Questionnaire (inc Questionnaire (including skip patterns)

Test 15 Specifications 11/13/12

WebCATI Front/Back Version 1.5

Tag	A1
Name	HELLO18
Field Description	Introduction
Universe	RNAME = blank
Form Pane Label	Hello18
Question Text	Read if incoming call: Thank you for returning our call. Hello, I’m [Fill 1: INTNAME] from the U.S. Census Bureau. May I please speak with someone at least 18 years old who lives here and knows about the people in this household? Would that be you?
Spanish question	Lea si es una llamada que se recibe: Gracias por devolvernos la llamada. Buenos días/Buenas tardes, soy [Fill 1: INTNAME] de la Oficina del Censo de los Estados Unidos. ¿Podría hablar con alguien que tenga al menos 15 años de edad que viva aquí y conozca acerca de las personas en este hogar? ¿Podría ser usted?
Input Options	1-Yes, speaking with the correct person. 2- Yes, correct person comes to the phone. 3-No, correct person is not available now 4-Other outcome Don’t Know Refused Blank is not an option on this screen.
Spanish input	1- Sí, hablando con la persona correcta. 2- Sí, la persona correcta responde al teléfono. 3- No, la persona correcta no está disponible ahora. 4- Otro resultado.
Fill Instructions	Fill 1: display <INTNAME>
Spanish fill instructions	Fill 1: display <INTNAME> Fill 2: display <RNAME>
Skip Instructions	Skip Instructions: If <1, 2>, goto INTRO If <3, 4, DK, RF>, goto CALLBACK
Special Instructions

Tag	A2
Name	HELLONAME
Field Description	Introduction
Universe	RNAME <> blank
Form Pane Label	HelloName
Question Text	Read if incoming call: Thank you for returning our call. Hello, I’m [Fill 1: <INTNAME>] from the U.S. Census Bureau. May I please speak with [Fill 2: <RNAME>]?
Spanish question	Lea si es una llamada que se recibe: Gracias por devolvernos la llamada. Buenos días/Buenas tardes, soy [Fill 1: INTNAME] de la Oficina del Censo de los Estados Unidos. ¿Podría hablar con [Fill 2: <RNAME>]?
Input Options	1-Yes, speaking with the correct person. 2- Yes, correct person comes to the phone. 3-No, correct person is not available now 4-Other outcome Don’t Know Refused Blank is not an option on this screen.
Spanish input	1- Sí, hablando con la persona correcta. 2- Sí, la persona correcta responde al teléfono. 3- No, la persona correcta no está disponible ahora. 4- Otro resultado
Fill Instructions	Fill 1: display <INTNAME> Fill 2: display <RNAME>
Spanish fill instructions	Fill 1: display <INTNAME> Fill 2: display <RNAME>
Skip Instructions	Skip Instructions: If <1, 2>, goto INTRO If <3, 4, DK, RF>, goto CALLBACK
Special Instructions	Set MARK = 11

Tag	A3
Name	INTRO
Field Description	Introduction
Universe	HELLO15 = (1, 2) or HELLONAME = (1, 2)
Form Pane Label	Intro
Question Text	? [F1] [Fill 1: Hello, I’m [Fill 2: <INTNAME>] from the U.S. Census Bureau.] We are doing research to develop new methods to make the next census easier, more convenient, and less costly for taxpayers. This study is designed to learn about alternative ways of contacting people to make it more likely they will send their form back. I will also ask a few simple questions about your household. ♦ If respondent indicates they cannot respond now, because they are driving or at work, enter 2 and try to schedule a callback. ♦ Otherwise, enter 1 to continue.
Spanish question	? [F1] [Fill 1: Buenos días/Buenas tardes, soy [Fill 2: <INTNAME>] de la Oficina del Censo de los Estados Unidos.] Estamos llevando a cabo una investigación para crear nuevos métodos que harán que el próximo censo sea más fácil, más conveniente y menos costoso para los contribuyentes. Este estudio está diseñado para conocer maneras alternativas de comunicarnos con las personas, con el fin de aumentar las probabilidades de que envíen de vuelta sus cuestionarios. También voy a hacer algunas preguntas simples sobre su hogar. ♦ Si el respondedor indica que no puede responder ahora, ya sea porque está conduciendo o está en el trabajo, entre 2 y trate de concertar una nueva llamada. ♦ De lo contrario, entre 1 para continuar.
Input Options	1-Continue 2-Respondent is driving or at work Blank is not an option on this screen. DK and RF are not options on this screen
Spanish input	1-Continuar 2-El respondedor está conduciendo o está en el trabajo.
Fill Instructions	Fill 1: If HELLO15 = 2 or HELLONAME = 2, display “Hello, I’m [Fill 2: <INTNAME>] from the U.S. Census Bureau.” Else display blank Fill 2: display <INTNAME>
Spanish fill instructions
Skip Instructions	Skip Instructions: If <1 >, Goto LETTER If <2>, goto CALLBACK
Special Instructions
Help Text	English: # H_INTRO Spanish: # H_INTRO_ESP

Tag	A4
Name	LETTER
Field Description	Did respondent receive letter
Universe	INTRO = 1
Form Pane Label	Letter
Question Text	My supervisor is working with me today and may listen in to evaluate my performance. Did you receive a letter about this survey?
Spanish question	Mi supervisor(a) está trabajando conmigo hoy y puede que (él, ella) escuche nuestra conversación para evaluar mi desempeño. ¿Usted ha recibido una carta sobre esta encuesta?
Input Options	1- Yes 2- No Blank is not an option on this screen.
Spanish input	1 – Sí 2 – No
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: If <1> , goto VERIFYADD If <2, DK, RF>, goto TITLE13
Special Instructions

Tag	A5
Name	TITLE13
Field Description	Title 13 Information
Universe	LETTER = 2, DK, RF
Form Pane Label	Letter
Question Text	? [F1] Your response to this survey is protected by law under Title 13 of the United States Code. This is the same law that protects your privacy. No one outside the Census Bureau will see your answers. This survey is mandatory and will take about 7 minutes.
Spanish question	? [F1] En conformidad con el Título 13 del Código de los Estados Unidos, su respuesta a esta encuesta está protegida por la ley. Ésta es la misma ley que protege su privacidad. Nadie fuera de la Oficina del Censo puede ver sus respuestas. Esta encuesta es obligatoria y va a tardar alrededor de 7 minutos.
Input Options	1-Continue Blank is not an option on this screen.
Spanish input	1- Continuar
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto VERIFYADD
Special Instructions
Help Text	English: # H_TITLE13 Spanish: # H_TITLE13_ESP

Tag	A6
Name	VERIFYADD
Field Description	Verify sample address
Universe	INTRO = 1
Form Pane Label	Verify Address
Question Text	? [F1] First, I need to verify your address. Is this [Fill 1: <ADDRESS>]?
Spanish question	? [F1] Primero, necesito verificar su dirección. ¿Es su dirección [Fill 1: <ADDRESS>]?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1 – Sí 2 – No
Fill Instructions	Fill 1: display <ADDRESS>
Spanish fill instructions	Fill 1: display <ADDRESS>
Skip Instructions	Skip Instructions: If <1>, goto TENURE If <2, DK, RF>, goto FAMILIARADD
Special Instructions	If they answer refused or don’t know here, Continue as if they don’t live there.
Help Text	English: # H_VERIFYADD Spanish: # H_VERIFYADD_ESP

Tag	A7
Name	FAMILIARADD
Field Description	Is respondent familiar with sample address
Universe	VERIFYADD=2, DK, RF
Form Pane Label	Knows address
Question Text	? [F1] Are you familiar with this address? [Fill 1: <ADDRESS>]
Spanish question	? [F1] ¿Usted conoce esta dirección? [Fill 1: <ADDRESS>]
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1 – Sí 2 – No
Fill Instructions	Fill 1: display <ADDRESS>
Spanish fill instructions	Fill 1: display <ADDRESS>
Skip Instructions	Skip Instructions: If <1>, goto FAMILIARADDHOW If <2, DK, RF>, goto HOUSENUM
Special Instructions
Help Text	English: # H_VERIFYADD Spanish: # H_VERIFYADD_ESP

