3-Web Third Interview-Web

U.S. Department of Labor FORM APPROVED:

OMB No XXXX-XXXX

APPROVAL EXPIRES: XX/XX/XXXX

Welcome to the

Longitudinal Study of Unemployment Insurance Recipients

(LS-UI)

Third Interview

Current Date

THIS IS A SECURE SITE

Sponsored by: Conducted by:

U.S. Department of Labor Mathematica Policy Research

To begin the survey, please refer to the letter you received to find your UserName and Password. Enter your UserName and Password in the fields below, then click the “Continue” button. If you do not have your UserName and Password, please call 1-800-xxx-xxxx, or email [email protected].

UserName: Password:

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is xxxx-xxxx. Public reporting burden for this collection of information is estimated to average 25 minutes per respondent, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Name, Address

SECTION A: CASE MANAGEMENT

PROGRAMMER: IF THE SURVEY IS TERMINATED PRIOR TO COMPLETION, DISPLAY THE FOLLOWING MESSAGE:

You have elected to stop the survey without completing. Thank you for responses so far. To complete the survey, log on again by using the same UserName and password.

ALL

INTRODUCTION

Welcome back to the Longitudinal Study of Unemployment Insurance Recipients (LS-UI)! This is the third survey for the LS-UI. As you might recall, the U.S. Department of Labor (DOL) is sponsoring this special study to learn more about the experiences of people who recently applied for unemployment insurance (UI) benefits. The study is being conducted by Mathematica Policy Research, an independent research company, on behalf of DOL. As part of this important study, Mathematica will survey people who applied for UI benefits in your state.

You have been scientifically selected from among people who recently filed for UI benefits to represent UI recipients in your state. Your participation is voluntary, but since you cannot be substituted with someone else, we need you to complete this important survey. Even if you did not receive or are no longer receiving UI benefits, your participation is needed.

Please complete the survey as soon as possible. The survey will take about 25 minutes to complete. Any information that we collect from you will be used for research purposes only and will be kept private to the extent permitted by law.

As a particpant in the LS-UI, you have already completed two surveys.  Thank you! You are being asked to complete your third survey at this time.  You will receive $30 for completing this survey.

If you have any questions or prefer to complete the survey by telephone, please call 1-800-xxx-xxxx toll-free to speak with an interviewer or send an email to [email protected].You may also contact the survey director, Julita Milliner-Waddell, at 609-275-2206.

ALL

A30. Please confirm that your name is correct as shown below.

[FILL FIRST] [FILL MIDDLE] [FILL LAST]

 Yes, name is correct as shown 1 GO TO A34

 No, my name is misspelled or has changed 2

HARD CHECK: IFA30 = NO RESPONSE; Please provide an answer to this question and continue.

A30 = 2

A31. Please enter your correct name below.

PROGRAMMER: FILL FIELDS WITH PRELOADED NAME DATA

First name

(STRING 20)

Middle name

(STRING 20)

Last name

(STRING 20)

HARD CHECK: IF A31_FirstName = NO RESPONSE; Please provide the correct spelling of your first name.

HARD CHECK: IF A31_LastName = NO RESPONSE; Please provide the correct spelling of your last name.

ALL

A34. What is your date of birth?

PROGRAMMER: INSERT DROPDOWNS WITH FOLLOWING RANGES

Month Day Year

▼

▼

▼

(1-12) (1-31) (1934 - 1996) Verification Box 1

NO RESPONSE M A35

SOFT CHECK: IF A34 = M; Please provide an answer to this question and continue.

To continue to the next question without providing a response, click the continue button.

A34=M

A35. How old are you?

(18-80)

NO RESPONSE M

SOFT CHECK: IF A35 = M; Please provide an answer to this question and continue.

To continue to the next question without providing a response, click the continue button.

PROGRAMMER VERIFICATION BOX a35.1

SET DOB_VERIFY:

IF a34 DOB MATCHES PRELOADED DOB OR a35 CONVERTS TO PRELOADED DOB, SET DOB_VERIFY = 1 AND SKIP TO BOX A37W.2;

IF A34 = M AND A35=M; OR A34 DOB AND A35 AGE DOES NOT MATCH PRELOADED DOB, SET DOB_VERIFY = 0 AND CONTINUE TO A37W.

DOB_VERIFY = 0 (DOB DOES NOT MATCH OR IS MISSING)

A37W. What are the last 4-digits of your Social Security Number?

(0000-9999)

NO RESPONSE M

SOFT CHECK: IF A37W = M; Please provide an answer to this question and continue.

To continue to the next question without providing a response, click the continue button.

HARD CHECK: IF A37W = LT OR GT 4 DIGITS; Please provide only the last four digits of your Social Security number.

PROGRAMMER VERIFICATION BOX A37W.1

SET SSN_VERIFY:

IF A37W SSN MATCHES PRELOADED DOB, SET SSN_VERIFY = 1;

IF A37W= M OR A37W SSN DOES NOT MATCH PRELOADED DOB, SET SSN_VERIFY = 0;

ALL RESPONSES CONTINUE TO BOX A37.2.

PROGRAMMER VERIFICATION BOX A37.2

IF DOB_VERIFY = 1 OR SSN_VERIFY = 1, GO TOA37b;

IF DOB_VERIFY = 0 AND SSN_VERIFY = 0, CONTINUE TO A37a;

(NAME_VERIFY = 1 AND (DOB_VERIFY = 0 AND SSN_VERIFY = 0)) OR NAME_VERIFY = 0

A37a. There may be a problem with our records. A representative from Mathematica will give you a call to verify our information.

PROGRAMMER: DISPLAY THE FOLLOWING QUESTIONS ON THE SAME SCREEN.

PROGRAMMER: DROPDOWN OPTIONS INCLUDE: Anytime, Weekday mornings, Weekday afternoons, Weekday evenings, Weekend mornings, Weekend afternoons, Weekend evenings

Please provide the best phone number at which you can be reached.

□ Check here if you cannot provide a phone number 1

▼

Please select the best time to reach you below.

Please enter your email address below.

□ Check here if you don’t have an email address 2

SOFT CHECK: IF A37a_phone = NO RESPONSE; Please provide a phone number so we can help you complete the survey. If you cannot provide a phone number, please check the box and call 1-xxx-xxx-xxxx to speak with an interviewer.

PROGRAMMER VERIFICATION BOX a37a.1

SEND CASE TO SUPERVISOR REVIEW.

SEND ALERT WITH THE INFORMATION COLLECTED AT A37a.

DOB_VERIFY = 1 OR SSN_VERIFY = 1

A37b. Are you male or female?

Select one response

 Male 01

 Female 02

SOFT CHECK: IF A37b = M; Please provide an answer to this question and continue.

To continue to the next question without providing a response, click the continue button.

FREQUENTLY ASKED QUESTIONS (FAQs)

PROGRAMMER: ALLOW R TO VIEW FAQS AT ANY TIME.

WHO OR WHICH AGENCY IS SPONSORING THE STUDY?

This study is being sponsored by the U.S. Department of Labor and has been approved by the U.S. Office of Management and Budget under OMB Control Number xxxx-xxxx. Without this approval we would not be able to conduct this survey.

WHO IS CONDUCTING THE STUDY?

Mathematica, an independent research company is conducting the study on behalf of the U.S. Department of Labor. Mathematica has more than 40 years of policy research and program evaluation experience. You can learn more about Mathematica by visiting our website at www.mathematica-mpr.com.

