Nonsub Change Request - Attachment C

Income and Assets (IAQ): Existing section below has been replaced with new items

Variable Name

SPSEINHH

ADLTINHH

MR
Screen
Name

Questio
n type Question text/description
Code list
IF (SP IS IN THE EXIT SAMPLE AND
PREVIOUS ROUND INTERVIEW
WAS NOT SKIPPED), GO TO IAINT8 SPSEINHH.
BOX IA1A routing ELSE GO TO IAINTRO - IAINT.
(01) YES
WAS SP'S SPOUSE LIVING IN THE (02) NO
HOUSEHOLD DURING THIS
(-8) Don't
IAINT8
code 1 ROUND?
Know
BESIDES SP (AND SP'S SPOUSE),
WAS ANY OTHER ADULT, AGE 15 (01) YES
OR OLDER, LIVING IN THE
(02) NO
HOUSEHOLD DURING THIS
(-8) Don't
IAINT9
code 1 ROUND?
Know

Text Fill Logic

Input
mask Routing

IAINT9 ADLTINHH

IAINTRO IAINT

Now I have some questions about
(PREVIOUS YEAR) income and
other financial resources for
[you/(SP)/you and your
(wife/husband)/(SP) and (his/her)
(wife/husband)].

IAINT

[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
As with all information collected by
[you and your] respondent is SP, SP
the MCBS, the data are
married
confidential and covered by the
[wife] SP's spouse female
Privacy Act of 1974. Your answers
[husband] SP's spouse male
will be combined with those of
[(SP)] respondent is proxy
other respondents, and
[his] SP male
[your/his/her] Medicare benefits
[her] SP female
will not be affected in any way by
[wife] SP's spouse female
your answers to these questions.
[husband] SP's spouse male
GIVE BROCHURE TO RESPONDENT.
[your] respondent is SP
ALLOW A FEW MINUTES FOR
[his] respondent is proxy, SP male
RESPONDENT TO REVIEW
(01) CONTINUE [her] respondent is proxy, SP
IAINTRO no entry BROCHURE IF NECESSARY.
(-7) Empty
female

IAINTRO1 IAINT1

As the brochure explains, your
responses to these questions can
help us determine the impact of
income on [your/his/her] use and
access to health care. I will be
asking a series of questions about
[your/(SP’s)/you and your
(wife’s/husband’s)/(SP) and
(his/her) (wife’s/husband’s)]
income and other financial
resources. First, I will ask whether
[you/(SP)/you and your
(wife/husband)/(SP) and (his/her)
(wife/husband)] had particular
types of income or other
resources. All these questions can
be answered with a "yes" or a
"no." Then, I will ask you to
estimate [your/(SP's)/their] total
income. [Please answer all
questions for [you and your
(wife/husband)/(SP) and (his/her)
(wife/husband)].

IAINT1

Please feel free to refer to any
records or other persons who may
IAINTRO1 no entry be of assistance to you.
In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .

[your] respondent is SP
[his] respondent is proxy, SP male
[her] respondent is proxy, SP
female
[your] respondent is SP, not
married
[(SP's)] respondent is proxy, SP not
married
[you and your] respondent is SP, SP
married
[wife's] SP's spouse female
[husband's] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife's] SP's spouse female
[husband's] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you and your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
(01) CONTINUE [wife] SP's spouse female
(-7) Empty
[husband] SP's spouse male

receive Social Security and/or
Railroad Retirement payments?

SSRRPROB

IA1A

list

[READ IF NECESSARY: Social
Security checks are either
automatically deposited in the
bank or mailed, and payment
generally arrives on the 3rd of the
month.]

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

IA1A SSRRPROB

IA1A SSIPROBE

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .

SSIPROBE

IA1A

list

(01) YES
receive Supplemental Security
(02) NO
Income, which is also called SSI, or (-8) Don't
Social Security Disability Insurance, Know
also called SSDI?
(-9) Refused

In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .

DISAPROB

IA1A

list

receive any disability payments
(other than Social Security, SSDI,
and/or Railroad Retirement)?

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .

PENPROBE

JOBPROBE

IA1A

IA1B

list

list

receive any retirement or survivor
pension or annuity (other than
Social Security or Railroad
Retirement)?
In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)] . . .
work at a job or business for pay?
That is, did [you/he/she/he or his
wife/she or her husband/you or
your (wife/husband)] receive
income by working for an
employer or by being selfemployed, such as owning a
business, professional practice, or
farm?

IA1A DISAPROB

IA1A PENPROBE

IA1B JOBPROBE

IA1B WELPROBE

In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)] . . .

WELPROBE

IA1B

list

receive any income from public
assistance or welfare from the
state or local welfare office?
Please include programs such as
Temporary Assistance for Needy
Families, or TANF, and food
stamps.

In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)] . . .

RELPROBE

IA1B

list

receive financial assistance from
relatives or friends?

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)] . . .

IRAWD

IA1B

list

convert or withdraw any funds
from an IRA, Keogh, 401K, or other
retirement savings account in
(PREVIOUS YEAR)?

In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .

STOKPROB

IA1C

list

receive any dividends from any
investments in stocks or mutual
funds or other investments?

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

IA1B RELPROBE

IA1B IRAWD

IA1C STOKPROB

IA1C LUMPPROB

In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .

LUMPPROB

IA1C

list

receive a lump sum or any onetime payments such as a life
insurance or pension settlement,
inheritance, or a capital gain from
the sale of securities, property, or
a business?

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .

ESTPROBE

IA1C

list

(01) YES
receive any regular payments from (02) NO
estates, trusts, annuities (other
(-8) Don't
than pensions), life insurance, or Know
royalties?
(-9) Refused

In (PREVIOUS YEAR), did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .

PROPRENT

OTHPROBE

IA1C

IA13

list

(01) YES
(02) NO
(-8) Don't
receive any income from the rental Know
of properties?
(-9) Refused

code 1

Not including anything you've
already told me about, did
[you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)] receive income
from any other sources, such as
Department of Veterans Affairs
payments, worker's or
unemployment compensation,
child support, or alimony?

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

IA1C ESTPROBE

IA1C PROPRENT

IA13 OTHPROBE

BOX IA1

BOX IA1

routing

IF AT LEAST ONE INCOME PROBE
AT IA1A, IA1B, IA1C, OR IA13 WAS
ANSWERED "YES", GO TO IA14 INCYRAMT.
ELSE GO TO BOX IA2AA.
SHOW CARD IA1
Taking all of these income sources
into account, please estimate
[your/(SP’s)/you and your
(wife’s/husband’s)/(SP) and
(his/her) (wife’s/husband’s)]
income for (PREVIOUS YEAR).
[PROBE: In estimating
(your/his/her/their) total income
you can respond for all of
(PREVIOUS YEAR), or, if you prefer,
provide a one month estimate.]

INCYRAMT

IA14

[PROBE: REVIEW THESE SOURCES
WITH RESPONDENT: [Social
Security or Railroad Retirement/
(SSI/SSDI)/disability/pensions/job,
business, professional practice,
farm/public assistance
programs/assistance from
relatives or friends/withdrawal
from retirement or
savings/dividends/lump sum
payments/other regular
quantity payments/rental properties/other
unit
sources]]

(01)
[Continuous
answer.]
(-8) Don't
Know
(-9) Refused

[your] respondent is SP, not
married
[(SP's)] respondent is proxy, SP not
married
[you and your] respondent is SP, SP
married
[wife's] SP's spouse female
[husband's] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife's] SP's spouse female
[husband's] SP's spouse male
[your] respondent is SP
[his] respondent is proxy, SP male,
SP not married
[her] respondent is proxy, SP
female, SP not married
[their] respondent is proxy, SP
married

IA14 INCYRUNT

SHOW CARD IA1
Taking all of these income sources
into account, please estimate
[your/(SP’s)/you and your
(wife’s/husband’s)/(SP) and
(his/her) (wife’s/husband’s)]
income for (PREVIOUS YEAR).

INCYRUNT

INCYRMT1

IA14

IA15

[your] respondent is SP, not
[PROBE: In estimating
married
(your/his/her/their) total income
[(SP's)] respondent is proxy, SP not
you can respond for all of
married
(PREVIOUS YEAR), or, if you prefer,
[you and your] respondent is SP, SP
provide a one month estimate.]
married
[wife's] SP's spouse female
[PROBE: REVIEW THESE SOURCES
[husband's] SP's spouse male
WITH RESPONDENT: [Social
[(SP)] respondent is proxy
Security or Railroad Retirement/
[his] SP male
(SSI/SSDI)/disability/pensions/job,
[her] SP female
business, professional practice,
[wife's] SP's spouse female
farm/public assistance
(01) TOTAL
[husband's] SP's spouse male
programs/assistance from
FOR (PREVIOUS [your] respondent is SP
relatives or friends/withdrawal
YEAR)
[his] respondent is proxy, SP male,
from retirement or
(02) ONE
SP not married
savings/dividends/lump sum
MONTH
[her] respondent is proxy, SP
payments/other regular
(-8) Don't
female, SP not married
quantity payments/rental properties/other Know
[their] respondent is proxy, SP
unit
sources]]
(-9) Refused
married

code 1

INCYRMT2

IA16

code 1

INCYRMT3

IA17

code 1

(01) YES
(02) NO
Was it more than
(-8) Don't
($20,000/$1,700/$40,000/$3,300) Know
?
(-9) Refused

(01) YES
(02) NO
Was it more than
(-8) Don't
($12,000/$1,000/$25,000/$2,000) Know
?
(-9) Refused
(01) YES
(02) NO
(-8) Don't
Was it more than
Know
($7,700/$640/$17,000/$1,400)?
(-9) Refused

(01) BOX
IA2AA
(02) BOX
IA2AA
(-8) IA15 INCYRMT1
(-9) IA15 INCYRMT1
(01) BOX
IA2AA
(02) IA16 INCYRMT2
(-8) BOX
IA2AA
(-9) BOX
IA2AA
(01) BOX
IA2AA
(02) IA17 INCYRMT3
(-8) BOX
IA2AA
(-9) BOX
IA2AA

BOX IA2AA

BOX
IA2AA

HHINCOME

IA17A

routing

code 1

IF (IAINT9 - ADLTINHH = 1/Yes) OR
(THERE IS AN ADULT AGE 15 OR
OLDER LIVING WITH THE SP IN THE
CURRENT ROUND OTHER THAN
THE SPOUSE), GO TO IA17A HHINCOME.
ELSE GO TO IA18A - HOMEPRBB.

SHOW CARD IA2
According to our records, other
than [you/(SP)/you and your
(wife/husband)/(SP) and (his/her)
(wife/husband)], at least one
person 15 years of age or older
lives in (your household/the
household). Including their
income as well as [your/(SP’s)/you
and your (wife’s/husband’s)/(SP)
and (his/her) (wife’s/husband’s)]
income, please look at this card
and tell me which letter represents
the total combined income of all
the members of [your
household/(SP’s) household]. This
includes income from jobs, Social
Security, Railroad Retirement,
other retirement, and any other
money income received by all
members of (your household/the
household).

(01) A. Less
than $5,000
(02) B. $5,000
– 9,999
(03) C. $10,000
– 14,999
(04) D. $15,000
– 19,999
(05) E. $20,000
– 24,999
(06) F.$25,000
– 29,999
(07) G. $30,000
– 34,999
(08) H. $35,000
– 39,999
(09) I. $40,000
– 44,999
(10) J. $45,000
– 49,999
(11) K. $50,000
and more
(-8) Don't
Know
(-9) Refused

[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you and your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[your household] respondent is SP
[the household] respondent is
proxy
[you] respondent is SP
[he] respondent is proxy, SP male,
not married
[she] respondent is proxy, SP
female, not married
[they] respondent is proxy, SP
married
[your household] respondent is SP
[(SP's) household] respondent is
proxy
[your household] respondent is SP
[the household] respondent is
proxy

IA18A HOMEPRBB

HOMEPRBB

HOMEEVAL

IA18A

IA19

code 1

dollar

[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you and your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
(01) OWN
[wife] SP's spouse female
IF THE SP IS HOMELESS, IS
(02) RENT
[husband] SP's spouse male
TRANSIENT WITH NO PERMANENT (03) DOESN'T [live] respondent is SP
HOME, OR IS IN JAIL OR PRISON, OWN OR RENT [lives] respondent is proxy
CODE WITHOUT ASKING. SELECT " (04) BOTH
[lived] SP has no permanent home
SP IS HOMELESS/TRANSIENT/IN
OWN AND
[Do] respondent is SP
JAIL OR PRISON".
RENT
[Did] SP has no permanent home or
The next questions are about the (05) SP
SP deceased
place where [you/(SP)/you and
REPORTED
[Does] respondent is proxy
your (wife/husband)/(SP) and
SUBSIDIZED
[you] respondent is SP, not married
(his/her) (wife/husband)]
RENTAL
[(SP)] respondent is proxy, SP not
(live/lives/lived).
HOUSING
married
(06) SP IS
[you and your] respondent is SP, SP
(Do/Did/Does) [you/(SP)/you and HOMELESS/TR married
your (wife/husband)/(SP) and
ANSIENT/IN
[wife] SP's spouse female
(his/her) (wife/husband)]] own the JAIL OR PRISON [husband] SP's spouse male
place where (you/he/she/they)
(-8) Don't
[(SP)] respondent is proxy
(live/lives/lived), or (do/did/does) Know
[his] SP male
(you/he/she/they) rent it?
(-9) Refused
[her] SP female
[your] respondent is SP, not
married
Please tell me the present value of
[(SP's)] respondent is proxy, SP not
[your/(SP’s)/you and your
married
(wife’s/husband’s)/(SP) and
[you and your] respondent is SP, SP
(his/her) (wife’s/husband’s)]
(01)
married
home. About how much do you
[Continuous
[wife's] SP's spouse female
think this (house and
answer.]
[husband's] SP's spouse male
lot/condominium unit) would sell (-8) Don't
[house and lot] SP lives in house
for if it were for sale? Please give Know
[conodominium unit] SP lives in
your best estimate.
(-9) Refused
condominium

(01) IA19 HOMEEVAL
(02) IA22 HOMERENT
(03)
IAINTRO4 IAINT4
(04) DO
NOT
DISPLAY.
DATA
EDITING
ONLY.
(05) DO
NOT
DISPLAY.
DATA
EDITING
ONLY.
(06)
IAINTRO4 IAINT4
(-8)
IAINTRO4 IAINT4
(-9)
IAINTRO4 IAINT4

IA20 HOMEMOR
T

HOMEMORT

HOMEOWE

IA20

IA21

code 1

(Do/Did/Does) [you/(SP)/you or
your (wife/husband)/(SP) or
(his/her) (wife/husband)] have a
mortgage, deed of trust, home
equity loan, or a land contract on
the property?