Tag	A8
Name	FAMILIARADDHOW
Field Description	How is respondent familiar with sample address
Universe	FAMILIARADD = 1
Form Pane Label	How knows address
Question Text	? [F1] How are you familiar with this address? [Fill 1: <ADDRESS>] ♦ Enter all that apply, separate with commas.
Spanish question	? [F1] ¿De dónde conoce esta dirección? [Fill 1: <ADDRESS>] ♦ Entre todas las que apliquen, separadas por comas.
Input Options	1-I used to live there 2-My parents live there 3-My children live there 4-Another relative lives there 5-I use this address for billing purposes 6-I use this as a shipping address 7-Other Don’t Know Refused Blank is not an option on this screen. Multiple responses allowed.
Spanish input	1-Yo vivía allí antes 2-Mis padres viven allí 3-Mis hijos viven allí 4-Otro pariente vive allí 5-Uso esa dirección para recibir facturas o cuentas 6-La uso como mi dirección postal 7-Otra
Fill Instructions	Fill 1: display <ADDRESS>
Spanish fill instructions	Fill 1: display <ADDRESS>
Skip Instructions	Skip Instructions: If <7>, goto FAMILIARADDOTH If NE 7 goto HOUSENUM
Special Instructions
Help Text	English: # H_VERIFYADD Spanish: # H_VERIFYADD_ESP

Tag	A9
Name	FAMILIARADDOTH
Field Description	Other way respondent is familiar with address
Universe	FAMILIARADDHOW = 7
Form Pane Label	Other knows address
Question Text	? [F1] Read if necessary: How are you familiar with that address? [Fill 1: <ADDRESS>]
Spanish question	? [F1] Lea si es necesario: ¿De dónde conoce esa dirección? [Fill 1: <ADDRESS>]
Input Options	String 100. Don’t Know and Refused are options on this screen, but they can’t be used with other text entered. Blank is not an option on this screen.
Spanish input	String 100.
Fill Instructions	Fill 1: display <ADDRESS>
Spanish fill instructions	Fill 1: display <ADDRESS>
Skip Instructions	Skip Instructions: Goto HOUSENUM
Special Instructions
Help Text	English: # H_VERIFYADD Spanish: # H_VERIFYADD_ESP

Tag	A10a
Name	HOUSENUM
Field Description	House Number
Universe	VERIFYADD = 2, DK, RF
Form Pane Label	House number
Question Text	? [F1] What is your current address? ♦ Fill appropriate address fields. ♦ Probe for missing address parts. Street address: House number, Street name, Apartment number (if mentioned), City, State, ZIP code. Rural Route address: Rural Route and Box number, City, State, ZIP code
Spanish question	? [F1] ¿Cuál es su current dirección? ♦ Llene los campos de dirección adecuados. ♦ Indague sobre la información que falte de la dirección. La dirección de calle debe tener número de la casa, nombre de la calle, número del apartamento (si se menciona), ciudad, estado, código postal. La dirección de ruta rural debe tener número de ruta rural y número de buzón, ciudad, estado, código postal.
Input Options	String 20.  Don’t Know, Refused and Blank are options on this screen.
Spanish input	String 20.
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto STREET
Special Instructions
Help Text	English: # H_STREET Spanish: # H_STREET_ESP

Tag	A10b
Name	STREET
Field Description	Street Name
Universe	VERIFYADD = 2, DK, RF
Form Pane Label	Street name
Question Text	? [F1] Read if necessary: What is your current address. ♦ Fill appropriate address fields. ♦ Probe for missing address parts. Street address: House number, Street name, Apartment number (if mentioned), City, State, ZIP code. Rural Route address: Rural Route and Box number, City, State, ZIP code ♦ Verify spelling.
Spanish question	? [F1] Lea si es necesario: ¿Cuál es su current dirección? ♦ Llene los campos de dirección adecuados. ♦ Indague sobre las partes que falten de la dirección Dirección de calle: número de casa, nombre de calle, número de apartamento (si se menciona), ciudad, estado, código postal. Dirección de ruta rural: número de ruta rural y número de buzón, ciudad, estado, código postal ♦ Verifique la ortografía.
Input Options	String 100.  Don’t Know, Refused and Blank are options on this screen.
Spanish input	String 100.
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: If HOUSENUM = Blank, DK, RF and STREET <> Blank, DK, RF, goto STREETCHECK Else goto UNIT
Special Instructions
Help Text	English: # H_STREET Spanish: # H_STREET_ESP

Tag	A10b1
Name	STREETCHECK (Active Signal)
Field Description	Edit for house number and street name
Universe	HOUSENUM = BLANK, DK, RF and STREET <> Blank, DK, RF
Form Pane Label
Question Text	Can you provide a house number on [Fill 1: <STREET>]?
Spanish question	¿Puede proveer el número de la casa para [Fill 1: <STREET>]?
Input Options	Suppress, Goto, and Close Variables to display HOUSENUM.
Spanish input	Suppress, Goto, and Close Variables to display HOUSENUM.
Fill Instructions	Fill 1: Display <STREET>
Spanish fill instructions	Fill 1: Display <STREET>
Skip Instructions	Skip Instructions: If Suppress or Close, goto UNIT
Special Instructions	Error message -

Tag	A10c
Name	UNIT
Field Description	Unit
Universe	VERIFYADD = 2, DK, RF
Form Pane Label	Unit
Question Text	? [F1] Read if necessary: What is your current address. ♦ Fill appropriate address fields. ♦ Probe for missing address parts. Street address: House number, Street name, Apartment number (if mentioned), City, State, ZIP code. Rural Route address: Rural Route and Box number, City, State, ZIP code
Spanish question	? [F1] Lea si es necesario: ¿Cuál es su current dirección? ♦ Llene los campos de dirección adecuados. ♦ Indague sobre las partes que falten de la dirección Dirección de calle: número de casa, nombre de calle, número de apartamento (si se menciona), ciudad, estado, código postal. Dirección de ruta rural: número de ruta rural y número de buzón, ciudad, estado, código postal
Input Options	String 52.  Don’t Know, Refused and Blank are options on this screen.
Spanish input	String 52.
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto RURALROUTE
Special Instructions
Help Text	English: # H_STREET Spanish: # H_STREET_ESP

Tag	A10d
Name	RURALROUTE
Field Description	Rural Route
Universe	VERIFYADD = 2, DK, RF
Form Pane Label	Rural Route
Question Text	? [F1] Read if necessary: What is your current address. ♦ Fill appropriate address fields. ♦ Probe for missing address parts. Street address: House number, Street name, Apartment number (if mentioned), City, State, ZIP code. Rural Route address: Rural Route and Box number, City, State, ZIP code ♦ Must contain the rural route type (e.g. R.R., H.C.R, S.R.).
Spanish question	? [F1] Lea si es necesario: ¿Cuál es su current dirección? ♦ Llene los campos de dirección adecuados. ♦ Indague sobre las partes que falten de la dirección Dirección de calle: número de casa, nombre de calle, número de apartamento (si se menciona), ciudad, estado, código postal. Dirección de ruta rural: número de ruta rural y número de buzón, ciudad, estado, código postal ♦ Tiene que contener el tipo de ruta rural (por ejemplo, R.R., H.C.R, S.R.).
Input Options	String 40.  Don’t Know, Refused and Blank are options on this screen.
Spanish input	String 40.
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto LOCATION
Special Instructions
Help Text	English: # H_RURAL Spanish: # H_RURAL_ESP

Tag	A10e
Name	LOCATION
Field Description	Location Description
Universe	VERIFYADD = 2, DK, RF
Form Pane Label	Location Description
Question Text	? [F1] Read if necessary: What is your current address. ♦ Fill appropriate address fields. ♦ Probe for missing address parts. Street address: House number, Street name, Apartment number (if mentioned), City, State, ZIP code. Rural Route address: Rural Route and Box number, City, State, ZIP code ♦ Fill if no street or rural route address has been provided.
Spanish question	? [F1] Lea si es necesario: ¿Cuál es su current dirección? ♦ Llene los campos de dirección adecuados. ♦ Indague sobre las partes que falten de la dirección Dirección de calle: número de casa, nombre de calle, número de apartamento (si se menciona), ciudad, estado, código postal. Dirección de ruta rural: número de ruta rural y número de buzón, ciudad, estado, código postal ♦ Llene si no se ha provisto una dirección de calle o ruta rural.
Input Options	String 100.  Don’t Know, Refused and Blank are options on this screen.
Spanish input	String 100.
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto POBOX
Special Instructions
Help Text	English: # H_LOCATION Spanish: # H_LOCATION_ESP

