Interent Group 1 Version 2

Attachment T: ACS Respondent Burden Testing Internet Survey Instrument: Group 1, Version 2

INET_G1_V2_Packet 1

2010 or later - Specify year

1980 to 2009
1940 to 1979
1939 or ealier

INET_G1_V2_Packet 1

When did you move into this house?

INET_G1_V2_Packet 1

INET_G1_V2_Packet 1

Does this house have -

INET_G1_V2_Packet 1

a. At this house, do you or any member of this household own or use a desktop, laptop
or a tablet?

INET_G1_V2_Packet 1

b. At this house, do you or any member of this household own or use a smartphone?

INET_G1_V2_Packet 1

ŽĂŶLJŽĨƚŚĞƐŵĂƌƚƉŚŽŶĞƐŽǁŶĞĚŽƌƵƐĞĚďLJLJŽƵŽƌĂŶLJŵĞŵďĞƌŽĨƚŚŝƐŚŽƵƐĞŚŽůĚ
ŚĂǀĞĂƉĂŝĚĐĞůůƵůĂƌĚĂƚĂƉůĂŶĨŽƌĂĐĐĞƐƐŝŶŐƚŚĞ/ŶƚĞƌŶĞƚ͍

INET_G1_Packet 2

ŽLJŽƵŽƌĂŶLJŵĞŵďĞƌŽĨƚŚŝƐŚŽƵƐĞŚŽůĚƉĂLJĨŽƌĂĐĐeƐƐƚŽƚŚĞ/ŶƚĞƌŶĞƚƵƐŝŶŐĂͲ

Broadband (high speed) Internet service, such as cable,
fiber optic, or DSL service installed in this house?
Satellite Internet service installed in this house?
Dial-Up Internet service installed in this house?
Some other service? Specify service

INET_G1_Packet 3a

ŽLJŽƵŽƌĂŶLJŵĞŵďĞƌŽĨƚŚŝƐŚŽƵƐĞŚŽůĚƉĂLJĨŽƌĂĐĐĞƐƐƚŽƚŚĞ/ŶƚĞƌŶĞƚƵƐŝŶŐĂͲ

Cellular data plan for a mobile device?
Broadband (high speed) Internet service, such as cable, fiber optic,
or DSL service installed in this house?
Satellite Internet service installed in this house?
Dial-Up Internet service installed in this house?
Some other service? Specify service

INET_G1_Packet 3b

ĂŶLJŽƵŽƌĂŶLJŵĞŵďĞƌŽĨƚŚŝƐŚŽƵƐĞŚŽůĚďŽƚŚŵĂŬĞĂŶĚƌĞĐĞŝǀĞƉŚŽŶĞĐĂůůƐ
when ĂƚƚŚŝƐhouse͍/ŶĐůƵĚĞĐĂůůƐƵƐŝŶŐĐĞůůƉŚŽŶĞƐ͕ůĂŶĚůŝŶĞƐ͕ŽƌŽƚŚĞƌƉŚŽŶĞĚĞǀŝĐĞƐ.

INET_G1_Packet 3b