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

dollar

How much (do/did/does)
[you/(SP)/you and your
(wife/husband)/(SP) and (his/her)
(wife/husband)] owe, in total, on
any mortgages, deeds, loans, or
land contracts for this property?

(01)
[Continuous
answer.]
(-8) Don't
Know
(-9) Refused

[Do] respondent is SP
[Did] SP no longer has permanent
home or SP deceased
[Does] respondent is proxy
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[Do] respondent is SP
[Did] SP no longer has permanent
home or SP deceased
[Does] respondent is proxy
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

(01) IA21 HOMEOWE
(02)
IAINTRO4 IAINT4
(-8)
IAINTRO4 IAINT4
(-9)
IAINTRO4 IAINT4

IAINTRO4 IAINT4

dollar

How much monthly rent
(do/did/does) [you/(SP)/you and
your (wife/husband)/(SP) and
(his/her) (wife/husband)] pay for
the place where (you/he/she/they)
(live/lives/lived)?

HOMERENT

IA22

IAINT4

Now, let's turn to savings or other
assets which can be used to
provide income. I will ask whether
[you/(SP)/you and your
(wife/husband)/(SP) and (his/her)
(wife/husband)] had particular
types of assets in (PREVIOUS
YEAR). All these questions can be
answered with a "yes" or a "no".
[Please answer for [you and your
(wife/husband)/(SP) and (his/her)
IAINTRO4 no entry (wife/husband)].

(01)
[Continuous
answer.]
(-8) Don't
Know
(-9) Refused

[Do] respondent is SP
[Did] SP no longer has permanent
home or SP deceased
[Does] respondent is proxy
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP
[he] respondent is proxy, SP male,
SP not married
[she] respondent is proxy, SP
female, SP not married
[they] respondent is proxy, SP
married
[live] respondent is SP
[lives] respondent is proxy
[lived] SP no longer has permanent
home or SP deceased
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you and your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you and your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

IAINTRO4 IAINT4

RAPROBE

IA23A

list

For all or part of (PREVIOUS YEAR),
did [you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .
(01) YES
(02) NO
have any IRA, Keogh, 401K
(-8) Don't
accounts, thrift plans, or other
Know
retirement savings accounts?
(-9) Refused
For all or part of (PREVIOUS YEAR),
did [you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .

SAVPROBE

IA23A

list

have money in any kind of savings,
interest earning checking, or other
bank account? Include checking,
savings, money market funds,
certificates of deposit, or any other
interest earning bank accounts.

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

For all or part of (PREVIOUS YEAR),
did [you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .

BONDPROB

IA23A

list

have any stocks, mutual funds,
municipal or corporate bonds, or
U.S. Government securities such as
savings bonds, treasury bills or
bonds?

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

For all or part of (PREVIOUS YEAR),
did [you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)]. . .

INSPROBE

IA23A

list

own any life insurance policies
which build up cash equity
(sometimes called whole life or
universal life)?

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

IA23A SAVPROBE

IA23A BONDPROB

IA23A INSPROBE

IA23B PROPPROB

For all or part of (PREVIOUS YEAR),
did [you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)] . . .

PROPPROB

CARPROBE

ASTPROBE

IA23B

IA23B

IA23B

list

list

list

own any property, [other than
(your/his/her/their) primary
residence,] such as a vacation
home, apartment house,
commercial property, or rental
property?

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

For all or part of (PREVIOUS YEAR),
did [you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(01) YES
(wife/husband)] . . .
(02) NO
(-8) Don't
own any cars, trucks, recreational Know
vehicles, or boats?
(-9) Refused
For all or part of (PREVIOUS YEAR),
did [you/(SP)/you or your
(wife/husband)/(SP) or (his/her)
(wife/husband)] . . .
have any other savings, assets, a
business or professional practice,
property such as a farm,
mortgages from which payments
are received, or any other financial
investments not already
mentioned?

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[your] respondent is SP
[his] respondent is proxy, SP male,
SP not married
[her] respondent is proxy, SP
female, SP not married
[their] respondent is proxy, SP
married
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

IA23B CARPROBE

IA23B ASTPROBE

(01) IA30 ASTCODE
(02) BOX
IA2
(-8) BOX IA2
(-9) BOX IA2

ASTCODE

IA30

BOX IA2

What type of asset is it?
code all CHECK ALL THAT APPLY.
IF AT LEAST ONE ASSET PROBE AT
IA23A OR IA23B WAS ANSWERED
"YES", GO TO IA31 - ASSTTOTL.
routing ELSE GO TO IA34 - OTHDEBTS.

(01) SAVINGS
(02) ASSETS
(03) FARM
(04) BUSINESS
(05)
PROFESSIONAL
PRACTICE
(91) OTHER
(-8) Don't
Know
(-9) Refused

SHOW CARD IA3
You've mentioned [READ ASSETS
LISTED BELOW]. Please estimate
[your/(SP’s)/you and your
(wife’s/husband’s)/(SP) and
(his/her) (wife’s/husband’s)] assets
for (PREVIOUS YEAR). Do not
include interest or dividend
payments already reported as
income. [Please exclude the value
of (your/his/her/their) home.]

ASSTTOTL

IA31

dollar

(01) BOX
IA2
(02) DATA
EDITING
ONLY. DO
NOT
DISPLAY.
(03) BOX
IA2
(04) BOX
IA2
(05) BOX
IA2
(91) IA30 ASTSPECI
(-8) BOX IA2
(-9) BOX IA2

(01)
[(retirement savings
[Continuous
accounts/other bank
answer.]
accounts/stocks, mutual funds,
(-8) Don't
bonds/life insurance policies/other Know
property/vehicles/other assets)] (-9) Refused

[your] respondent is SP, not
married
[(SP's)] respondent is proxy, SP not
married
[you and your] respondent is SP, SP
married
[wife's] SP's spouse female
[husband's] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife's] SP's spouse female
[husband's] SP's spouse male
[your] respondent is SP
[his] respondent is proxy, SP male,
SP not married
[her] respondent is proxy, SP
female, SP not married
[their] respondent is proxy, SP
married

(01) IA32 ASSTDEBT
(-8) IA31A VALSSET
(-9) IA31A VALSSET

It is often difficult to place an exact
dollar amount on the value of
assets. Thinking about all of the
assets that you mentioned, [READ
ASSETS LISTED BELOW], would you
say that the total value of
[your/(SP’s)/you and your
(wife’s/husband’s)/(SP) and
(his/her) (wife’s/husband’s)] assets
for (PREVIOUS YEAR) was less than
$40,000.00 or was it $40,000.00 or
more?

VALSSET

VALPICK

IA31A

IA31B

code 1

[your] respondent is SP, not
married
[(SP's)] respondent is proxy, SP not
married
[you and your] respondent is SP, SP
married
[wife's] SP's spouse female
[husband's] SP's spouse male
[(retirement savings
[(SP)] respondent is proxy
accounts/other bank
[his] SP male
accounts/stocks, mutual funds,
[her] SP female
bonds/life insurance policies/other
[wife's] SP's spouse female
property/vehicles/other assets)] (01) LESS THAN [husband's] SP's spouse male
$40,000.00
[your] respondent is SP
[READ IF NECESSARY: Again do not (02)
[his] respondent is proxy, SP male,
include interest or dividend
$40,000.00 OR SP not married
payments already reported as
MORE
[her] respondent is proxy, SP
income [, and please exclude the (-8) Don't
female, SP not married
value of (your/his/her/their)
Know
[their] respondent is proxy, SP
home]].
(-9) Refused
married

(01) IA31B VALPICK
(02) IA31B VALPICK
(-8) IA32 ASSTDEBT
(-9) IA32 ASSTDEBT

code 1

(01) A. Less
than $5,000
(02) B. $5,000 9,999
SHOW CARD IA4
(03) C. $10,000
Which of these categories do you - 19,999
[Do] respondent is SP
think is a good estimate of the
(04) D. $20,000 [Did] respondent is proxy, SP
total value of [your/(SP’s)/you and – 39,999
deceased
your (wife’s/husband’s)/(SP) and (05) E. $40,000 -[Does] respondent is proxy, SP alive
(his/her) (wife’s/husband’s)] assets 74,999
[you] respondent is SP, not married
for (PREVIOUS YEAR)?
(06) F. $75,000 - [(SP)] respondent is proxy, SP not
149,999
married
[READ IF NECESSARY: You
(07) G.
[you or your] respondent is SP, SP
mentioned the following assets:
$150,000 –
married
[READ ASSETS LISTED BELOW].]
299,999
[wife] SP's spouse female
(08) H.
[husband] SP's spouse male
[(retirement savings
$300,000 and [(SP)] respondent is proxy
accounts/other bank
more
[his] SP male
accounts/stocks, mutual funds,
(-8) Don't
[her] SP female
bonds/life insurance policies/other Know
[wife's] SP's spouse female
property/vehicles/other assets)] (-9) Refused
[husband's] SP's spouse male

IA32 ASSTDEBT

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

[Do] respondent is SP
[Did] respondent is proxy, SP
deceased
[Does] respondent is proxy, SP alive
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife's] SP's spouse female
[husband's] SP's spouse male

(01) IA33 ADEBTTOT
(02) IA34 OTHDEBTS
(-8) IA34 OTHDEBTS
(-9) IA34 OTHDEBTS

(01)
How much (do/did/does)
[Continuous
[you/(SP)/you and your
answer.]
(wife/husband)/(SP) and (his/her) (-8) Don't
(wife/husband)] owe, in total, on Know
these debts?
(-9) Refused

[do] respondent is SP
[did] respondent is proxy, SP
deceased
[does] respondent is proxy, SP alive
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you and your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

IA34 OTHDEBTS

(Do/Did/Does) [you/(SP)/you or
your (wife/husband)/(SP) or
(his/her) (wife/husband)] have any
outstanding debts associated with
the [READ ASSETS LISTED BELOW]?

ASSTDEBT

ADEBTTOT

IA32

IA33

code 1

dollar

[(retirement savings
accounts/other bank
accounts/stocks, mutual funds,
bonds/life insurance policies/other
property/vehicles/other assets)]

OTHDEBTS

IA34

code 1

DEBTTOT

IA35

dollar

DEBTMED

IA36

dollar

(Do/Did/Does) [you/(SP)/you or
your (wife/husband)/(SP) or
(his/her) (wife/husband)] have any
(other) outstanding debts (that we
haven't talked about), such as
credit card charges, loans, medical
bills, or legal bills?

(01) YES
(02) NO
(-8) Don't
Know
(-9) Refused

(01)
[Continuous
answer.]
(-8) Don't
Know
(-9) Refused
(01)
[Continuous
answer.]
(-8) Don't
How much of the (AMOUNT FROM Know
IA35) is for medical care costs?
(-9) Refused
If you added up all of these other
debts for [you/(SP)/you and your
(wife/husband)/(SP) and (his/her)
(wife/husband)], about how much
would they amount to right now?

[Do] respondent is SP
[Did] respondent is proxy, SP
deceased
[Does] respondent is proxy, SP alive
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you or your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

(01) IA35 DEBTTOT
(02) BOX
IA6
(-8) BOX IA6
(-9) BOX IA6

[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not
married
[you and your] respondent is SP, SP
married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male

(01) IA36 DEBTMED
(-8) BOX IA6
(-9) BOX IA6

BOX IA6

Income and Assets (IAQ): Existing section has been replaced with new items below
Variable Name
MR Screen Name Question type Question text/description
Now I have some questions about (PREVIOUS YEAR)
income and other financial resources for [you/(SP)/you
and your (wife/husband)/(SP) and (his/her)
(wife/husband)].

LFINTRO1

LFINTRO1

no entry

As with all information collected by the MCBS, the data
are confidential and covered by the Privacy Act of 1974.
Your answers will be combined with those of other
respondents, and [your/his/her] Medicare benefits will
not be affected in any way by your answers to these
questions.
GIVE BROCHURE TO RESPONDENT. ALLOW A FEW
MINUTES FOR RESPONDENT TO REVIEW BROCHURE IF
NECESSARY.

Code list

(01)
CONTINUE
(-7) Empty

As the brochure explains, your responses to these
questions can help us determine the impact of income on
[your/his/her] use and access to health care. I will be
asking a series of questions about [your/(SP’s)/you and
your (wife’s/husband’s)/(SP) and (his/her)
(wife’s/husband’s)] income and other financial resources.
First, I will ask whether [you/(SP)/you and your
(wife/husband)/(SP) and (his/her) (wife/husband)] had
particular types of income or other resources. All these
questions can be answered with a "yes" or a "no." Then, I
will ask you to estimate [your/(SP's)/their] total income.
[Please answer all questions for [you and your
(wife/husband)/(SP) and (his/her) (wife/husband)].

LFINTRO2

WORKWEEK

RETNEVWK

IAABSENT

LFINTRO2

LF1

LF1B

LF2

no entry

code one

code one

code one

WORKMONTH

LF3

code one

MULTIJOB

LF4

yes/no

(01)
CONTINUE
(-7) Empty
(1) YES
(2) NO
(3)
Did [you/SP] do any work for pay in the last week? By the RETIRED/DON’
last week, I mean the week beginning on Sunday
T WORK
{MONTH, DAY OF SUNDAY PRIOR TO TODAY/MONTH, DAY ANYMORE
OF SUNDAY PRIOR TO THE SATURDAY BEFORE TODAY’S
(-8) DON’T
DATE} and ending {today/on Saturday {MONTH, DAY OF KNOW
SATURDAY PRIOR TO TODAY’S DATE}?
(-9) REFUSED
Please feel free to refer to any records or other persons
who may be of assistance to you.

