Worker Classification Survey-OMB Attachment F-Survey Questions Crosswalk

Worker Classification Survey-OMB Attachment F Survey questions crosswalk_09-13-2013.docx

Worker Classification Survey

Worker Classification Survey-OMB Attachment F-Survey Questions Crosswalk

OMB: 1235-0028

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Attachment F: Crosswalk between Worker Classification Survey Questions and Other Survey Questions

Question

Question Text

Response Categories

Source

Question # In Source

PART 1. INTRODUCTION

INTRO1

Hello, my name is [INTERVIEWER] and I'm calling on behalf of Abt Associates. We are conducting a national study on American work experiences and benefits.

NEW


S1

Are you a member of this household and at least 18 years old?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

GENERIC

S1

S2

May I speak to a household member who is at least 18 years old?

1. AVAILABLE

2. NOT AVAILABLE

3. THERE ARE NONE

8. DK (VOL)

9. REF (VOL)

GENERIC

S2

INTRO2

Hello, my name is [INTERVIEWER] and I'm calling on behalf of Abt Associates. We are conducting a national study on American work experiences and benefits.


If you are now driving a car or doing any activity requiring your full attention, I need to call you back later.

1. AVAILABLE/NOT DRIVING

2. NOT AVAILABLE/CURRENTLY DRIVING

8. DK (VOL)

9. REF (VOL)

NEW


S3

Are you at least 18 years old?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

GENERIC

S3

A. Screener and Selection

S4

Results from this survey will be used by the U.S. Department of Labor to improve policies and benefits for American workers. Information from the survey will help the Department’s efforts to promote fair hiring practices, and access to critical workplace benefits, opportunities and protections. Your answers will remain private.


To determine if your household qualifies for the survey, I need to get some information about the members of your household who are 18 years old or older. These questions will take just a minute to complete.

NEW


S5

How many adults age 18 or over live in your household? ______

RANGE=1-11, 99 DK/REF=SOFT REFUSAL

GENERIC

S5

S6

Of these, (IF NECESSARY, ADULTS OVER AGE 18) how many worked for pay or profit in the last 30 days?

RANGE=1-11, 99 DK/REF=SOFT REFUSAL

NEW


S6_1

Are you the person in your household who worked for pay or profit in the last 30 days?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


S6_R-AX

What is [your/the second/third/fourth adult]’s first name or initials?

NEW


S7_R-AX

IN THE LAST THIRTY DAYS [IF NECESSARY: BY THIRTY DAYS, I mean the days beginning on [interview date minus thirty, in day, month, date, year format], and ending [TODAY]]

[Have you / has A1-X] worked for pay or profit? Include any job from which (you were/name was) temporarily absent.

NEW


SHHNUM

Just to confirm, there [is/are] a total of [FILL ELIGIBLE] adult household member(s) who worked for pay or profit in the last 30 days. Is that correct? [IF NECESSARY: This includes household members who were temporarily absent from a job(s) in the last 30 days.]

1. NUMBER OF HH MEMBERS IN MATRIX CORRECT

2. NUMBER OF HH MEMBERS IS INCORRECT

NEW


READMSG

This is [INTERVIEWER] calling for a study that is being conducted by Abt Associates. We are conducting this study to learn more about American work experiences and benefits and your opinions are important. Your phone number was randomly selected and we want to assure you that your responses to our survey will be kept private. We hope that you will participate in this study, and we will call back within the next day or two. Thank you.

NEW


SELECT1

Of the following household members, who had the [most recent/next] birthday?


[LIST ELIGIBLE HH MEMBERS]

1. R

2. A1

3. A2

4. A3

8. DK

9. REF

NEW


SELECT2

INTERVIEWER DO NOT READ: THE RESPONDENT IS [INSERT]. IS R ON THE PHONE NOW OR IS R SOMEONE ELSE?

1. RESPONDENT IS PERSON ON THE PHONE NOW

2. RESPONDENT IS SOMEONE ELSE

NEW


HANDOFF1

[SELECT2] has been selected as the respondent for this survey. May I please speak to [FILL S6_AX] for the rest of the interview?

1. YES/PHONE HANDED OFF

2. NOT AVAILABLE

3. ALTERNATE NUMBER PROVIDED

8. DK (VOL)

9. REF (VOL)

GENERIC


HANDOFF1A

Is that a landline or cell phone number?

1. LAND

2. CELL

GENERIC

UP3

INTRO3

Hello, my name is [INTERVIEWER] and I'm calling on behalf of Abt Associates. We are conducting a national study on American work experiences and benefits. Results from this survey will be used by the U.S. Department of Labor to improve policies and benefits for American workers. Information from the survey will help the Department’s efforts to promote fair hiring practices, and access to critical workplace benefits, opportunities and protections. Your answers will remain private and your personal information will not be shared with the U.S. Department of Labor.

NEW


A1

Can you please confirm that in the last THIRTY DAYS you worked for pay or profit? [IF NECESSARY: This includes any job from which you were temporarily absent.]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


THANK01

Thank you very much, but we are only interviewing in households with members who are 18 and over.

GENERIC


THANK02

Thank you very much for the information. These are all the questions I have at this time.

GENERIC


THANK03

Thank you very much, but we are only interviewing people who have worked in the last THIRTY DAYS. These are all the questions I have at this time.

NEW


INFORMED CONSENT

[LANDLINE RESPONDENTS:] Your individual answers will remain private and will be combined with responses from about 10,000 people who are also participating in the study. Study results will be used by the U.S. Department of Labor and researchers to learn what workers know about their employment situation, so your opinions are important.


Your participation is voluntary and all information you provide will be kept private. We will not provide information that identifies you to anyone outside the study team, except as required by law. If we should come to any question you don’t understand or don’t want to answer, I’ll try to clarify or we can move on to the next question. The survey should take about 15 minutes to complete.


[CELL RESPONDENTS:] Your individual answers will remain private and will be combined with responses from about 10,000 people who are also participating in the study. Study results will be used by the U.S. Department of Labor and researchers to learn what workers know about their employment situation, so your opinions are important.


Your participation is voluntary and all information you provide will be kept private. We will not provide information that identifies you to anyone outside the study team, except as required by law. If we should come to any question you don’t understand or don’t want to answer, I’ll try to clarify or we can move on to the next question. The survey should take about 15 minutes to complete.


