gray out the first line Skip instructions: <1> go to OTHREGX <2, D, R> go to LUMP
3B NEW	OTHREGX	New question based on current ACS question OI	N/A	What was the amount from all sources? (Do not include lump sum payments such as money from an inheritance or sale of a home.) Value/skip instructions: <1-99999999> go to LUMP <D, R> go to OTHREGB
03B NEW	OTHREGB	New card question if OTHINCX is D or R	N/A	Could you tell me which range on CARD C best reflects the total amount received in Veteran’s Administration (VA) payments, unemployment compensation, child support, or alimony during the PAST 12 MONTHS? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to LUMP
Prev 4B, now 3B	REC_FS	Reword similar to current ACS question Move toward end of Section 3B	During the last 12 months, have ^YOU_ANY received any – Food stamps or electronic benefit transfers (EBTs)? * Include any SNAP (Supplemental Nutrition Assistance Program) benefits received. Yes No Skip instructions: <1> go to FS_MTHI <2, D, R> go to PAWELFAR	DURING THE PAST 12 MONTHS – Did anyone in this household receive Food Stamps or a Food Stamp benefit card? Include government benefits from the Supplemental Nutritional Assistance Program (SNAP). Do NOT include WIC of the National School Lunch Program. Yes No Special instructions: If OCCEXPN=1 bold-black the first line (“DURING THE PAST 12 MONTHS – “) else gray out the first line Skip instructions: <1> go to FS_MTHI <2, D, R> go to PAWELFAR
Prev 4B, now 3B	FS_MTHI	Move toward end of Section 3B Update skip instructions due to deleting FD_STMPS	In how many of the last 12 months were food stamps or EBTs received? Value/skip instructions: <1-12, D, R> go to FD_STMPS	In how many of the last 12 months were food stamps or EBTs received? Value/skip instructions: <1-12, D, R> go to FS_AMT
Prev 4B, now 3B DELETE	FD_STMPS	Delete question.	In the last month have ^YOU_ANY received any food stamps or EBTs? Yes No Skip instructions: <1> go to FS_AMT <2, D, R> go to PAWELFAR	Delete question.
Prev 4B, now 3B	FS_AMT	Move toward end of Section 3B	What was the dollar value of the last food stamps or EBT received? Value/skip instructions: <1-9999999999> go to PAWELFAR <D, R> go to PAWELFAR	What was the dollar value of the last food stamps or EBT received? Value/skip instructions: <1-9999999999> go to PAWELFAR <D, R> go to PAWELFAR
Prev 4B, now 3B	PAWELFAR	Reword similar to ACS field test question PAX – Q49F1 Move toward end of Section 3B Update skip instructions	During the last 12 months, did ^YOU_ANY receive any state or local government welfare program, such as TANF, or short-term emergency help? Yes No Skip instructions: <1> go to WELFRX <2, D, R> go to RENTAL	DURING THE PAST 12 MONTHS – Did [fill: you/you or any members of this household, including any children,] receive any welfare payments or cash assistance from the state or local welfare office? Please include even if only for one month. Do NOT include benefits from food, energy, or rental assistance programs. Yes No Special instructions: If REC_FS=1 bold-black the first line (“DURING THE PAST 12 MONTHS – “) else gray out the first line Fill instructions: if single person CU fill “you” else fill “you or any members of this household, including any children.” Skip instructions: <1> go to WELFRX <2, D, R> go to FREEMEAL
Prev 4B, now 3B	WELFRX	Renumber section 4B to section 3B Reword similar to ACS field test question PA – Q49F2	What was the total amount received ^BY_ALL? Value/skip instructions: <1-999999999> go to RENTAL <D, R> go to WELFRB	What was the amount for the PAST 12 MONTHS? Value/skip instructions: <1-99999999> go to FREEMEAL <D, R> go to WELFRB
Prev 4B, now 3B	WELFRB	Update question pattern (“last” to “past”) Update skip instructions	Could you tell me which range on CARD C best reflects the total amount of income from c ash assistance from state or local government welfare programs during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to RENTAL	Could you tell me which range on CARD C best reflects the total amount of income from cash assistance from state or local government welfare programs during the PAST 12 MONTHS? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to FREEMEAL
Prev 4B DELETE	RENTAL	Delete question.	During the last 12 months, did ^YOU_ANY have any net income or loss from any type of rental rooms or living units? Yes No Skip instructions: <1> go to ROOMX <2, D, R> go to CHDSUP	Delete question.