Tag	A10f
Name	POBOX
Field Description	PO Box
Universe	VERIFYADD = 2, DK, RF
Form Pane Label	PO Box
Question Text	Read if necessary: What is your current address. ♦ Fill appropriate address fields. ♦ Probe for missing address parts. Street address: House number, Street name, Apartment number (if mentioned), City, State, ZIP code. Rural Route address: Rural Route and Box number, City, State, ZIP code
Spanish question	Lea si es necesario: ¿Cuál es su current dirección? ♦ Llene los campos de dirección adecuados. ♦ Indague sobre las partes que falten de la dirección Dirección de calle: número de casa, nombre de calle, número de apartamento (si se menciona), ciudad, estado, código postal. Dirección de ruta rural: número de ruta rural y número de buzón, ciudad, estado, código postal
Input Options	String 40.  Don’t Know, Refused and Blank are options on this screen.
Spanish input	String 40.
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto CITY
Special Instructions

Tag	A10f1
Name	POBOXCHECK (Active Signal)
Field Description	Edit for if only PO Box provided
Universe	STREET = Blank, DK, RF and LOCATION = Blank, DK, RF and POBOX <> Blank OR STREET = Blank, DK, RF and LOCATION = Blank, DK, RF and RURALROUTE <> Blank
Form Pane Label
Question Text	Can you provide a physical address in addition to the [Fill1: <PO Box/Rural Route address/PO Box and Rural Route address>]? Read if necessary: This might be: an address you would give to a shipping company if you wanted a package delivered to your home, or an address you would provide if you were requesting emergency services such as a 911 call.  ♦ Ideally, this will be a street address, but you may have to use the location description field if the respondent does not have either of these types of addresses.
Spanish question	¿Puede proveer una dirección física además [Fill 1: <del apartado postal/de dirección de ruta rural/ del apartado postal y dirección de ruta rural> ? Lea si es necesario: Esta dirección puede ser: la dirección que usted le daría a una compañía de envíos si quiere que le entreguen un paquete a domicilio, o la dirección que usted proveería si estuviera pidiendo un servicio de emergencia como el de una llamada al 911.  ♦ Lo ideal sería que fuera una dirección de calle, pero es posible que usted tenga que usar el campo para la descripción del lugar si el respondedor no tienen ninguno de estos tipos de direcciones.
Input Options	Suppress, Goto, and Close Variables to display HOUSENUM, STREET, RURALROUTE, LOCATION
Spanish input	Suppress, Goto, and Close Variables to display HOUSENUM, STREET, RURALROUTE, LOCATION
Fill Instructions	Fill1: If POBOX <> Blank and RURALROUTE = blank, then display <PO Box> If RURALROUTE <> Blank and POBOX = blank, then display <Rural Route address> If POBOX <> blank and RURALROUTE <> Blank, then display <PO Box and Rural Route address>
Spanish fill instructions	Fill1: If POBOX <> Blank and RURALROUTE = blank, then display < apartado postal > If RURALROUTE <> Blank and POBOX = blank, then display < de dirección de ruta rural > If POBOX <> blank and RURALROUTE <> Blank, then display < del apartado postal y dirección de ruta rural >
Skip Instructions	Skip Instructions: If Suppress or Close, goto CITY
Special Instructions

Tag	A10g
Name	CITY
Field Description	City
Universe	VERIFYADD = 2, DK, RF
Form Pane Label	City
Question Text	? [F1] Read if necessary: What is your current city. ♦ Verify spelling.
Spanish question	? [F1] Lea si es necesario: ¿Cuál es su current ciudad? ♦ Verifique la ortografía.
Input Options	String 28.  Don’t Know and Refused are options on this screen. Blank is not an option on this screen
Spanish input	String 28.
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto STATE
Special Instructions
Help Text	English: # H_CITY Spanish: # H_CITY_ESP

Tag	A10h
Name	STATE
Field Description	State
Universe	VERIFYADD = 2, DK, RF
Form Pane Label	State
Question Text	? [F1] Read if necessary: What is your current state.
Spanish question	? [F1] Lea si es necesario: ¿Cuál es su current estado?
Input Options	String 2 from State list. Don’t Know, Refused are options on this screen. Blank is not an option on this screen
Spanish input	String 2 from State list.
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto ZIP
Special Instructions
Help Text	English: # H_STATE Spanish: # H_STATE_ESP

Tag	A10i
Name	ZIP
Field Description	ZIP Code
Universe	VERIFYADD = 2, DK, RF
Form Pane Label	ZIP Code
Question Text	? [F1] Read if necessary: What is your current ZIP code.
Spanish question	? [F1] Lea si es necesario: ¿Cuál es su current código postal?
Input Options	String 5. Numeric only. Don’t Know, Refused are options on this screen. Blank is not an option on this screen
Spanish input	String 5. Numeric only.
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto TENURE
Special Instructions	Set MARK = 12 Set MARKTWO = 11 Set VALIDADD = 1 if [HOUSENUM < > (blank, DK, RF) and STREET < > (blank, DK, RF)] and [[CITY < > (blank, DK, RF) and STATE < > (blank, DK, RF)] or [ZIP < > (blank, DK, RF)]]   or RURALROUTE < > (blank, DK, RF) and [[CITY < > (blank, DK, RF) and STATE < > (blank, DK, RF)] or [ZIP < > (blank, DK, RF)]]   or LOCATION < > (blank, DK, RF)] and [[CITY < > (blank, DK, RF) and STATE < > (blank, DK, RF)] or [ZIP < > (blank, DK, RF)]] Also, if VALIDADD = 1, then set MARK=18
Help Text	English: # H_ZIP Spanish: # H_ZIP_ESP

Tag	A11
Name	TENURE
Field Description	Does respondent own or rent
Universe	INTRO = 1
Form Pane Label	Tenure
Question Text	? [F1] Do you or does someone in this household own this house, apartment or mobile home with a mortgage or loan (including home equity loans), own it free and clear, rent it, or occupy it without having to pay rent?
Spanish question	? [F1] ¿ Es esta casa, apartamento o casa móvil propiedad suya o de alguna otra persona en este hogar con una hipoteca o préstamo, incluyendo préstamos sobre el valor líquido de la casa; propiedad libre y sin deuda; alquilada; u ocupada sin pago de alquiler?
Input Options	1-Own with a mortgage or loan (including home equity loans) 2-Own free and clear 3-Rent 4-Occupy without having to pay rent Don’t Know Refused Blank is not an option on this screen.
Spanish input	1-Propiedad con una hipoteca o préstamo (incluyendo préstamos sobre el valor líquido de la casa) 2-Propiedad libre y sin deudas 3-Alquilada 4-Ocupada sin pago de alquiler
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto ADDRESSTIME
Special Instructions
Help Text	English: # H_TENURE Spanish: # H_TENURE_ESP

Tag	A12
Name	ADDRESSTIME
Field Description	How long respondent has lived at address
Universe	INTRO = 1
Form Pane Label	How long at address
Question Text	? [F1] How long have you lived at this address? [Fill 1: <HOUSE#, STREET NAME, UNIT>] [Fill 2: <RURAL ROUTE>] [Fill 3: <PO BOX>] [Fill 4: <LOCATION>] [Fill 5: <CITY, STATE, ZIP>]
Spanish question	? [F1] ¿Cuánto tiempo hace que vive en esta dirección? [Fill 1: <HOUSE#, STREET NAME, UNIT>] [Fill 2: <RURAL ROUTE>] [Fill 3: <PO BOX>] [Fill 4: <LOCATION>] [Fill 5: <CITY, STATE, ZIP>]
Input Options	Less than 1 year 1 to 2 years More than 2 years to 5 years More than 5 years Don’t Know Refused Blank is not an option on this screen.
Spanish input	Menos de 1 año 1 a 2 años Entre 2 y 5 años Más de 5 años
Fill Instructions	[Fill 1: <HOUSE#, STREET NAME, UNIT>] [Fill 2: <RURAL ROUTE>] [Fill 3: <PO BOX>] [Fill 4: <LOCATION>] [Fill 5: <CITY, STATE, ZIP>]
Spanish fill instructions	[Fill 1: <HOUSE#, STREET NAME, UNIT>] [Fill 2: <RURAL ROUTE>] [Fill 3: <PO BOX>] [Fill 4: <LOCATION>] [Fill 5: <CITY, STATE, ZIP>]
Skip Instructions	Skip Instructions: Goto ROSTER
Special Instructions
Help Text	English: # H_ADDRESSTIME Spanish: # H_ADDRESSTIME_ESP