In appreciation of your time, we will pay you $10. So that we can mail you your check, at the end of the survey we will ask for your name and address. Your name and address will not be associated with your survey responses.

NEW

INTRO3

QBEGIN

Can we begin?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QGENDER

(DO NOT READ)

1. MALE

2. FEMALE

9. DK


NEW


B. Determine Main Job

QMAIN_INTRO

For the remainder of the interview, we’ll be talking about the work you did in the LAST THIRTY DAYS.

NEW


QJOBS

In the LAST THIRTY DAYS, did you have more than one job [or business], including part-time, evening or weekend work? That is, were you PAID BY more than one job [or business]?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

CPS Basic Monthly, Working Without Laws

MJ (CPS)

QCONFMJ

How many jobs paid you in the last thirty days?

______ [RANGE 2-40]

98. DK (VOL)

99. REF (VOL)

NEW


QCONFMJ_2

Please list the [INSERT NUMBER FROM QCONFMJ] jobs that paid you in the last 30 days. You can give me a nickname for each job. For this question, each job is defined by the clients, customers, or employers who have paid you.

[RECORD VERBATIM]

Working Without Laws

nempx2

QMAINJOB

How many hours per week do you USUALLY work at your MAIN job? [IF QJOBS= 1 THEN DISPLAY: By main job we mean the one at which you usually work the most hours.] [IF NECESSARY: For the purposes of this study please consider your job by payment received.]

____ [Enter number] 0-200 hours

996. Hours vary week to week

997. Hours same for all jobs

998. DK (VOL)

999. REF (VOL)

CPS Basic Monthly

HRUSL1

QJOBHOURS

Do you USUALLY work 35 hours or more per week at your main job? [IF NECESSARY: By main job we mean the one at which you usually work the most hours.]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

CPS Basic Monthly

HRFTPT

QMAINJOB_2

Throughout the rest of the survey, please consider this your MAIN job, that is, the job where you USUALLY work the most hours.

NEW


QMAINJOB_2A

At which job have you worked the longest?

1. R SELECTS ONE

2. WORKED SAME LENGTH OF TIME AT ALL

NEW


QMAINJOB_2A1

Throughout the rest of the survey, please consider this your MAIN job, that is, the job where you have worked the longest.

NEW


QMAINJOB_2B

Please select any one of these jobs as your main job.

NEW


QMAINJOB_2B1

Throughout the rest of the survey, please consider this your MAIN job, that is, the job where you have worked the longest.

NEW


QTEMPSTAFF

At your main job, do you work for a temporary or staffing agency?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QMAIN

Please give me a nickname for your main job, that is the employer or client, so I can refer to it throughout the rest of the survey. [IF QTEMPSTAFF=1 THEN DISPLAY: Please refer to your work with the temporary or staffing agency and not your current placement.]

[RECORD VERBATIM]

Working Without Laws (Adapted)

Main Employer

QMAINJOB_3

In what year did you begin this job? [IF NECESSARY: Please think about your [QMAIN] job.]

____[RANGE: 1900-2013, 9998, 9999]

9998. DK (VOL)

9999. REF (VOL)

NEW


QSTATE

In what state is your job? [IF NECESSARY: Please think about your [QMAIN] job.]

[PROGRAMMING: LIST STATES]

NEW


PART II. JOB DESCRIPTION

A. Employer Self-Report

QEMPLOYER

At your [QMAIN] job, are you employed by government, by a private company, a non-profit organization, or were you self-employed?

1. Government

2. Private-for-profit company

3. Non-profit organization including tax exempt and charitable organizations

4. Self-employed [IWER NOTE: INCLUDES INDEPENDENT CONTRACTOR, INDEPENDENT CONSULTANT, FREELANCE WORKER, OR “OWN MY OWN BUSINESS”]

5. OTHER (VOL)

8. DK (VOL)

9. REF (VOL)

CPS Basic Monthly

IO1INT

QEMP_2

Is this [private company] your family business?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

CPS Basic Monthly (Adapted)

IO1INT

QSELF_TITLE_1

In the last 30 days did you work in your [QMAIN] job as an independent contractor, independent consultant, free-lance worker, or something else?

1. Independent contractor

2. Independent consultant

3. Free-lance worker

4. Something else (SPECIFY)

8. DK

9. REF (VOL)

Contingent and Alternative Employment Arrangements, 2005 (Adapted)

PES7

QSELF_TITLE_2

Do you usually refer to your work at your [QMAIN] as…?

1. Your business?

2. Your (professional) practice?

3. Your self-employment?

4. Your client?

5. Your job?

6. Something else? (SPECIFY)

8. DK (VOL)

9. REF (VOL)

Canadian Self-Employment Survey (Adapted)

VL_Q3

QSELF_NUM

How many different people or companies have paid you in the last 30 days in your [QMAIN] job?

______ [RANGE 1-99, 998-999; 998=DK, 999=REF]

NEW


QCORP_1

Are you/is your business incorporated?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

CPS Basic Monthly (Adapted)

IO1INC

QCORP_2

Is your business…?

a. an LLC (IF NECESSARY: limited liability company)?

b. a partnership?

c. a franchise?

d. a sole proprietorship?


1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QCORP_3

Are you/is your business registered or licensed with the state?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QCHANGE_NE

Were you treated as an employee prior to the time you became [INSERT]? [INSERT “a/an [QSELF_TITLE_1]”; IF QSELF_TITLE_1=DK/REF, INSERT “self-employed”]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QCHANGE_NE2

In what year did you become self-employed in the work you do for your [QMAIN] job?

____ [RANGE: 1900-9999]

9997. IMMEDIATELY (VOL)

9998. DK (VOL)

9999. REF (VOL)

NEW


QCHANGE_NE3

You just told me that you have not always been self-employed on your [QMAIN] job. What were you BEFORE you became self-employed? Were you…?

1. Employee

2. Temporary worker

3. On-call worker

4. Probationary worker

5. Intern

6. Contract worker

7. Something else (SPECIFY)

98. DK (VOL)

99. REF (VOL)

NEW


QEMPLOYEE

At your [QMAIN] job, are you an employee?

1. YES

2. NO

8. NOT SURE/DON’T KNOW

9. REF (VOL)

NEW


QCHANGE_EE

While working on this job, have you always been an employee?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QCERTAIN_NE

How certain are you that you are SELF EMPLOYED on your [QMAIN] job and not an employee of the company or clients for whom you work?