Prev 4B DELETE	ROOMX	Delete question.	How much net income or loss was received from roomers or boarders? Skip instructions: <0> go to OTHRNTX <1-9999999999 > go to ROOMLOSS <D, R> go to ROOMLOSB	Delete question.
Prev 4B DELETE	ROOMLOSB	Delete question.	Could you tell me which range on CARD C best reflects your net income or loss from roomers or boarders? Loss $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12> go to ROOMLOSS <0, D, R> go to OTHRNTX	Delete question.
Prev 4B DELETE	ROOMLOSS	Delete question.	* Do not read. Was this an income or loss? Loss Income Skip instructions: <1, 2, D, R> go to OTHRNTX	Delete question.
Prev 4B DELETE	OTHRNTX	Delete question.	How much net income or loss was received from other rental units? Value/skip instructions: <0> go to CHDSUP <1-99999999> go to OTHLOSS <D, R> go to OTHLOSSB	Delete question.
Prev 4B DELETE	OTHLOSSB	Delete question.	Could you tell me which range on CARD C best reflects your net income or loss from other rental units during the last 12 months? Loss $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12> go to OTHLOSS <0, D, R> go to CHDSUP	Delete question.
Prev 4B DELETE	OTHLOSS	Delete question.	* Do not read. Was this an income or loss? Loss Income Skip instructions: <1, 2, D, R> go to CHDSUP	Delete question.
Prev 4B DELETE	CHDSUP	Delete question.	During the last 12 months, did ^YOU_ANY receive any income from child support? Yes No Skip instructions: <1> go to CHDLMP <2, D, R> go to ALIMSUP	Delete question.
Prev 4B DELETE	CHDLMP	Delete question.	Did you receive a one time lump sum payment for child support? Yes No <1> go to CHDLMPX <2, D, R> go to CHDSPOTH	Delete question.
Prev 4B DELETE	CHDLMPX	Delete question.	What was the total amount of lump sum payments for child support received ^BY_ALL in the last 12 months? Value/skip instructions: <1-999999999> go to CHDSPOTH <D, R> go to CHDLMPB	Delete question.
Prev 4B DELETE	CHDLMPB	Delete question.	Could you tell me which range on CARD C best reflects the total amount received in lump sum payments for child support during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to CHDSPOTH	Delete question.
Prev 4B DELETE	CHDSPOTH	Delete question.	Did you receive any child support payments in other than a lump sum amount? Yes No Skip instructions: <1> go to CHDOTHX <2, D, R> go to ALIMSUP	Delete question.
Prev 4B DELETE	CHDOTHX	Delete question.	What was the total amount of non-lump sum payments received ^BY_ALL in the last 12 months? Value/skip instructions: <1-999999999> go to ALIMSUP <D, R> go to CHDOTHB	Delete question.
Prev 4B DELETE	CHDOTHB	Delete question.	Could you tell me which range on CARD C best reflects the total amount received in child support payments, other than lump sum amounts, ^BY_ALL during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to ALIMSUP	Delete question.
Prev 4B DELETE	ALIMSUP	Delete question.	During the last 12 months, did ^YOU_ANY receive any REGULAR income from – Alimony? Yes No Skip instructions: <1, 2, D, R> go to OTHCONT	Delete question.
Prev 4B DELETE	OTHCONT	Delete question.	During the last 12 months, did ^YOU_ANY receive any REGULAR income from – Other sources such as from people who are not on your list? Yes No Skip instructions: <1, 2, D, R> if ALIMSUP=1 or OTHCONT=1 go to ALIOTHX else go to LUMP	Delete question.
Prev 4B DELETE	ALIOTHX	Delete question.	Altogether, what was the total amount received ^BY_ALL from alimony and other sources in the last 12 months? Value/skip instructions: <1-99999999> go to LUMP <D, R> go to ALIOTHB	Delete question.