(01) RETIRED
(02) NEVER
WORKED
(03) NO,
NEITHER OF
THESE IS TRUE
(-8) DON'T
Is this because (you were/SP was) retired or (you/SP)
KNOW
never worked?
(-8) REFUSED
(1) YES
(2) NO
(3)
RETIRED/DON’
T WORK
ANYMORE
{Do you/Does SP} have a job from which {you
(-8) DON’T
were/{he/she} was} absent last week because of illness, KNOW
vacation, or some other reason?
(-9) REFUSED
(1) YES
(2) NO
Now think about last month, that is {MONTH BEFORE
(-8) DON’T
INTERVIEW MONTH}. Did {you/SP} do any work for pay at KNOW
any time in the last month?
(-9) REFUSED
(1) YES
(2) NO
(-8) DON’T
Last week, did {you/SP} have more than one job, including KNOW
part-time, evening, or weekend work?
(-9) REFUSED

Text Fill Logic
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not married
[you and your] respondent is SP, SP married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[your] respondent is SP
[his] respondent is proxy, SP male
[her] respondent is proxy, SP female
[your] respondent is SP
[his] respondent is proxy, SP male
[her] respondent is proxy, SP female
[your] respondent is SP, not married
[(SP's)] respondent is proxy, SP not married
[you and your] respondent is SP, SP married
[wife's] SP's spouse female
[husband's] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife's] SP's spouse female
[husband's] SP's spouse male
[you] respondent is SP, not married
[(SP)] respondent is proxy, SP not married
[you and your] respondent is SP, SP married
[wife] SP's spouse female
[husband] SP's spouse male
[(SP)] respondent is proxy
[his] SP male
[her] SP female
[wife] SP's spouse female
[husband] SP's spouse male
[your] respondent is SP
[(SP's)] respondent is proxy, SP not married
[their] respondent is proxy, SP married
[you and your] respondent is SP, SP married
[wife] SP's spouse female
[husband] SP's spouse male
[you] respondent is SP
[(SP)] respondent is proxy
[beginning on Sunday (MONTH, DAY OF SUNDAY PRIOR
TO INTERVIEW)] TODAY’S date is a Saturday
[on Sunday (MONTH, DAY OF SUNDAY PRIOR TO THE SATURDAY BEFORE TODAY’S DATE})] if TODAY’S date is not a Saturday

Input mask Routing

LFINTRO2

LF1

[today] TODAY’S date is a Saturday
[on Saturday (MONTH, DAY OF SATURDAY PRIOR TO TODAY’S DATE)] if TODAY’S date is not a Saturday

(1) LF4
(2) LF2 LF1B
(3) BOX LF13
(-8) BOX LF13
(-9) BOX LF13

(you were) respondent is SP
(SP was) respondent is proxy

(1) BOX LF13
(2) BOX LF13
(3) LF3
(-8) BOX LF13
(-9) BOX LF13

[Do you] respondent is SP
[Does SP] respondent is proxy
[you were] respondent is SP
[he was] respondent is proxy, SP is male
[she was[ respondent is proxy, SP is female

(1) LF4
(2) LF3
(3) BOX LF13
(-8) BOX LF13
(-9) BOX LF13

[you] respondent is SP
[SP] respondent is proxy

(1) LF8
(2) BOX LF13
(-8) BOX LF13
(-9) BOX LF13

[you] respondent is SP
[SP] respondent is proxy

LF5

[do you] respondent is SP
[does SP] respondent is proxy
[your] respondent is SP
[his] respondent is proxy, SP is male
[her] respondent is proxy, SP is female
[main job] LF4=1 (YES)
[job] LF4≠ 1(YES)
[By main job, I mean the job at which you work}
the most hours.] LF4=1 (YES), respondent is SP
[By main job, I mean the job at which he works}
the most hours.] LF4=1 (YES), respondent is proxy, SP is male
[By main job, I mean the job at which she works}
the most hours.] LF4=1 (YES), respondent is proxy, SP is female
[job] LF4≠ 1(YES)

HOURSPERWEEK

HOURSLASTWEEK1

HOURSLASTWEEK2

LF5

quantity unit

BOX LF1

routing

LF6

LF7

quantity unit

quantity unit

PAYSCHEDULE

LF8

code one

OSPAYSCHEDULE

LF8A

verbatim

How many hours per week {do you/does SP} usually work
at {your/his/her} {job/main job}? {By main job, I mean the (1)
job at which {you work/{he/she} works} the most hours.} [continuous
response]
ENTER NUMBER OF HOURS USUALLY WORK
(-8) DON’T
KNOW
IF NUMBER OF HOURS VARY EACH WEEK, ENTER 997
(-9) REFUSED
If LF2=1 (YES, ABSENT LAST WEEK), go to LF7.
Otherwise go to LF6.
(1)
[continuous
response]
How many hours did {you/SP} work last week?
(-8) DON’T
KNOW
[you] respondent is SP
ENTER NUMBER OF HOURS
(-9) REFUSED [SP] respondent is proxy
[you were] respondent is SP
[SP was] respondent is proxy

(1)
You said {you were/SP was} absent from work last week. [continuous
How many hours did {you/he/she} work the last week
response]
{you were/{he/she} was} at work?
(-8) DON’T
KNOW
ENTER NUMBER OF HOURS
(-9) REFUSED
(1) EVERY
WEEK
(2) EVERY
TWO WEEKS
(3) TWO
TIMES A
MONTH
(4) ONCE A
MONTH
(5) DAILY
(9) OTHER
SCHEDULE
(SPECIFY)
{{Are you/Is SP} /In {your/SP’s} main job, {are you/is
(-8) DON’T
{he/she} }}paid every week, every two weeks, two times a KNOW
month, or on some other schedule?
(-9) REFUSED
(1)
[continuous
SPECIFY OTHER PAYMENT SCHEDULE
response]
How much was {your/SP’s} last paycheck before taxes and
any other deductions {for {your/his/her} main job}?

(1) LF7 LF8
(-8) LF8
(-9) LF8

[you] respondent is SP
[he] respondent is proxy, SP is male
[she] respondent is proxy, SP is female

[you were] respondent is SP
[he was] respondent is proxy, SP is male
[she was] respondent is proxy, SP is female

[Are you] LF4≠ 1(YES), respondent is SP
[Is SP] LF4≠ 1(YES), respondent is proxy
[In your main job, are you] LF4= 1(YES), respondent is SP
[In SP's main job, is he] LF4= 1(YES), respondent is proxy, SP male
[In SP's main job, is she] LF4= 1(YES), respondent is proxy, SP female

LF8

(1) LF9
(2) LF9
(3) LF9
(4) LF9
(5) LF9
(9) LF8A
(-8) LF9
(-9) LF9

LF9

IF NEEDED: We don’t need an exact dollar amount. An
approximate amount is fine.

LASTPAYCHECK

LF9

code one

(1) ENTER
PAYCHECK
AMOUNT
IF NEEDED: If it is easier, you can just tell me how much
(2) ENTER PAY
{you earn/SP earns} per hour or per day.
PER HOUR
(3) ENTER PAY
IF NEEDED: We know questions like these may be difficult PER DAY
to answer, but we need to know this to understand how (-8) DON’T
people manage financially as they age and what effect this KNOW
might have on their health.
(-9) REFUSED

(1) BOX LF1
(-8) LF8
(-9) LF8

ENTER PAYCHECK AMOUNT
PAYCHECKAMT

LF9A

quantity unit

$

(1)
[continuous
response]

[your] respondent is SP
[SP's] respondent is proxy
[for your main job] LF4=1(YES), respondent is SP
[for his main job] LF4=1(YES), respondent is proxy, SP is male
[for her main job] LF4=1(YES), respondent is proxy, SP is female

(1) LF9A
(2) LF9B
(3) LF9C
(-8) BOX LF13
(-9) BOX LF13
Use input
mask in
response
field
($999,999)
so that
dollar sign is
displayed
and
commas are
inserted
appropriatel
y.
LF10

ENTER PAY PER HOUR
PAYCHECKHOURLY

LF9B

quantity unit

$

ENTER PAY PER DAY
PAYCHECKDAILY

LF9C

quantity unit

$
Now thinking about the month of {CURRENT MONTH -1
MONTH}, how much did {you/SP} earn altogether from
any work {you/he/she} did in {CURRENT MONTH -1
MONTH}, before taxes and before any other deductions?

Use input
mask in
response
field
($999.99) so
that dollar
sign is
displayed
and decimal
point is
inserted
appropriatel
y.
LF10
Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and comma
is inserted
appropriatel
y.
LF10

(1)
[continuous
response]

(1)
[continuous
response]

IF NEEDED: We don’t need an exact dollar amount. An
approximate amount is fine.

MONTHPAY

LF10

quantity unit

BOX LF13

routing

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how (1)
people manage financially as they age and what effect this [continuous
might have on their health.
response]
(-8) DON’T
ENTER DOLLAR AMOUNT
KNOW
$
(-9) REFUSED
If ENS11-JOBSTAT = 1 of [ROSTREL = 2 (SPOUSE) or
ROSTREL = 51 (PARTNER) for anyone living in HH from ENS
go to LF13.
Otherwise, go to HO1

[you] respondent is SP
[SP] respondent is proxy
[you] respondent is SP
[he] respondent is proxy, SP is male
[she] respondent is proxy, SP is female

Use input
mask in
response
field
($999,999)
so that
dollar sign is
displayed
and
commas are
inserted
appropriatel
y.
BOX LF13

[your partner] respondent is SP, LIVING WITH A PARTNER
[your husband] respondent is SP, spouse is male
[your wife] respondent is SP, spouse is female

SPOUSEWORK

LF13

code one

SPOUSEEARN

LF14

quantity unit

IAOWNHOME

HO1

code one

Did {you/your/SP’s} {husband/wife/partner} do any work
for pay in the month of {CURRENT MONTH-1 MONTH}?
In {CURRENT MONTH -1 MONTH}, how much altogether
did {you/your/SP’s} {husband/wife/partner} earn before
taxes and before any other deductions?

(1) YES
(2) NO
(-8) DON’T
KNOW
(-9) REFUSED

[you] respondent is proxy, PROXY RELATIONSHIP=SPOUSE or PARTNER
[SP's partner] respondent is proxy, PROXY RELATIONSHIP≠SPOUSE or PARTNER, LIVING WITH A PARTNER
[SP's husband] respondent is proxy, PROXY RELATIONSHIP≠SPOUSE or PARTNER, spouse is male
[SP's wife] respondent is proxy, PROXY RELATIONSHIP≠SPOUSE or PARTNER, spouse is female

(1) LF14
(2) HO1
(-8) HO1
(-9) HO1

Use input
mask in
response
IF NEEDED: We don’t need an exact dollar amount. An
field
approximate amount is fine.
($999,999)
[you] respondent is proxy, IN6-ROSTREL =SPOUSE (2) or PARTNER (56) and HHFLAG = 1
so that
IF NEEDED: We know questions like these may be difficult
[your husband] respondent is SP, MARISTAT = 1, spouse is male
dollar sign is
to answer, but we need to know this to understand how (1)
[your wife] respondent is SP, MARISTAT = 1, spouse is female
displayed
people manage financially as they age and what effect this [continuous [your partner] respondent is SP, person in ENS enumerated as partner (ROSTREL = 56) and HHFLAG = 1
and
might have on their health.
response]
[SP's husband] respondent is proxy, IN6-ROSTREL NE SPOUSE (2) or PARTNER (56), MARISTAT = 1, spouse is male
commas are
(-8) DON’T
[SP's wife] respondent is proxy, IN6-ROSTREL NE SPOUSE (2) or PARTNER (56), spouse is female
inserted
ENTER DOLLAR AMOUNT
KNOW
[SP's partner] respondent is proxy, IN6-ROSTREL NE SPOUSE (2) or PARTNER (56), someone in ENS ROSTREL = 56 (Partner) and HHFLAG = 1 appropriatel
$
(-9) REFUSED
y.
HO1
[home] HAQ-Dwelling in(1,2,4,5,91,96,-8,-9)
[apartment or condo] HAQ-Dwelling in(3,6)
(1) OWN
(2) RENT (OR [Do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
Next, I'd like to ask you some questions about the
PAY MONTHLY [Do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
{home/apartment or condo} at {SP’s {ADDRESS 1,
AMOUNT)
[Do you] respondent is SP, SP is not married or living with a partner
ADDRESS 2} from PERSON ROSTER}.
(3) SOME
[Does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
OTHER
relationship≠SPOUSE or PARTNER
{Do you/Does SP} {or {SP FIRSTNAME
ARRANGEMEN [Does SP] respondent is proxy, SP is not married or living with a partner
(1) HO2
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
T
(2) HO6
own the {home/apartment or condo} at {SP’s {ADDRESS 1, (-8) DON’T
(3) HO5
ADDRESS 2} from PERSON ROSTER}, rent it, or is there
KNOW
(-8) HO5
some other arrangement?
(-9) REFUSED
(-9) HO5

MORTGAGE

HO2

code one

MORTGAGE_AMT1

HO3

quantity unit

MORTGATE_AMT2

HO3A

code one

MORTGAGELGNTH

HO3B

code one

(1) PAID OFF
(2) STILL
Is {your/SP’s} {or {SP FIRSTNAME
MAKE
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}’s} PAYMENTS
mortgage paid off or are monthly mortgage payments still (3) REVERSE
being made?
MORTGAGE
(-8) DON’T
IF NEEDED: Include any payments on a home equity loan KNOW
or second mortgage.
(-9) REFUSED

(1)
[continuous
response]
How much altogether is that each month?
(-8) DON’T
KNOW
ENTER DOLLAR AMOUNT
(-9) REFUSED
(1) LESS THAN
$250
(2) $250 TO
LESS THAN
$500
(3) $500 TO
LESS THAN
$1,000
(4) $1,000 TO
LESS THAN
$3,000
(5) $3,000 TO
LESS THAN
SHOW CARD HO1 IA1
$5,000
(6) $5,000 OR
Please look at this card and tell me which is closest.
MORE
(-8) DON’T
IF NEEDED: Include any payments on a home equity loan KNOW
or second mortgage.
(-9) REFUSED
(1) WITHIN 5
YEARS
(2) WITHIN 10
{Do you/Does SP} {or {SP FIRSTNAME
YEARS
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}
(3) LONGER
expect to pay off the mortgage within 5 years, 10 years, or THAN 10
longer?
YEARS
(-8) DON’T
IF NEEDED: Include any payments on a home equity loan KNOW
or second mortgage.
(-9) REFUSED
About how much {do you/does SP} {or {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
still owe on the mortgage?

[your or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[your or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[your] respondent is SP, SP is not married or living with a partner
[SP's or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship≠SPOUSE
or PARTNER
[SP's] respondent is proxy, SP is not married or living with a partner

Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) HO3B
appropriatel (-8) HO3A
y.
(-9) HO3B

HO3B

[Do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[Do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[Do you] respondent is SP, SP is not married or living with a partner
[Does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
relationship≠SPOUSE or PARTNER
[Does SP] respondent is proxy, SP is not married or living with a partner

IF NEEDED: The nearest $10,000 is fine.