1. Very certain

2. Somewhat certain

3. Not too certain

4. Not at all certain

8. DK (VOL)

9. REF (VOL)

NEW


QCERTAIN_EE

How certain are you that you are an EMPLOYEE on your [QMAIN] job and not another type of worker such as an independent contractor, or temporary worker?

1. Very certain

2. Somewhat certain

3. Not too certain

4. Not at all certain

8. DK (VOL)

9. REF (VOL)

NEW


QCONT_1

Some companies provide employees or their services to other companies or clients under contract. A few examples of services that can be contracted out include security, landscaping, or computer programming. Did you work for a company that contracts out you or your services in the last THIRTY DAYS?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Contingent and Alternative Employment Arrangements, 2005

PES6

QJOBFIND

Did you use any type of agency to help you obtain your [QMAIN] job?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QAGENCY

What type of agency helped you obtain your [QMAIN] job? [SELECT ONE RESPONSE.]

1. Temporary agency

2. Employee staffing organization

3. Employment agency

4. Labor broker

5. City or county job placement agency

6. Service referral agency or registry

7. Client-matching service

8. Other, specify__________

98. DK (VOL)

99. REF (VOL)

NEW


QREFER

How did you learn about the [QAGENCY] that helped you obtain this job? [IF NECESSARY: Please think about your [QMAIN] job.]

1. Employer sent you there to apply for work

2. Through a personal referral (friend/family)

3. Through an advertisement

4. Some other way (SPECIFY)

8. DK (VOL)

9. REF (VOL)

NEW


QREQUIRE

To work at your [QMAIN] job, were you REQUIRED to…? [SOURCE: Adapted from WORKERS WITHOUT LAWS]


a. Sign a contract, form or other legal document

b. Create your own business or LLC

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Workers Without Laws (Adapted)

jb26

QSIGN_SP

What type(s) of contract, form, or other legal document did you sign? (SELECT ALL THAT APPLY)

a. Tax withholding forms

b. Partnership agreement

c. Franchise agreement

d. Employment contract

e. Independent contractor agreement

f. Something else ___________________

g. DK (VOL)

h. REF (VOL)


1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


B. Industry

QIND_INTRO

Now I have some questions about the type of work you do.

NEW


QINDUSTRY


QINDUSTRY_VERBATIM


QINDUSTRY_CODE

What kind of business or industry is this? [IF NECESSARY: What do they make or do where you work? For example: hospital, newspaper publishing, mail order house, auto engine manufacturing, bank]? [IF NECESSARY: Please think about your [QMAIN] job.]


[INTERVIEWER: RECORD VERBATIM AND ALSO APPLY A CODE]

1. CONSTRUCTION

2. TECHNOLOGY

3. JANITORIAL OR CLEANING SERVICES (INCLUDES DOMESTIC WORKERS, MAIDS, HOME CLEANING SERVICES)

4. HOME HEALTH CARE SERVICES

5. CHILD CARE SERVICES

6. TRANSPORTATION (TRUCKING/CAB DRIVER)

7. TELECOMMUNICATIONS SERVICES (CABLE, PHONE, INTERNET)

8. BEAUTY / PERSONAL CARE SERVICES (HAIR, NAIL, SKIN)

9. LANDSCAPING

10. CONSULTING

11. FOOD SERVICE

12. OTHER

98. DK (VOL)

99. REF (VOL)

CPS Basic Monthly, ACS

IO1IND

C. Occupation

QOCCUP


QOCCUP_VERBATOM


QOCCUP_CODE

What kind of work do you do, that is, what is your occupation? [IF NECESSARY: For example, home health aide, information technology worker, security guard, janitor, or salesperson.] [IF NECESSARY: What was your job title?] ? [IF NECESSARY: Please think about your [QMAIN] job.] [SOURCE: Adapted from CPS]


[INTERVIEWER: RECORD VERBATIM AND ALSO APPLY A CODE]



1. MANAGEMENT OCCUPATIONS

2. BUSINESS AND FINANCIAL OPERATIONS OCCUPATIONS

3. COMPUTER AND MATHEMATICAL OCCUPATIONS

4. ARCHITECTURE AND ENGINEERING OCCUPATIONS

5. LIFE, PHYSICAL, AND SOCIAL SCIENCE OCCUPATIONS

6. COMMUNITY AND SOCIAL SERVICE OCCUPATIONS

7. LEGAL OCCUPATIONS

8. EDUCATION, TRAINING, AND LIBRARY OCCUPATIONS

9. ARTS, DESIGN, ENTERTAINMENT, SPORTS, AND MEDIA OCCUPATIONS

10. HEALTHCARE PRACTITIONERS AND TECHNICAL OCCUPATIONS

11. HEALTHCARE SUPPORT OCCUPATIONS

12. PROTECTIVE SERVICE OCCUPATIONS

13. FOOD PREPARATION AND SERVING RELATED OCCUPATIONS

14. BUILDING AND GROUNDS CLEANING AND MAINTENANCE OCCUPATIONS

15. PERSONAL CARE AND SERVICE OCCUPATIONS

16. SALES AND RELATED OCCUPATIONS

17. OFFICE AND ADMINISTRATIVE SUPPORT OCCUPATIONS

18. FARMING, FISHING, AND FORESTRY OCCUPATIONS

19. CONSTRUCTION AND EXTRACTION OCCUPATIONS

20. INSTALLATION, MAINTENANCE, AND REPAIR OCCUPATIONS

21. PRODUCTION OCCUPATIONS

22. TRANSPORTATION AND MATERIAL MOVING OCCUPATIONS

23. MILITARY SPECIFIC OCCUPATIONS

24. OTHER

98. DK (VOL)

99. REF (VOL)

99. REF (VOL)

CPS Basic Monthly (Adapted)

IO1OCC

QDUTIES

What are your usual activities or duties at this job? (INTERVIEWER NOTE – DO NOT READ TO RESPONDENT: for example, keeps account books, work on the internet, files, sells cars, operates printing press, lays brick.)? [IF NECESSARY: Please think about your [QMAIN] job.]

[RECORD VERBATIM]

CPS Basic Monthly (Adapted)

IO1DT

QFIRMSIZE

Counting ALL LOCATIONS where (your employer/you) operate(s), what is the total number of persons who work for (your employer/you) including yourself?


[READ CATEGORIES ONLY IF NECESSARY.]

