Credit Matters Survey

Initials

Surveyor
: Complete
Incomplete

Respondent ID:
«Unique Identifier»

|__|__|

O
O

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
DATE SURVEY (MMDDYY):

TIME STARTED SURVEY (HHMM):

1

BLOCK A: PERSONAL INFORMATION
Question Asked
Enter Surveyor ID

2

Branch

3

Enter Member Name

01
02
03
04
05
First

O
O
O
O
O

Chippewa
Dellwood
Forest Park
Graham Rd.
University City

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Middle Initial
Last

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Generational Suffix (eg, Sr., Jr., III, etc.)

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1

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
4

What is the best phone number to reach you at?
What type of phone is this –
Mobile? House? Work?

5

What is the second best phone number to reach
you at?
What type of phone is this –
Mobile? House? Work?

6

01
02
03

O
O
O

Mobile
House
Work

01
02
03

O
O
O

Mobile
House
Work

|__|__|__||__|__|__||__|__|__|__|

What is your current mailing address?
Street
Street 2
City
State
Zip Code

7

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Do you live at this address?
01 Yes

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|__|__|__|__|__|__|__|__|__|
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01
02

O
O

Yes
No

02 No
[If 01, skip to 9]

2

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
8

What is the address where you currently live?
Street
Street 2
City
State
Zip Code

9

Have you moved addresses in the past 5 years?
01 Yes

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|__|__|__|__|__|__|__|__|__|
01
02

O
O

Yes
No

02 No
10

[If 02, skip to 11]
What is your most recent previous address?
Street
Street 2
City
State
Zip Code

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11 What is your SLCCU Account Number?
>>SEPARATE THESE FIRST 3 PAGES FROM THE REMAINDER OF THE QUESTIONNAIRE>>

3

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
12

BLOCK B: DEMOGRAPHIC INFORMATION
What is your gender?

13

01 Female
02 Male
What is your ethnicity or origin?

01
02

O
O

Female
Male

01
02

O
O

Hispanic or Latino
Not Hispanic or
Latino

What is your race? Please select one or more.

01

[ ]

01 American Indian or Alaska Native
02 Asian
03 Black or African-American
04 Native Hawaiian or Other Pacific Islander
05 White

02
03

[ ]
[ ]

04

[ ]

05
777

[ ]
[ ]

American Indian
or Alaska
Native
Asian
Black or AfricanAmerican
Native Hawaiian
or Other Pacific
Islander
White
Other

01 Hispanic or Latino
02 Not Hispanic or Latino
14

This means
that the adult
lives at the house
50% of the time
or more. Adults
are defined as
people over 18
years old.

15

Are you married?

01
02
888
999

O
O
O
O

Yes
No
Don’t know
Refused

16

Do you share an active credit card with your
spouse or other family member?

01
02
888
999

O
O
O
O

Yes
No
Don’t know
Refused

17

How many adults live in your household,
including you? Please only include in this number
individuals with whom you share finances –
meaning you are dependent on a shared or
pooled income -- since later survey questions will
ask about the finances of the household.

888
999

O
O

Don’t know
Refused

4

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
This means
that the child
lives at the house
50% of the time
or more. Children
are defined as
people under 18
years old. We
want to know
about how many
children live at
the house that
are dependent
on the income of
you and/or any
adults with
whom you share
finances.

18

19

How many children live in your household?

What was your annual household income in
2013?
01 Less than $10,000?
02 $10,000 - $19,999?
03 $20,000 - $29,999?
04 $30,000 - $39,999?
05 $40,000 - $49,999?
06 $50,000 or more?

Be sure to
read all
responses/
distinguish
between
graduating and
partial
completion.

20

What is the highest level of schooling you’ve
completed?
01 Less than 9th grade
02 Some High school
03 High school Graduate
04 GED
05 Trade School
06 Some College
07 Associates Degree
08 Bachelor’s Degree
09 Master’s Degree
10 Professional Degree
11 Doctorate Degree

888
999

O
O

Don’t know
Refused

01
02
03
04
05
06
888
999

O
O
O
O
O
O
O
O

Less than $10,000
$10,000-$19,999
$20,000-$29,999
$30,000-$39,999
$40,000-$49,999
$50,000 or more
Don’t know
Refused

01
02
03
04
05
06
07
08
09
10
11
888
999

O
O
O
O
O
O
O
O
O
O
O
O
O

Less than 9 gr.
Some HS
HS grad.
GED
Trade School
Some College
Associates Degree
Bachelor’s Degree
Master’s Degree
Professional Deg.
Doctorate Degree
Don’t know
Refused

th

BLOCK C: FINANCIAL INFORMATION

5

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
21

This is not
their credit score
but their credit
report/ record.