Prev 4B DELETE	ALIOTHB	Delete question.	Could you tell me which range on CARD C best reflects the total amount received in alimony and other sources during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to LUMP	Delete question.
Prev 4B, now 3B	LUMP	Make question pattern consistent with new, other revised questions Add “child support” Update skip instructions to co go OTHIN next	During the last 12 months, did ^YOU_ANY receive any – Lump sum payments from insurance, estates, trusts, royalties, alimony, prizes or games of chance, or from people who are not on your list? Yes No Skip instructions: <1> go to LUMPX <2, D, R> go to SALE	DURING THE PAST 12 MONTHS - Did ^YOU_ANY receive any lump sum payments from insurance, estates, trusts, royalties, child support, alimony, prizes or games of chance, or from people who are not on your list? Yes No Special instructions: If OTHREG=1 bold-black the first line (“DURING THE PAST 12 MONTHS – “) else gray out the first line Skip instructions: <1> go to LUMPX <2, D, R> go to OTHIN
Prev 4B, now 3B	LUMPX	Update skip instructions to co go OTHIN next	What was the total amount received ^BY_ALL? Value/skip instructions: <1-99999999> go to SALE <D, R> go to LUMPB	What was the total amount received ^BY_ALL? Value/skip instructions: <1-9999999> go to OTHIN <D, R> go to LUMPB
Prev 4B, now 3B	LUMPB	Update skip instructions to co go OTHIN next Update question pattern (“last” to “past”)	Could you tell me which range on CARD C best reflects the total lump sum payments during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to SALE	Could you tell me which range on CARD C best reflects the total lump sum payments during the PAST 12 MONTHS? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to OTHIN
Prev 4B DELETE	SALE	Delete question.	During the last 12 months, did ^YOU_ANY receive any – Money from the sale of household furnishings, equipment, clothing, jewelry, pets, or other belongings, not including the sale of vehicles or real estate? Yes No Special instructions: If LUMP=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY receive any– “ else gray out first part of question text Skip instructions: <1> go to SALEX <2, D, R> go to OTHIN	Delete question.
Prev 4B DELETE	SALEX	Delete question.	What was the total amount received ^BY_ALL? Value/skip instructions: <1-999999999> go to OTHIN <D, R> go to SALEB	Delete question.
Prev 4B DELETE	SALEB	Delete question.	Could you tell me which range on CARD C best reflects the total amount received from these sales during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to OTHIN	Delete question.
Prev 4B, now 3B	OTHIN	Add “not already reported”	During the last 12 months, did ^YOU_ANY receive any – Other money income, including money received from cash scholarship and fellowship, stipends not based on working, or from the care of foster children? Yes No Special instructions: If OTHIN=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY receive any– “ else gray out first part of question text Skip instructions: <1> go to OTHINX <2, D, R> go to FEDREF	DURING THE PAST 12 MONTHS Other money income, including money received from cash scholarship and fellowship, stipends not based on working, or from the care of foster children, not already reported? Yes No Special instructions: If LUMP=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY receive any– “ else gray out first part of question text Skip instructions: <1> go to OTHINX <2, D, R> go to FEDREF
Prev 4B, now 3B	OTHINX	NO CHANGE	What was the total amount received ^BY_ALL? Value/skip instructions: <1-99999999> go to FEDREF <D, R> go to OTHINB	What was the total amount received ^BY_ALL? Value/skip instructions: <1-99999999> go to FEDREF <D, R> go to OTHINB
Prev 4B, now 3B	OTHINB	Update question pattern (“last” to “past”)	Could you tell me which range on CARD C best reflects the total amount of other money income received during the last 12 months? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to FEDREF	Could you tell me which range on CARD C best reflects the total amount of other money income received during the PAST 12 MONTHS? $0-$999 $1,000-$1,999 $2,000-$2,999 $3,000-$3,999 $4,000-$4,999 $5,000-$9,999 $10,000-$14,999 $15,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000 and over Skip instructions: <1-12, D, R> go to FEDREF