WHAT IS THE PURPOSE OF THE STUDY?

This study is to learn about the adjustments that people make after they become unemployed or have their work hours reduced and file for unemployment insurance benefits. This information will help policymakers to assess how well the UI program is serving the nation’s workers and refine it to better meet their needs.

WHO IS ELIGIBLE TO PARTICIPATE IN THE STUDY?

The U.S. Department of Labor is interested in hearing from people in your state who recently filed for unemployment insurance benefits. You were scientifically selected to participate in the study from among persons who filed for benefits around the same time and from the same geographic area as you.

I DON’T COLLECT UNEMPLOYMENT BENEFITS ANY MORE OR I COLLECTED THEM FOR A VERY SHORT TIME.

We want to interview people who filed for unemployment insurance benefits in your state in the past year. Even if you no longer receive or never collected unemployment benefits, your experience and input is very important to the study. Hearing from people with different experiences helps us learn more about people who file for unemployment insurance benefits.

HOW DID YOU GET MY NAME?

Your name was scientifically selected from among persons in your state who filed for unemployment insurance benefits within the past year.

WILL MY ANSWERS BE KEPT PRIVATE?

Yes. All of the information we collect in the survey will be kept private to the extent permitted by federal law and will be used for research purposes only. Your answers will be combined with those of others and your name will never be used in reporting the results of the study. Your answers to questions will not affect your eligibility for any public program.

FAQs – (continued)

HOW LONG WILL THIS TAKE?

The length of the interview is different for different people, but it usually takes about 25 minutes.

WHY DO YOU WANT TO INTERVIEW ME THREE TIMES?

The Department of Labor is interested in capturing how the experiences of unemployed workers and workers who have their work hours reduced change over time. By interviewing you three times, we will be able to learn more about the adjustments that unemployment insurance recipients make. You will be paid for each interview you complete.

WILL I BE PAID?

Yes, by participating in this special study you can receive up to $90 as an incentive payment. Here’s how it works—in addition to the $5 that was included with your letter, Mathematica will send you $25 after you complete the survey today. We will ask you to complete two more surveys with us over the next six months or so. You can receive $30 for completing those two surveys using the web or by calling Mathematica.

WHO CAN I CONTACT FOR MORE INFORMATION?

For more information about the study, you can visit the U.S. Department of Labor (DOL) website at http://www.dol.gov/asp/evaluation/ongoing. For questions about the survey you can call Mathematica’s Survey Director, Julita Milliner-Waddell at 609-275-2206.

SECTION B: DEMOGRAPHIC AND HOUSEHOLD CHARACTERISTICS

B2 THROUGH B6 NOT ASKED AT THIRD INTERVIEW

All

B0. Is your current marital status the same as in [INT2 DATE]?

 Yes 01 B7

 No 00

NO RESPONSE M

SOFT CHECK: IF B0 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

B0 = 00, d or r

B1. What is your current marital status?

Select one response

 Married 01

 Separated 02

 Divorced 03

 Widowed 04

 Never married 05

NO RESPONSE M

SOFT CHECK: IF B1 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

All

B7. In general, would you say your health is excellent, good, fair or poor?

Select one response

 Excellent 01

 Good 02

 Fair 03

 Poor 04

NO RESPONSE M

SOFT CHECK: IF B7 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

SECTION C: UNEMPLOYMENT INSURANCE RECEIPT

SECTION C NOT ASKED AT THIRD INTERVIEW, EXCEPT C2b, C2c, C2d

c1=01 or c2=date provided

C2b. Are you currently receiving unemployment insurance benefits?

 Yes 01 C3

 No 00

NO RESPONSE M C3

SOFT CHECK: IF C2b = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

C2b=00

C2c. When did you stop receiving unemployment insurance benefits?

1. C3

Month Day Year

(01-12) (01-31) (2014-2016)

 NEVER COLLECTED 99 C3

NO RESPONSE M

SOFT CHECK: IF C2c = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

C2b=00

C2d. Why did you stop receiving unemployment insurance benefits from your claim filed around [UI CLAIM DATE]?

Select one response

New Income Sources

 I was re-employed/found a job; started a job; or started my own business 01

Benefit Restriction Issues

 My benefits ran out/were exhausted 02

 I was disqualified 03

 I received workmen’s compensation/had case pending 04

 I was not eligible for UI in the first place; I was denied benefits 05

Not Available To Work

 I had an illness or disability 06

 I voluntarily dropped out of the labor force/went to school 07

 I got back my immigration papers/had lost my immigration papers 08

 I went into the military 09

 I retired or received social security 10

 I moved 11

Other

 I had too much trouble dealing with or reaching the UI office 12

 I did not want unemployment insurance anymore 13

 I never collected 14

 Some other reason 99

(STRING (NUM))

NO RESPONSE M

SOFT CHECK: IF C2d = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

IF OTHER SPECIFY (99): What was the reason you stopped receiving unemployment insurance benefits?

C3 THROUGH C21 NOT ASKED AT THIRD INTERVIEW

SECTION D: JOB SEARCH AND OFFERS

D1 NOT ASKED AT THIRD INTERVIEW

all

D2. Since your last interview in [INT2 MONTH], have you applied for a job?

 Yes 1

 No 0 D4

NO RESPONSE M D4

SOFT CHECK: IF D2 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

D2=01

D3. Since [INT2 MONTH], did you apply for any jobs that would require you to relocate?

 Yes 01

 No 00 D9

NO RESPONSE M D9

SOFT CHECK: IF D3 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

ALL

D4. Have you received any job offers since [INT2 MONTH]?

If you were recalled to your old job, select “yes.”

 Yes 01

 No 00 D9

NO RESPONSE M D9

SOFT CHECK: IF D4 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

D4=01

D4a. How many job offers have you received since [INT2 MONTH]?

Enter Number of Job Offers Received

(01-10)

NO RESPONSE M

SOFT CHECK: IF D4a = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

D4=01

IF d4a=01, “THAT JOB OFFER”; IF D4a GT 01, “ANY OF THOSE JOB OFFERS”

D4b. Did you accept (that job offer/any of those job offers)?

 Yes 01 D9

 No 00 D5

 I have not decided d D5

NO RESPONSE M D5

SOFT CHECK: IF D4ba = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

D4b=00, M

IF D4a gt 1, “OFFERS “AND read sentence in parentheses and “BEST”.

D5. To help us better understand the job market, we’d like to ask a few questions about the job offer(s) you received. (If you received more than one job offer, please think about the best job offer you received.) What was the offered pay rate, including tips, bonuses and commissions for the (best) job offer you received/?

The best job offer is what that means to you. You can think about things like the salary offered, benefits, location, and other factors that are important to you.

Your best estimate is fine.

Amount Pay Period

▼

per

($5.00 - $500,000.00)

PROGRAMMER: USE PAY PERIOD OPTIONS BELOW

 Per hour 01

 Per week 02

 Once every two weeks 03

 Twice a month 04

 Per month 05

 Per year 06

 Some other pay period 99

Specify (STRING 250)

NO RESPONSE M

SOFT CHECK: IF D5 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

IF OTHER SPECIFY (99): What category would best describe (your total income/the total income for you and all the members of your household) just before your (job ended/work hours were reduced) in [JOB SEPARATION MONTH]?

SOFT CHECKS: OUT OF RANGE PER RESPONSE: You indicated [dollar amount] per [range]. Is this correct?