Tag	C1
Name	FNAME
Field Description	Collect roster first names.
Universe	INTRO = 1
Form Pane Label	First Name
Question Text	<SEE FILL INSTRUCTIONS> ♦ Enter First Name. ♦ If there are no additional people, type 999 in the first name and press enter. ♦ Once you indicate there are no additional people on the roster, you WILL NOT be able to go back to edit the roster.
Spanish Question	<SEE SPANISH FILL INSTRUCTIONS> ♦ Entre el nombre. ♦ Si no hay que listar personas adicionales, entre 999 para continuar. ♦ Once you indicate there are no additional people on the roster, you WILL NOT be able to go back to edit the roster.
Input Options	String 20.
Spanish Input Options	String 20.
Fill Instructions	If LNO=1, display: Tenemos que listar a las personas que usualmente viven y duermen aquí. Vamos a empezar con usted, ¿cuál es su nombre? Else display: ¿Hay alguien más? ¿Cuál es el nombre de esa persona?
Spanish Fill Instructions
Skip Instructions	Skip Instructions: If FNAME =999 GOTO REL Else GOTO MNAME
Special Instructions	First Name: Store as FNAME, 20 Characters, alphanumeric Add 1 to PERSONCOUNT for each name added to roster.

Tag	C2
Name	MNAME
Field Description	Collect middle name.
Universe	FNAME
Form Pane Label	Middle
Question Text	Middle name? ♦ Enter middle name or initial.
Spanish Question	¿Segundo nombre? ♦ Entre el segundo nombre o la inicial.
Input Options	String 20. Blank, Don’t Know, and Refused are options.
Spanish Input Options	String 20.
Fill Instructions
Skip Instructions	Skip Instructions: GOTO LNAME
Special Instructions	Set MI = first character of MNAME

Tag	C3
Name	LNAME
Field Description	Collect roster last names.
Universe	FNAME
Form Pane Label	Last Name
Question Text	Last name? ♦ Enter Last Name.
Spanish Question	¿Apellido? ♦ Entre el apellido.
Input Options	String 20.
Spanish Input Options	String 20.
Fill Instructions
Skip Instructions	Skip Instructions: If PERSONCOUNT = 12, goto MAXPERSON Else goto FNAME
Special Instructions	Last Name: Store as LNAME, 20 Characters, alphanumeric Set NAME# = “FNAME MI LNAME” for each LNO.

Tag	C3a
Name	NAMECHECK (Active Signal)
Field Description	Prompt to provide first name if left blank
Universe	FNAME and LNAME = Blank, DK, RF
Form Pane Label
Question Text	Listing names helps to make sure that everyone in the household is included and no one is listed twice. If you are uncomfortable providing names, please provide nicknames or descriptions so that you will know who each question refers to.
Spanish question	Incluir su nombre ayuda a asegurarnos de que todas las personas de su hogar se incluyen y nadie se lista dos veces. Si no se siente cómodo(a) dando su nombre, haga el favor de proveer un apodo o descripción para que usted sepa a quién se refiere cada pregunta.
Input Options	Suppress, Goto, and Close Variables to display FNAME, MNAME, LNAME
Spanish input	Suppress, Goto, and Close Variables to display FNAME, MNAME, LNAME
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: If Suppress or Close, goto REL
Special Instructions	Once NAMECHECK is raised, if FNAME=LNAME=BLANK, DK, REF, go to THANK. Else, got to REL

Tag	C3b
Name	MAXPERSON (Active Signal)
Field Description	Tell Respondent we do not need additional people
Universe	PERSONCOUNT=12
Form Pane Label
Question Text	We do not need to know about any more people in your household. We’ll ask you the rest of the questions about the people you’ve told us about so far. ♦ After this screen, you WILL NOT be able to go back to edit the roster.
Spanish question	No necesitamos conocer acerca de más personas en su hogar. Le haremos el resto de las preguntas acerca de las personas de las que usted nos ha hablado hasta el momento. ♦ After this screen, you WILL NOT be able to go back to edit the roster.
Input Options	Suppress, and Close
Spanish input	Suppress, and Close
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto REL
Special Instructions

Tag	C4
Name	REL
Field Description	Obtain relationship for HH member in multi-person HH.
Universe	PERSONCOUNT is (2 to 12)
Form Pane Label	Relationship
Question Text	? [F1] How is [Fill 1: <NAME# >] related to you?
Spanish question text	? [F1] ¿Cómo está [Fill 1: <NAME# >] relacionado(a) con usted?
Input Options	1-Husband or wife 2-Son or daughter 3- Brother or sister 4- Father or mother 5-Grandchild 6-Parent-in-law 7-Son-in-law or daughter-in-law 8-Other relative 9-Roomer or boarder 10-Housemate or roommate 11-Unmarried partner 12-Other nonrelative Don’t Know Refused Blank is not an option on this screen.
Spanish input options	1- Esposo(a) 2- Hijo(a) 3- Hermano(a) 4- Padre o madre 5- Nieto(a) 6- Suegro(a) 7- Yerno o nuera 8- Otro pariente 9- Inquilino(a) o pupilo(a) 10- Compañero(a) de casa o de cuarto 11- Pareja no casada 12- Otro no pariente
Fill Instructions	Fill 1: Display <NAME# >
Spanish Fill Instructions	Fill 1: Display <NAME# >
Set Instructions
Skip Instructions	IF LNO < PERSONCOUNT, goto REL for next LNO Else, goto SEX
Special Instructions
Help Text	English: # H_REL Spanish: # H_REL_ESP

Tag / Name	C5 – SEX
Field Description	Obtain sex of person
Universe	PERSONCOUNT is (1 to 12)
Form Pane Label	Sex
Question Text	? [F1] ♦ Ask or verify sex. Do not enter/record sex based upon observation or responses to other items. [Fill 1: Are you/Is <NAME# >] male or female?
Spanish Question Text	? [F1] ♦ Pregunte o verifique el sexo de todas las personas. No entre/registre el sexo basándose en la observación o la respuesta a otras preguntas. [Fill 1 :¿Es usted/Es <NAME#>] de sexo masculino o femenino?
Input Options	1-Male 2-Female Don’t Know Refused Blank is not an option on this screen.
Spanish Input Options	1-Sexo masculino 2-Sexo feminino
Fill Instructions	Fill 1: If LNO = 1, display “Are you” If LNO > 1, display “Is <NAME#>”
Spanish Fill Instructions	Fill 1: If LNO = 1, display “Es usted” If LNO > 1, display “Es <NAME#>”
Skip Instructions	IF LNO < PERSONCOUNT, goto SEX for next LNO Else, goto AGE
Special Instructions	Only allow one response Help: SEX
Help Text	English: # H_SEX Spanish: # H_SEX_ESP

Tag	C6
Name	AGE
Field Description	Collect roster ages.
Universe	PERSONCOUNT is (1 to 12)
Form Pane Label	Age
Question Text	? [F1] What is [Fill 1: your/<NAME#>’s] age? ♦ Read aloud when necessary: If you don’t know the exact age, please estimate. ♦ Do not enter age in months. ♦ For babies less than 1 year old, enter 0 as the age.
Spanish Question	? [F1] ¿Qué edad tiene [Fill 1: usted/<NAME#>]? ♦ Lea cuando sea necesario: Si no sabe la edad exacta, haga el favor de indicar la edad aproximada. ♦ No entre la edad en meses. ♦ Para bebés menores de 1 año, entre 0 para la edad.
Input Options	Allow ages 0-125, Don’t Know, and Refused.
Spanish Input Options	Allow ages 0-125, Don’t Know, and Refused.
Fill Instructions	Fill 1: If LNO = 1, display “your” If LNO > 1, display “<NAME#>’s”
Spanish Fill Instructions	Fill 1: If LNO = 1, display “usted” If LNO > 1, display “<NAME#>”
Skip Instructions	IF LNO < PERSONCOUNT, goto AGE for next LNO Else, goto ORIGIN
Special Instructions
Help Text	English: # H_AGE Spanish: # H_AGE_ESP