22

23

In the past 12 months, have you checked your
credit score?
01 Yes
02 No
In the past 12 months, have you obtained a copy
of your credit report?
01 Yes
02 No
Have you had difficulty getting approved for
loans in the past three years?
01 Yes
02 No
03 I have not tried to get approved for a loan.

Include
amount saved
below each that
apply. This
should be a
“snapshot” of
what the
respondent
currently has
saved up in each
of the options
applicable.

24

Are you saving in any of the following ways?
How much in total do you currently have saved in
each way?
01 Saving cash at home or in wallet
02 Making deposits into a savings account at
another financial institution
03 Buying financial investment products, other
than pension funds
04 401k/Retirement Plan
05 Prepaid cards
06 I have not been actively saving (I don’t save/I
have no money to save)
777 Other way (including remittances, buying
property)

01
02
888
999

O
O
O
O

Yes
No
Don’t know
Refused

01
02
888
999

O
O
O
O

Yes
No
Don’t know
Refused

01
02
03

O
O
O

888
999

O
O

Yes
No
I have not tried
to get approved
for a loan.
Don’t know
Refused

01

[ ]

Saving cash at
home/in wallet
$|__|__|__|__|__|__|
02
[ ]
Making deposits
into
savings
account
$|__|__|__|__|__|__|
03
[ ]
Buying fin
investment
products
$|__|__|__|__|__|__|
04
[ ]
401k/Retirement
Plan
$|__|__|__|__|__|__|
05
[ ]
Prepaid cards
$|__|__|__|__|__|__|
777
[ ]
Other way
06

[ ]

888
999

[ ]
[ ]

$|__|__|__|__|__|__|
I have not been
actively saving
Don’t know
Refused

6

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
This
includes debts in
deferment, grace
period, or not yet
in repayment.

25

Clarify that this
does not include
regular bills.
26

Cosign
means to sign
onto a loan with
another person,
where you share
responsibility; if
the first
borrower does
not pay back the
loan, the person
who “cosigned”
with them is
legally required
to make
payment on their
behalf.

27

Not including any mortgages or auto loans, what
is the size of your household’s overall debt (eg
credit card debt, student debt, payday loans
(small, short-term unsecured loans))?
01 Less than $5,000
02 $5000 - $9,999
03 $10,000 - $20,000
04 Above $20,000
What is the size of your household’s monthly
payments toward this debt?
01 Below $100
02 $100 - $199
03 $200 - $300
04 Above $300
Have you ever cosigned on a loan for another
person?

01
02
03
04
888
999

O
O
O
O
O
O

Less than $5,000
$5000 - $9,999
$10,000-$20,000
Above $20,000
Don’t know
Refused

01
02
03
04
888
999

O
O
O
O
O
O

Below $100
$100 - $199
$200 - $300
Above $300
Don’t know
Refused

01
02
888
999

O
O
O
O

Yes
No
Don’t know
Refused

7

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
28

29

How often do you buy lottery tickets?

03

O

Would you say
01 “Multiple tickets per week”
02 “About one ticket per week”
03 “About once a month”
04 “A few times a year”
05 “Less than 1 ticket per year average my
adult life”
06 “Never purchased a lottery ticket”

04

O

05

O

06

O

07

O

08
888
999
01

O
O
O
O

02

O

03

O

How often do you go to the casino?
Would you say
01 “At least once a week”
02 “At least once a month”
03 “At least once a year”
04 “Less than once a year”05 “I’ve never
been to the casino”
If 05, skip to 32.

30

When you go to the casino, do you set a
spending limit for yourself ahead of time?
01 Yes.
02 No.
03 Sometimes

31

If 02, skip to 32.
How often do you exceed the spending limit
you set for yourself?
01 Always
02 Very Often
03 Fairly Often
04 Sometimes
05 Almost Never
06 Never

04

Multiple per
week
About one per
week
About once a
month
A few times a
year
Less than once
per year
Never
Don’t know
Refused
At least once a
week
At least once a
month
At least once a
year
Less than once a

888
999
01
02
03
888
999

O
O
O
O
O
O
O

I’ve never been
to the casino
Don’t know
Refused
Yes
No
Sometimes
Don’t know
Refused

01
02
03
04
05
06

[
[
[
[
[
[

O
year
05
O

]
]
]
]
]
]

Always
Very Often
Fairly Often
Sometimes
Almost Never
Never

8

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
32

If you want to buy something that you really
want but don’t need and you don’t currently
have enough cash, which of the following do
you do:
01 “Save up for it”
02 “Take out a loan”
03 “Put it on layaway”
04 “Borrow money from a friend or relative”
05 “Sell some possessions”
06 “Credit card”
07 “Rent-to-Own”
08 “Do not buy the item”
777 “Other”

33

How would you describe your overall
financial situation? Would you say
“excellent”, “very good”, “ok”, “not very
good”, or “bad”?