PER HOUR: >$50; PER WEEK: >$2,000; PER YEAR: >$100,000; ONCE EVERY TWO WEEKS: $4,000; TWICE PER MONTH: >$4,000; PER MONTH: >$8,000

D4b=00, M

D6. Were any of the following benefits included in that job offer?

PROGRAMMER: CODE ONE PER ROW

Select one response per row

	YES	NO
a. health insurance benefits?	01 	00 
b. paid sick days?	01 	00 
c. a retirement savings or pension plan?	01 	00 

SOFT CHECK: IF ANY ROWS ARE EMPTY; You have missed one or more questions on this page. Please review your answers and provide the missing response(s).

To continue to the next question without making changes, click the continue button.

D4b=00, d or M

D7. Did the job offered require relocation?

 Yes 01

 No 00

NO RESPONSE M

SOFT CHECK: IF D7 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

d4b=00, d or r

IF D4b=d, “IS” AND “HAVE NOT DECIDED WHETHER TO ACCEPT”

IF D4a GT1, “BEST”

COBRA C23

D8. There are many reasons why people sometimes do not accept a job offer. What (was/is) the main reason why you (did not accept/have not decided whether to accept) the (best) job that you were offered?

(STRING 250)

SOFT CHECK: IF D8 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

ALL

D9. Now I’m going to ask about services you may have received or used at [STATE One Stop Center NAME] or another American Job Center. Please include services received in person as well as on-line or by telephone. Since [INT2 MONTH], have you…

INTERVIEWER: READ STEM FIRST TIME, THEN AS NECESSARY.

PROGRAMMER: CODE ONE PER ROW

	CODE ONE PER ROW
	YES	NO
a. used a resource room? PROGRAMMER:SHOW IN HOVER/LINK: Each American Job Center usually has an area open to anyone, typically called a resource room. In these areas, you can use computers and the Internet to look for a job, and you can get information about specific jobs, different careers, and services available in the community.	01 	00 
b. attended any workshops? PROGRAMMER:SHOW IN HOVER/LINK: A workshop involves a small group of people coming together with a leader or instructor to learn how to do something, like use a computer, write a resume, or conduct a job search.	01 	00 
c. taken either tests or assessments?	01 	00 
d. attended meetings for either job clubs or job groups? PROGRAMMER:SHOW IN HOVER/LINK:These groups involve getting together with other job seekers for support and to talk about job leads and ways to find jobs.	01 	00 
e. received either career counseling or one-on-one assistance to support you in your job search or training?	01 	00 
f. received labor market information about what occupations were in demand in your local area?	01 	00 
g. received information on education or job training programs?	01 	00 
h. registered with either the Employment Service or your state’s job bank?	01 	00 

SOFT CHECK: IF ANY ROWS ARE EMPTY; You have missed one or more questions on this page. Please review your answers and provide the missing response(s).

To continue to the next question without making changes, click the continue button.

ANY OF D9a to D9h = 01

D10. How useful were the services you received through [STATE ONE STOP CENTER NAME] or another American Job Center in helping you to search for a job?

Select one response

 Very useful 01

 Somewhat useful 02

 Not very useful 03

 Not at all useful 04

NO RESPONSE M

SOFT CHECK: IF D10 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

ALL

if d4b=01, “including the job offer you accepted”

D11. (Including the job offer you accepted), Are you currently working at a job for pay? Please include both part-time and full-time jobs, as well as any self-employment jobs held for pay or profit.

 Yes 01 F2

 No 00

NO RESPONSE M

HARD CHECK: IF D11 = M; Your response to this question is important. Please provide a response and continue.

d11 ne 01

D12. Did you look for work last week?

 Yes 01 D13

 No 00 D15

NO RESPONSE M D15

SOFT CHECK: IF D12 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

D12=01

D13. Below is a list of things people sometimes do when looking for work. Please indicate whether you did any of these things to look for work last week.

Last week, did you…

PROGRAMMER:SHOW IN HOVER/LINK: Your responses will be combined with those of others. Your specific responses will not be shared with the Department of Labor or any other agency.

Select one response per row

	YES	NO
a. Contact either a private employment or placement agency?	01 	00 
b. Use services from [STATE ONE STOP CENTER NAME] or another American Job Center?	01 	00 
c. Contact your former employer?	01 	00 
d. Contact friends, relatives or professional associates about job openings?	01 	00 
e. Use the internet, including social media sites either to look for or apply for work?	01 	00 
f. Answer any want ads in newspapers or other publications?	01 	00 
g. Apply directly to places that you might want to work?	01 	00 

SOFT CHECK: IF ANY ROWS ARE EMPTY; You have missed one or more questions on this page. Please review your answers and provide the missing response(s).

To continue to the next question without making changes, click the continue button.

D12=01

D14. About how many hours did you spend looking for work last week?

Your best estimate is fine.

Hours spent looking for work last week E1

(01-80)

NO RESPONSE M

SOFT CHECK: IF D14 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

D14=M

D14a. Would you say you spent between…

Select one response

 1 and 5 hours, 01

 6 and 10 hours, 02

 11 and 20 hours, 03

 21 and 30 hours, 04

 31 and 40 hours, OR 05

 More than 40 hours looking for work last? 06

NO RESPONSE M

SOFT CHECK: IF D14a = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

PROGRAMMER BOX D14A.1

GO TO E1.

d1=99 OR D12=00 or M

if d1=99, “have not begun to look for work”

D15. People have different reasons for not looking for work. What is the main reason that you (have not begun to look for work/did not look for work last week)?

Please write in your main reason below 99

(STRING 100)

NO RESPONSE M

IF OTHER SPECIFY (99): What is the main reason that you (have not begun to look for work/did not look for work last week)?

SOFT CHECK: IF D15 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

SECTION E: RE-EMPLOYMENT EXPECTATIONS

PROGRAMMER SKIP BOX D15.1

IF D11=01 (CURRENTLY WORKING) - GO TO F1.

D11 NE 01

IF D15=04, “BE RECALLED TO YOUR old JOB”.

IF D15=05, “HAVE YOUR work HOURS REINSTATED”. OTHERWISE, “START A NEW JOB”.

E1. These next questions ask about your outlook on your employment situation. As of today, how many weeks or months do you think it will take you to (start a new job/be recalled to your old job/have your work hours reinstated)?

Your best estimate is fine.

Number Period

▼

E2

PROGRAMMER: USE PERIOD OPTIONS BELOW

 Weeks 01

 Months 02

 Years 03

 I do not want to work 98 F1

NO RESPONSE M

SOFT CHECK: IF E1 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

E1=M

E1a. Do you think it would take…

Select one response

 Two weeks or less, 01

 More than 2 weeks up to 1 month, 02

 More than 1 month, up to 2 months, 03

 More than 2 months, up to 3 months, 04

 More than 3 months, up to 6 months, 05

 More than 6 months, up to 9 months, 06

 More than 9 months, up to one year, or 07

 More than one year? 08

 I do not want to work 98 F1

NO RESPONSE M

PROGRAMMER BOX E1A.1

IF D4b=01—ACCEPTED JOB OFFER--SKIP TO F1

SOFT CHECK: IF E1a = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

ALL

E2. When looking for a job, people have different needs and requirements. For these next questions, please suppose someone offered you a job today and think about what is most important to you. For example, you might think about things like salary, work schedule, fringe benefits, location, how interested you are in the work, the costs of taking a job, which might include child care and transportation expenses, and other job attributes.