1 1 Worker

2 2-4 Workers

3 5-9

4 10-19

5 20-49

6 50-99

7 100-249

8 250-499

9 500 or more

98. DK (VOL)

99. REF (VOL)

CPS March Supplement (Adapted)

NOEMP

D. Permanence

QTEMP_1

Some jobs are temporary. They last only for a set number of weeks or months or until the completion of a project. Is your [QMAIN] job temporary?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Contingent and Alternative Employment Arrangements, 2005

PES1

QTEMP_2

Provided the economy does not change and your job performance is adequate, can you continue to work in your current job as long as you wish? [IF NECESSARY: Please think about your [QMAIN] job.]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Contingent and Alternative Employment Arrangements, 2005 (Adapted)

PES25B

QTEMP_1A

Are you working only until a specific project is completed?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Contingent and Alternative Employment Arrangements, 2005

S1a

QTEMP_1B

Were you hired for a fixed period of time?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Contingent and Alternative Employment Arrangements, 2005

S1c

QTEMP_1C

Is your [QMAIN] job SEASONAL or YEAR-ROUND?

1. Seasonal

2. Year-round

8. DK (VOL)

9. REF (VOL)

Contingent and Alternative Employment Arrangements, 2005 (Adapted)

S1d

QONCALL_1

Some people are in a pool of workers who are ONLY called to work as needed, although they can be scheduled to work for several days or weeks in a row, for example substitute teachers, information technology workers, and construction workers supplied by a union hiring hall. These people are sometimes referred to as ON-CALL workers. Were you an ON-CALL worker in the last THIRTY DAYS? [IF NECESSARY: Please think about your [QMAIN] job.]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Contingent and Alternative Employment Arrangements, 2005 (Adapted)

S4

QONCALL_2

Some ON-CALL workers have regularly scheduled hours, but IN ADDITION must work when called (for example, doctors, nurses, and managers). Other ON-CALL workers work ONLY when called (for example, substitute teachers, information technology workers). Which type of ON-CALL worker are you? [IF NECESSARY: Please think about your [QMAIN] job.]

1. Work regular hours, but must be available

2. Only work when called

3. Other (Specify)

8. DK (VOL)

9. REF (VOL)

Contingent and Alternative Employment Arrangements, 2005 (Adapted)

S4a

QDAYLABOR

Some people get work by waiting at a place where employers pick up people to work for a day. These people are sometimes called DAY LABORERS. Were you a DAY LABORER in the last THIRTY DAYS? [IF NECESSARY: Please think about your [QMAIN] job.]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Contingent and Alternative Employment Arrangements, 2005

S5

E. Pay

ERNP

Now I have some questions about your earnings.


CPS

ERNP

ERNPR

For your [QMAIN] job, what is the easiest way for you to report your total earnings BEFORE taxes or other deductions: hourly, weekly, annually, or on some other basis? [IF NECESSARY: We use this information to compare the amount that people earn in different types of jobs.]

1 Hourly

2 Weekly

3 Bi-weekly

4 Twice monthly

5 Monthly

6 Annually

7 Other (specify)

8 DK (VOL)

9 REF (VOL)

CPS Basic Monthly

ERNPR

ERNUOT

Do you usually receive overtime pay, tips, or commissions at your [QMAIN] job?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

CPS Basic Monthly


ERNUOT

ERNHRTD

(EXCLUDING overtime pay, tips and commissions) what is your hourly rate of pay on your [QMAIN] job?

ENTER DOLLAR AMOUNT

[RANGE=1-999,997; 999,998=DK; 999,999=REF]

CPS Basic Monthly

ERNHRTD

ERNHRTC

(EXCLUDING overtime pay, tips and commissions) what is your hourly rate of pay on your [QMAIN] job?

ENTER CENTS AMOUNT

[RANGE=0-99; 998=DK; 999=REF]

CPS Basic Monthly

ERNHRTC

ERNHRED

What is your best estimate of your hourly rate of pay?

ENTER DOLLAR AMOUNT

[RANGE=1-999,997; 999,998=DK; 999,999=REF]

CPS Basic Monthly

ERNHRED

ERNHREC

What is your best estimate of your hourly rate of pay?

ENTER CENTS AMOUNT

[RANGE=0-99; 998=DK; 999=REF]

CPS Basic Monthly

ERNHREC

ERNHRCON

INTERVIEWER CONFIRM HOURLY DOLLAR, CENTS

[DISPLAY ERNHRTD AND ERNHRTC OR ERNHRED AND ERNHRED]

CPS Basic Monthly

ERNRG1/ERNHCOC

ERNHR

How many hours do you usually work per week at this rate?

ENTER NUMBER OF HOURS

[RANGE: 1-997; 998=DK, 999=REF]

CPS Basic Monthly

ERNHR

ERNXXTD

EXCLUDING overtime pay, tips and commissions, what is your [INSERT PERIODICITY] rate of pay on your [QMAIN] job?

ENTER DOLLAR AMOUNT

CPS Basic Monthly

(Adapted)

ERNHRTD

ERNXXTC

EXCLUDING overtime pay, tips and commissions, what is your [INSERT PERIODICITY] rate of pay on your [QMAIN] job?

ENTER CENTS AMOUNT

CPS Basic Monthly

(Adapted)

ERNHRTC

ERNXXED

What is your best estimate of your [INSERT PERIODICITY] rate of pay?

ENTER DOLLAR AMOUNT

CPS Basic Monthly

(Adapted)

ERNHRED

ERNXXEC

What is your best estimate of your [INSERT PERIODICITY] rate of pay?

ENTER CENTS AMOUNT

CPS Basic Monthly

(Adapted)

ERNHREC

ERNXXCON

INTERVIEWER CONFIRM [INSERT PERIODICITY] DOLLAR, CENTS


CPS Basic Monthly

(Adapted)

ERNRG1/ERNHCOC

ERNOTP

At your [QMAIN] job, how much do you usually receive JUST in overtime pay, tips or commissions, before taxes or other deductions? [SOURCE: CPS]


DO NOT READ TO RESPONDENT, ENTER PERIODICITY

1 Per hour

2 Per day

3 Per week

4 Per month

5 Per year

6 Other

8 DK (VOL)

9 REF (VOL

CPS Basic Monthly

ERNOTP

ERNOTHD

(At your [QMAIN] job, how much do you usually receive JUST in overtime pay, tips or commissions, before taxes or other deductions?)