07
08
09
10

[
[
[
[

11

[ ]

12
13
14

]
]
]
]

[ ]
[ ]
[ ]
item
777
[ ]
888 [ ]
999 [ ]
01
O
02
O
03
O
04
O
05
O

Save up for it
Take out a loan
Put it on layaway
Borrow money
from a friend or
relative
Sell some
possessions
Credit card
Rent-to-own
Do not buy the
Other
Don’t know
Refused
Excellent
Very good
OK
Not very good
Bad

9

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot



Read Aloud: I am going to read out some attitude and behavior statements. I would like to
know how much you agree or disagree that each of the statements applies to you, personally.
Please again use a scale of 1 to 5, where 1 tells me that you completely agree that the
statement describes you and 5 shows that you completely disagree:
34 My financial situation is a source of stress in
my life.
01
02
03
04
05

Completely agree
2
3
4
Completely disagree

35 Before I buy something I carefully consider
whether I can afford it.
01
02
03
04
05

Completely agree
2
3
4
Completely disagree

36 I tend to live for today and let tomorrow take
care of itself.
01
02
03
04
05

Completely agree
2
3
4
Completely disagree

37 In a typical month, it is difficult for me to cover
my expenses and pay all my bills.
01
02
03
04
05

Completely agree
2
3
4
Completely disagree

01

O

02
03
04
05

O
O
O
O

888
999
01

O
O
O

02
03
04
05

O
O
O
O

888
999
01

O
O
O

02
03
04
05

O
O
O
O

888
999
01

O
O
O

02
03
04
05

O
O
O
O

888
999

O
O

Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused
Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused
Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused
Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused

10

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
38 I am confident that I could come up with
$2000 if an unexpected need arose within the
next month.
01
02
03
04
05

Clarify that
the chance is not
a guarantee.

Completely agree
2
3
4
Completely disagree

39 I am willing to take a risk financially if there is
a chance of substantial gain.

01
02
03
04
05

Completely agree
2
3
4
Completely disagree

40 I set long term financial goals of five years or
more and strive to achieve them.
01
02
03
04
05

Completely agree
2
3
4
Completely disagree

41 The purpose of money is for it to be spent.
01
02
03
04
05
06

Completely agree
2
3
4
Completely disagree

01

O

02
03
04
05

O
O
O
O

888
999
01

O
O
O

02
03
04
05

O
O
O
O

888
999

O
O

01

O

02
03
04
05

O
O
O
O

888
999
01

O
O
O

02
03
04
05

O
O
O
O

888
999

O
O

Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused
Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused
Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused
Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused

11

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
42 I often find that I regret spending money. I
wish that when I had cash, I was better
disciplined and saved my money rather than
spent it.
01
02
03
04
05

Completely agree
2
3
4
Completely disagree

43 I demand the highest quality in everything I do.
01
02
03
04
05
06

Completely agree
2
3
4
Completely disagree

44 I have trouble finishing or completing my tasks.
01
02
03
04
05

Completely agree
2
3
4
Completely disagree

45 Success is a matter of hard work; luck has little
or nothing to do with it.
01
02
03
04
05

Completely agree
2
3
4
Completely disagree

01

O

02
03
04
05

O
O
O
O

888
999

O
O

01

O

02
03
04
05

O
O
O
O

888
999
01

O
O
O

02
03
04
05

O
O
O
O

888
999
01

O
O
O

02
03
04
05

O
O
O
O

888
999

O
O

Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused
Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused
Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused
Completely
agree
2
3
4
Completely
disagree
Don’t know
Refused

12

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
46 Suppose the credit union held a raffle and you
won. You have a choice: you can collect $50 in
cash today or $100 in cash one month from
today. Which would you choose?
01 $50 today
02 $100 in one month

01
02

O
O

888
999

O
O

01
02

O
O

888
999

O
O

01
02

O
O

888
999

O
O

01
02

O
O

888
999

O
O

01
02

O
O

888
999

O
O

$50 today
$100 in one
month
Don’t know
Refused

[If 02, skip to 48]
47 Ok, you prefer to receive $50 today in that first
scenario. Now say you had the choice between
collecting the $50 cash today and collecting
$150 in 1 month? Which would you choose?
01 $50 today
02 $150 in one month