MORTGAGEOWE1

HO3C

quantity unit

MORTGAGEOWE2

HO3D

code one

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.
(1)
[continuous
IF NEEDED: Include any payments on a home equity loan response]
or second mortgage.
(-8) DON’T
KNOW
ENTER DOLLAR AMOUNT
(-9) REFUSED
(1) less than
$50,000,
(2) $50,000 to
less than
$100,000, or
(3) $100,000
or more?
(-8) DON’T
KNOW
Is the amount owed…
(-9) REFUSED

(1) HO4
(2) HO3
(3) HO4
(-8) HO4
(-9) HO4

[do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[do you] respondent is SP, SP is not married or living with a partner
[does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
relationship≠SPOUSE or PARTNER
[does SP] respondent is proxy, SP is not married or living with a partner

HO3C

Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) HO4
appropriatel (-8) HO3D
y.
(-9) HO4

HO4

What is the present value of this [home/apartment or
condo]? I mean, about what would it bring if it was sold
today, not counting any loans or outstanding mortgages?
IF NEEDED: Your best guess or the nearest $10,000 is fine.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.
PRESENTVALUE1

HO4

quantity unit

PRESENTVALUE2

HO4A

code one

PAYRENT

HO5

yes/no

(1)
[continuous
response]
(-8) DON’T
KNOW
[home] HAQ-Dwelling in(1,2,4,5,91,96,-8,-9)
ENTER DOLLAR AMOUNT
(-9) REFUSED [apartment or condo] HAQ-Dwelling in(3,6)
(1) LESS THAN
$50,000
(2) $50,000
TO LESS THAN
$75,000
(3) $75,000
TO LESS THAN
$100,000
(4) $100,000
TO LESS THAN
$200,000
(5) $200,000
TO LESS THAN
$300,000
(6) $300,000
TO LESS THAN
$500,000
(7) $500,000
TO LESS THAN
$750,000
(8) $750,000
OF MORE
SHOW CARD HO2 IA2
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
[Do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
(1) YES
[Do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
(2) NO
[Do you] respondent is SP, SP is not married or living with a partner
{Do you/Does SP} {or {SP FIRSTNAME
(-8) DON’T
[Does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME} pay KNOW
relationship≠SPOUSE or PARTNER
rent to live here?
(-9) REFUSED [Does SP] respondent is proxy, SP is not married or living with a partner

How much is that each month?
RENTAMT1

HO6

quantity unit

ENTER DOLLAR AMOUNT

SHOW CARD HO3 IA3
RENTAMT2

SECTION8

HO6A

code one

BOX HO1

routing

HO7

yes/no

Please look at this card and tell me which is closest.
If HO6>=$750 or HO6A=4 ($1,000 TO LESS THAN $3,000),
5 ($3,000 TO LESS THAN $5,000), OR 6 ($5,000 OR MORE)
go to IAQINTRO1.
Otherwise, go to HO7.

Is this home in Section 8 or public housing or housing for
low-income seniors?

(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED
(1) LESS THAN
$250
(2) $250 TO
LESS THAN
$500
(3) $500 TO
LESS THAN
$1,000
(4) $1,000 TO
LESS THAN
$3,000
(5) $3,000 TO
LESS THAN
$5,000
(6) $5,000 OR
MORE
(-8) DON’T
KNOW
(-9) REFUSED

(1) YES
(2) NO
(-8) DON’T
KNOW
(-9) REFUSED

Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) IAQINTRO1
appropriatel (-8) HO4A
y.
(-9) IAQINTRO1

IAQINTRO1

(1) HO6
(2) IAQINTRO1
(-8) IAQINTRO1
(-9) IAQINTRO1
Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) IAQINTRO1
appropriatel (-8) HO6A
y.
(-9) HO6A

BOX HO1

IAQINTRO1

We are interested in how people are getting along
financially these days. The next few questions are about
income and other resources. Your responses can help us
understand how people manage financially as they age.
Please feel free to refer to any records or other persons
that may be of assistance in answering these questions.

IAQINTRO1

IAQINTRO1

no entry

Many of these questions ask about “last month.” By last
month, I mean in {CURRENT MONTH – 1}.

Did {you/SP} {or {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
receive Social Security retirement and/or Railroad
Retirement payments in the last month, that is in
{CURRENT MONTH –
1}?
IF NEEDED: These checks are either automatically
deposited in the bank or mailed to arrive on the 3rd of
every month. If mailed, they are often sent in gold or
manila-colored envelopes.
SSRR_LASTMONTH

SSDEPOSIT

MMSTARTSS

YYSTARTSS

SSI_LASTMONTH

IAQ1

code all

BOX IAQ1

routing

IAQ2

IAQ3

IAQ3

IAQ4

[SELECT ALL THAT APPLY]
IF IAQ1 NE (1) SP PAYMENT THEN GO TO IAQ4, ELSE GO
TO IAQ2

(1) YES, SP
RECEIVED
PAYMENT
FROM
SOURCE
(2) YES,
SPOUSE/PART
NER RECEIVED
PAYMENT
FROM
SOURCE
(3) NO
PAYMENT
RECEIVED
FROM THIS
SOURCE
(-8) DON’T
KNOW
(-9) REFUSED

(1) MAIL
(2) DIRECT
DEPOSIT
(3) PREPAID
CARD
(-8) DON’T
KNOW
(-9) REFUSED
(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED
(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED

code one

{Do you/Does SP} get payments by direct deposit, on a
prepaid card, or by mail?

quantity unit

What month and year did {you/SP} start receiving Social
Security? ENTER MONTH

quantity unit

What month and year did {you/SP} start receiving Social
Security? ENTER YEAR

code all

(1) YES, SP
RECEIVED
PAYMENT
FROM
SOURCE
(2) YES,
SPOUSE/PART
NER RECEIVED
PAYMENT
FROM
Did {you/SP} {or {SP FIRSTNAME
SOURCE
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
(3) NO
receive Supplemental Security Income, which is also called PAYMENT
SSI, last month?
RECEIVED
FROM THIS
IF NEEDED: These are monthly government payments to SOURCE
lower-income people in need.
(-8) DON’T
KNOW
{SELECT ALL THAT APPLY}
(-9) REFUSED

[you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[you] respondent is SP, SP is not married or living with a partner
[SP's or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship≠SPOUSE
or PARTNER
[SP's] respondent is proxy, SP is not married or living with a partner
Display "SELECT ALL THAT APPLY" and response option
2, “YES, SPOUSE/PARTNER RECEIVED PAYMENT FROM SOURCE if SP is married or living with a partner
Do no display "SELECT ALL THAT APPLY" and response option
2, “YES, SPOUSE/PARTNER RECEIVED PAYMENT FROM SOURCE if SP is not married or living with a partner
Display “in the last month” in underlined text.

(1) BOX IAQ1
(2) BOX IAQ1
(3) IAQ4
(-8) IAQ4
(-9) IAQ4

[Do you] respondent is SP
[Does SP] respondent is proxy

IAQ3-MMSTARTSS

[you] respondent is SP
[SP] respondent is proxy

IAQ3-YYSTARTSS

[you] respondent is SP
[SP] respondent is proxy

IAQ4

[you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[you] respondent is SP, SP is not married or living with a partner
[SP's or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship≠SPOUSE
or PARTNER
[SP's] respondent is proxy, SP is not married or living with a partner
Display "SELECT ALL THAT APPLY" and response option
2, “YES, SPOUSE/PARTNER RECEIVED PAYMENT FROM SOURCE if SP is married or living with a partner
Do no display "SELECT ALL THAT APPLY" and response option
2, “YES, SPOUSE/PARTNER RECEIVED PAYMENT FROM SOURCE if SP is not married or living with a partner
Display “in the last month” in bold underlined text.

IAQ5

VA_LASTMONTH

PENSION_LASTMONTH

401K_LASTMONTH

MUTUALFUNDS

IAQ5

IAQ6

IAQ7

IAQ8

code all

(1) YES, SP
RECEIVED
PAYMENT
FROM
SOURCE
(2) YES,
SPOUSE/PART
NER RECEIVED
PAYMENT
Did {you/SP} {or {SP FIRSTNAME
FROM
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
SOURCE
receive any payments from the Veteran’s Administration, (3) NO
last month related to military service or veteran survivor’s PAYMENT
benefits?
RECEIVED
FROM THIS
[IF NEEDED: The Veteran's Administration is also known as SOURCE
the U.S. Department of Veterans Affairs.]
(-8) DON’T
KNOW
{SELECT ALL THAT APPLY}
(-9) REFUSED
People sometimes have other retirement income. This
may be from pensions or retirement plans related to their
jobs.
(1) YES, SP
{Do you/Does SP} {or {SP FIRSTNAME
HAS PENTION
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
(2) YES,
have any pension plans that were a job-related or union SPOUSE/PART
benefit?
NER HAS
PENSION
IF NEEDED: These plans often require that a person work (3) NO
for a certain number of years before they qualify or “are PENSIONS
vested” in the pension plan.
(-8) DON’T
KNOW
{SELECT ALL THAT APPLY}
(-9) REFUSED
(1) YYES, SP
HAS 401K,
403B, IRA, OR
SHOW CARD IA4
OTHER
RETIREMENT
Please look at the types of retirement plans on this card. PLANS
{Do you/Does SP} {or {SP FIRSTNAME
(2) YES,
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
SPOUSE/PART
have any of these?
NER HAS
401K, 403B,
IF NEEDED: 401Ks and 403Bs are plans where you
IRA, OR
contribute an amount each month from your paycheck,
OTHER
and your employer may match some of your contribution. RETIREMENT
PLANS
IF NEEDED: IRAs, also known as Individual Retirement
(3) NO PLANS
Accounts, are a type of plan you set up on your own.
(-8) DON’T
KNOW
{SELECT ALL THAT APPLY}
(-9) REFUSED

code all

(1) YES, SP
HAS ASSET
(2) YES,
SPOUSE/PART
NER HAS
ASSET
(3) YES, SP
AND
SPOUSE/PART
NER HAVE
{Not including the retirement accounts we have already ASSET JOINTLY
talked about, {do you/does SP}/{Do you/Does SP}} {or {SP (4) NO ASSET
FIRSTNAME LASTNAME/SPOUSE/PARTNER FIRSTNAME
OF THIS TYPE
LASTNAME}} own any mutual funds or stocks?
(-8) DON’T
KNOW
{SELECT ALL THAT APPLY}
(-9) REFUSED

code all

code all

[you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[you] respondent is SP, SP is not married or living with a partner
[SP's or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship≠SPOUSE
or PARTNER
[SP's] respondent is proxy, SP is not married or living with a partner
Display "SELECT ALL THAT APPLY" and response option 2, “YES, SPOUSE/PARTNER RECEIVED PAYMENT FROM SOURCE if SP is married or
living with a partner
Do no display "SELECT ALL THAT APPLY" and response option 2, “YES, SPOUSE/PARTNER RECEIVED PAYMENT FROM SOURCE if SP is not
married or living with a partner

IAQ6

[Do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[Do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[Do you] respondent is SP, SP is not married or living with a partner
[Does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
relationship≠SPOUSE or PARTNER
[Does SP] respondent is proxy, SP is not married or living with a partner
Display "SELECT ALL THAT APPLY" and response option 2, “YES, SPOUSE/PARTNER RECEIVED PAYMENT FROM SOURCE if SP is married or
living with a partner
Do no display "SELECT ALL THAT APPLY" and response option 2, “YES, SPOUSE/PARTNER RECEIVED PAYMENT FROM SOURCE if SP is not
married or living with a partner

IAQ7

[Do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[Do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[Do you] respondent is SP, SP is not married or living with a partner
[Does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
relationship≠SPOUSE or PARTNER
[Does SP] respondent is proxy, SP is not married or living with a partner
Display "SELECT ALL THAT APPLY" and response option
2, “YES, SPOUSE/PARTNER HAS 401K, 403B, IRA, OR KEOGH”. if SP is married or living with a partner
Do no display "SELECT ALL THAT APPLY" and response option
2, “YES, SPOUSE/PARTNER HAS 401K, 403B, IRA, OR KEOGH” if SP is not married or living with a partner
[Not including the retirement accounts we have already talked about, do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is
SP, SP is married or living with a partner, IA7 = 1 (SP RETIREMENT ACCT) or 2 (SPOUSE RETIREMENT ACCT)
[Not including the retirement accounts we have already talked about, do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is
married or living with partner, proxy relationship= SPOUSE or PARTNER, IA7 = 1 (SP RETIREMENT ACCT) or 2 (SPOUSE RETIREMENT ACCT)
[Not including the retirement accounts we have already talked about, do you] respondent is SP, SP is not married or living with a partner,
IA7 = 1 (SP RETIREMENT ACCT) or 2 (SPOUSE RETIREMENT ACCT)
[Not including the retirement accounts we have already talked about, does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent
is proxy, SP is married or living with partner, proxy relationship≠SPOUSE or PARTNER, IA7 = 1 (SP RETIREMENT ACCT) or 2 (SPOUSE
RETIREMENT ACCT)
[Not including the retirement accounts we have already talked about, does SP] respondent is proxy, SP is married or living with partner,
proxy relationship≠SPOUSE or PARTNER, IA7 = 1 (SP RETIREMENT ACCT) or 2 (SPOUSE RETIREMENT ACCT)

IAQ8

[Do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with a partner, IA7 ≠ 1 (SP RETIREMENT
ACCT) or 2 (SPOUSE RETIREMENT ACCT)
[Do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER,
IA7 ≠ 1 (SP RETIREMENT ACCT) or 2 (SPOUSE RETIREMENT ACCT)
[Do you] respondent is SP, SP is not married or living with a partner, IA7 ≠ 1 (SP RETIREMENT ACCT) or 2 (SPOUSE RETIREMENT ACCT)
[Does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
relationship≠SPOUSE or PARTNER, IA7 ≠ 1 (SP RETIREMENT ACCT) or 2 (SPOUSE RETIREMENT ACCT)
[Does SP] respondent is proxy, SP is married or living with partner, proxy relationship≠SPOUSE or PARTNER, IA7 ≠ 1 (SP RETIREMENT ACCT)
or 2 (SPOUSE RETIREMENT ACCT)
Display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP married or living with a partner
Do not display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP not married or living with a
partner

IAQ9

Not including what we’ve already talked about, {do
you/does SP} {or {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
own any bonds, such as Government Savings Bonds,
corporate, municipal, or other types of bonds?
BONDS

CHECKING

IAQ9

IAQ10

code all

{SELECT ALL THAT APPLY}

code all

(1) YES, SP
HAS ASSET
(2) YES,
SPOUSE/PART
NER HAS
ASSET
The next questions ask about different kinds of bank or
(3) YES, SP
savings accounts people sometimes have or property they AND
own.
SPOUSE/PART
NER HAVE
Not counting what we’ve already talked about, {do
ASSET JOINTLY
you/does SP} {or {SP FIRSTNAME
(4) NO ASSET
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
OF THIS TYPE
have...
(-8) DON’T
KNOW
A checking account?
(-9) REFUSED

code all

(1) YES, SP
HAS ASSET
(2) YES,
SPOUSE/PART
NER HAS
ASSET
(3) YES, SP
AND
SPOUSE/PART
NER HAVE
ASSET JOINTLY
(4) NO ASSET
OF THIS TYPE
(-8) DON’T
KNOW
(-9) REFUSED

[IF NEEDED: Not counting what we’ve already talked
about, {do you/does SP} {or {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
have...]
SAVINGS

IAQ11

A savings account or money market account?