Which of the following benefits must be offered by a job for you to take it? Must the job offer adequate…

PROGRAMMER:SHOW IN HOVER/LINK: Adequate for your needs.

PROGRAMMER: CODE ONE PER ROW

Select one response per row

	YES	NO
a. health insurance benefits?	01 	00 
b. paid sick days?	01 	00 
c. a retirement savings or pension plan?	01 	00 

SOFT CHECK: IF ANY ROWS ARE EMPTY; You have missed one or more questions on this page. Please review your answers and provide the missing response(s).

To continue to the next question without making changes, click the continue button.

ALL

E3. What is the lowest wage or salary you are willing to accept, before deductions, for the type of work you are looking for?

Amount Pay Period

▼

per

($5.00 - $500,000.00)

PROGRAMMER: USE PAY PERIOD OPTIONS BELOW

 Per hour 01

 Per week 02

 Once every two weeks 03

 Twice a month 04

 Per month 05

 Per year 06

NO RESPONSE M

SOFT CHECK: IF E3 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

SOFT CHECKS: OUT OF RANGE PER RESPONSE: You indicated [dollar amount] per [range]. Is this correct?

PER HOUR: >$50; PER WEEK: >$2,000; PER YEAR: >$100,000; ONCE EVERY TWO WEEKS: $4,000; TWICE PER MONTH: >$4,000; PER MONTH: >$8,000

ALL

E4. Do you think you will need to relocate for a job that meets your requirements?

 Yes 01

 No 00

NO RESPONSE M

SOFT CHECK: IF E4 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

SECTION F: RE-EMPLOYMENT

PROGRAMMER: IF INT2 F9 NE 98 FOR INT2 JOBS 1-5, GO TO F1

PROGRAMMER: ASK FT1-FT4 FOR ALL EMPLOYER NAMES FROM INT2 WHERE INT2 F9=98—STILL AT JOB.

PROGRAMMER LOOP BOX FT1.1

ASK FT1 ACROSS ALL JOBS FIRST, THEN ASK FT1a-FT4 FOR ALL JOBS

Int2 F9=98 for any job

IF MORE THAN ONE EMPLOYER NAME FILLED FROM INT2, SAY “AND AT” [NEWJOB1-NEWHJOB5] AT FT1.

FT1. On [INT2 DATE] we learned that you were working at [INT2 NEWJOB1 (and at INT2NEWJOB2 and at INT2NEWJOB3 and at INT2NEWJOB4 and at INT2NEWJOB5)] at that time. Is that correct?

 Yes 01 FT2

 No 00

NO RESPONSE M

SOFT CHECK: IF FT1=NO RESPONSE; Your response to this question is important. Please provide a response and continue.

To continue to the next question without providing a response, click the continue button.

FT1 NE 01

FT1a. What (is/are) the correct name(s) of the employer(s) you worked for on [INT2 DATE]?

PROGRAMMER: REPLACE INT2 EMPLOYER NAME(S) WITH THIS OR THESE EMPLOYER NAME(S) FOR FT2 THROUGH FT4.

(STRING 50)

NO RESPONSE M

SOFT CHECK: IF FT1a=NO RESPONSE; Your response to this question is important. Please provide a response and continue.

To continue to the next question without providing a response, click the continue button.

FT1=01 or FT1a = 99

FT2. Are you still working at [INT2NEWJOB1-INT2NEWJOB5]?

PROGRAMMER: IF FT2=01, PREFILL EMPLOYER NAME(S) AT F5 AS INT2NEWJOB1-INT2NEWJOB5.

 Yes 01

 No 00

NO RESPONSE M

SOFT CHECK: IF FT2=NO RESPONSE; Your response to this question is important. Please provide a response and continue.

To continue to the next question without providing a response, click the continue button.

FT2 NE 01

FT3. On what date did your job at [INT2NEWJOB1-INT2NEWJOB5] end?

Your best estimate is fine.

▼

▼

▼

(1-12) (1-31) (2014 - 2015) Verification Box 1

NO RESPONSE M

SOFT CHECK: IF FT3 = M; Please provide an answer to this question and continue.

To continue to the next question without providing a response, click the continue button.

FT2 NE 01

FT4. What was the main reason that your job at [INT2NEWJOB1-INT2NEWJOB5] ended? Was it because…

 You were laid off 01

PROGRAMMER:SHOW IN HOVER/LINK: (Include: reorganization/downsizing/ company sold/company moved/company went out of business/plant or facility moved or closed/reduction in force or rif’ed/job or position eliminated)

 You retired 02

 You were discharged or fired 03

 You quit 04

 Some other reason? 99

(STRING 250)

NO RESPONSE M

SOFT CHECK: IF FT4= M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

d11 ne 01

if INT2F9=98 FOR ANY JOB, “OTHER” AND “ANY OTHER JOBS besides the one(s) we just discussed”

F1. The next questions are about any (other) jobs you may have had since your last interview. Since [INT2 DATE], have you worked (at a job/at any other jobs besides the one(s) we just discussed) for pay? Include both part-time and full-time jobs, as well as any self-employment jobs or business ventures held for pay or profit, even if you held them for only a short time.

 Yes 01

 No 00

NO RESPONSE M

SOFT CHECK: IF F1=NO RESPONSE; Your response to this question is important. Please provide a response and continue.

To continue to the next question without providing a response, click the continue button.

PROGRAMMER SKIP BOX F1.1

IF FT2=01 AND F1=00, M, GO TO F14

IF FT2=01 and F1=01, GO TO F4

IF FT2=00 AND F1=01, GO TO F4

IF FT2=00 AND F1=00, GO TO G3.

F2 NOT ASKED AT THIRD INTERVIEW

F3 IS ASKED LATER THIS ROUND

D11 OR F1=01

IF D11 OR FT2=01, “INCLUDING YOUR CURRENT JOB(S)”

IF FT2=01 FOR GT1 JOB, “JOBS”

F4. (Including your current job(s)) how many different jobs have you had since your last interview in [INT2 MONTH]? Again, please include both part time and full-time jobs, as well as any self-employment jobs or business ventures held for pay or profit.

Please include both part time and full-time jobs, as well as any self-employment jobs or business ventures held for pay or profit.

PROGRAMMER:SHOW TWO BULLETS BELOW IN HOVER/LINK:

• If a job that was interrupted by two or more unpaid weeks, count as separate jobs, even if it is with the same employer. If the separation was less than two weeks, count it as one job.

• Treat jobs with temporary agencies and self-employed consulting jobs as one job, regardless of the number of assignments.

▼

Number of jobs

(01-05)

NO RESPONSE M

SOFT CHECK: IF F4 = 01 – 05; You reported that you currently have [FILL F4] paid jobs. Please check that this is correct and either keep your answer or change your answer below.

To keep your answer without making changes, click the continue button.

HARD CHECK: IF F4 = M; You mentioned in a previous question that you are currently working. You just mentioned that you have 0 jobs. Click here to go back and change your answer about currently working. You may also change your answer below.

To continue to the next question, click the continue button.