Tag	C7
Name	ORIGIN
Field Description	Collect Hispanic origin information.
Universe	PERSONCOUNT is (1 to 12)
Form Pane Label	Hispanic origin
Question Text	? [F1] [Fill 1: Are you Hispanic, Latino, or Spanish origin?/And how about <NAME#>? Is <NAME#> Hispanic, Latino, or Spanish origin?]
Spanish Question	? [F1] [Fill 1:¿Es usted de origen hispano, latino o español?/ ¿Es <NAME#> hispano, latino o español?/ ¿Y <NAME#>? ¿Es <NAME#> de origen hispano, latino o español?]
Input Options	1- Yes 2-No Don’t Know Refused
Spanish Input Options	1- Sí 2-No
Fill Instructions	Fill 1: If LNO = 1, display “Are you Hispanic, Latino, or Spanish origin?” If LNO = 2, display “Is <NAME#> Hispanic, Latino, or Spanish origin?” If LNO > 2, display “And how about <NAME#>? Is <NAME#> Hispanic, Latino, or Spanish origin?”
Spanish Fill Instructions	Fill 1: If LNO = 1, display “Es usted de origen hispano, latino o español?” If LNO = 2, display “¿Es <NAME#> de origen hispano, latino o español?” If LNO > 2, display “¿Y <NAME#>?” ¿Es <NAME#> de origen hispano, latino o español?
Skip Instructions	If LNO < PERSONCOUNT, goto ORIGIN for next LNO Else, goto RACE
Special Instructions
Help Text	English: # H_ORIGIN Spanish: # H_ORIGIN_ESP

Tag	C7a
Name	RACE
Field Description	Collect roster races.
Universe	PERSONCOUNT is (1 to 12)
Form Pane Label	Race
Question Text	? [F1] [Fill 1: I’m going to read you a list of categories. You may choose one or more races. For this survey, Hispanic origin is not a race. Are you White; Black or African American; American Indian or Alaska Native; Asian; Native Hawaiian or Other Pacific Islander?/ Is <NAME#> White; Black or African American; American Indian or Alaska Native; Asian; Native Hawaiian or Other Pacific Islander?/And how about <NAME#>? Is <NAME#> White; Black or African American; American Indian or Alaska Native; Asian; Native Hawaiian or Other Pacific Islander?] ♦ Enter all that apply, separate with commas.
Spanish Question	? [F1] [Fill 1: Le voy a leer una lista de categorías de raza. Usted puede escoger una o más categorías. ¿Es usted de raza blanca; negra o africana americana; de raza india americana o nativa de Alaska; asiática; nativa de Hawaii o de otra de las islas del Pacífico?/ ¿Es <NAME#> de raza blanca; negra o africana americana; de raza india americana o nativa de Alaska; asiática; nativa de Hawaii o de otra de las islas del Pacífico?/ ¿Y <NAME#>? ¿Es <NAME#> de raza blanca; negra o africana americana; de raza india americana o nativa de Alaska; asiática; nativa de Hawaii o de otra de las islas del Pacífico?] ♦ Entre todas las que apliquen, separadas por comas.
Input Options	1-White 2-Black or African American 3-American Indian or Alaska Native 4-Asian 5-Native Hawaiian or Other Pacific Islander 6-Some other race or origin Don’t Know Refused Multiple responses allowed.
Spanish Input Options	1- Blanca 2- Negra o africana americana 3- India americana o nativa de Alaska 4- Asiática 5- Nativa de Hawaii u otra de las islas del Pacífico 6- Alguna otra raza
Fill Instructions	Fill 1: If LNO = 1, display “I’m going to read you a list of categories. You may choose one or more. Are you White; Black or African American; American Indian or Alaska Native; Asian; Native Hawaiian or Other Pacific Islander?” If LNO = 2, display “Is <NAME#> White; Black or African American; American Indian or Alaska Native; Asian; Native Hawaiian or Other Pacific Islander?” If LNO > 2, display “And how about <NAME#>? Is <NAME#> White; Black or African American; American Indian or Alaska Native; Asian; Native Hawaiian or Other Pacific Islander?”
Spanish Fill Instructions	Fill 1: If LNO = 1, display “Le voy a leer una lista de categorías de raza. Usted puede escoger una o más categorías. ¿Es usted de raza blanca; negra o africana americana; de raza india americana o nativa de Alaska; asiática; nativa de Hawaii o de otra de las islas del Pacífico?” If LNO = 2, display “¿Es <NAME#> de raza blanca; negra o africana americana; de raza india americana o nativa de Alaska; asiática; nativa de Hawaii o de otra de las islas del Pacífico?” If LNO > 2, display “¿Y <NAME#>?” ¿Es <NAME#> de raza blanca; negra o africana americana; de raza india americana o nativa de Alaska; asiática; nativa de Hawaii o de otra de las islas del Pacífico?
Skip Instructions	If RACE=7, goto OTHERRACE Else if VERIFYADD = <2, DK, RF>, goto TABLET Else if LNO < PERSONCOUNT, goto RACE for next LNO Else, goto CELL
Special Instructions	I tried to update the race text to be one big fill with three options based on the first person always being the respondent, and not needing to read the full text for more than two people.
Help Text	English: # H_RACE Spanish: # H_RACE_ESP

Tag	C7b
Name	OTHERRACE
Field Description	Some other race or ethnicity
Universe	RACE = 7
Form Pane Label	Other race
Question Text	? [F1] Read if necessary: You said [Fill 1: you are/<NAME#> is] some other race or origin. What is that specific race or origin?
Spanish question	? [F1] Lea si es necesario: Usted dijo que [Fill 1: usted/<NAME#>] es de alguna otra raza u origen. ¿Cuál es esa raza u origen específico?
Input Options	String 100. Don’t Know and Refused are options on this screen, but they can’t be used with other text entered. Blank is not an option on this screen.
Spanish input	String 100.
Fill Instructions	Fill 1: If LNO = 1, display “You are” If LNO > 1, display “<NAME#> is”
Spanish fill instructions	Fill 1: If LNO = 1, display “usted” If LNO > 1, display “<NAME#>”
Skip Instructions	Skip Instructions: If LNO < PERSONCOUNT, goto RACE for next LNO Else if VERIFYADD = <2, DK, RF>, goto TABLET Else goto CELL
Special Instructions
Help Text	English: # H_OTHERRACE Spanish: # H_OTHERRACE_ESP

Tag	C8
Name	CELL
Field Description	Does person have a cell phone
Universe	VERIFYADD = 1 and Person 1 and all persons with AGE > 17
Form Pane Label	Has cell phone
Question Text	? [F1] [Fill 1: In preparation for the 2020 Census, we are interested in understanding how we might be able to contact people. We want to study the various ways people can be contacted. Do you have a personal cell phone? / Does [Fill 2: <NAME>] have a personal cell phone?]
Spanish question	? [F1] [Fill 1: Como parte de la preparación para el Censo del 2020, nos interesa comprender cómo podríamos comunicarnos con las personas. No tenemos planes de usar esta información para comunicarnos con usted, solamente queremos estudiar las diferentes maneras en que nos podemos comunicar con las personas. ¿Usted tiene teléfono celular personal? / ¿[Fill 2: <NAME>] tiene teléfono celular personal?]
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions	Fill 1: If LNO=1, fill “In preparation for the 2020 Census, we are interested in understanding how we might be able to contact people. We just want to study the various ways people can be contacted. Do you have a personal cell phone?” Else, fill “Does [Fill 2: <NAME>] have a personal cell phone?” Fill 2: Fill <NAME>
Spanish fill instructions	Fill 1: If LNO=1, fill “Como parte de la preparación para el Censo del 2020, nos interesa comprender cómo podríamos comunicarnos con las personas. No tenemos planes de usar esta información para comunicarnos con usted, solamente queremos estudiar las diferentes maneras en que nos podemos comunicar con las personas. ¿Usted tiene teléfono celular personal?” Else, fill “¿[Fill 2: <NAME>] tiene teléfono celular personal?” Fill 2: Fill <NAME>
Skip Instructions	Skip Instructions: If CELL = 1, go to TEXT. If CELL = 2, DK, RF and another person > 17, go to CELL for next person Else goto LANDLINE
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C9
Name	TEXT
Field Description	Does person text
Universe	CELL = 1
Form Pane Label	Texts
Question Text	? [F1] [Fill 1: Do you/Does <NAME>] use the cell phone for texting?
Spanish question	? [F1] [Fill 1: ¿Usted/<NAME>] usa el teléfono celular para enviar mensajes de texto?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions	Fill 1: If LNO=1, fill “Do you” Else, fill “Does <NAME>”
Spanish fill instructions	Fill 1: If LNO=1, fill “Usted” Else, fill “<NAME>”
Skip Instructions	Skip Instructions: GOTO INTERNET
Special Instructions
Help Text	English: # H_TEXT Spanish: # H_TEXT_ESP