[IF NEEDED: Not counting what we’ve already talked
about, {do you/does SP} {or {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
have…]
CERTDEPOSIT

IAQ12

code all

Certificates of deposit?

{Do you/Does SP} {or {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}}
own a business, a farm, or any other real estate {besides
{your/SP’s} home}, including land or rental properties?
OTHER_LAND

IAQ13

(1) YES, SP
HAS ASSET
(2) YES,
SPOUSE/PART
NER HAS
ASSET
(3) YES, SP
AND
SPOUSE/PART
NER HAVE
ASSET JOINTLY
(4) NO ASSET
OF THIS TYPE
(-8) DON’T
KNOW
(-9) REFUSED

code all

{SELECT ALL THAT APPLY}

(1) YES, SP
HAS ASSET
(2) YES,
SPOUSE/PART
NER HAS
ASSET
(3) YES, SP
AND
SPOUSE/PART
NER HAVE
ASSET JOINTLY
(4) NO ASSET
OF THIS TYPE
(-8) DON’T
KNOW
(-9) REFUSED
(1) YES, SP
HAS ASSET
(2) YES,
SPOUSE/PART
NER HAS
ASSET
(3) YES, SP
AND
SPOUSE/PART
NER HAVE
ASSET JOINTLY
(4) NO ASSET
OF THIS TYPE
(-8) DON’T
KNOW
(-9) REFUSED

[do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[do you] respondent is SP, SP is not married or living with a partner
[does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
relationship≠SPOUSE or PARTNER
[does SP] respondent is proxy, SP is not married or living with a partner
Display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP is married or living with a partner
Do not display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP is not married or living with a
partner

IAQ10

[do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[do you] respondent is SP, SP is not married or living with a partner
[does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
relationship≠SPOUSE or PARTNER
[does SP] respondent is proxy, SP is not married or living with a partner
Display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP is married or living with a partner
Do not display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP is not married or living with a
partner

IAQ11

[do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[do you] respondent is SP, SP is not married or living with a partner
[does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
relationship≠SPOUSE or PARTNER
[does SP] respondent is proxy, SP is not married or living with a partner
Display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP is married or living with a partner
Do not display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP is not married or living with a
partner

IAQ12

[do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[do you] respondent is SP, SP is not married or living with a partner
[does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
relationship≠SPOUSE or PARTNER
[does SP] respondent is proxy, SP is not married or living with a partner
Display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP is married or living with a partner
Do not display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP is not married or living with a
partner

IAQ13

[do you or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is SP, SP is married or living with partner
[do you or {SP FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy relationship= SPOUSE or PARTNER
[do you] respondent is SP, SP is not married or living with a partner
[does SP or {SPOUSE/PARTNER FIRSTNAME LASTNAME}] respondent is proxy, SP is married or living with partner, proxy
relationship≠SPOUSE or PARTNER
[does SP] respondent is proxy, SP is not married or living with a partner
Display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP is married or living with a partner
Do not display “SELECT ALL THAT APPLY” and response option
2, “YES, SPOUSE/PARTNER HAS ASSET” and 3, “YES, SP AND SPOUSE/PARTNER HAVE ASSET JOINTLY” if SP is not married or living with a
partner
[besides SP's home] respondent is proxy, SP owns home
[besides your home] respondent is SP, SP owns home

IAQINTRO2

IAQINTRO2

SSRR_COMBINED1

SSRR_COMBINED2

IAQINTRO2

no entry

BOX IAQ2

routing

IAQ14

IAQ14A

code one

quantity unit

We now have a few questions about income which are
important for understanding how
people manage financially as they age.
If IAQ1 = 1 (SP RECEIVED SS/RR) and 2 (SPOUSE RECEIVED
SS/RR), go to IAQ14.
Else if IA1 = 1 (SP RECEIVED SS/RR), go to IAQ15A.
Else if IA1 = 2 (SPOUSE RECEIVED SS/RR), go to IAQ16A.
Otherwise, go to BOX IAQ3.
First, what was the amount of {your/SP’s} and {SP
FIRSTNAME LASTNAME/SPOUSE/PARTNER FIRSTNAME
LASTNAME}’s most recent monthly Social Security or
Railroad Retirement payment (for the month of {CURRENT
MONTH – 1})?

(1) ENTER
COMBINED
AMOUNT
(2) ENTER SP
AND
SPOUSE/PART
IF NEEDED: We don’t need an exact dollar amount.
NER
AMOUNTS
IF NEEDED: We know questions like these may be difficult SEPARATELY
to answer, but we need to know this to understand how (-8) DON’T
people manage financially as they age and what effect this KNOW
might have on their health.
(-9) REFUSED

ENTER COMBINED SP AND SPOUSE/PARTNER SOCIAL
SECURITY/RAILROAD RETIREMENT AMOUNT

SHOW CARD IA5
SSRR_COMBINED3

IAQ14B

code one

BOX IAQ2

Please look at this card and tell me which is closest.
What was the amount of {your/SP’s} most recent monthly
Social Security or Railroad Retirement payment
(for the month of {CURRENT MONTH – 1})?

[your] respondent is SP or proxy who is spouse or partner
[SP's] respondent is proxy who is not spouse or partner
[SPOUSE/PARTNER FIRSTNAME LASTNAME] respondent is SP or proxy who is not spouse or partner and SP is married or living with a
partner
[SP FIRSTNAME LASTNAME] respondent is proxy, proxy relationship= SPOUSE or PARTNER

(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED
(1) LESS THAN
$1,300
(2) $1,300 TO
LESS THAN
$1,700
(3) $1,700 TO
LESS THAN
$2,200
(3) $2,200 TO
LESS THAN
$2,600
(5) $2,600 OR
MORE
(-8) DON’T
KNOW
(-9) REFUSED

IF NEEDED: We don’t need an exact dollar amount.

SSRR_SP_AMT1

IAQ15A

quantity unit

SSRR_SP_AMT2

IAQ15B

code one

BOX IAQ2A

routing

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how (1)
people manage financially as they age and what effect this [continuous
might have on their health.
response]
(-8) DON’T
ENTER SP SOCIAL SECURITY/RAILROAD RETIREMENT
KNOW
[your] respondent is SP
AMOUNT
(-9) REFUSED [SP's] respondent is proxy
(1) LESS THAN
$700
(2) $700 TO
LESS THAN
$1,000
(3) $1,000 TO
LESS THAN
$1,300
(4) $1,300 TO
LESS THAN
$1,600
(5) $1,600 OR
MORE
SHOW CARD IA6
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
If IAQ14 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY), go to IAQ16A.
Otherwise, go to BOX IAQ3.

(1) IAQ14A
(2) IAQ15A
(-8) IAQ14B
(-9) IAQ14B
Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ3
appropriatel (-8) IAQ14B
y.
(-9) IAQ14B

BOX IAQ3
Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ2A
appropriatel (-8) IAQ15B
y.
(-9) IAQ15B

BOX IAQ2A

What was the amount of {your/{SPOUSE/PARTNER
FIRSTNAME LASTNAME}’s} most recent monthly Social
Security or Railroad Retirement payment (for the month
of {CURRENT MONTH – 1})?
IF NEEDED: We don’t need an exact dollar amount.

SSRR_SPOUSE_AMT1

IAQ16A

quantity unit

SSRR_SPOUSE_AMT2

IAQ16B

code one

BOX IAQ3

routing

SSRR_COMBINED1

IAQ17

code one

SSRR_COMBINED2

IAQ17A

quantity unit

SSRR_COMBINED3

IAQ17B

code one

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how (1)
people manage financially as they age and what effect this [continuous
might have on their health.
response]
(-8) DON’T
ENTER SPOUSE/PARTNER SOCIAL SECURITY/RAILROAD
KNOW
RETIREMENT AMOUNT
(-9) REFUSED
(1) LESS THAN
$700
(2) $700 TO
LESS THAN
$1,000
(3) $1,000 TO
LESS THAN
$1,300
(4) $1,300 TO
LESS THAN
$1,600
(5) $1,600 OR
MORE
SHOW CARD IA6
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
If IAQ4 = 1 (SP RECEIVED SSI) and 2 (SPOUSE RECEIVED
SSI), go to IAQ17.
Else if IAQ4 = 1 (SP RECEIVED SSI), go to IAQ18A.
Else if IAQ4 = 2 (SPOUSE RECEIVED SSI), go to IAQ19A.
Otherwise, go to BOX IAQ4.
(1) ENTER
What was the amount of {your/SP’s} and {SP FIRSTNAME COMBINED
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}’s AMOUNT
most recent monthly SSI payment (for the month of
(2) ENTER SP
{CURRENT MONTH – 1})?
AND
SPOUSE/PART
IF NEEDED: We don’t need an exact dollar amount.
NER
AMOUNTS
IF NEEDED: We know questions like these may be difficult SEPARATELY
to answer, but we need to know this to understand how (-8) DON’T
people manage financially as they age and what effect this KNOW
might have on their health.
(-9) REFUSED

(1)
[continuous
response]
(-8) DON’T
KNOW
ENTER COMBINED SP AND SPOUSE/PARTNER SSI AMOUNT (-9) REFUSED
(1) LESS THAN
$300
(2) $300 TO
LESS THAN
$700
(3) $700 TO
LESS THAN
$1,000
(4) $1,000 OR
MORE
SHOW CARD IA7
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED

If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “your”.
Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME}’s”.

Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ3
appropriatel (-8) IAQ16B
y.
(-9) IAQ16B

BOX IAQ3

If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56)), display “your”.
Otherwise, display “SP’s”.
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display "SP FIRSTNAME LASTNAME".
Otherwise, display "SPOUSE/PARTNER FIRSTNAME LASTNAME".

(1) IAQ17A
(2) IAQ18A
(-8) IAQ17B
(-9) IAQ17B
Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ4
appropriatel (-8) IAQ17B
y.
(-9) IAQ17B

BOX IAQ4

What was the amount of {your/SP’s} most recent monthly
SSI payment (for the month of {CURRENT MONTH – 1})?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.
SSI_SP_AMT1

IAQ18A

quantity unit

ENTER SP SSI AMOUNT

SHOW CARD IA8
SSI_SP_AMT2

IAQ18B

code one

BOX IAQ3A

routing

Please look at this card and tell me which is closest.
If IAQ17 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY), go to IAQ19A.
Otherwise, go to BOX IAQ4.

(1)
[continuous
response]
(-8) DON’T
KNOW
[your] respondent is SP
(-9) REFUSED [SP's] respondent is proxy
(1) LESS THAN
$100
(2) $100 TO
LESS THAN
$200
(3) $200 TO
LESS THAN
$400
(4) $400 TO
LESS THAN
$700
(5) $700 OR
MORE
(-8) DON’T
KNOW
(-9) REFUSED

What was the amount of {your/{SPOUSE/PARTNER
FIRSTNAME LASTNAME}’s} most recent monthly SSI
payment (for the month of {CURRENT MONTH – 1})?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.
SSI_SPOUSE_AMT3

IAQ19A

quantity unit

ENTER SPOUSE/PARTNER SSI AMOUNT

SHOW CARD IA8
SSI_SPOUSE_AMT4

IAQ19B

code one

BOX IAQ4

routing

Please look at this card and tell me which is closest.
If IAQ5 = 1 (SP RECEIVED VA) and 2 (SPOUSE RECEIVED
VA), go to IAQ20.
Else if IAQ5 = 1 (SP RECEIVED VA), go to IA21A.
Else if IAQ5 = 2 (SPOUSE RECEIVED VA), go to IAQ22A.
Otherwise, go to BOX IAQ5.

(1)
[continuous
response]
(-8) DON’T
KNOW
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “your”.
(-9) REFUSED Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME}’s”.
(1) LESS THAN
$100
(2) $100 TO
LESS THAN
$200
(3) $200 TO
LESS THAN
$400
(4) $400 TO
LESS THAN
$700
(5) $700 OR
MORE
(-8) DON’T
KNOW
(-9) REFUSED

(1) ENTER
COMBINED
AMOUNT
(2) ENTER SP
AND
SPOUSE/PART
IF NEEDED: We don’t need an exact dollar amount.
NER
AMOUNTS
IF NEEDED: We know questions like these may be difficult SEPARATELY
to answer, but we need to know this to understand how (-8) DON’T
people manage financially as they age and what effect this KNOW
might have on their health.
(-9) REFUSED

Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ3A
appropriatel (-8) IAQ18B
y.
(-9) IAQ18B

BOX IAQ3A

Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ4
appropriatel (-8) IAQ19B
y.
(-9) IAQ19B

BOX IAQ4

What was the amount of {your/SP’s} and {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}’s
most recent monthly Veteran’s Administration payment
(for the month of {CURRENT MONTH – 1})?

VA_AMT_COMBINED1

IAQ20

code one

If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56)), display “your”.
Otherwise, display “SP’s”.
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display "SP FIRSTNAME LASTNAME".
Otherwise, display "SPOUSE/PARTNER FIRSTNAME LASTNAME".

(1) IAQ20A
(2) IAQ21A
(-8) IAQ20B
(-9) IAQ20B

VA_AMT_COMBINED2

IAQ20A

quantity unit

VA_AMT_COMBINED3

IAQ20B

code one

(1)
[continuous
response]
(-8) DON’T
KNOW
ENTER COMBINED SP AND SPOUSE/PARTNER VA AMOUNT (-9) REFUSED
(1) LESS THAN
$1,000
(2) $1,000 TO
LESS THAN
$1,400
(3) $1,400 TO
LESS THAN
$1,800
(4) $1,800 TO
LESS THAN
$2,200
(5) $2,200 OR
MORE
SHOW CARD IA9
(-8) DON’T
KNOW
If SPPROXY = 1(SAMPLE PERSON), display “your”.
Please look at this card and tell me which is closest.
(-9) REFUSED Otherwise, display “SP’s”.
What was the amount of {your/SP’s} most recent monthly
Veteran’s Administration payment (for the month of
{CURRENT MONTH – 1})?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.

VA_SP_AMT1

IAQ21A

quantity unit

ENTER SP VA AMOUNT

SHOW CARD IA10
VA_SP_AMT2

IAQ21B

code one

BOX IAQ4A

routing

Please look at this card and tell me which is closest.
If IAQ20 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY), go to IAQ22A.
Otherwise, go to BOX IAQ5.
What was the amount of {your/{SPOUSE/PARTNER
FIRSTNAME LASTNAME}’s} most recent monthly Veteran’s
Administration payment (for the month of {CURRENT
MONTH – 1})?