ENTER DOLLAR AMOUNT

CPS Basic Monthly

ERNOTHD

ERNOTHC

(At your [QMAIN] job, how much do you usually receive JUST in overtime pay, tips or commissions, before taxes or other deductions?)

ENTER CENTS AMOUNT

CPS Basic Monthly

ERNOTHC

ERNOTCON

INTERVIEWER CONFIRM HOURLY DOLLAR, CENTS


CPS Basic Monthly

ERNRG1/ERNHCOC

EARNWKD

BEFORE taxes or other deductions and EXCLUDING overtime pay, tips and commissions, what is your best estimate of your WEEKLY rate of pay?

ENTER DOLLAR AMOUNT

CPS Basic Monthly

(Adapted)

ERNHRTD

EARNWKC

BEFORE taxes or other deductions and EXCLUDING overtime pay, tips and commissions, what is your best estimate of your WEEKLY rate of pay?

ENTER CENTS AMOUNT

CPS Basic Monthly

(Adapted)

ERNHRTC

EARNWKCON

INTERVIEWER CONFIRM WEEKLY DOLLAR, CENTS


CPS Basic Monthly

(Adapted)

ERNRG1/ERNHCOC

OTWKD

At your [QMAIN] job, how much do you usually receive JUST in overtime pay, tips or commissions, before taxes or other deductions, on a weekly basis? [IF NECESSARY: Please give me your best estimate.]

ENTER DOLLAR AMOUNT

CPS Basic Monthly

(Adapted)

ERNOTHD

OTWKC

At your [QMAIN] job, how much do you usually receive JUST in overtime pay, tips or commissions, before taxes or other deductions, on a weekly basis? [IF NECESSARY: Please give me your best estimate.]

ENTER CENTS AMOUNT

CPS Basic Monthly

(Adapted)

ERNOTHC

OTWKCON

INTERVIEWER CONFIRM WEEKLY OT DOLLAR, CENTS


CPS Basic Monthly

(Adapted)

ERNRG1/ERNHCOC

QPAY_4

Please tell me how you usually RECEIVE your pay from your [QMAIN] job.

1. By company/corporate check

2. By personal check

3. In cash

4. ATM/Debit card

5. Direct deposit

6. Some other way (SPECIFY)

7. BY CHECK (NOT SPECIFIED) (VOL) [IWER: PROBE FOR COMPANY/CORPORATE (CODE AS 1) OR PERSONAL (CODE AS 2)]

8. DK (VOL)

9. REF (VOL)

NEW


QPAYSTUB

Do you receive or have access to a pay stub or any document listing your pay and any deductions?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Working Without Laws (Adapted)

pyw37a

QDEDANY

Do you have any deductions from your pay for your [QMAIN] job? [IF NECESSARY: This may include income tax, insurance, social security contributions, retirement or pension fund contributions, or union or association dues.]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QDEDSPEC

Please tell me how often each of the following items is deducted from your pay: always, sometimes, or never.


How often are/is [INSERT 1-5] deducted?

1. Taxes (federal, state, local)

2. Social security and Medicare taxes also known as FICA

3. Benefit plans (medical, dental, vision)

4. Tools, uniforms, or equipment

5. Anything else (SPECIFY)


1. Always

2. Sometimes

3. Never

98. DK (VOL)

NEW


QDEDCONF

Just to confirm, you told me that at your [QMAIN] job, you have no deductions from your pay (ever). Is that correct?

1. Yes, correct, no deductions

2. No [GO BACK TO QDEDSPEC}

8. DK (VOL)

9. REF (VOL)

NEW


QDOCUMENT

Now I am going to ask you about the tax forms you get at your [QMAIN] job.[Did/Will] you receive a…?



a. W-2

b. W-4

c. 1099-MISC

d. W-9

e. Schedule K-1

f. Any other tax forms (SPECIFY)


1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


PART III. DETAILED CLASSIFICATION QUESTIONS

A. Behavioral Control

BEHAVE_INTRO

Now I have some questions about your usual activities or duties at this, your [QMAIN] job.

NEW


QBEHAV1

On your [QMAIN] job, do you report directly to a manager, supervisor, foreman or someone else who regularly directs and controls HOW you do your work?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Economic Realities Test (Adapted)

N/A – source is not a survey

QBEHAV1_A

(On your [QMAIN] job,) Do you determine your own schedule or the hours that you work?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Economic Realities Test (Adapted)

N/A – source is not a survey

QBEHAV1_B

(On your [QMAIN] job,) Do you need approval for your schedule or hours worked?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Economic Realities Test (Adapted)

N/A – source is not a survey

QBEHAV1_C

(On your [QMAIN] job,) Do you need permission to leave your place of work, or can you come and go at will?

1. NEED PERMISSION

2. CAN COME AND GO AT WILL/DO NOT NEED PERMISSION

3. IT DEPENDS

8. DK (VOL)

9. REF (VOL)

Economic Realities Test (Adapted)

N/A – source is not a survey

QBHEAV2

(On your [QMAIN] job,) How often does someone tell you how to perform your usual work activities and duties?

1. Multiple times per day

2. Every day/shift

3. Every week

4. 2-3 times per week

5. Less frequently

6. Never

8. DK (VOL)

9. REF (VOL)

NEW


QBEHAV2_1

(On your [QMAIN] job,) At any time COULD someone direct HOW you perform your work duties?

1. Multiple times per day

2. Every day/shift

3. Every week

4. 2-3 times per week

5. Less frequently

6. Never

8. DK (VOL)

9. REF (VOL)

Economic Realities Test (Adapted)

N/A – source is not a survey

QBEHAV2_A

(On your [QMAIN] job,) Are you required to wear a uniform including any specific type, style, or color of clothing? [IF NECESSARY: A uniform includes clothing associated with a specific employer because of an emblem, logo, or distinctive color, and also may include any specific type and style of clothing that an employer requires its employees to wear at work, such as a tuxedo for a maitre d’ or a blazer of a distinctive color for a salesperson.]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QBEHAV3

(On your [QMAIN] job,) Are you required to perform your job duties in a specific location?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QBEHAVE3A

Does the nature of your work require that you provide these duties at a specific location? [IF NECESSARY: For example, a theatre actor may work in a specific location because the play shows in a certain theatre, or a home cleaning service works in a specific location because they clean in a client’s home.]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Economic Realities Test (Adapted)

N/A – source is not a survey

QBEHAV4

Is there a job or procedures manual for the duties you perform that tells you HOW to perform the job?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QBEHAV4A

How closely would you say you are required to follow the manual? Are you required to follow it very closely, somewhat closely, not very closely, or not at all? Please give me your best estimate.