$50 today
$150 in one
month
Don’t know
Refused

[Skip to 49]
48 Ok, you’re willing to wait 1 month for $100
instead of $50 today. Now let’s say the choice
is between collecting a $50 cash prize today or
$75 in 1 month. Which would you choose?
01 $50 today
02 $75 in one month
49 Suppose you were choosing between
collecting $50 in cash 6 months from today or
$100 in cash 7 months from today. Which
would you choose?
01 $50 in 6 months
02 $100 in 7 months

$50 today
$75 in one
month
Don’t know
Refused
$50 in 6 months
$100 in 7
months
Don’t know
Refused

[If 02, skip to 51]
50 Ok, you prefer to receive $50 in 6 months.
Now say you had the choice between
collecting the $50 in 6 months and collecting
$150 in 7 months? Which would you choose?
01 $50 in 6 months
02 $150 in 7 months

$50 in 6 months
$150 in 7
months
Don’t know
Refused

[Skip to 52]

13

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
51 Ok, you’re willing to wait 7 months for $100
instead of getting $50 in 6 months. Now let’s
say the choice is between collecting a $50 cash
prize in 6 months or $75 in 7 months. Which
would you choose?

Put decimal
place in
appropriate box.

01 $50 in 6 months
02 $75 in 7 months
52 Suppose you put $100 into a no feesavings
account with a guaranteed interest rate of 2%
per year. You don’t make any further
payments into this account and you don’t
withdraw any money. How much would be in
the account at the end of the first year, once
the interest payment is made?
53 How much would be in the account at the end
of five years? Would it be:
01 More than $110
02 Exactly $110
03 Less than $110
04 It is impossible to tell from the information
given

01
02
888
999

O
O
O
O

$50 in 6 months
$75 in 7 months
Don’t know
Refused

01
888
999

O
O

Don’t know
Refused

01
02
03
04

O
O
O
O

888
999

O
O

More than $110
Exactly $110
Less than $110
It is impossible
to tell from the
information
given
Don’t know
Refused

$

14

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot



Respondent ID:
«Unique Identifier»

Read Aloud: Now I’m going to read out a list of items. After I read each one, please tell me
whether you think it can affect the amount of interest that you would pay on a bank loan.
The first is..
54 Your credit rating? Would you say…
01
O Yes – this
affects the
01 Yes – this affects the amount of interest you
amount of
would pay on a bank loan.
interest.
02 No – this does NOT affect the amount of
02
O
No
– this
interest you would pay on a bank loan.
does NOT
affect the
amount of
interest.
888 O
Don’t know
999 O
Refused
55 The amount of money you have in savings?
01
O
Yes – this
affects the
01 Yes – this affects the amount of interest you
amount of
would pay on a bank loan.
interest.
02 No – this does NOT affect the amount of
02
O
No – this
interest you would pay on a bank loan.
does NOT
affect the
amount of
interest.
888
O
Don’t know
999
O
Refused
56 Your annual income?
01
O
Yes – this
affects the
01 Yes – this affects the amount of interest you
amount of
would pay on a bank loan.
interest.
02 No – this does NOT affect the amount of
02
O
No – this
interest you would pay on a bank loan.
does NOT
affect the
amount of
interest.
888
O
Don’t know
999
O
Refused

15

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
57 Your health?
01 Yes – this affects the amount of interest you
would pay on a bank loan.
02 No – this does NOT affect the amount of
interest you would pay on a bank loan.

58 Your age?
01 Yes – this affects the amount of interest you
would pay on a bank loan.
02 No – this does NOT affect the amount of
interest you would pay on a bank loan.

59 How much you borrow overall?
01 Yes – this affects the amount of interest you
would pay on a bank loan.
02 No – this does NOT affect the amount of
interest you would pay on a bank loan.

01

O

02

O

888
999
01

O
O
O

02

O

888
999
01

O
O
O

02

O

888
999

O
O

Yes – this
affects the
amount of
interest.
No – this
does NOT
affect the
amount of
interest.
Don’t know
Refused
Yes – this
affects the
amount of
interest.
No – this
does NOT
affect the
amount of
interest.
Don’t know
Refused
Yes – this
affects the
amount of
interest.
No – this
does NOT
affect the
amount of
interest.
Don’t know
Refused

16

Respondent ID:
«Unique Identifier»

St. Louis Community Credit Union Credit Builder Loan – Baseline Survey Pilot
60 How long you take to repay the loan?
01 Yes – this affects the amount of interest you
would pay on a bank loan.
02 No – this does NOT affect the amount of
interest you would pay on a bank loan.

01

O

02

O

888
999

O
O

Yes – this
affects the
amount of
interest.
No – this
does NOT
affect the
amount of
interest.
Don’t know
Refused

TIME COMPLETED SURVEY (HHMM):

17