Prev 4B, now 3B	FEDREF	Update question pattern to match others	During the last 12 months, did ^YOU_ANY receive any REFUNDS from any of the following – Federal income tax? Yes No Skip instructions: <1> go to FEDREFX <2, D, R> go to STATREF	DURING THE PAST 12 MONTHS – Did ^YOU_ANY receive any REFUNDS from any of the following – Federal income tax in addition to that withheld from earnings? Yes No Skip instructions: <1> FEDREFX <2, D, R> go to STATREF
Prev 4B, now 3B	FEDREFX	NO CHANGE	What was the total amount received ^BY_ALL? Value/skip instructions: <1-9999999999, D, R> go to STATREF	What was the total amount received ^BY_ALL? Value/skip instructions: <1-9999999999, D, R> go to STATREF
Prev 4B, now 3B	STATREF	Update question pattern to match others Alter second line Gray out first line	During the last 12 months, did ^YOU_ANY receive any REFUNDS from any of the following – State and local income tax? Yes No Special instructions: If FEDREF=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY receive any REFUNDS from any of the following – “ else gray out first part of question text Skip instructions: <1> go to STATREFX <2, D, R> go to SSREF	DURING THE PAST 12 MONTHS – Did ^YOU_ANY receive any REFUNDS from – State and local income tax? Yes No Special instructions: If FEDREF =1 bold-black the second line (“Did ^YOU_ANY receive any REFUNDS from - “) else gray out the second line Skip instructions: <1> go to STATREFX <2, D, R> go to EITC
Prev 4B, now 3B	STATREFX	Update skip instructions due to deleting SSREF, SSREFX, INSREF, INSREFX, PTAXREF, PTAXREFX, OTHREF, RFNDOTH, OTHREFX	What was the total amount received ^BY_ALL? Value/skip instructions: <1-99999999, D, R> go to SSREF	What was the total amount received ^BY_ALL? Value/skip instructions: <1-99999999, D, R> go to EITC
Prev 4B DELETE	SSREF	Delete question.	During the last 12 months, did ^YOU_ANY receive any REFUNDS from any of the following – Overpayment on Social Security? Yes No Special instructions: If STATREF=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY receive any REFUNDS from any of the following – “ else gray out first part of question text Skip instructions: <1> go to SSREFX <2, D, R> go to INSREF	Delete question.
Prev 4B DELETE	SSREFX	Delete question.	What was the total amount received ^BY_ALL? Value/skip instructions: <1-9999999, D, R> go to INSREF	Delete question.
Prev 4B DELETE	INSREF	Delete question.	During the last 12 months, did ^YOU_ANY receive any REFUNDS from any of the following – Insurance policies? Yes No Special instructions: If SSREF=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY receive any REFUNDS from any of the following – “ else gray out first part of question text Skip instructions: <1> go to INSREFX <2, D, R> go to PTAXREF	Delete question.
Prev 4B DELETE	INSREFX	Delete question.	What was the total amount received ^BY_ALL? Value/skip instructions: <1-999999999, D, R> go to PTAXREF	Delete question.
Prev 4B DELETE	PTAXREF	Delete question.	During the last 12 months, did ^YOU_ANY receive any REFUNDS from any of the following – Property taxes? Yes No Special instructions: If INSREF=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY receive any REFUNDS from any of the following – “ else gray out first part of question text Skip instructions: <1> go to PTAXREFX <2, D, R> go to OTHREF	Delete question.
Prev 4B DELETE	PTAXREFX	Delete question.	What was the total amount received ^BY_ALL? Value/skip instructions: <1-99999999, D, R> go to OTHREF	Delete question.
Prev 4B DELETE	OTHREF	Delete question.	During the last 12 months, did ^YOU_ANY receive any REFUNDS from any of the following – Other sources, including any other taxes? Yes No Special instructions: If PTAXREF=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY receive any REFUNDS from any of the following – “ else gray out first part of question text Skip instructions: <1> go to RFNDOTH <2, D, R> go to ADDFED	Delete question.
Prev 4B DELETE	RFNDOTH	Delete question.	Specify: Value/skip instructions: <30 characters> go to OTHREFX	Delete question.
Prev 4B DELETE	OTHREFX	Delete question.	What was the total amount received ^BY_ALL? Value/skip instructions: <1-999999999, D, R> go to ADDFED	Delete question.