PROGRAMMER LOOP BOX F4.1

ALLOW FOR NUMBER OF JOBS REPORTED AT F4

ASK F5 ACROSS ALL NEW JOBS FIRST, THEN ASK F6-18 FOR ALL NEW JOBS

IF FT2=01 FOR ANY JOB AND F1=01, ASK F14-F17 ABOUT JOBS WHERE FT2=01 FIRST, THEN ASK F6-F18 ABOUT NEW JOBS FROM F5

new jobs only

D11, FT2, OR F1=01

IF FT2 or f1=01, “Other”, IF FT2=01, START AT F14

The next questions ask about the jobs you’ve had since [INT2 MONTH/YEAR]).

F5. Starting with the first job, please enter the names of all the companies you worked for since [INT2 MONTH].

PROGRAMMER: THE NUMBER OF JOBS LISTED SHOULD MATCH NUMBER AT F4.

INT3NEWJOB [1] (STRING 50)

INT3NEWJOB [2] (STRING 50)

INT3NEWJOB [3] (STRING 50)

INT3NEWJOB [4] (STRING 50)

INT3NEWJOB [5] (STRING 50)

NO RESPONSE M

HARD CHECK: IF F5=NO RESPONSE; Your response to this question is important. Please provide a response and continue. If you have not had [FILL NUMBER AT F4] jobs, please click here to return to that question and update the number of jobs. PROGRAMMER: PROVIDE LINK TO F4 SO THAT RESPONDENT CAN UPDATE RESPONSE

INT2new jobs only

F1=01

F6. Please confirm that since [INT2 MONTH] you worked at [FILL F5 NAMES FOR INT3NEWJOBS 1-5]. Is this correct?

 Yes 01

 No 00

NO RESPONSE M

PROGRAMMER BOX F6.1

IF F6=00, GO BACK TO F4 AND F5 AND ALLOW RESPONDENT TO UPDATE THE NUMBER AND NEWJOB1-NEWJOB5 NAMES.

SOFT CHECK: IF F6=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without providing a response, click the continue button.

INT2new jobs only

F1=01

F6a. Is [INT3NEWJOB1-INT3NEWJOB5] the same employer you worked for in [JOB SEPARATION MONTH, YEAR]?

 Yes 01

 No 00

NO RESPONSE M

SOFT CHECK: IF F6a=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without providing a response, click the continue button.

new jobs only

ALL

F7. In what month and year did you first start working at [INT3NEWJOB1-INTNEWJOB5]?

PROGRAMMER: IF RESPONDENT RETURNED TO THE SAME EMPLOYER, DATE MUST BE AFTER UI CLAIM DATE.

Your best estimate is fine.

PROGRAMMER: INSERT DROPDOWNS WITH FOLLOWING RANGES

Month Day Year

▼

▼

▼

F9

(1-12) (1-31) (1964 - 2014)

NO RESPONSE M

SOFT CHECK: IF F7 MONTH OR F7 YEAR = NO RESPONSE; Please provide an answer to this question and continue.

To continue to the next question without providing a response, click the continue button.

HARD CHECK: IF THE DATE IS PRIOR TO UI CLAIM DATE: Your start date at [EMPLOYER NAME should come after the date you applied for unemployment insurance benefits in [UI CLAIM DATE].

Please update your response and click the continue button.

INT3new jobs only

F7 = M

F8. About how many weeks or months ago did you start working at [INT3NEWJOB1-INT3NEWJOB5]?

Your best estimate is fine.

▼

Number Period

(0-99)

PROGRAMMER: USE PERIOD OPTIONS BELOW

 Weeks 01

 Months 02

NO RESPONSE M

SOFT CHECK: IF F8 = NO RESPONSE; Please provide an answer to this question and continue.

To continue to the next question without providing a response, click the continue button.

INT3new jobs only

ALL

F9. On what date did your job at [INT3NEWJOB1-NEWJOB5] end?

Your best estimate is fine.

PROGRAMMER: INSERT DROPDOWNS WITH FOLLOWING RANGES

Month Day Year

▼

▼

▼

F14

(1-12) (1-31) (2015-2016)

□ Check here if you are still at [EMPLOYER NAME] 98 F11

NO RESPONSE M

SOFT CHECK: IF F9 MONTH OR F9 YEAR = NO RESPONSE; Please provide an answer to this question and continue.

To continue to the next question without providing a response, click the continue button.

INT2new jobs only

F9 = M

F10. Would you say your job at [INT3NEWJOB1-INT2NEWJOB5] ended…

Your best estimate is fine.

Select one response

 Within the past two weeks, 01

 Between 3 and 4 weeks ago, 02

 Between 5 and 6 weeks ago, 03

 Between 7 and 8 weeks ago, or 04

 More than 8 weeks ago? 05

NO RESPONSE M

SOFT CHECK: IF F10 = NO RESPONSE; Please provide an answer to this question and continue.

To continue to the next question without providing a response, click the continue button.

HARD CHECK: AFTER ASKING ABOUT THE LAST JOB, IF D11=01 (CURRENTLY WORKING) CHECK THAT FT2=01 OR AT LEAST ONE OF NEWJOB1-NEWJOB5=98 (STILL AT JOB). IF NO, SAY: Earlier you indicated that you are currently working, but reported an end date for each of your jobs. In order to continue, please select the question that needs to be corrected and update your response.

PROGRAMMER: SHOW QUESTION AND RESPONSE FOR D11, FT2, F9 (FOR NEWJOB 1-NEWJOB5). E.G.:

Question	Response
 (Including the job offer you accepted), Are you currently working at a job for pay? Please include both part-time and full-time jobs, as well as any self-employment jobs held for pay or profit.  Are you still working at [INT2NEWJOB1-INT2NEWJOB5?	[FILL YES, NO, RESPONSE MISSING] [FILL YES, NO, RESPONSE MISSING]
 On what date did your job at [NEWJOB1] end?	[FILL F9 DATE FOR NEWJOB1]
 On what date did your job at [NEWJOB 2] end?	[FILL F9 DATE FOR NEWJOB 2]
 On what date did your job at [NEWJOB 3] end?	[FILL F9 DATE FOR J NEWJOB 3]
 On what date did your job at [NEWJOB 4] end?	[FILL F9 DATE FOR NEWJOB 4]
 On what date did your job at [NEWJOB 5] end?	[FILL F9 DATE FOR NEWJOB 5]

INT3new jobs only

F9=98 AND F6a NE 01

F11. What kind of work do you do or duties do you have at [INT3NEWJOB1-INT3NEWJOB5]?

What (is/was) your occupation?

(STRING 250)

NO RESPONSE M

SOFT CHECK: IF F11=NO RESPONSE; Your response to this question is important. Please provide a response and continue.

To continue to the next question without providing a response, click the continue button.

INT3new jobs only

F9=98 AND F6a NE 01

F12. What kind of company is this—what do they make, sell, or do?

(STRING 250)

NO RESPONSE M

SOFT CHECK: IF F12=NO RESPONSE; Your response to this question is important. Please provide a response and continue.

To continue to the next question without providing a response, click the continue button.

INT2new jobs only

F9=98 AND F6a NE 01

F13. Are any of the following benefits available to you at [INT3NEWJOB1-INT3NEWJOB3]?

Select “yes” if the benefits are available, but not used. If the benefits were or will be available to you after a standard probationary period, select “yes”, even if not used.

Select one per row

	YES	NO
a. Health insurance benefits	01 	00 
b. Paid sick days	01 	00 
c. A retirement savings or pension plan	01 	00 

SOFT CHECK: IF ANY ROWS ARE EMPTY; You have missed one or more questions on this page. Please review your answers and provide the missing response(s).