Tag	C10
Name	INTERNET
Field Description	Does person access Internet on phone
Universe	CELL = 1
Form Pane Label	Internet
Question Text	? [F1] [Fill 1: Do you/Does <NAME>] use the cell phone to access the Internet?
Spanish question	? [F1] [Fill 1: ¿Usted/<NAME>] usa el teléfono celular para acceder a Internet?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions	Fill 1: If LNO=1, fill “Do you” Else, fill “Does <NAME>”
Spanish fill instructions	Fill 1: If LNO=1, fill “Usted” Else, fill “<NAME>”
Skip Instructions	Skip Instructions: GOTO CELLNUM
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C11
Name	CELLNUM
Field Description	Person’s cell number
Universe	CELL = 1
Form Pane Label	Cell number
Question Text	? [F1] What is [Fill 1: your/ <NAME>’s] cell phone number? ♦ Enter 10 digit phone number with no spaces or dashes. Read if necessary: Do you have this number stored in your cell phone or in a phone book? Would you mind checking there?
Spanish question	? [F1] ¿Cuál es el número de teléfono de [Fill 1: usted/ <NAME>]? ♦ Entre el número de teléfono de 10 cifras sin espacios ni guiones. Lea si es necesario: ¿Usted tiene este número anotado en su teléfono celular o en una guía telefónica? ¿Le importaría verificar allí?
Input Options	10 digit number DK/REF Blank is not an option on this screen.
Spanish input	10 digit number DK/REF Blank is not an option on this screen.
Fill Instructions	Fill 1: If LNO=1, fill “your” Else, fill “<NAME>’s”
Spanish fill instructions	Fill 1: If LNO=1, fill “usted” Else, fill “<NAME>”
Skip Instructions	Skip Instructions: If another person > 17, go to CELL for next person Else, GOTO LANDLINE
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C12
Name	LANDLINE
Field Description	Does household have landline?
Universe	VERIFYADD = 1
Form Pane Label	Landline
Question Text	? [F1] Does this household have a landline?
Spanish question	? [F1] ¿Este hogar tiene una línea fija?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: If LANDLINE=1, goto LANDLINENUM Else, goto OTHERPHONE
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C12a
Name	LANDLINENUM
Field Description	Collect landline numbers.
Universe	LANDLINE = 1
Form Pane Label	Landline number
Question Text	? [F1] <SEE FILL INSTRUCTIONS> ♦ Enter 10 digit phone number with no spaces or dashes. Read if necessary: Do you have this number stored in your cell phone or in a phone book? Would you mind checking there? ♦ If there are no additional landline phone numbers, type 999 and press enter.
Spanish Question	? [F1] <SEE SPANISH FILL INSTRUCTIONS> ♦ Entre el número de teléfono de 10 cifras sin espacios ni guiones. Lea si es necesario: ¿Usted tiene este número anotado en su teléfono celular o en una guía telefónica? ¿Le importaría verificar allí? ♦ Si no hay números de líneas fijas adicionales, anote 999 y presione Enter.
Input Options	String 20.
Spanish Input Options	String 20.
Fill Instructions	If first phone number, display: What is it ? Read if necessary: What is the landline phone number? Else display: Are there any other landline phone numbers? Read if necessary: What is another one?
Spanish Fill Instructions	If first phone number, display: ¿Cuál es? Lea si es necesario: ¿Cuál es el número de la línea fija? Else display: ¿Hay algún otro número de línea telefónica fija? Lea si es necesario: ¿Cuál es el otro número?
Skip Instructions	Skip Instructions: If LANDLINE = 999, goto OTHERPHONE Else, goto UNPUB
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C12b
Name	UNPUB
Field Description	Any numbers unlisted or unpublished?
Universe	LANDLINE=1
Form Pane Label	Any unlisted
Question Text	? [F1] Is this landline number unlisted? ♦ If the respondent says their number is “unpublished”, also check “yes”.
Spanish question	? [F1] ¿Este número de línea fija es privado? ♦ If the respondent says their number is “unpublished”, also check “yes”.
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Go to LANDLINENUM for next line
Special Instructions
Help Text	English: # H_UNPUB Spanish: # H_UNPUB_ESP