3A NEW	EITC	New question on Earned Income Tax Credit (EIC)	N/A	The Earned Income Tax Credit is a benefit for certain people who work and have low to moderate wages. A tax credit means more money in your pocket. It reduces the amount of tax you owe and may also give you a refund. During the past 12 months, did ^YOU_ANY claim an Earned Income Tax Credit on your federal income tax return? Yes No Skip instructions: <1, 2, D, R> go to ADDFED
Prev 4B, now 3B	ADDFED	Update question pattern to match others	During the last 12 months, did ^YOU_ANY PAY any of the following – Federal income tax in addition to that withheld from earnings? Yes No Skip instructions: <1> go to ADDFEDX <2, D, R> go to ADDSTA	DURING THE PAST 12 MONTHS – Did ^YOU_ANY PAY any of the following – Federal income tax in addition to that withheld from earnings? Yes No Skip instructions: <1> go to ADDFEDX <2, D, R> go to ADDSTA
Prev 4B, now 3B	ADDFEDX	NO CHANGE	What was the total amount PAID ^BY_ALL? Value/skip instrucdtions: <1-99999999, D, R> go to ADDSTA	What was the total amount PAID ^BY_ALL? Value/skip instructions: <1-99999999, D, R> go to ADDSTA
Prev 4B, now 3B	ADDSTA	Update question pattern to match others Alter second line Gray out first line Update skip instructions due to deleting TAXPROP	During the last 12 months, did ^YOU_ANY PAY any of the following – State and local income tax in addition to that withheld from earnings? Yes No Special instructions: If ADDFED=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY PAY any of the following – “ else gray out first part of question text Skip instructions: <1> go to ADDSTAX <2, D, R> go to TAXPROP	DURING THE PAST 12 MONTHS – Did ^YOU_ANY PAY any– State and local income tax in addition to that withheld from earnings? Yes No Special instructions: If ADDFED =1 bold-black the second line (“Did ^YOU_ANY PAY any - “) else gray out the second line Skip instructions: <1> go to ADDSTAX <2, D, R> go to ADDOTH
Prev 4B, now 3B	ADDSTAX	NO CHANGE	What was the total amount PAID ^BY_ALL? Value/skip instructions: <1-9999999999, D, R> go to TAXPROP	What was the total amount PAID ^BY_ALL? Value/skip instructions: <1-9999999999, D, R> go to ADDOTH
Prev 4B DELETE	TAXPROP	Delete question.	During the last 12 months, did ^YOU_ANY PAY any of the following – Personal property taxes for vehicles/ Yes No Special instructions: If ADDSTA=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY PAY any of the following – “ else gray out first part of question text Skip instructions: <1> go to TAXPROPX <2, D, R> go to ADDOTH	Delete question.
Prev 4B DELETE	TAXPROPX	Delete question.	What was the total amount PAID ^BY_ALL? Value/skip instructions: <1-99999999, D, R> go to ADDOTH	Delete question.
Prev 4B, now 3B	ADDOTH	Update question pattern to match others Alter second line Gray out first line Reword to “other taxes such as inheritance or estate taxes” Update skip instructions	During the last 12 months, did ^YOU_ANY PAY any of the following – Personal property taxes and other taxes not reported elsewhere? Do not include Social Security tax for the self-employed or real estate taxes. Yes No Special instructions: If TAXPROP=1 bold-black first part of question text “During the last 12 months, did ^YOU_ANY PAY any of the following – “ else gray out first part of question text Skip instructions: <1> go to MISCOTH <2, D, R> go to OCCEXPN	DURING THE PAST 12 MONTHS – Did ^YOU_ANY PAY any of the following – Other taxes such as inheritance or estate taxes? Yes No Special instructions: If ADDSTA =1 bold-black the second line (“Did ^YOU_ANY PAY any - “) else gray out the second line Skip instructions: <1> go to ADDTHX <2, D, R> go to OCCEXPN
Prev 4B DELETE	MISCOTH	Delete question.	Specify: Value/skip instructions: <30 characters> go to ADDOTHX	Delete question.