[INTERVIEWER: PROBE FOR BEST ESTIMATE OF Somewhat closely OR Not very closely IF NECESSARY.]

1. Very closely

2. Somewhat closely

3. Not very closely

4. Do not follow it at all

8. DK (VOL)

9. REF (VOL)

NEW


QBEHAV5_A

Has your [QMAIN] job provided you with any training?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


QBEHAV5_B

Did you need to have any specialized education or training, apprenticeships, or certification to get your [QMAIN] job?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

NEW


B. Financial Relationship

QFINAN1

On your [QMAIN] job, how much of your own money do you spend each year, on average, on tools, equipment, computers, or other materials you use for your work?

1. More $10,000

2. Between $1,000 and $10,000

3. Under $1,000, or

4. None (You have not spent money on materials for your work)

8. DK (VOL)

9. REF (VOL)

ABC test (Adapted)

A14

QFINAN1A

Are you required to purchase or lease SPECIFIC TOOLS OR EQUIPMENT or do you decide what to buy? [IF NECESSARY: Please think about your [QMAIN] job.]

1. Required to buy specific tools or equipment

2. I decide what to buy

3. Both/Depends

8. DK (VOL)

9. REF (VOL)

NEW


QFINAN1B

Are you required to purchase or lease tools or equipment from a specific source or do you decide where to buy them? [IF NECESSARY: Please think about your [QMAIN] job.]

1. Required to buy from a specific source

2. I decide where to buy

3. Both/Depends

8. DK (VOL)

9. REF (VOL)

NEW


QFINAN3

On your [QMAIN] job, have you ever invested your own money where you work to support the day-to-day operations? [IF NECESSARY: Examples include purchasing equipment, renting space, or advertising?]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

Economic Realities Test (Adapted)

N/A – source is not a survey

QFINAN4

At your [QMAIN] job, can you … ?


a. hire additional workers?

b. change the way the business is run?

1. YES

2. NO

3. IT DEPENDS

8. DK (VOL)

9. REF (VOL)

Economic Realities Test (Adapted)

N/A – source is not a survey

QFINAN5

In the event that the company where you work loses money, would you continue to earn your wage for the work you perform?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

ABC test (Adapted)

A16

C. Employment Relationship

QRELATE1

Besides your main job, do you perform similar paid work for others [IF NECESSARY: other companies or businesses]?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

SS-8 IRS (Adapted)

Part IV, #3

QRELATE2

Are you required to get approval from your [QMAIN] job in order to provide these duties and activities for others?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

SS-8 IRS (Adapted)

Part IV, #3

QRELATE3

Do you use your own funds to advertise your services, with a website, flyers, newspapers, business cards or any other way?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

SS-8 IRS (Adapted)

Part IV, #6

QINTEGRAL

Are the duties you perform on your [QMAIN] job a part of the regular services or operations of the company where you work? [IF NECESSARY: Is the work you do the same as the work the company does for its customers?]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

ABC test (Adapted)

B1

QINTEGRAL2

You have indicated that you are either NOT an EMPLOYEE or NOT SURE if you are an EMPLOYEE. Are there workers at your [QMAIN] job who are called “employees” and perform the same work duties that you do? [IF NECESSARY: Please provide your best estimate.] [INTERVIEWER: EMPHASIZE “EMPLOYEES”]

1. Yes, there are employees performing your same work duties [INTERVIEWER: CONFIRM: These people are “EMPLOYEES”]

2. No, you are the only one performing your work duties

3. Other (SPECIFY)

4. DOES NOT APPLY TO ME (VOL)

5. RESPONDENT SAYS S/HE IS AN EMPLOYEE (VOL)

8. DK (VOL)

9. REF (VOL)

Economic Realities Test (Adapted)

N/A – source is not a survey

PART IV. KNOWLEDGE

KNOW_INTRO

We're interested in finding out how much people know about working for an employer, or being an EMPLOYEE, compared to working for themselves, or being SELF-EMPLOYED. I'm going to ask you a few questions, but if you don't know the answer, that’s o.k., you can reply “don’t know”.

NEW


QCOVER_MW_A-B/C

A. To your knowledge, is your [QMAIN] job covered by…

B. Would your [QCOVER] coverage change if you became [self-employed/an employee]?

C. Under what conditions would your [QCOVER] coverage change?

1. Minimum Wage Requirements

A-B.

1. YES

2. NO

8. DK

9. REF

C.

1. IF YOU BECAME AN EMPLOYEE

2. IF YOU BECAME SELF-EMPLOYED

3. IF YOUR WORKER STATUS CHANGED (UNSPECIFIED)

4. OTHER REASON (SPECIFY)

5. NONE

8. DK

9. REF

NEW


QCOVER_OT_A-B/C

A. To your knowledge, is your [QMAIN] job covered by…

B. Would your [QCOVER] coverage change if you became [self-employed/an employee]?

C. Under what conditions would your [QCOVER] coverage change?

2. Overtime pay for hours you work beyond forty hours in one week

A-B.

1. YES

2. NO

8. DK

9. REF

C.

1. IF YOU BECAME AN EMPLOYEE

2. IF YOU BECAME SELF-EMPLOYED

3. IF YOUR WORKER STATUS CHANGED (UNSPECIFIED)

4. OTHER REASON (SPECIFY)

5. NONE

8. DK

9. REF

NEW


QCOVER_UI_A-B/C

A. To your knowledge, is your [QMAIN] job covered by…

B. Would your [QCOVER] coverage change if you became [self-employed/an employee]?

C. Under what conditions would your [QCOVER] coverage change?

3. Unemployment Insurance (IF NECESSARY: A federal program whereby eligible unemployed persons receive cash benefits for a specified period of time. These benefits are paid out of funds derived from employer, employee and government contributions.)

A-B.

1. YES

2. NO

8. DK

9. REF

C.

1. IF YOU BECAME AN EMPLOYEE

2. IF YOU BECAME SELF-EMPLOYED

3. IF YOUR WORKER STATUS CHANGED (UNSPECIFIED)

4. OTHER REASON (SPECIFY)

5. NONE

8. DK

9. REF

NEW


QCOVER_WC_A-B/C

A. To your knowledge, is your [QMAIN] job covered by…

B. Would your [QCOVER] coverage change if you became [self-employed/an employee]?

C. Under what conditions would your [QCOVER] coverage change?

4. Workers’ Compensation (IF NECESSARY: insurance paid by companies to provide benefits to employees who become ill or injured on the job.)