Tag	C13
Name	OTHERPHONE
Field Description	Does household have other phone numbers?
Universe	VERIFYADD = 1
Form Pane Label	Other phones
Question Text	? [F1] Are there any other phone numbers used by any members of this household, perhaps a work phone or an additional line?
Spanish question	? [F1] ¿Hay otros números de teléfono que use alguno de los miembros de este hogar, tal vez un número del trabajo o una línea adicional?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen.
Spanish input	1- Sí 2-No
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: If OTHERPHONE=1, goto OTHERNUM Else, goto EMAILINT
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C13b
Name	OTHERNUM
Field Description	Collect other phone numbers.
Universe	OTHERPHONE=1
Form Pane Label	Other number
Question Text	? [F1] <SEE FILL INSTRUCTIONS> ♦ Enter 10 digit phone number with no spaces or dashes. Read if necessary: Do you have this number stored in your cell phone or in a phone book? Would you mind checking there? ♦ If there are no additional landline phone numbers, type 999 and press enter.
Spanish Question	? [F1] <SEE SPANISH FILL INSTRUCTIONS> ♦ Entre el número de teléfono de 10 cifras sin espacios ni guiones. Lea si es necesario: ¿Usted tiene este número anotado en su teléfono celular o en una guía telefónica? ¿Le importaría verificar allí? ♦ Si no hay números de líneas fijas adicionales, anote 999 y presione Enter.
Input Options	String 20.
Spanish Input Options	String 20.
Fill Instructions	If first phone number, display: What are they? Read if necessary: What are the other phone numbers? Else display: Are there any other phone numbers? Read if necessary: What are they?
Spanish Fill Instructions	If first phone number, display: ¿Cuáles son? Lea si es necesario: ¿Cuáles son los otros números de teléfono? Else display: ¿Hay algún otro número de teléfono? Lea si es necesario: ¿Cuáles son?
Skip Instructions	Skip Instructions: If OTHERNUM =999 goto EMAILINT If 3rd phone number collected, goto EMAILINT Else, go to OTHERNUM for next line
Special Instructions	Maximum of 3 other phone numbers
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C14
Name	EMAILINT
Field Description	Email introduction
Universe	VERIFYADD = 1 and at least one person AGE >17 in household
Form Pane Label	Email intro
Question Text	? [F1] For the 2020 Census, respondents may have the option to receive their form via email and to fill it out online. Because of this, we also are interested in how often people use email.
Spanish question	? [F1] Para el Censo del 2020, los respondedores podrían tener la opción de recibir el formulario por correo electrónico y completarlo por Internet. Por esa razón, también nos interesa conocer con qué frecuencia las personas usan el correo electrónico.
Input Options	1-Continue Blank is not an option on this screen.
Spanish input	1-Continuar
Fill Instructions
Spanish fill instructions
Skip Instructions	Skip Instructions: Goto EMAIL
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C15
Name	EMAIL
Field Description	How often does person check email
Universe	VERIFYADD = 1 and Person 1 and all persons with AGE > 17
Form Pane Label	Checks email
Question Text	? [F1] How often [Fill 1: do you/does<NAME#>] check email? ♦ Read answer categories if necessary.
Spanish question	? [F1] ¿Con qué frecuencia revisa [Fill 1: usted/ <NAME#>] su correo electrónico? ♦ Lea las categorías de respuestas si es necesario.
Input Options	1-Every day 2-Most days 3-At least once a week 4-A few times a month 5-Once a month 6-Less than once a month 7-Never/Doesn’t have email Don’t Know Refused Blank is not an option on this screen..
Spanish input	1-Todos los días 2-Casi todos los días 3-Al menos una vez a la semana 4-Varias veces al mes 5-Una vez al mes 6-Menos de una vez al mes 7-Nunca/No tiene correo electrónico
Fill Instructions	Fill 1: If LNO=1, fill “do you” Else, fill “does <Name#>”
Spanish fill instructions	Fill 1: If LNO=1, fill “usted” Else, fill “<Name#>”
Skip Instructions	Skip Instructions: If <1,2,3 >, goto EMAILADD If <4,5,6,7, DK, RF> AND another person AGE >17, goto EMAIL for next person Else goto TABLET
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C16a
Name	EMAILADD
Field Description	Person’s email address
Universe	EMAIL = 1, 2, 3
Form Pane Label	Email address
Question Text	? [F1] [Fill 2: What email address or addresses [Fill 1: do you/ does <NAME#>] typically check at least once a week?/ Any other email addresses? Read if necessary: What email address or addresses [Fill 1: do you/ does <NAME#>] check at least once a week?] ♦ Have respondent spell email address. ♦ Read email address back to respondent to verify. Read if necessary: Do you have this email stored in your cell phone or in a phone book? Would you mind checking there? ♦ Enter 999 if there are no more email addresses.
Spanish question	? [F1] [Fill 2: ¿Qué dirección o direcciones de correo electrónico revisa [Fill 1: usted/ <NAME#>] típicamente al menos una vez a la semana?/ ¿Alguna otra dirección de correo electrónico? Lea si es necesario: ¿Qué dirección o direcciones de correo revisa [Fill 1: usted/ <NAME#>] al menos una vez a la semana?] ♦ Pida al respondedor que deletree la dirección de correo electrónico. ♦ Léale la dirección de correo electrónico al respondedor para verificar. Lea si es necesario: ¿Tiene esta dirección de correo electrónico anotada en su celular o en una libreta telefónica? ¿Le importaría que la verificáramos allí? ♦ Entre 999 si no hay más direcciones de correo electrónico.
Input Options	Must have “@” and “.” in field. 999 not allowed for first email address. DK and RF are allowed. Blank is not an option on this screen.
Spanish input	Must have “@” and “.” in field. 999 not allowed for first email address. DK and RF are allowed. Blank is not an option on this screen.
Fill Instructions	Fill 1: If LNO=1, display “do you” Else, display “does <NAME#>” Fill 2: If first email address for person, display “What email address or addresses [Fill 1: do you/ does <NAME#>] check at least once a week?” If not first email address for person, display “Any other email addresses? Read if necessary: What email address or addresses [Fill 1: do you/ does <NAME#>] check at least once a week?”
Spanish fill instructions	Fill 1: If LNO=1, display “usted” Else, display “<NAME#>” Fill 2: If first email address for person, display “¿Qué dirección o direcciones de correo electrónico revisa [Fill 1: usted/ <NAME#>] al menos una vez a la semana?” If not first email address for person, display “¿Alguna otra dirección de correo electrónico? Lea si es necesario: ¿Qué dirección o direcciones de correo electrónico revisa [Fill 1: usted/ <NAME#>] al menos una vez a la semana?”
Skip Instructions	If DK, RF for first email address, goto DOMAIN1 Else if 999 and another person AGE >17, goto EMAIL for next person Else if 999 and no more people AGE >17, goto TABLET Else, goto EMAILWH
Special Instructions	Maximum of 5 email addresses
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C16b
Name	EMAILWH
Field Description	Is email address work or home
Universe	EMAILADD < > 999
Form Pane Label	Work or home
Question Text	? [F1] Is that a work email address or personal email address?
Spanish question	? [F1] ¿Es esa una dirección de correo electrónico de trabajo o personal?
Input Options	1-Work 2-Personal 3-Both 4-Neither Don’t Know Refused Blank is not an option on this screen..
Spanish input	1-De trabajo 2-Personal 3-Ambos 4-Ninguno de los dos
Fill Instructions
Spanish fill instructions
Skip Instructions	If 5 emails collected, and another person AGE >17, goto EMAIL for next person If 5 emails collected and no more people AGE >17, goto TABLET Else goto EMAILADD
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C17a
Name	DOMAIN1
Field Description	Has Yahoo email
Universe	EMAIL=1, 2, 3 and first EMAILADD = DK, RF
Form Pane Label	Domain1
Question Text	? [F1] [Fill 1: Do you/does<NAME#>] have a Yahoo account?
Spanish question	? [F1] ¿Tiene [Fill 1: usted/<NAME#>] una cuenta de Yahoo?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions	Fill 1: If LNO=1, fill “Do you” Else, fill “Does <Name#>”
Spanish fill instructions	Fill 1: If LNO=1, fill “usted” Else, fill “<Name#>”
Skip Instructions	Goto DOMAIN2
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C17b
Name	DOMAIN2
Field Description	Has AOL email
Universe	EMAIL=1, 2, 3 and EMAILADD = DK, RF
Form Pane Label	Domain1
Question Text	? [F1] Read if necessary: [Fill 1: Do you/does<NAME#>] have …an AOL account?
Spanish question	? [F1] Lea si es necesario: ¿Tiene [Fill 1: usted/tiene<NAME#>] …una cuenta de AOL?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions	Fill 1: If LNO=1, fill “Do you” Else, fill “Does <Name#>”
Spanish fill instructions	Fill 1: If LNO=1, fill “usted” Else, fill “<Name#>”
Skip Instructions	Goto DOMAIN3
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C17c
Name	DOMAIN3
Field Description	Has HOTMAIL email
Universe	EMAIL=1, 2, 3 and EMAILADD = DK, RF
Form Pane Label	Domain1
Question Text	? [F1] Read if necessary: [Fill 1: Do you/does<NAME#>] have …a Hotmail account?
Spanish question	? [F1] Lea si es necesario: ¿Tiene [Fill 1: usted/ <NAME#>] …una cuenta de Hotmail?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions	Fill 1: If LNO=1, fill “Do you” Else, fill “Does <Name#>”
Spanish fill instructions	Fill 1: If LNO=1, fill “usted” Else, fill “<Name#>”
Skip Instructions	Goto DOMAIN4
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C17d
Name	DOMAIN4
Field Description	Has MSN email
Universe	EMAIL=1, 2, 3 and EMAILADD = DK, RF
Form Pane Label	Domain1
Question Text	? [F1] Read if necessary: [Fill 1: Do you/does<NAME#>] have …a MSN account?
Spanish question	? [F1] Lea si es necesario: ¿Tiene [Fill 1: usted/<NAME#>] …una cuenta de MSN?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions	Fill 1: If LNO=1, fill “Do you” Else, fill “Does <Name#>”
Spanish fill instructions	Fill 1: If LNO=1, fill “usted” Else, fill “<Name#>”
Skip Instructions	Goto DOMAIN5
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C17e
Name	DOMAIN5
Field Description	Has COMCAST email
Universe	EMAIL=1, 2, 3 and EMAILADD = DK, RF
Form Pane Label	Domain1
Question Text	? [F1] Read if necessary: [Fill 1: Do you/does<NAME#>] have …a Comcast email account?
Spanish question	? [F1] Lea si es necesario: ¿Tiene [Fill 1: usted/ <NAME#>] …una cuenta de Comcast?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions	Fill 1: If LNO=1, fill “Do you” Else, fill “Does <Name#>”
Spanish fill instructions	Fill 1: If LNO=1, fill “usted” Else, fill “<Name#>”
Skip Instructions	Goto DOMAIN6
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C17f
Name	DOMAIN6
Field Description	Has Gmail email
Universe	EMAIL=1, 2, 3 and EMAILADD = DK, RF
Form Pane Label	Domain1
Question Text	? [F1] Read if necessary: [Fill 1: Do you/does<NAME#>] have …a Gmail account?
Spanish question	? [F1] Lea si es necesario: ¿Tiene [Fill 1: usted/ <NAME#>] …una cuenta de Gmail?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions	Fill 1: If LNO=1, fill “Do you” Else, fill “Does <Name#>”
Spanish fill instructions	Fill 1: If LNO=1, fill “usted” Else, fill “<Name#>”
Skip Instructions	Goto DOMAIN7
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C17f
Name	DOMAIN7
Field Description	Has other email
Universe	EMAIL=1, 2, 3 and EMAILADD = DK, RF
Form Pane Label	Domain1
Question Text	? [F1] Read if necessary: [Fill 1: Do you/does<NAME#>] have …an email account with another provider?
Spanish question	? [F1] Lea si es necesario: ¿Tiene [Fill 1: usted/ <NAME#>] …una cuenta de correo electrónico con otro proveedor de servicios?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions	Fill 1: If LNO=1, fill “Do you” Else, fill “Does <Name#>”
Spanish fill instructions	Fill 1: If LNO=1, fill “usted” Else, fill “<Name#>”
Skip Instructions	If DOMAIN7=1, goto DOMAINOTH If DOMAIN 7 = (2, DK, RF) and another person AGE > 17, goto EMAILADD If DOMAIN 7 = (2, DK, RF) and no other person AGE > 17, goto TABLET
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C17g
Name	DOMAINOTH
Field Description	Other domain
Universe	DOMAIN7 = 1
Form Pane Label	Other domain
Question Text	? [F1] Read if necessary: What is that other provider?
Spanish question	? [F1] Lea si es necesario: ¿Cuál es el otro proveedor de servicios?
Input Options	String 100. Don’t Know and Refused are options on this screen, but they can’t be used with other text entered. Blank is not an option on this screen.
Spanish input	String 100.
Fill Instructions
Spanish fill instructions
Skip Instructions	If another person AGE > 17, goto EMAILADD If no other person AGE > 17, goto TABLET
Special Instructions
Help Text	English: # H_EMAILPHONE Spanish: # H_EMAILPHONE_ESP