Prev 4B, now 3B	ADDOTHX	NO CHANGE	What was the total amount PAID ^BY_ALL? Value/skip instructions: <1-999999999, D, R> go to OCCEXPN	What was the total amount PAID ^BY_ALL? Value/skip instructions: <1-999999999, D, R> go to OCCEXPN
Prev 4B, now 3B	OCCEXPN	Update question pattern to match others	During the last 12 months, did ^YOU_ANY have any occupational expenses such as union dues, tools, uniforms, business or professional association dues, licenses, or permits? Yes No Skip instructions: <1> go to OCCEXPNX <2, D, R> go to FREEMEAL	DURING THE PAST 12 MONTHS – Did ^YOU_ANY have any occupational expenses such as union dues, tools, uniforms, business or professional association dues, licenses, or permits? Yes No Special instructions: If ADDOTH =1 bold-black the first line (“DURING THE PAST 12 MONTHS“) else gray out the second line Skip instructions: <1> go to OCCEXPNX <2, D, R> go to FREEMEAL
Prev 4B, now 3B	OCCEXPNX	NO CHANGE	What was the total amount of these occupational expenses? Value/skip instructions: <1-9999999999, D, R> go to FREEMEAL	What was the total amount of these occupational expenses? Value/skip instructions: <1-9999999999, D, R> go to FREEMEAL
Prev 4B, now 3B	FREEMEAL	Update question pattern to match others	During the last 12 months, have ^YOU_ANY received any free meals at work as part of your pay? Yes No Skip instructions: <1> go to FREEMLX <2, D, R> go to RTASPAY	DURING THE PAST 12 MONTHS – Have ^YOU_ANY received any free meals at work as part of your pay? Yes No Special instructions: If PAWELFAR =1 bold-black the first line (“DURING THE PAST 12 MONTHS“) else gray out the second line Skip instructions: <1> go to FREEMLX <2, D, R> go to RTASPAY
Prev 4B, now 3B	FREEMLX	NO CHANGE	About what was the weekly dollar value of such meals? Value/skip instructions: <1-99999999, D, R> go to MEALWKI	About what was the weekly dollar value of such meals? Value/skip instructions: <1-99999999, D, R> go to MEALWKI
Prev 4B, now 3B	MEALWKI	NO CHANGE	How many weeks did ^YOU_ANY receive such meals during the last 12 months? Value/skip instructions: <01-52, D, R> go to RTASPAY	How many weeks did ^YOU_ANY receive such meals during the last 12 months? Value/skip instructions: <01-52, D, R> go to RTASPAY
Prev 4B, now 3B	RTASPAY	Update question pattern to match others	During the last 12 months, did ^YOU_ANY receive any free or reduced rent for this unit as a form of pay? Yes No Skip instructions: <1> go to RTCOMPX <2, D, R> go to SEC4BFLG	DURING THE PAST 12 MONTHS – Did ^YOU_ANY receive any free or reduced rent for this unit as a form of pay? Yes No Special instructions: If FREEMEAL =1 bold-black the first line (“DURING THE PAST 12 MONTHS“) else gray out the second line Skip instructions: <1> go to RTCOMPX <2, D, R> go to SEC4BFLG
Prev 4B, now 3B	RTCOMPX	NO CHANGE	What is the rental charge to another tenant for a similar unit? Value/skip instructions: <0-9999999, D, R> go to RTCMPPD	What is the rental charge to another tenant for a similar unit? Value/skip instructions: <0-9999999, D, R> go to RTCMPPD
Prev 4B, now 3B	RTCMPPD	NO CHANGE	What period of time does this cover? Week 2 Weeks Month Other Skip instructions: <1-3, D, R> go to SEC4BFLG <4> go to RTCM_SP	What period of time does this cover? Week 2 Weeks Month Other Skip instructions: <1-3, D, R> go to SEC4BFLG <4> go to RTCM_SP
Prev 4B, now 3B	RTCM_SP	NO CHANGE	* Specify: Value/skip instructions: <30 characters> go to SEC4BFLG	* Specify: Value/skip instructions: <30 characters> go to SEC4BFLG

Page 0 of 19

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	brattland_j
File Modified	0000-00-00
File Created	2021-01-30