To continue to the next question without making changes, click the continue button.

ALL JOBS

FT2=01 OR F9=DATE OR 98

F14. How many hours per week, including regular overtime hours do you usually work at [INT2NEWJOB1-INT2NEWJOB5/INT3NEWJOB1-INT3NEWJOB5]?

On average. Your best estimate is fine.

Hours per week

(01-80)

NO RESPONSE M

SOFT CHECK: IF F14=NO RESPONSE; Your response to this question is important. Please provide a response and continue.

To continue to the next question without providing a response, click the continue button.

ALL JOBS

F14=v, d, OR r

F15. Would you say you work less than 20 hours per week, between 20 and 29 hours per week, between 30 and 34 hours per week, or 35 or more hours per week?

On average. Your best estimate is fine.

Select one response

 Less than 20 hours per week 01

 Between 20 and 29 hours per week 02

 Between 30 and 34 hours per week 03

 35 or more hours per week 04

NO RESPONSE M

SOFT CHECK: IF F15=NO RESPONSE; Your response to this question is important. Please provide a response and continue.

To continue to the next question without providing a response, click the continue button.

ALL JOBS

FT2=01 OR F9= DATE OR 98

F16. What is your usual pay, including tips, bonuses and commissions at [INT2NEWJOB1-INT2NEWJOB5/INT3NEWJOB1-INT3NEWJOB5] before taxes or other deductions (were/are) taken?

Your best estimate is fine.

Amount Pay Period

▼

per F18

($5.00 - $500,000.00)

PROGRAMMER: USE PAY PERIOD OPTIONS BELOW

 Per hour 01

 Per week 02

 Once every two weeks 03

 Twice a month 04

 Per month 05

 Per year 06

 Other 99

Please write in your usual pay period here.

(STRING 250)

NO RESPONSE M

SOFT CHECK: IF F16=NO RESPONSE; Your response to this question is important. Please provide a response and continue.

To continue to the next question without providing a response, click the continue button.

SOFT CHECKS: OUT OF RANGE PER RESPONSE: You indicated [dollar amount] per [range]. Is this correct?

PER HOUR: >$50; PER WEEK: >$2,000; PER YEAR: >$100,000; ONCE EVERY TWO WEEKS: $4,000; TWICE PER MONTH: >$4,000; PER MONTH: >$8,000

ALL JOBS

F16 = M

F17. I’ll read some ranges. Please try to estimate your annual pay at [INT2NEWJOB1-INT2NEWJOB5/INT2NEWJOB1-INT2NEWJOB5]. Would you say your annual earnings are…

Select one response

 Less than $10,000 per year, 01

 $10,000 or more, but less than $20,000 per year, 02

 $20,000 or more but less than $30,000 per year, 03

 $30,000 or more but less than $40,000 per year, 04

 $40,000 or more but less than $50,000 per year, 05

 $50,000 or more but less than $75,000 per year, 06

 $75,000 or more but less than $100,000 per year, or 07

 More than $100,000 per year? 08

NO RESPONSE M

SOFT CHECK: IF F17= M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

PROGRAMMER SKIP BOX F17.1

IF F9=98, GO TO PROGRAMMER BOX F18.1, ELSE CONTINUE

new JOBS

f9 ne 98

F18. What was the main reason this job at [NEWJOB1-NEWJOB3] ended? Was it because…

Select one response

 You were laid off 01

PROGRAMMER:SHOW IN HOVER/LINK: (Include: reorganization/downsizing/ company sold/company moved/company went out of business/plant or facility moved or closed/reduction in force or rif’ed/job or position eliminated)

 You retired 02

 You were discharged or fired 03

 You quit 04

 Some other reason? 99

(STRING 250)

NO RESPONSE M

SOFT CHECK: IF F17= M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

PROGRAMMER LOOP BOX F18.1

IF CURRENT LOOP IS FOR INT2NEWJOB1 AND FT2=1 FOR INT2NEWJOB2 OR INT2NEWJOB3, GO TO F14 FOR THAT (THOSE) JOB(S), IF (LAST INT2NEWJOB OR FT2 NE 1) AND F1=01, GO TO F6a FOR INT2NEWJOB1

IF ALL JOBS FROM INT2 AND F5 HAVE BEEN LOOPED, GO TO PROGRAMMER SKIP BOX F3.1

PROGRAMMER SKIP BOX F3.1

IF THE SUM OF HOURS AT F14 GE 35 OR F15=04 FOR ANY JOB, GO TO G3. ELSE GO TO F3

ALL JOBS

SUM OF HOURS AT F14 LT 35 OR F15 NE 04 FOR ANY JOB

F3. Do you want to work a full-time workweek of 35 hours or more per week?

 Yes 01

 No 00

NO RESPONSE M

SOFT CHECK: IF F3 = M; Your response to this question is important. please provide a response and continue.

To continue to the next question without making changes, click the continue button.

SECTION G: FINANCIAL WELL-BEING

G1, G1a, AND G2 NOT ASKED AT THIRD INTERVIEW

ALL

If INT1 B2 gt 01, “and other members of your HOUSEHOLD”

IF INT1 G1a=01 OR INT2 G2=01, “BUT DO NOT INCLUDE YOUR MORTGAGE HERE”.

We understand that many people who become unemployed face difficulty paying their bills and meeting their financial commitments. These next questions are about financial obligations.

G3. What is the total amount of debt and loans you (and other members of your household) have currently? Please include automobile loans, student loans, balances on credit cards, medical bills, and personal loans owed to individuals (but do not include your mortgage here).

Your best estimate is fine.

PROGRAMMER: ADD DOLLAR SIGN TO FIELD

Total debt at job separation

(0-999,999) G5

NO RESPONSE M

SOFT CHECK: IF GT $100,000: You indicated [G3 dollar amount]. Is this correct?

SOFT CHECK: IF G3 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

G3=M

G4. Would you say it was…

Select one response

 Less than $5,000, 01

 Between $5,000 to under $10,000, 02

 Between $10,000 to under $20,000, 03

 Between $20,000 to under $30,000, 04

 Between $30,000 to under $50,000, 05

 Between $50,000 to under $100,000, or 06

 More than $100,000? 07

NO RESPONSE M

SOFT CHECK: IF G4 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

ALL

If INT1 B2 gt 01, “OR OTHER MEMBERS OF YOUR HOUSEHOLD”

G5. Since [INT2 MONTH], have you (or other members of your household) been 60 or more days late paying any of your bills?

 Yes 01

 No 00

NO RESPONSE M

SOFT CHECK: IF G5 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

ALL

IF C2b=01, “ARE”, ELSE “WERE”

G6. Since [INT2 MONTH], how important (are/were) your unemployment insurance payments in helping you meet your financial obligations?

Select one response

 Very important 01

 Somewhat important 02

 Somewhat unimportant 03

 Very unimportant 04

 I did not receive benefits/have not received benefits yet N

NO RESPONSE M

SOFT CHECK: IF G6 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

all

G6a. In addition to financial adjustments, people sometimes make adjustments in their eating habits following the loss of a job. Which of the following statements best describes the food eaten in your household since you were interviewed in [INT2 MONTH].

Select one response

 I had enough of the kinds of food I wanted to eat. 01

 I had enough but not always the kind of food I wanted to eat. 02

 I sometimes did not have enough to eat. 03

 I often did not have enough to eat. 04

NO RESPONSE M

SOFT CHECK: IF G6a = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

G7 NOT ASKED AT THIRD INTERVIEW

all

G8. About how much savings do you have now?