(1)
[continuous
response]
(-8) DON’T
KNOW
If SPPROXY = 1(SAMPLE PERSON), display “your”.
(-9) REFUSED Otherwise, display “SP’s”.
(1) LESS THAN
$500
(2) $500 TO
LESS THAN
$700
(3) $700 TO
LESS THAN
$900
(4) $900 TO
LESS THAN
$1,100
(5) $1,100 OR
MORE
(-8) DON’T
KNOW
(-9) REFUSED

IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.
VA_SPOUSE_AMT1

IAQ22A

quantity unit

ENTER SPOUSE/PARTNER VA AMOUNT

(1)
[continuous
response]
(-8) DON’T
KNOW
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “your”.
(-9) REFUSED Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME}’s”.

Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ5
appropriatel (-8) IAQ20B
y.
(-9) IAQ20B

BOX IAQ5
Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ4A
appropriatel (-8) IAQ21B
y.
(-9) IAQ21B

BOX IAQ4A

Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ5
appropriatel (-8) IAQ22B
y.
(-9) IAQ22B

SHOW CARD IA10
VA_SPOUSE_AMT2

IAQ22B

BOX IAQ5

PENSION_COMBINED1

PENSION_COMBINED2

IAQ23

IAQ23A

code one

routing

code one

quantity unit

Please look at this card and tell me which is closest.
If IAQ6 = 1 (SP RECEIVED PENSION PLAN) and 2 (SPOUSE
RECEIVED PENSION PLAN), go to IAQ23.
Else if IAQ6 = 1 (SP RECEIVED PENSION PLAN), go to
IAQ24A.
Else if IAQ6 = 2 (SPOUSE RECEIVED PENSION PLAN), go to
IAQ25A.
Otherwise, go to BOX IAQ6.
You told me earlier that {you/SP} and {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}
have job-related pension plans. In all, how much was
received from these pension plans in the last month,
before any federal or state taxes were taken out (for the
month of {CURRENT MONTH – 1})?

IAQ23B

code one

BOX IAQ5

If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56)), display “you”.
Otherwise, display “SP”.
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display "SP FIRSTNAME LASTNAME".
Otherwise, display "SPOUSE/PARTNER FIRSTNAME LASTNAME".

(1) ENTER
COMBINED
AMOUNT
(2) ENTER SP
AND
SPOUSE/PART
IF NEEDED: We don’t need an exact dollar amount.
NER
AMOUNTS
IF NEEDED: We know questions like these may be difficult SEPARATELY
to answer, but we need to know this to understand how (-8) DON’T
people manage financially as they age and what effect this KNOW
might have on their health.
(-9) REFUSED

ENTER COMBINED SP AND SPOUSE/PARTNER PENSION
PLAN AMOUNT

SHOW CARD IA11
PENSION_COMBINED3

(1) LESS THAN
$500
(2) $500 TO
LESS THAN
$700
(3) $700 TO
LESS THAN
$900
(4) $900 TO
LESS THAN
$1,100
(5) $1,100 OR
MORE
(-8) DON’T
KNOW
(-9) REFUSED

Please look at this card and tell me which is closest.
{You told me earlier that {you have/SP has} a job-related
pension plan.} In all, how much was received from
{{your/SP's} job-related /this} pension plan in the last
month, before any federal or state taxes were taken out
(for the month of {CURRENT MONTH – 1})?

(1) IAQ23A
(2) IAQ24A
(-8) IAQ23B
(-9) IAQ23B
Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ6
appropriatel (-8) IAQ23B
y.
(-9) IAQ23B

(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED
(1) LESS THAN
$600
(2) $600 TO
LESS THAN
$1,300
(3) $1,300 TO
LESS THAN
$2,100
(4) $2,100 TO
LESS THAN
$5,900
(5) $5,900 OR
MORE
(-8) DON’T
KNOW
(-9) REFUSED

BOX IAQ6

IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.
PENSION_SP_AMT1

IAQ24A

quantity unit

ENTER SP PENSION PLAN AMOUNT

(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED

If SPPROXY = 1(SAMPLE PERSON), display “you have” and "your".
Otherwise, display “SP has" and "SP's".
If IA23=2, (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), display "{your/SP's} job-related".
Otherwise, display "You told me earlier that {you have/SP has} a job-related pension plan." and "this".

Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ5A
appropriatel (-8) IAQ24B
y.
(-9) IAQ24B

SHOW CARD IA12
PENSION_SP_AMT2

IAQ24B

code one

BOX IAQ5A

routing

Please look at this card and tell me which is closest.
If IAQ23 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY), go to IAQ25A.
Otherwise, go to BOX IAQ6.
{You told me earlier that {you have/{SPOUSE/PARTNER
FIRSTNAME LASTNAME} has} a job-related pension plan.}
In all, how much was received from
{{your/{SPOUSE/PARTNER FIRSTNAME LASTNAME}'s} jobrelated/this} pension plan in the last month, before any
federal or state taxes were taken out (for the month of
{CURRENT MONTH – 1})?

(1) LESS THAN
$400
(2) $400 TO
LESS THAN
$900
(3) $900 TO
LESS THAN
$1,600
(4) $1,600 TO
LESS THAN
$3,800
(5) $3,800 OR
MORE
(-8) DON’T
KNOW
(-9) REFUSED

BOX IAQ5A

IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.
PENSION_SPOUSE_AMT1

IAQ25A

quantity unit

ENTER SPOUSE/PARTNER PENSION PLAN AMOUNT

SHOW CARD IA12
PENSION_SPOUSE_AMT2

IAQ25B

BOX IAQ6

401K_COMBINED1

IAQ26

code one

routing

code one

Please look at this card and tell me which is closest.

(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED
(1) LESS THAN
$400
(2) $400 TO
LESS THAN
$900
(3) $900 TO
LESS THAN
$1,600
(4) $1,600 TO
LESS THAN
$3,800
(5) $3,800 OR
MORE
(-8) DON’T
KNOW
(-9) REFUSED

If IAQ7 = 1 (SP HAS RETIREMENT ACCT) and 2 (SPOUSE
HAS RETIREMENT ACCT), go to IAQ26.
Else if IAQ7 = 1 (SP HAS RETIREMENT ACCT), go to IAQ27A.
Else if IAQ7 = 2 (SPOUSE HAS RETIREMENT ACCT), go to
IAQ28A.
Otherwise, go to BOX IAQ9.
This next question is a bit different. You mentioned that
{you/SP} and {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}
have retirement accounts. In total, about how much is
(1) ENTER
currently in all of these retirement accounts?
COMBINED
AMOUNT
IF NEEDED: Retirement accounts include 401K, 403B, IRA, (2) ENTER SP
and other retirement accounts.
AND
SPOUSE/PART
IF NEEDED: We don’t need an exact dollar amount.
NER
AMOUNTS
IF NEEDED: We know questions like these may be difficult SEPARATELY
to answer, but we need to know this to understand how (-8) DON’T
people manage financially as they age and what effect this KNOW
might have on their health.
(-9) REFUSED

If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “you have” and "your".
Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME} has” and "{SPOUSE/PARTNER FIRSTNAME LASTNAME}'s".
If IA23 = 2 (ENTER SP and SPOUSE/PARTNER AMOUNTS SEPARATELY), display "{your/SP's} job-related".
Otherwise, display "You told me earlier that {you have/{SPOUSE/PARTNER FIRSTNAME LASTNAME} has} a jobrelated pension plan" and
"this".

Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ6
appropriatel (-8) IAQ25B
y.
(-9) IAQ25B

BOX IAQ6

If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56)), display “you”. Otherwise, display “SP”.
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display "SP FIRSTNAME LASTNAME".
Otherwise, display "SPOUSE/PARTNER FIRSTNAME LASTNAME".
Display “currently” in underlined text.

(1) IAQ26A
(2) IAQ27A
(-8) IAQ26B
(-9) IAQ26B

401K_COMBINED2

IAQ26A

quantity unit

401K_COMBINED3

IAQ26B

code one

(1)
[continuous
response]
(-8) DON’T
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT KNOW
ACCOUNT AMOUNT
(-9) REFUSED
(1) LESS THAN
$34,000
(2) $34,000
TO LESS THAN
$82,000
(3) $82,000
TO LESS THAN
$175,000
(4) $175,000
TO LESS THAN
$413,000
(5) $413,000
OR MORE
SHOW CARD IA13
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
This next question is a bit different. You mentioned that
{you have/SP has} retirement accounts. In total, about
how much is currently in all of these retirement accounts?
IF NEEDED: Retirement accounts include 401K, 403B, IRA
and other retirement accounts.
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.

401K_SP_AMT1

IAQ27A

quantity unit

ENTER SP RETIREMENT ACCOUNT AMOUNT

SHOW CARD IA14
401K_SP_AMT2

IAQ27B

code one

BOX IAQ6A

routing

Please look at this card and tell me which is closest.
If IAQ26 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY), go to IAQ28A.
Otherwise, go to BOX IAQ7.
This next question is a bit different. You mentioned that
{you have/{SPOUSE/PARTNER FIRSTNAME LASTNAME}
has} retirement accounts. In total, about how much is
currently in all of these retirement accounts?

(1)
[continuous
response]
(-8) DON’T
If SPPROXY = 1(SAMPLE PERSON), display “you have”.
KNOW
Otherwise, display “SP has”.
(-9) REFUSED Display “currently” in underlined text.
(1) LESS THAN
$20,000
(2) $20,000
TO LESS THAN
$47,000
(3) $47,000
TO LESS THAN
$92,000
(4) $92,000
TO LESS THAN
$218,000
(5) $218,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED

IF NEEDED: Retirement accounts include 401K, 403B, IRA
and other retirement accounts.
IF NEEDED: We don’t need an exact dollar amount.

401K_SPOUSE_AMT1

IAQ28A

quantity unit

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how (1)
people manage financially as they age and what effect this [continuous
might have on their health.
response]
(-8) DON’T
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “you have”.
ENTER SPOUSE/PARTNER RETIREMENT ACCOUNT
KNOW
Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME} has”.
AMOUNT
(-9) REFUSED Display “currently” in underlined text.

Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ7
appropriatel (-8) IAQ26B
y.
(-9) IAQ26B

BOX IAQ7

Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ6A
appropriatel (-8) IAQ27B
y.
(-9) IAQ27B

BOX IAQ6A

Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ7
appropriatel (-8) IAQ28B
y.
(-9) IAQ28B

SHOW CARD IA14
401K_SPOUSE_AMT2

IAQ28B

BOX IAQ7

RECIEVE_COMBINED1

IAQ29

code one

Please look at this card and tell me which is closest.

routing

If IAQ7 = 1 (SP HAS RETIREMENT ACCT) and 2 (SPOUSE
HAS RETIREMENT ACCT), go to IAQ29.
Else if IAQ7 = 1 (SP HAS RETIREMENT ACCT), go to IAQ30A.
Else if IAQ7 = 2 (SPOUSE HAS RETIREMENT ACCT), go to
IAQ31A.
Otherwise, go to BOX IAQ8.
Last month, how much altogether did {you/SP} and {SP
FIRSTNAME LASTNAME/SPOUSE/PARTNER FIRSTNAME
LASTNAME} receive or withdraw from all of these
retirement accounts (for the month of {CURRENT MONTH
– 1})?

code one

RECIEVE_COMBINED2

IAQ29A

quantity unit

RECIEVE_COMBINED3

IAQ29B

code one

(1) LESS THAN
$20,000
(2) $20,000
TO LESS THAN
$47,000
(3) $47,000
TO LESS THAN
$92,000
(4) $92,000
TO LESS THAN
$218,000
(5) $218,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED

(1) ENTER
COMBINED
AMOUNT
(2) ENTER SP
AND
SPOUSE/PART
IF NEEDED: We don’t need an exact dollar amount.
NER
AMOUNTS
IF NEEDED: We know questions like these may be difficult SEPARATELY
to answer, but we need to know this to understand how (-8) DON’T
people manage financially as they age and what effect this KNOW
might have on their health.
(-9) REFUSED

BOX IAQ7

If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56)), display “you”.
Otherwise, display “SP”.
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display "SP FIRSTNAME LASTNAME".
Otherwise, display "SPOUSE/PARTNER FIRSTNAME LASTNAME".
Display “Last month” in bold underlined text.

(1)
[continuous
response]
(-8) DON’T
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT KNOW
ACCOUNT RECEIVED/WITHDRAWN AMOUNT
(-9) REFUSED
(1) LESS THAN
$200
(2) $200 TO
LESS THAN
$500
(3) $500 TO
LESS THAN
$1,000
(4) $1,000 TO
LESS THAN
$2,500
(5) $2,500 OR
MORE
SHOW CARD IA15
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED Display “last month” in underlined text.
Last month, how much altogether did {you/SP} receive or
withdraw from {your/his/her} retirement accounts (for the
month of {CURRENT MONTH – 1})?
IF NEEDED: We don’t need an exact dollar amount.

RECEIVE_SP1

IAQ30A

quantity unit

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how (1)
people manage financially as they age and what effect this [continuous
might have on their health.
response]
(-8) DON’T
If SPPROXY = 1(SAMPLE PERSON), display “you” and “your”.
ENTER SP RETIREMENT ACCOUNT RECEIVED/WITHDRAWN KNOW
Otherwise, display “SP” and “{his/her}”.
AMOUNT
(-9) REFUSED Display “last month” in underlined text.

(1) IAQ29A
(2) IAQ30A
(-8) IAQ29B
(-9) IAQ29B
Use input
mask in
response
field
($99,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ8
appropriatel (-8) IAQ29B
y.
(-9) IAQ29B

BOX IAQ8
Use input
mask in
response
field
($99,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ7A
appropriatel (-8) IAQ30B
y.
(-9) IAQ30B

RECEIVE_SP2

IAQ30B

code one

BOX IAQ7A

routing

SHOW CARD IA16
Please look at this card and tell me which is closest.
If IAQ29 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY), go to IAQ31A.
Otherwise, go to BOX IAQ8.
Last month, how much altogether did
{you/{SPOUSE/PARTNER FIRSTNAME LASTNAME}} receive
or withdraw from {your/his/her} retirement accounts (for
the month of {CURRENT MONTH – 1})?

(1) LESS THAN
$100
(2) $100 TO
LESS THAN
$300
(3) $300 TO
LESS THAN
$700
(4) $700 TO
LESS THAN
$1,700
(5) $1,700 OR
MORE
(-8) DON’T
KNOW
(-9) REFUSED Display “last month” in underlined text.

IF NEEDED: We don’t need an exact dollar amount.