Tag	C18
Name	TABLET
Field Description	Asks if the respondent owns a tablet.
Universe	INTRO = 1
Form Pane Label	Tablet
Question Text	? [F1] Do you own a tablet computer, like an iPad?
Spanish question	? [F1] ¿Usted tiene una computadora tipo tableta, como un iPad?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen..
Spanish input	1- Sí 2-No
Fill Instructions
Spanish fill instructions
Skip Instructions	Goto GEOINFO
Special Instructions
Help Text	English: # H_TABLET Spanish: # H_TABLET_ESP

Tag	C19
Name	GEOINFO
Field Description	Opinion on collecting geographic information
Universe	INTRO = 1
Form Pane Label	Geographic info
Question Text	? [F1] In order to count people in the right place, the Census Bureau must collect detailed geographic information. This information can be time-consuming for respondents to provide and it can be expensive for the census to process. To assist in our efforts to increase the accuracy of the census and save a lot of taxpayers’ money, we could use cell phone or tablet technology, such as GPS, to determine your location more easily and accurately. If, during the completion of your 2020 Census questionnaire, we asked to use this technology to obtain geographic information directly from your mobile device, would you allow it?
Spanish question	? [F1] Para poder contar a las personas en el lugar correcto, la Oficina del Censo tiene que recopilar información geográfica detallada. Esta información puede ocuparles tiempo a los respondedores y puede resultar costosa para el proceso del censo. Para que nos ayude en nuestros esfuerzos por aumentar la precisión del censo y posiblemente ahorrar una gran cantidad de dinero de los contribuyentes, podríamos utilizar al tecnología de los teléfonos celulares o las tabletas, tal como el GPS, para determinar su localización con más facilidad y precisión. Si le pidiéramos utilizar esta tecnología para obtener información geográfica directamente de su dispositivo móvil cuando esté completando el cuestionario del Censo del 2020, ¿usted lo permitiría?
Input Options	1-Yes 2-No Don’t Know Refused Blank is not an option on this screen.
Spanish input	1- Sí 2-No
Fill Instructions
Spanish fill instructions
Skip Instructions	Goto THANK_COMP
Special Instructions
Help Text	English: # H_GEOINFO Spanish: # H_GEOINFO_ESP

Tag	B1
Name	CALLBACK
Field Description	Best callback time for respondent over 15
Universe	HELLO15 = 3, 4, DK, RF or HELLONAME = 3, 4, DK, RF or INTRO = 2
Form Pane Label	Callback
Question Text	I’d like to schedule a date to conduct the interview. What date and time would be the best to call back? ♦ Enter the appointment time in WebCATI.
Spanish question	Quisiera hacer una cita para llevar a cabo la entrevista. ¿Qué día y hora sería mejor para llamar de nuevo? ♦ Entre la hora de la cita en WebCATI.
Input Options	1-Callback time provided Don’t Know Refused Blank is not an option on this screen.
Spanish input	1-Se dio un día y hora para llamar de nuevo
Fill Instructions
Skip Instructions	Skip Instructions: Goto RNAME
Special Instructions

Tag	B2
Name	RNAME
Field Description	Name of person to call back
Universe	HELLO15 = 3, 4, DK, RF or HELLONAME = 3, 4, DK, RF or INTRO = 2
Form Pane Label	Callback name
Question Text	Whom should I ask for when I call back?
Spanish question	¿Por quién debo preguntar cuando llame de nuevo?
Input Options	String 42 Don’t Know and Refused are options on this screen, but they can’t be used with other responses. Blank is not an option on this screen.
Spanish input	String 42
Fill Instructions
Skip Instructions	Skip Instructions: Goto THANK
Special Instructions

Tag	B3
Name	THANK
Field Description	Thanks respondent.
Universe	HELLO15 = 3, 4, DK, RF or HELLONAME = 3, 4, DK, RF or INTRO = 2
Form Pane Label	Thank
Question Text	Thank you for your time.
Spanish question	Gracias por su tiempo.
Input Options	1 Continue Blank, Don’t Know, and Refused are not options on this screen.
Spanish input	1 - Continuar
Fill Instructions
Skip Instructions	Skip Instructions: Goto OUTCOME
Special Instructions

Tag	B4
Name	THANK_COMP
Field Description	Thanks respondent for completing survey.
Universe	INTRO = 1
Form Pane Label	Thank complete
Question Text	This concludes our interview. Thank you very much for your cooperation.
Spanish question	Con esto termina nuestra entrevista. Muchas gracias por su cooperación.
Input Options	1 Continue Blank, Don’t Know, and Refused are not options on this screen.
Spanish input	1 - Continuar
Fill Instructions
Skip Instructions	Skip Instructions: Goto LANGUAGE
Special Instructions	Set OUTCOME = 001

Tag	B5
Name	LANG
Field Description	Asks the enumerator which language the majority of the interview was conducted in.
Universe	INTRO = 1
Form Pane Label	Language
Question Text	What language was the majority of the interview conducted in?
Spanish question	¿En qué idioma se llevó a cabo la mayor parte de la entrevista?
Input Options	1. English 2. Spanish 3. Another language 4. Did not speak with anyone
Spanish input	1. Inglés 2. Español 3. Otro idioma 4. No hablé con nadie
Fill Instructions
Skip Instructions	Skip Instructions: Goto OUTCOME
Special Instructions	Household level

Tag	B6
Name	EXIT_WEBCATI
Field Description	Exit to WebCATI
Universe	LANGUAGE or THANK
Form Pane Label	Exit to WebCATI
Question Text	♦ Once in WebCATI, set appropriate status.
Spanish question	♦ Una vez que esté en WebCATI, establezca el estatus apropiado.
Input Options	1 Continue Blank, Don’t Know, and Refused are not options on this screen.
Spanish input	1 - Continuar
Fill Instructions
Skip Instructions	Skip Instructions: Goto OUTCOME
Special Instructions

Tag	B7
Name	OUTCOME
Field Description	Set Outcome codes.
Universe	THANK or LANGUAGE or EXIT_WEBCATI
Form Pane Label
Question Text
Input Options
Fill Instructions
Skip Instructions
Special Instructions	If THANK_COMP < > empty, set OUTCOME=001 (complete)

Tag	B8
Name	MARK
Field Description	Set Mark codes.
Universe	OUTCOME
Form Pane Label
Question Text
Input Options
Fill Instructions
Skip Instructions
Special Instructions	If HELLONAME < > Empty, set MARK = 11 If VERIFYADD < > empty, set MARK = 12 If LNAME < > empty, set MARK = 13 If RACE < > empty, set MARK = 14 If OTHERPHONE < > empty, set MARK = 15 If EMAILADD < > empty, set MARK = 16

Tag	B9
Name	MARK_TWO
Field Description	Set Mark_two codes.
Universe	MARK
Form Pane Label
Question Text
Input Options
Fill Instructions
Skip Instructions
Special Instructions	If VERIFYADD=1 or CITY <> empty , set MARK_TWO = 11 (sufficient partial)