Please think about savings you could easily access and do not include money you may have had in retirement savings accounts.

By easily access we mean money you could retrieve and use quickly. Your best estimate is fine.

Select one response

 Less than $5,000 01

 $5,000 to under $10,000 02

 $10,000 to under $15,000 03

 $15,000 to under $20,000 04

 More than $20,000 05

NO RESPONSE M

SOFT CHECK: IF G8 = M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

INT1 G7a, INT1 G7b, INT1 G7c, INT1 G7d, INT1 G7e, OR INT1 G7f = 01

If INT1 B2 gt 01, “OR ANYONE ELSE IN YOUR HOUSEHOLD”

G9. Since [INT2 MONTH], did you (or anyone else in your household)…

PROGRAMMER: CODE ONE PER ROW

Select one response per row

	YES	NO
a. (G7a = 01) withdraw money from savings accounts?	01 	00 
b. (G7b = 01) access cash from credit card accounts?	01 	00 
c. (G7c= 01) access money from a home equity line of credit?	01 	00 
d. (G7d=01) access funds from investment accounts such as certificates of deposits, money market accounts, stocks, or bonds?	01 	00 
e. (G7e=01) make an early withdrawal from a retirement savings investment account such as a 401(k), 403(b), or IRA?	01 	00 
f. (G7f=01) take early retirement to get benefits from a pension plan?	01 	00 

SOFT CHECK: IF ANY ROWS ARE EMPTY; You have missed one or more questions on this page. Please review your answers and provide the missing response(s).

To continue to the next question without making changes, click the continue button.

G10 THROUGH G14b NOT ASKED AT THIRD INTERVIEW

INT1 B2 GT 01

G15. For these next questions about finances and income support, please answer in terms of what is happening now. Is anyone else in your household now receiving unemployment insurance compensation benefits? Please do not include your benefits here.

Please do not include your unemployment insurance compensation benefits here.

 Yes 01

 No 00

NO RESPONSE M

SOFT CHECK: IF G15=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

ALL

IF INT1 B2 GT 01, “OR ANYONE ELSE IN YOUR HOUSEHOLD”

G16. Are you (or anyone else in your household) now receiving…

PROGRAMMER: CODE ONE PER ROW

Select one response per row

	YES	NO
a. Food Stamp or SNAP benefits?	01 	00 
b. Welfare benefits such as [STATE TANF NAME] or General Assistance?	01 	00 
c. SSI, SSDI, or other disability benefits?	01 	00 
d. Social Security or Pension benefits?	01 	00 
e. Medicaid or [STATEMED]?	01 	00 

SOFT CHECK: IF ANY ROWS ARE EMPTY; You have missed one or more questions on this page. Please review your answers and provide the missing response(s).

To continue to the next question without making changes, click the continue button.

(int1, int2, OR int3 g15 NE 01) OR (INT1, INT2, OR INT3 G16a through g16e NE 01 FOR AT LEAST ONE INTERVIEW)

If INT1b2 gt 01, “OR ANYONE ELSE IN YOUR HOUSEHOLD”

IF INT1C10=02, “WORK HOURS WERE REDUCED”

G16a. (Since your (job at [SEPARATION EMPLOYER] ended/work hours were reduced) in [JOB SEPARATION MONTH, YEAR], have you (or anyone else in your household) applied for…

PROGRAMMER: CODE ONE PER ROW

Select one response per row

PROGRAMS	YES	NO
0. (INT1b2 gt 01 AND G15 NE 01 at int1, int2, OR int3) unemployment insurance compensation benefits	01 	00 
1. (G16a ne 01 at int1, int2, OR int3) food stamp or SNAP benefits?	01 	00 
2. (G16b ne 01 at int1, int2, OR int3) welfare benefits such as [STATE TANF NAME] or General Assistance?	01 	00 
3. (G16c ne 01 at int1, int2, OR int3) SSI, SSDI, or other disability benefits?	01 	00 
4. (G16d ne 01 at int1, int2, OR int3) Social Security or pension benefits?	01 	00 
5. (G16e ne 01 at int1, int2, OR int3) Medicaid or [STATEMED] benefits?	01 	00 

SOFT CHECK: IF ANY ROWS ARE EMPTY; You have missed one or more questions on this page. Please review your answers and provide the missing response(s).

To continue to the next question without making changes, click the continue button.

at least one of iNT3G16a_0 through int3G16a_5 = 01

G16b. Is that application for [fill PROGRAM] pending or was it denied?

PROGRAMMER: CODE ONE PER ROW

Select one response per row

PROGRAMS	YES	NO
0. (INT3G16a_0=01) unemployment insurance compensation benefits	01 	00 
1. (INT3G16a_1=01) food stamp or SNAP benefits	01 	00 
2. (INT3G16a_2=01) welfare benefits such as [STATE TANF NAME] or General Assistance	01 	00 
3. (INT3G16a_3=01) SSI, SSDI, or other disability benefits	01 	00 
4. (INT3G16a_4=01) Social Security or pension benefits	01 	00 
5. (INT3G16a_5=01) Medicaid or [STATEMED] benefits	01 	00 

SOFT CHECK: IF ANY ROWS ARE EMPTY; You have missed one or more questions on this page. Please review your answers and provide the missing response(s).

To continue to the next question without making changes, click the continue button.

INT1B1=01 or INT1B3=01,02, 03 or 04

IF INT1 B1=01, FILL “SPOUSE”, IF B3=01 OR 04, FILL “PARTNER”. IF B3=02, FILL “BOYFRIEND”. IF B3=03, FILL “GIRLFRIEND”

G17. On average, how many hours per week does your (spouse/partner/boyfriend/girlfriend) usually work now?

Hours per week

(10-80)

NO RESPONSE M G11

SOFT CHECK: IF G17=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

SOFT CHECK: IF LT 10 OR GT 80: You indicated [G17 hour amount]. Is this correct?

INT2 B2GT 02

G18. Since [INT2 MONTH], did anyone else in your household besides you begin working or begin working more hours?

 Yes 01

 No 00

NO RESPONSE M

SOFT CHECK: IF G18=M; Your response to this question is important. Please provide a response and continue.

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SECTION H: CUSTOMER SATISFACTION

ALL

HT1. This section asks about your satisfaction the unemployment insurance program.

Overall, how satisfied or dissatisfied are you with your experience with the unemployment insurance program?

Select one response

 Very satisfied 01

 Somewhat satisfied 02

 Somewhat dissatisfied 03

 Very dissatisfied 04

NO RESPONSE M

SOFT CHECK: IF HT1=M; Your response to this question is important. Please provide a response and continue.

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H1 NOT ASKED AT THIRD INTERVIEW

H2a-H2d NOT ASKED AT THIRD INTERVIEW

ALL

H2e. How satisfied or dissatisfied are you with the speed or timeliness of receiving your benefit checks or deposits?

Select one response

 Very satisfied 01

 Somewhat satisfied 02

 Somewhat dissatisfied 03

 Very dissatisfied 04

NO RESPONSE M

SOFT CHECK: IF H1=M; Your response to this question is important. Please provide a response and continue.

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H3 AND H4 NOT ASKED AT THIRD INTERVIEW

SECTION I: CLOSING AND CONTACT INFORMATION

ALL

fill with contact info from INT2 i1 SAMPLE LOAD OR FROM INTI2, IF UPDATED..