RECEIVE_SPOUSE1

IAQ31A

quantity unit

RECEIVE_SPOUSE2

IAQ31B

code one

BOX IAQ8

YRRECIEVE_COMBINED1

YRRECIEVE_COMBINED2

IAQ32

IAQ32A

routing

code one

quantity unit

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how (1)
people manage financially as they age and what effect this [continuous
might have on their health.
response]
(-8) DON’T
ENTER SPOUSE/PARTNER RETIREMENT ACCOUNT
KNOW
RECEIVED/WITHDRAWN AMOUNT
(-9) REFUSED
(1) LESS THAN
$100
(2) $100 TO
LESS THAN
$300
(3) $300 TO
LESS THAN
$700
(4) $700 TO
LESS THAN
$1,700
(5) $1,700 OR
MORE
SHOW CARD IA16
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED

If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “you” and “your”.
Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME}” and “{his/her}.
Display “Last month” in underlined text.

BOX IAQ7A

Use input
mask in
response
field
($99,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ8
appropriatel (-8) IAQ31B
y.
(-9) IAQ31B

Display “last month” in underlined text.

BOX IAQ8

If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56)), display “you”.
Otherwise, display “SP”.
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display "SP FIRSTNAME LASTNAME".
Otherwise, display "SPOUSE/PARTNER FIRSTNAME LASTNAME".
Display “last year” in underlined text.

(1) IAQ32A
(2) IAQ33A
(-8) IAQ32B
(-9) IAQ32B

If IAQ7 = 1 (SP HAS RETIREMENT ACCT) and 2 (SPOUSE
HAS RETIREMENT ACCT), go to IAQ32.
Else if IAQ7 = 1 (SP HAS RETIREMENT ACCT), go to IAQ33A.
Else if IAQ7 = 2 (SPOUSE HAS RETIREMENT ACCT), go to
IAQ34A.
Otherwise, go to BOX IAQ9.
Now thinking about all of last year, that is calendar year
{CURRENT YEAR – 1}, how much altogether did {you/SP}
and {SP FIRSTNAME LASTNAME/SPOUSE/PARTNER
FIRSTNAME LASTNAME} receive or withdraw from all of
these retirement accounts?

(1) ENTER
COMBINED
AMOUNT
(2) ENTER SP
AND
IF NEEDED: We don’t need an exact dollar amount.
SPOUSE/PART
NER
IF NEEDED: We know questions like these may be difficult AMOUNTS
to answer, but we need to know this to understand how SEPARATELY
people manage financially as they age and what effect this (-8) DON’T
might have on
KNOW
their health.
(-9) REFUSED

(1)
[continuous
response]
(-8) DON’T
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT KNOW
ACCOUNT RECEIVED/WITHDRAWN AMOUNT
(-9) REFUSED

Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ9
appropriatel (-8) IAQ32B
y.
(-9) IAQ32B

SHOW CARD IA17
YRRECIEVE_COMBINED3

IAQ32B

code one

Please look at this card and tell me which is closest.
Now thinking about all of last year, that is calendar year
{CURRENT YEAR – 1}, how much altogether did {you/SP}
receive or withdraw from all of {your/his/her} retirement
plans?

(1) LESS THAN
$2,400
(2) $2,400 TO
LESS THAN
$6,000
(3) $6,000 TO
LESS THAN
$12,000
(4) $12,000
TO LESS THAN
$30,000
(5) $30,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED Display “last year” in underlined text.

IF NEEDED: We don’t need an exact dollar amount.

YRRECEIVE_SP1

IAQ33A

quantity unit

YRRECEIVE_SP2

IAQ33B

code one

BOX IAQ8A

routing

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how (1)
people manage financially as they age and what effect this [continuous
might have on their health.
response]
(-8) DON’T
ENTER SP RETIREMENT ACCOUNT RECEIVED/WITHDRAWN KNOW
AMOUNT
(-9) REFUSED
(1) LESS THAN
$1,200
(2) $1,200 TO
LESS THAN
$3,600
(3) $3,600 TO
LESS THAN
$8,400
(4) $8,400 TO
LESS THAN
$20,400
(5) $20,400
SHOW CARD IA18
OR MORE
(-8) DON’T
For last year, that is calendar year {CURRENT YEAR – 1},
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
If IAQ32 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY), go to IAQ34A.
Otherwise, go to BOX IAQ9.

If SPPROXY = 1(SAMPLE PERSON), display “you” and “your”.
Otherwise, display “SP” and “{his/her}”.
Display “last year” in underlined text.

Display “last year” in underlined text.

Now thinking about all of last year, that is calendar year
{CURRENT YEAR – 1}, how much altogether did
{you/{SPOUSE/PARTNER FIRSTNAME LASTNAME}} receive
or withdraw from all of {your/his/her} retirement plans?
IF NEEDED: We don’t need an exact dollar amount.

YRRECEIVE_SPOUSE1

IAQ34A

quantity unit

YRRECEIVE_SPOUSE2

IAQ34B

code one

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how (1)
people manage financially as they age and what effect this [continuous
might have on their health.
response]
(-8) DON’T
ENTER SPOUSE/PARTNER RETIREMENT ACCOUNT
KNOW
RECEIVED/WITHDRAWN AMOUNT
(-9) REFUSED
(1) LESS THAN
$1,200
(2) $1,200 TO
LESS THAN
$3,600
(3) $3,600 TO
LESS THAN
$8,400
(4) $8,400 TO
LESS THAN
$20,400
(5) $20,400
OR MORE
SHOW CARD IA15 IA18
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED

If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “you” and “your”.
Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME}” and “{his/her}”.
Display “last year” in underlined text.

Display “last year” in underlined text.

BOX IAQ9
Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ8A
appropriatel (-8) IAQ33B
y.
(-9) IAQ33B

BOX IAQ8A

Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ9
appropriatel (-8) IAQ34B
y.
(-9) IAQ34B

BOX IAQ9

BOX IAQ9

OTHER_COMBINED1

IAQ35

routing

code one

OTHER_COMBINED2

IAQ35A

quantity unit

OTHER_COMBINED3

IAQ35B

code one

BOX IAQ9A

routing

IAQ35C

code one

OTHER_COMBINED4

If [IAQ8 = 1 (SP MUTUAL FUNDS) and IAQ8 = 2 (SPOUSE
MUTUAL FUNDS)] or IAQ8 = 3 (JOINT MUTUAL
FUNDS) or [IAQ9 = 1 (SP BONDS) and IAQ9 = 2 (SPOUSE
BONDS)] or IAQ9 = 3 (JOINT BONDS), go to IAQ35.
Else if IAQ8 = 1 (SP MUTUAL FUNDS) or IAQ9 = 1 (SP
BONDS), go to IAQ36A.
Else if IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2
(SPOUSE BONDS), go to IAQ37A.
Otherwise, go to BOX IAQ10.
You told me earlier that {you/SP} and {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME
LASTNAME} own {mutual funds or stocks} {government,
corporate, or other bonds} that are not part of retirement
accounts. About how much are these worth?

(1) ENTER
COMBINED
AMOUNT
(2) ENTER SP
AND
SPOUSE/PART
IF NEEDED: We don’t need an exact dollar amount.
NER
AMOUNTS
IF NEEDED: We know questions like these may be difficult SEPARATELY
to answer, but we need to know this to understand how (-8) DON’T
people manage financially as they age and what effect this KNOW
might have on their health.
(-9) REFUSED

If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56)), display “you”.
Otherwise, display “SP”.
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display "SP FIRSTNAME LASTNAME".
Otherwise, display "SPOUSE/PARTNER FIRSTNAME LASTNAME".
If IA8 = 1 (SP MUTUAL FUNDS) or 2 (SPOUSE MUTUAL FUNDS) or 3 (JOINT MUTUAL FUNDS), display
“mutual funds or stocks”.
If IA9 = 1 (SP BONDS) or 2 (SPOUSE BONDS) or 3 (JOINT BONDS), display “government, corporate, or
other bonds”.
If more than one type of asset displayed, display “and” between them.

Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ10
appropriatel (-8) BOX IAQ9A
y.
(-9) BOX IAQ9A

(1)
[continuous
response]
(-8) DON’T
ENTER COMBINED SP AND SPOUSE’S/PARTNER'S MUTUAL KNOW
FUNDS/STOCKS/BONDS AMOUNT
(-9) REFUSED
(1) LESS THAN
$9,000
(2) $9,000 TO
LESS THAN
$18,000
(3) $18,000
TO LESS THAN
$93,000
(4) $93,000
TO LESS THAN
$350,000
(5) $350,000
OR MORE
SHOW CARD IA16 IA19
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
If [IAQ8 = 1 (SP MUTUAL FUNDS) and IAQ8 = 2 (SPOUSE
MUTUAL FUNDS)] or IAQ8= 3 (JOINT MUTUAL FUNDS), go
to IAQ35B.
Otherwise, go to IAQ35C.
(1) LESS THAN
$600
(2) $600 TO
LESS THAN
$5,000
(3) $5,000 TO
LESS THAN
$16,000
(4) $16,000
TO LESS THAN
$62,000
(5) $62,000
SHOW CARD IA17 IA20
OR MORE
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
You told me earlier that {you own/SP owns} {mutual funds
or stocks} {government, corporate, or other bonds} that
are not part of retirement accounts. About how much are
these worth?

BOX IAQ10

IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.
OTHER_SP1

IAQ36A

quantity unit

BOX IAQ9B

routing

ENTER SP MUTUAL FUNDS/STOCKS/BONDS AMOUNT
If IAQ8 = 1 (SP MUTUAL FUNDS), go to IAQ36B.
Otherwise, go to IAQ36C.

(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED

(1) IAQ35A
(2) IAQ36A
(-8) IAQ35B
(-9) IAQ35B

If SPPROXY = 1(SAMPLE PERSON), display “you own”.
Otherwise, display “SP owns”.
If IA8 = 1 (SP MUTUAL FUNDS), display “mutual funds or stocks”.
If IA9 = 1 (SP BONDS), display “government, corporate, or other bonds”.
If more than one type of asset displayed, display “and” between them.

BOX IAQ10
Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ9C
appropriatel (-8) BOX IAQ9B
y.
(-9) BOX IAQ9B

SHOW CARD IA18 IA21

OTHER_SP2

IAQ36B

code one

Please look at this card and tell me which is closest.

SHOW CARD IA19 IA22

OTHER_SP3

IAQ36C

code one

BOX IAQ9C

routing

Please look at this card and tell me which is closest.
If IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2 (SPOUSE
BONDS), go to IAQ37A.
Otherwise, go to BOX IAQ10.
You told me earlier that {you own/{SPOUSE/PARTNER
FIRSTNAME LASTNAME} owns} {mutual funds or stocks}
{government, corporate, or other bonds} that are not part
of retirement accounts. About how much are these
worth?

(1) LESS THAN
$8,000
(2) $8,000 TO
LESS THAN
$62,000
(3) $62,000
TO LESS THAN
$192,000
(4) $192,000
TO LESS THAN
$213,000
(5) $213,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED
(1) LESS THAN
$300
(2) $300 TO
LESS THAN
$2,500
(3) $2,500 TO
LESS THAN
$8,000
(4) $8,000 TO
LESS THAN
$37,000
(5) $37,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED

BOX IAQ9C

BOX IAQ9C

IF NEEDED: We don’t need an exact dollar amount.

OTHER_SPOUSE1

IAQ37A

quantity unit

BOX IAQ9D

routing

OTHER_SPOUSE2

IAQ37B

code one

OTHER_SPOUSE3

IAQ37C

code one

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how (1)
people manage financially as they age and what effect this [continuous
might have on their health.
response]
(-8) DON’T
ENTER SPOUSE’S/PARTNER’S MUTUAL
KNOW
FUNDS/STOCKS/BONDS AMOUNT
(-9) REFUSED
If IAQ8 = 2 (SPOUSE MUTUAL FUNDS), go to IAQ37B.
Otherwise, go to IA37B.
(1) LESS THAN
$8,000
(2) $8,000 TO
LESS THAN
$62,000
(3) $62,000
TO LESS THAN
$192,000
(4) $192,000
TO LESS THAN
$213,000
(5) $213,000
SHOW CARD IA18 IA21
OR MORE
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
(1) LESS THAN
$300
(2) $300 TO
LESS THAN
$2,500
(3) $2,500 TO
LESS THAN
$8,000
(4) $8,000 TO
LESS THAN
$37,000
(5) $37,000
SHOW CARD IA19 IA22
OR MORE
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED

If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “you own”.
Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME} owns”.
If IA8 = 2 (SPOUSE MUTUAL FUNDS), display “mutual funds or stocks”.
If IA9 = 2 (SPOUSE BONDS), display “government, corporate, or other bonds”.
If more than one type of asset displayed, display “and” between each one.

Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ10
appropriatel (-8) BOX IAQ9D
y.
(-9) BOX IAQ9D

BOX IAQ10

BOX IAQ10

BOX IAQ10

ACCTS_COMBINED1

ACCTS_COMBINED2

IAQ38

routing

code one

IAQ38A

quantity unit

BOX IAQ10A

routing

If [IAQ10 = 1 (SP CHECKING) and IAQ10 = 2 (SPOUSE
CHECKING)] or IAQ10 = 3 (JOINT CHECKING) or [IAQ11 = 1
(SP SAVINGS) and IAQ11 = 2 (SPOUSE SAVINGS)] or IAQ11
= 3 (JOINT SAVINGS), or
[IAQ12 = 1 (SP CDS) and IAQ12= 2 (SPOUSE CDS)] or IAQ12
= 3 (JOINT CDS), go to IAQ38.
Else if IAQ10 = 1 (SP CHECKING) or IAQ11 = 1 (SP SAVINGS)
or IAQ13 = 1 (SP CDS), go to IAQ39A.
Else if IAQ10 = 2 (SPOUSE CHECKING) or IAQ11 = 2
(SPOUSE SAVINGS) or IAQ13 = 2 (SPOUSE CDS), go to
IAQ40A.
Otherwise, go to BOX IAQ11.
You told me earlier that {you/SP} and {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}
have {checking accounts} {savings or money market
accounts} {certificates of deposit or CDs}.
(1) ENTER
COMBINED
If you added up all of these accounts, about how much
AMOUNT
were they worth early last month (meaning in the
(2) ENTER SP
beginning of {CURRENT MONTH – 1})?
AND
SPOUSE/PART
IF NEEDED: We don’t need an exact dollar amount.
NER
AMOUNTS
IF NEEDED: We know questions like these may be difficult SEPARATELY
to answer, but we need to know this to understand how (-8) DON’T
people manage financially as they age and what effect this KNOW
might have on their health.
(-9) REFUSED

ENTER COMBINED SP AND SPOUSE'S/PARTNER'S
ACCOUNTS TOTAL AMOUNT
If IAQ12 = [1 (SP CDs) and 2 (SPOUSE CDs)] or 3 (JOINT
CDs), go to IAQ38B.
Otherwise, go to IAQ38C.

