1525-0012-0196-FY15/16 CMS Focus Groups 1525-0012-0197-Platinum Eagle Consumer Research

NAXION Study # U002-25-XXX

Date

SCREENER

UNITED STATES MINT CUSTOMERS – City A

ask TO SPEAK TO PERSON NAMED on list

GET A MIX

GET A MIX

( ) female

( ) male

FROM LIST

( )	High Spend (“$500+”)		GET A MIX
( )	Mid Spend (“$100 - $499.99”)
( )	Low Spend (“$.01-$99.99”)

RESPONDENT NAME:

ADDRESS:

CITY/STATE: ZIP CODE:

TELEPHONE #: FAX #:

GROUP SCHEDULE

Attending:

Date

Group 1( ) 6:00 PM – 8:00 PM – General U.S. Mint Customers

Date

Group 2 ( ) 8:00 PM – 10:00 PM – General U.S. Mint Customers

SUGGESTED INTRODUCTION: Hello, I'm __________________________ calling for NAXION, a marketing research firm based in Philadelphia. This is not a sales call. We are conducting a research study for The United States Mint, and are inviting people who meet certain qualifications to participate in an informal group discussion on (DAY/DATE).

Are you free on that date?

Yes ( )

No ( ) THANK AND TERMINATE

I’d like to ask you a few questions. This survey is strictly voluntary. We are also required, by law, to report to you the OMB Control Number for this public information request. That number is OMB#1525-0012-0196(c).

1. Do you, or does anyone in your household or family, own or work for? (READ AND SELECT ALL THAT APPLY)

Yes No

A) A coin dealer, or a retail store that sells coins? ( ) ( )

B) A newspaper, radio station, or television station? ( ) ( )

C) The United States Mint? ( ) ( )

D) An advertising agency? ( ) ( )

E) A market research company? ( ) ( )

F) A company that manufactures or markets ( ) ( )

collectible items (dolls, cards, memorabilia, etc.)?

IF "YES" TO ANY THANK AND TERMINATE

2. Have you ever attended a group discussion for market research purposes or participated in an over-the-phone research interview?

Yes ( )

___________________________________

No ( ) SKIP TO Q.4

3. When was the last time you did so?

MONTH YEAR

TERMINATE IF WITHIN THE PAST 6 MONTHS

4. In the past year, have you sold any U.S. coins for income purposes other than to round out a personal collection? (IF NECESSARY, PROBE: Are you a coin dealer?)

Yes ( ) THANK AND TERMINATE

__________________________________________

No ( )

5. When was the first time that you purchased coins or coin-related items from the United States Mint? Was it: (READ. CHECK APPROPRIATE BOX.)

Within the past 12 months,	( )	SKIP TO Q.7
1 to 2 years ago,	( )
3 to 4 years ago, or	( )
More than 4 years ago?	( )

TRY TO RECRUIT 1-2 “Within the past 12 months” PER GROUP

6. When was the most recent time that you purchased coins or coin-related items from the United States Mint? Was it: (READ. CHECK APPROPRIATE BOX.)

Within the past 12 months,			( )
1 to 2 years ago,			( )
3 to 4 years ago, or			( )		TERMINATE
More than 4 years ago?			( )

7. In the past two years, which of the following items, if any, did you purchase from the United States Mint? (READ AND CHECK ALL THAT APPLY.)

	Yes	No
A. Gold, Silver, or Clad Commemorative Coins	( )	( )
B. Any young collectors sets (e.g., National Baseball Hall of Fame Young Collectors set, Theodore Roosevelt Presidential Discovery Set, Girl Scouts of the USA Young Collectors Set, etc.)	( )	( )
C. Birth, Congratulations, and/or Birthday Set	( )	( )
D. Presidential Bronze Medals	( )	( )
E. Any other Medals (e.g., First Spouse, Military, Historical, etc.)	( )	( )
F. Any gold coins (e.g., American Buffalo, American Eagle, First Spouse, etc.)?	( )	( )
G. American Eagle Silver Coins?	( )	( )
H. Uncirculated Sets?	( )	( )
I.   Annual Clad or Silver Proof – Full Set?	( )	( )
J. Annual Clad or Silver Proof – Quarters Set?	( )	( )
K. Annual Clad Proof – Presidential $1 Coin Set, Rolls, or Bags?	( )	( )
L. Any Commemorative Sets in the past 5 years (e.g., 2012 Infantry Soldier Silver Dollar Defenders of Freedom Set, 2009 Lincoln Coin and Chronicles Set, etc.)?	( )	( )
M. Other United States Mint Products	( )	( )