I1. PROGRAMMER: IF WE HAVE NAME, ADDRESS, AND PHONE NUMBER FROM THE FIRST INTERVIEW, DISPLAY THAT ADDRESS, AND PHONE NUMBER.

That was the last survey question. Please verify your current mailing information so that we can send your check for $30. Is your name, current address and phone number [FILL FROM I1 in INT2]?

Please include an apartment number, if applicable.

Select one response

 Yes, all of the information is correct 00 I2a

 No, I need to update the information 01

NO RESPONSE M

HARD CHECK: IF I1=M; Please verify your contact information so we can send your payment.

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I1=01, d, OR r

I2. UPDATE INFORMATION BELOW

Please update your name,current mailing address and phone number below.

First Name: (STRING 50)

Middle Initial: (STRING 50)

Last Name: (STRING 50)

Mailing Address 1: (STRING 60)

Mailing Address 2: (STRING 60)

Apartment #: (STRING 10)

City: STRING 60)

State: (STRING 2)

Zip: (STRING (NUM))

Phone Number: (STRING 10)

NO RESPONSE M

HARD CHECK: IF MAILING ADDRESS 1 IS MISSING; Please enter your mailing address so we can send your payment. To continue to the next question without providing a response, click the continue button.

HARD CHECK: IF CITY IS MISSING; Please enter your city so we can send your payment. To continue to the next question without providing a response, click the continue button.

HARD CHECK: IF PHONE NUMBER HAS DATA ENTERED, BUT IS NOT 10 NUM DIGITS; The phone number should be 10 digits. Please correct the number below.

INT2 I2b = answer

IT2a. Is your cell phone number [FILL INT2 I2b]?

 Yes 01

 No 00 I2b

NO RESPONSE M I2b

SOFT CHECK: IF IT2a=M; Your response to this question is important. Please provide a response and continue.

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INT2 I2b NE answer OR I2A=NE 01

I2b. What is your cell phone number?

□ Check here if you don’t have a cell phone

Phone number

NO RESPONSE M

HARD CHECK: IF PHONE NUMBER HAS DATA ENTERED, BUT IS NOT 10 NUM DIGITS; The phone number should be 10 digits. Please correct the number below.

SOFT CHECK: IF I2b=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

INT2 I4 = answer

IT3. Is your email address [FILL INT2 I4]?

 Yes 01 I5

 No 00 I4

NO RESPONSE M I4

SOFT CHECK: IF IT2a=M; Your response to this question is important. Please provide a response and continue.

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INT1 I4 NE answer OR IS3 NE 01

I4. What is your email address?

E-Mail (STRING 50)

□ Check here if you don’t have an email address

NO RESPONSE M

HARD CHECK: IF E-MAIL DOES NOT HAVE A “@” OR “.”; Please enter a valid e-mail address.

SOFT CHECK: IF I4=M; Your response to this question is important. Please provide a response and continue.

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ALL

I5. We will mail the check for $30 to you at [fill ADDRESS] within the next two weeks. In case you move, we would like to have the name, address, and phone number of two people who do not live with you who will know how to reach you. We would only contact these persons if we have trouble getting in touch with you directly.

In [FILL INT2 MONTH] you provided contact information for [FILL INT2 CONTACT 1 NAME, ADDRESS AND PHONE]. Is this information still accurate and would they still know how to reach you?

 Yes, that information is still accurate 01 I9T

 No, the information is incorrect or has changed 02

NO RESPONSE M

SOFT CHECK: IF I4=M; Your response to this question is important. Please provide a response and continue.

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I5 NE 01

I5T. What is your first contact person’s name?

First Name: (STRING 50)

Middle Initial: (STRING 50)

Last Name: (STRING 50)

NO RESPONSE M Thanks.

SOFT CHECK: IF I5T=M; It is important you provide at least one person to help us reach you in the future.

If there is no one who will know how to contact you, click the continue button.

I5 NE 00

I6. What is [FIRST NAME FROM I5T]’s address?

Please include an apartment number, if applicable.

Street Address 1: (STRING 60)

Street Address 2: (STRING 60)

Apartment #: (STRING 10)

City: STRING 60)

State: (STRING 2)

Zip: (STRING 5)

NO RESPONSE M

SOFT CHECK: IF CITY AND STATE ARE MISSING; Please enter just the city and state if you can.

To continue to the next question, click the “next” button below.

SOFT CHECK: IF I6=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question, click the “next” button below.

I5 NE 00

I7. What is [NAME FROM I5T]’s phone number?

Phone number

NO RESPONSE M

SOFT CHECK: IF I7=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

HARD CHECK: IF PHONE NUMBER HAS DATA ENTERED, BUT IS NOT 10 NUM DIGITS; The phone number should be 10 digits. Please correct the number below.

I5 NE 00

I8. How is [NAME FROM I5T] related to you?

Select one response

 Spouse/partner/boyfriend/girlfriend 01

 Mother 02

 Father 03

 Son or daughter 04

 Grandparent 05

 Brother/sister 06

 Aunt/uncle 07

 Other relative 08

 Friend 09

 Not related 10

NO RESPONSE M

SOFT CHECK: IF I8=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question, click the “next” button below.

INT2 I9=answer

I9T. In [FILL INT2 MONTH] you also provided contact information for [FILL INT2 CONTACT 2 NAME, ADDRESS AND PHONE]. Is this information still accurate and would they still know how to reach you?

 SAME AS PROVIDED 01 THANKS

 INCORRECT INFORMATION ABOVE, NEED TO ENTER NEW INFORMATION 01

NO RESPONSE M

SOFT CHECK: IF I9T=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

I9T ne 00

I9. What is your second contact person’s name?

First Name: (STRING 50)

Middle Initial: (STRING 50)

Last Name: (STRING 50)

NO RESPONSE M Thanks

SOFT CHECK: IF I9=M; It is important you provide at least one person to help us reach you in the future.

If there is no one else who will know how to contact you, click the continue button.

I9T ne 00

I10. What is [SECOND NAME FROM I9]’s address?

Street Address 1: (STRING 60)

Street Address 2: (STRING 60)

Apartment #: (STRING 10)

City: STRING 60)

State: (STRING 2)

Zip: (STRING 5)

NO RESPONSE M

SOFT CHECK: IF CITY AND STATE ARE MISSING; Please enter just the city and state if you can.

To continue to the next question, click the “next” button below.

SOFT CHECK: IF I10=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

I9T ne 00

I11. What is [NAME FROM I9]’s phone number?

Phone number

NO RESPONSE M

SOFT CHECK: IF I11=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

HARD CHECK: IF PHONE NUMBER HAS DATA ENTERED, BUT IS NOT 10 NUM DIGITS; The phone number should be 10 digits. Please correct the number below.

I9s ne 00

I12. How is [NAME FROM I9] related to you?

Select one response

 Spouse/partner/boyfriend/girlfriend 01

 Mother 02

 Father 03

 Son or daughter 04

 Grandparent 05

 Brother/sister 06

 Aunt/uncle 07

 Other relative 08

 Friend 09

 Not related 10

NO RESPONSE M

SOFT CHECK: IF I12=M; Your response to this question is important. Please provide a response and continue.

To continue to the next question without making changes, click the continue button.

ALL

Thanks. That was the last survey question. We really appreciate you taking the time to complete the third survey as part of this important study. Thanks again and best wishes.