A-B.

1. YES

2. NO

8. DK

9. REF

C.

1. IF YOU BECAME AN EMPLOYEE

2. IF YOU BECAME SELF-EMPLOYED

3. IF YOUR WORKER STATUS CHANGED (UNSPECIFIED)

4. OTHER REASON (SPECIFY)

5. NONE

8. DK

9. REF

NEW


QCOVER_OS_A-B/C

A. To your knowledge, is your [QMAIN] job covered by…

B. Would your [QCOVER] coverage change if you became [self-employed/an employee]?

C. Under what conditions would your [QCOVER] coverage change?

5. OSHA safety standards (IF NECESSARY: OSHA refers to the Occupational Health and Safety Act of 1970. OSHA standards limit the amount of hazardous chemicals workers can be exposed to, require the use of certain safe practices and equipment, and require employers to monitor hazards and keep records of workplace injuries and illnesses.)

A-B.

1. YES

2. NO

8. DK

9. REF

C.

1. IF YOU BECAME AN EMPLOYEE

2. IF YOU BECAME SELF-EMPLOYED

3. IF YOUR WORKER STATUS CHANGED (UNSPECIFIED)

4. OTHER REASON (SPECIFY)

5. NONE

8. DK

9. REF

NEW


QCOVER_SK_A-B/C

If you take time off from your [QMAIN] job for family or medical leave, is your job guaranteed when you return?

B. Would this change if you became [self-employed/an employee]?

C. Under what condition would your [QCOVER] coverage change? [IF NECESSARY: Is there any condition where your job [would/would not] be guaranteed if you took time off for family or medical leave?]


A-B.

1. YES

2. NO

8. DK

9. REF

C.

1. IF YOU BECAME AN EMPLOYEE

2. IF YOU BECAME SELF-EMPLOYED

3. IF YOUR WORKER STATUS CHANGED (UNSPECIFIED)

4. OTHER REASON (SPECIFY)

5. NONE

8. DK

9. REF

NEW


QCOVER_WHY_XX

You said your [QMAIN] job is not covered by [INSERT]. Do you know why not?

1. YES

2. NO

9. REF

NEW


QREASON_XX

Why not? [IF NECESSARY: Why is your job not covered by this]

1. NOT ELIGIBLE, HAVE NOT WORKED ENOUGH HOURS

2. NOT ELIGIBLE, HAVE NOT WORKED AT ORGANIZATION FOR LONG ENOUGH

3. NOT ELIGIBLE, BECAUSE NOT AN EMPLOYEE

4. NOT ELIGIBLE, OTHER REASON (SPECIFY)

5. SOME OTHER REASON (SPECIFY)

8. DK

9. REF

NEW


QCOVER_SS_A

Do you contribute to social security and Medicare tax otherwise known as FICA?

1. YES

2. NO

8. DK

9. REF

NEW


QCOVER_SS_B

How much of your gross pay OR what percentage, of your gross pay, do you contribute to FICA? [IF NECESSARY: FICA includes social security and Medicare tax]

$ ________ (Range 1-99999, 99998=DK, 99999=REF)

OR

_____ % (Range 1-100, 998=DK, 999=REF)

NEW


QCOVER_SS_C

If you became [employed/self-employed] how would your share of the FICA contribution change?

1. My share would go up

2. My share would go down

3. No change

8. DK

9. REF

NEW


QCOVER_SS_D

Under what condition would this change? [IF NEC: Is there any condition where your FICA contribution [would/would not] change?]

1. IF YOU BECAME AN EMPLOYEE

2. IF YOUR BECAME SELF-EMPLOYED

3. IF YOUR WORKER STATUS CHANGED (UNSPECIFIED)

4. OTHER REASON

5. NONE

8. DK

9. REF

NEW


QAGREE

Earlier you indicated that you are [an employee/self-employed]. Do you agree with this classification or do you think that legally, you should be [self-employed/an employee]?

1. You agree with this classification

2. You think you should be classified differently

8. DK (VOL)

9. REF (VOL)

NEW


QAGREE_2

Just to confirm, you have indicated that you are [self-employed/an employee]. Do you agree with this classification or do you think that legally, you should be [an employee/self-employed]?

1. You agree with this classification

2. You think you should be classified differently

8. DK (VOL)

9. REF (VOL)

NEW


QTHINK

Based on your responses to earlier questions, we are unable to determine if you are considered an employee or self-employed. What do you think your worker status should be? Should it be…?

1. Self-employed

2. Employee

3. Or, something else (SPECIFY)

8. DK (VOL)

9. REF (VOL)

NEW


PART V. DEMOGRAPHICS

A. Standard Demographics

QDEMO_INTRO

Now we have a few questions to help us better understand your responses.

NEW


QEDUCATION_1

What is the highest level of school you have completed or the highest degree you have received?

1. LESS THAN 1ST GRADE

2. 1ST, 2ND, 3RD OR 4TH GRADE

3. 5TH OR 6TH GRADE

4. 7TH OR 8TH GRADE

5. 9TH GRADE

6. 10TH GRADE

7. 11TH GRADE

8. 12TH GRADE NO DIPLOMA

9. HIGH SCHOOL GRAD-DIPLOMA OR EQUIV (GED)

10. SOME COLLEGE BUT NO DEGREE

11. ASSOCIATE DEGREE-OCCUPATIONAL/VOCATIONAL

12. ASSOCIATE DEGREE-ACADEMIC PROGRAM

13. BACHELOR'S DEGREE (EX: BA, AB, BS)

14. MASTER'S DEGREE (EX: MA, MS, MEng, MEd, MSW)

15. PROFESSIONAL SCHOOL DEG (EX: MD, DDS, DVM)

16. DOCTORATE DEGREE (EX: PhD, EdD)

98. DK

99. REF

CPS Basic Monthly

EDUCAscrn

QEDUCATION_2

Last week, were you enrolled in a high school, college, or university?