RECRUIT AT LEAST 4 ANSWERING “YES” TO “A” AND/OR “L”

RECRUIT AT LEAST 2 ANSWERING “YES” TO “D” AND/OR “E”

RECRUIT AT LEAST 5 ANSWERING “YES” TO “H”

TRY TO RECRUIT AT LEAST 5 RESPONDENTS WHO PURCHASED FROM TWO OR MORE OF THESE CATEGORIES

IF A CUSTOMER ANSWERS “YES” ONLY TO “M” (Other), TERMINATE.

8. Were these purchases: (READ AND CHECK ALL THAT APPLY.)

A. For yourself?	( )
B. For a gift?	( )
C. Both?	( )

IF A “$500+ CUSTOMER” ANSWERS “YES” ONLY TO B, CONTINUE THROUGH THE REST OF THE SCREENER AND TERMINATE AT END OF SCREENER.

9. Is your age: (READ. CHECK APPROPRIATE BOX.)

Under 18,	( )	TERMINATE AT END OF SCREENER
18 to 30,	( )	GET
31 to 39,	( )	AN
40 to 49,	( )	EVEN
50 to 59,	( )	MIX
60 to 70, or	( )	NO MORE THAN ONE PER GROUP
Over 70?	( )	TERMINATE AT END OF SCREENER

10. What is the last grade of school you completed? Is it: (READ. CHECK APPROPRIATE BOX.)

Less than high school,	( )	TERMINATE AT END OF SCREENER
High school,	( )
Some College,	( )		GET
College, or	( )		A
Graduate school?	( )		MIX

11. The United States Mint is interested in getting the opinions of people of diverse cultural backgrounds, and we would like to ask you a few questions about your background. (READ)

Are you Latino or Hispanic Yes ( ) No ( )

___________________________________________________________________________

What is your race? Please select one or more. (READ)

White	( )	GET A MIX
Black or African-American	( )
Asian	( )
Native Hawaiian or other Pacific Islander, or	( )
American Indian or Alaska Native?	( )
_____________________________________________________
(DO NOT READ) Prefer not to answer.	( )

12. Are you employed? (READ. CHECK APPROPRIATE BOX.)

Full time,	( )	GET
Part time, or	( )	A
Not Employed?	( )	MIX

13. Is your total annual household income before taxes: (READ. CHECK APPROPRIATE BOX.)

Under $25,000,	( )	NO MORE THAN 1 PER GROUP
$25,000 to $49,000,	( )	GET A MIX
$50,000 to $75,000,	( )
$75,000 to $99,999, or	( )
$100,000 or more?	( )

EXTEND INVITATION TO ELIGIBLE RESPONDENT AND RECORD INFORMATION ON FRONT. We'd like to invite you to participate in this research project.

You will receive an honorarium of $75 for your participation.

Note to recruiters: As part of our ISO certification, we require that the following be read to each respondent.

Thank you for your time. We look forward to having a discussion with you regarding the U.S. Mint. We want to assure you that it is NAXION’s policy to keep interviews anonymous and responses secured. The information you provide during the interview will be reported in aggregate and at no stage will your name or other identifying information be associated with your responses.

The interview may be recorded or viewed by others.

For further information on NAXION’s privacy policy, you can visit their website at

http://www.naxionthinking.com/privacy-policy/information-privacy-policy

Please let us know if you have any questions or concerns about your upcoming appointment with NAXION.

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