[CODE YES IF CURRENTLY ON HOLIDAY OR SEASONAL VACATION, CODE NO FOR SUMMER VACATION]

1. Yes, high school

2. Yes, college

3. Yes, university

4. Yes, vocational/technical school

5. Yes, other schooling (SPECIFY)

6. No, not enrolled

7. No, for summer vacation

98. DK (VOL)

99. REF (VOL)

CPS Basic Monthly (Adapted)

SCHENR

QLGBT

Do you think of yourself as…

1. [For men/QGENDER=1:] Gay / [For women/QGENDER=2:] Lesbian or gay

2. [For men/QGENDER=1:] Straight, that is, not gay / [For women/QGENDER=2:]

3. Straight, that is, not lesbian or gay, or

4. Bisexual?

5. SOMETHING ELSE (VOL)

8. DK (VOL)

9. REF (VOL)

FMLA SURVEY

D9

QMARITAL

Are you currently…

1. Married,

2. Living with a partner,

3. Separated,

4. Divorced,

5. Widowed, or

6. Never married?

8. DK (VOL)

9. REF (VOL)

FMLA SURVEY

D10

QAGE

What is your age? ______

[RANGE: 18-99, REF=99]

NHIS

HHC.120_01.000

QINCOME

What is the total combined income of all members of your FAMILY during the past 12 months? This includes money from jobs, net income from business, farm or rent, pensions, dividends, interest, social security payments and any other money income received by members of your family who are 15 years of age or older

1. GAVE ANSWER $__________ [MAX RANGE= 9,999,999]

8. DK (VOL)

9. REF (VOL)

CPS Basic Monthly

FAMINscrn

QINC_A

Was your family income $35,000 or above?

1. YES

2. NO

8. DK

9. REF

NEW


QINC_B

Was it $40,000 or above?

1. YES

2. NO

8. DK

9. REF

NEW


QINC_C

Was it $50,000 or above?

1. YES

2. NO

8. DK

9. REF

NEW


QINC_D

Was it $75,000 or above?

1. YES

2. NO

8. DK

9. REF

NEW


QINC_E

Was it $100,000 or above?

1. YES

2. NO

8. DK

9. REF

NEW


QINC_F

Was it $30,000 or above?

1. YES

2. NO

8. DK

9. REF

NEW


QINC_G

Was it $20,000 or above?

1. YES

2. NO

8. DK

9. REF

NEW


QINC_H

Was it $10,000 or above?

1. YES

2. NO

8. DK

9. REF

NEW


QINC_J

Was it $5,000 or above?

1. YES

2. NO

8. DK

9. REF

NEW


QPASTWEEK

In the PAST WEEK, did you work for pay or profit? [IF NECESSARY: This includes any job from which you were temporarily absent.]

1. YES

2. NO

8. DK

9. REF

NEW


QUNION

Are you a member of a labor union?

1. YES

2. NO

8. DK

9. REF

NEW


QHISPANIC

Do you consider yourself to be Hispanic or [Latino/Latina]? [IF NECESSARY: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.]

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

CPS Basic Monthly

D5

QRACE

What race do you consider yourself to be? Please select one or more of the following.

1. American Indian or Alaska Native

2. Asian

3. Native Hawaiian or Pacific Islander

4. Black or African American

5. White

6. SOME OTHER RACE (VOL) _______________________

8. DK (VOL)

9. REF (VOL)

CPS Basic Monthly

D6

B. English Proficiency

QL

Now we have some questions about languages you speak. Is [English/Spanish] your native language?

1. YES

2. NO

8. DK (VOL)

9. REF (VOL)

New Immigrant Survey

J1

QL_2

How well would you say you UNDERSTAND English when someone is speaking to you? Would you say you understand English very well, somewhat well, not well or not at all?

1. Very well

2. Somewhat well

3. Not well

4. Not at all

8. DK (VOL)

9. REF (VOL)

New Immigrant Survey

J11

QL_3

How well would you say you SPEAK English? Would you say…?

1. Very well

2. Somewhat well

3. Not well

4. Not at all

8. DK (VOL)

9. REF (VOL)

New Immigrant Survey

J12

QL_4

How well would you say you READ English? Would you say…?

1. Very well

2. Somewhat well

3. Not well

4. Not at all

8. DK (VOL)

9. REF (VOL)

New Immigrant Survey

J13

C. Telephone Usage

INTRO_T

We’re almost done. Now we just have a few quick questions about telephone use in your household. These items will be used for statistical purposes to make sure that all households in the country are represented in this study.

NEW


T1

Now thinking about your telephone use, do you have a working cell phone?

1. YES, HAVE CELL PHONE

2. NO, DO NOT HAVE CELL PHONE

9. DK/REF (VOL)

NHIS

COV.334_00.000

T2

[Including this one,] How many working cell phones do YOU personally have?

(1-6). RECORD NUMBER [ENTER 6 IF 6 OR GREATER]

9. DK/REF (VOL)

NHIS

COV.335_00.000

T3

Thinking about the other adults in your household, how many working cell phones in total do THEY have?

(0-6). RECORD NUMBER [ENTER 6 IF 6 OR GREATER]

9. DK/REF (VOL)

NHIS

COV.335_00.000

T4

Is a cell phone your ONLY phone, or do you also have a regular landline telephone at home?

1. CELL PHONE IS ONLY PHONE

2. HAVE LANDLINE TELEPHONE AT HOME

9. DK/REF (VOL)

NHIS

COV.331_00.000

T5

[Including this number,] How many different residential phone NUMBERS do you have coming into your household, not including lines dedicated to a fax machine, modem, or used strictly for business purposes? Do not include cellular phones.

(1-6). RECORD NUMBER [ENTER 6 IF 6 OR GREATER]

9. DK/REF (VOL)

FMLA SURVEY

T5

T6

Of all the telephone calls that you [IF S5 > 1 (2+ ADULT HOUSEHOLD): or your family] receive, are:

1. All or almost all calls received on cell phones,

2. Some received on cell phones and some on regular phones, or

3. Very few or none on cell phones?

9. DK/REF (VOL)

NHIS

COV.337_00.000

QZIP

Finally, so that we can group households geographically, may I have your zip code?

RANGE: 00000-99999

999998 DK (VOL)

999999 REF (VOL)

FMLA SURVEY

ZIP

QEND

Thank you very much for your time. If you have any questions or would like further information about this study, you can call INSERT NAME at (1-XXX-XXX-XXXX) during normal business hours.

FMLA SURVEY

END2



pg. 10

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleAbt Single-Sided Body Template
AuthorJan Nicholson
File Modified0000-00-00
File Created2021-01-29

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