SHOW CARD IA20 IA23

ACCTS_SEPARATE1

IAQ38B

code one

Please look at this card and tell me which is closest.

SHOW CARD IA21 IA24

ACCTS_SEPARATE2

IAQ38C

code one

Please look at this card and tell me which is closest.

(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED

(1) LESS THAN
$11,000
(2) $11,000
TO LESS THAN
$25,000
(3) $25,000
TO LESS THAN
$50,000
(4) $50,000
TO LESS THAN
$108,000
(5) $108,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED
(1) LESS THAN
$2,000
(2) $2,000 TO
LESS THAN
$7,000
(3) $7,000 TO
LESS THAN
$17,000
(4) $17,000
TO LESS THAN
$57,000
(5) $57,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED

If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56)), display “you”.
Otherwise, display “SP”.
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display "SP FIRSTNAME LASTNAME".
Otherwise, display "SPOUSE/PARTNER FIRSTNAME LASTNAME".
If IA10a = 1 (SP CHECKING) or IA10a = 2 (SPOUSE CHECKING) or IA10a = 3 (JOINT CHECKING), display “checking
accounts”.
If IA10b = 1 (SP SAVINGS) or IA10b = 2 (SPOUSE SAVINGS) or IA10b = 3 (JOINT SAVINGS), display “savings or money
market accounts”.
If IA10c = 1 (SP CDS) or IA10c = 2 (SPOUSE CDS) or IA10c = 3 (JOINT CDS), display “certificates of deposit or
CDs”.
If more than one type of account displayed, display “and” between each one.
Display “last month” in underlined text.

(1) IAQ38A
(2) IAQ39A
(-8) IAQ38B
(-9) IAQ38B
Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ11
appropriatel (-8) BOX IAQ10A
y.
(-9) BOX IAQ10A

BOX IAQ11

BOX IAQ11

You told me earlier that {you have/SP has} {a checking
account} {a savings or money market account} {certificates
of deposit or CDs}.
If you added up all of these accounts, about how much
were they worth early last month (meaning in the
beginning of {CURRENT MONTH – 1})?
IF NEEDED: We don’t need an exact dollar amount.

ACCTS_SP1

IAQ39A

quantity unit

BOX IAQ10B

routing

ACCTS_SP2

IAQ39B

code one

ACCTS_SP3

IAQ39C

code one

BOX IAQ10C

routing

If SPPROXY = 1(SAMPLE PERSON), display “you have”.
IF NEEDED: We know questions like these may be difficult (1)
Otherwise, display “SP has”.
to answer, but we need to know this to understand how [continuous If IA10a = 1 (SP CHECKING), display “a checking account”.
people manage financially as they age and what effect this response]
If IA10b = 1 (SP SAVINGS), display “a savings or money market account”.
might have on their health.
(-8) DON’T
If IA10c = 1 (SP CDS), display “certificates of deposit or CDs”.
KNOW
If more than one type of account displayed, display “and” between each one.
ENTER SP ACCOUNTS TOTAL AMOUNT
(-9) REFUSED Display “last month” in underlined text.
If IAQ12 = 1 (SP CDs), go to IAQ39b.
Otherwise, go to IAQ39c.
(1) LESS THAN
$8,000
(2) $8,000 TO
LESS THAN
$13,000
(3) $13,000
TO LESS THAN
$28,000
(4) $28,000
TO LESS THAN
$54,000
(5) $54,000
SHOW CARD IA22 IA25
OR MORE
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
(1) LESS THAN
$500
(2) $500 TO
LESS THAN
$1,900
(3) $1,900 TO
LESS THAN
$5,000
(4) $5,000 TO
LESS THAN
$20,000
(5) $20,000
SHOW CARD IA23 IA26
OR MORE
(-8) DON'T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
If IAQ10 = 2 (SPOUSE CHECKING) or IAQ11 = 2 (SPOUSE
SAVINGS) or IAQ12 = 2 (SPOUSE CDS), go to IAQ40A.
Otherwise, go to BOX IAQ11.
You told me earlier that {you have/{SPOUSE/PARTNER
FIRSTNAME LASTNAME} has} {a checking account} {a
savings or money market account} {certificates of deposit
or CDs}.
If you added up all of these accounts, about how much
were they worth early last month (meaning in the
beginning of {CURRENT MONTH – 1})?
IF NEEDED: We don’t need an exact dollar amount.

ACCTS_SPOUSE1

IAQ40A

quantity unit

BOX IAQ10D

routing

If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “you have”.
IF NEEDED: We know questions like these may be difficult (1)
Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME} has”.
to answer, but we need to know this to understand how [continuous If IA10a = 2 (SPOUSE CHECKING), display “a checking account”.
people manage financially as they age and what effect
response]
If IA10b = 2 (SPOUSE SAVINGS), display “a savings or money market account”.
this might have on their health.
(-8) DON’T
If IA10c = 2 (SPOUSE CDS), display “certificates of deposit or CDs”.
KNOW
If more than one type of account displayed, display “and” between each one.
ENTER SPOUSE/PARTNER ACCOUNTS TOTAL AMOUNT
(-9) REFUSED Display “last month” in underlined text.
If IAQ12 = 2 (SPOUSE CDS), go to IAQ40b.
Otherwise, go to IAQ40c.

Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ10C
appropriatel (-8) BOX IAQ10B
y.
(-9) BOX IAQ10B

BOX IAQ10C

BOX IAQ10C

Use input
mask in
response
field
($9,999,999)
so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ11
appropriatel (-8) BOX IAQ10D
y.
(-9) BOX IAQ10D

SHOW CARD IA22 IA25

ACCTS_SPOUSE2

IAQ40B

code one

Please look at this card and tell me which is closest.

SHOW CARD IA23 IA26

ACCTS_SPOUSE3

INTEREST_COMBINED1

INTEREST_COMBINED2

IAQ40C

code one

BOX IAQ11

routing

IAQ41

IAQ41A

code one

quantity unit

Please look at this card and tell me which is closest.
If [IAQ8 = 1 (SP MUTUAL FUNDS) and IAQ8 = 2 (SPOUSE
MUTUAL FUNDS)] or IAQ8 = 3 (JOINT MUTUAL FUNDS) or
[IAQ9 = 1 (SP BONDS) and IAQ9 = 2 (SPOUSE BONDS)] or
IAQ9 = 3 (JOINT BONDS), or
[IAQ10 = 1 (SP CHECKING) and IAQ10 = 2 (SPOUSE
CHECKING)] or IAQ10 = 3 (JOINT CHECKING) or
[IAQ11 = 1 (SP SAVINGS) and IAQ11 = 2 (SPOUSE
SAVINGS)] or IAQ11 = 3 (JOINT SAVINGS), or
[IAQ12 = 1 (SP CDS) and IAQ12= 2 (SPOUSE CDS)] or IAQ12
= 3 (JOINT CDS), go to IAQ41.
Else if IAQ8 = 1 (SP MUTUAL FUNDS) or IAQ9 = 1 (SP
BONDS) or IAQ10 = 1 (SP CHECKING) or IAQ11 = 1 (SP
SAVINGS) or IAQ12 = 1 (SP CDS), go to IAQ42A.
Else if IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2
(SPOUSE BONDS) or IAQ10 = 2 (SPOUSE CHECKING) or
IAQ11 = 2 (SPOUSE SAVINGS) or IAQ12 = 2 (SPOUSE CDS),
go to IAQ43A.
Otherwise, go to BOX IAQ12.
Now thinking about all of last year, that is calendar year
{CURRENT YEAR – 1}, how much interest and dividend
income did {you/SP} and {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}
have altogether from {mutual funds or stocks}
{government, corporate, or other bonds} {bank accounts
or CDs}?

(1) LESS THAN
$8,000
(2) $8,000 TO
LESS THAN
$13,000
(3) $13,000
TO LESS THAN
$28,000
(4) $28,000
TO LESS THAN
$54,000
(5) $54,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED
(1) LESS THAN
$500
(2) $500 TO
LESS THAN
$1,900
(3) $1,900 TO
LESS THAN
$5,000
(4) $5,000 TO
LESS THAN
$20,000
(5) $20,000
OR MORE
(-8) DON'T
KNOW
(-9) REFUSED

If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56)), display “you”.
(1) ENTER
Otherwise, display “SP”.
COMBINED
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display "SP FIRSTNAME LASTNAME".
AMOUNT
Otherwise, display "SPOUSE/PARTNER FIRSTNAME LASTNAME".
(2) ENTER SP If IA8 = 1 (SP MUTUAL FUNDS) or 2 (SPOUSE MUTUAL FUNDS) or 3 (JOINT MUTUAL FUNDS), display “mutual
AND
funds or stocks”.
SPOUSE/PART If IA9 = 1 (SP BONDS) or 2 (SPOUSE BONDS) or 3 (JOINT BONDS), display “government, corporate, or other
IF NEEDED: We don’t need an exact dollar amount.
NER
bonds”.
AMOUNTS
If [IA10a = 1 (SP CHECKING) or 2 (SPOUSE CHECKING) or 3 (JOINT CHECKING)] or [IA10b = 1 (SP SAVINGS) or 2
IF NEEDED: We know questions like these may be difficult SEPARATELY (SPOUSE SAVINGS) or 3 (JOINT SAVINGS)] or [IA10c = 1 (SP CDS) or 2 (SPOUSE CDS) or 3 (JOINT CDS)], display
to answer, but we need to know this to understand how (-8) DON’T
“bank accounts or CDs”.
people manage financially as they age and what effect this KNOW
If more than one type of asset displayed, display “and” between each one.
might have on their health.
(-9) REFUSED Display “In the last year” in underlined text.

ENTER SP AND SPOUSE’S/PARTNER’S INTEREST AND
DIVIDEND INCOME AMOUNT

(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED

BOX IAQ11

BOX IAQ11

(1) IAQ41A
(2) IAQ42A
(-8) IAQ41B
(-9) IAQ41B
Use input
mask in
response
field
($99,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ12
appropriatel (-8) BOX IAQ11A
y.
(-9) BOX IAQ11A

SHOW CARD IA24 IA27
INTEREST_COMBINED3

IAQ41B

code one

Please look at this card and tell me which is closest.
Now thinking about all of last year, that is calendar year
{CURRENT YEAR – 1}, how much interest and dividend
income did {you/SP} have altogether from {mutual funds
or stocks} {bonds} {bank accounts or CDs}?

(1) LESS THAN
$200
(2) $200 TO
LESS THAN
$1,000
(3) $1,000 TO
LESS THAN
$4,000
(4) $4,000 TO
LESS THAN
$16,000
(5) $16,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED

IF NEEDED: We don’t need an exact dollar amount.

INTEREST_SP1

IAQ42A

quantity unit

INTEREST_SP2

IAQ42B

code one

BOX IAQ11A

routing

If SPPROXY = 1(SAMPLE PERSON), display “you”.
IF NEEDED: We know questions like these may be difficult (1)
Otherwise, display “SP”.
to answer, but we need to know this to understand how [continuous If IA8 = 1 (SP MUTUAL FUNDS), display “mutual funds or stocks”.
people manage financially as they age and what effect this response]
If IA9 = 1 (SP BONDS), display “bonds”.
might have on their health.
(-8) DON’T
If IA10a = 1 (SP CHECKING) or IA10b = 1 (SP SAVINGS) or IA10c = 1 (SP CDS), display “bank accounts or CDs”.
KNOW
If more than one type of asset displayed, display “and” between each one.
ENTER SP INTEREST AND DIVIDEND INCOME AMOUNT
(-9) REFUSED Display “In the last year” in underlined text.
(1) LESS THAN
$400
(2) $400 TO
LESS THAN
$1,000
(3) $1,000 TO
LESS THAN
$2,000
(4) $2,000 TO
LESS THAN
$11,000
(5) $11,000
OR MORE
SHOW CARD IA25 IA28
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
If IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2 (SPOUSE
BONDS) or IAQ10 = 2 (SPOUSE CHECKING) or IAQ11 =
2 (SPOUSE SAVINGS) or IAQ12 = 2 (SPOUSE CDS), go to
IAQ43A.
Otherwise, go to BOX IAQ12.
Now thinking about all of last year, that is calendar year
{CURRENT YEAR – 1}, how much interest and dividend
income did {you/{SPOUSE/PARTNER FIRSTNAME
LASTNAME}} have altogether from {mutual funds or
stocks} {bonds} {bank accounts or CDs}?
IF NEEDED: We don’t need an exact dollar amount.

INTEREST_SPOUSE1

IAQ43A

quantity unit

INTEREST_SPOUSE2

IAQ43B

code one

If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “you”.
IF NEEDED: We know questions like these may be difficult
Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME}”.
to answer, but we need to know this to understand how (1)
If IA8 = 2 (SPOUSE MUTUAL FUNDS,) display “mutual funds or stocks”.
people manage financially as they age and what effect this [continuous If IA9 = 2 (SPOUSE BONDS), display “bonds”.
might have on their health.
response]
If IA10a = 2 (SPOUSE CHECKING) or IA10b = 2 (SPOUSE SAVINGS) or IA10c = 2 (SPOUSE CDS), display “bank
(-8) DON’T
accounts or CDs”.
ENTER SPOUSE/PARTNER INTEREST AND DIVIDEND
KNOW
If more than one type of asset displayed, display “and” between each one.
INCOME AMOUNT
(-9) REFUSED Display “In the last year” in bold underlined text.
(1) LESS THAN
$400
(2) $400 TO
LESS THAN
$1,000
(3) $1,000 TO
LESS THAN
$2,000
(4) $2,000 TO
LESS THAN
$11,000
(5) $11,000
OR MORE
SHOW CARD IA25 IA28
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED

BOX IAQ12
Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ11A
appropriatel (-8) IAQ42B
y.
(-9) IAQ42B

BOX IAQ11A

Use input
mask in
response
field
($9,999) so
that dollar
sign is
displayed
and
commas are
inserted
(1) BOX IAQ12
appropriatel (-8) IAQ43B
y.
(-9) IAQ43B

BOX IAQ12

BOX IAQ12

LAND_COMBINED1

LAND_COMBINED2

IAQ44

IAQ44A

routing

code one

quantity unit

If [IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE) and IAQ13
= 2 (SPOUSE BUSINESS/FARM/REAL ESTATE)] or IAQ13 =3
(JOINT BUSINESS/FARM/REAL ESTATE), go to IAQ44.
Else if IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE), go to
IAQ45A.
Else if IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE),
go to IAQ46A.
Otherwise, go to BOX IAQ13.
You told me earlier that {you/SP} and {SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}
have a business, a farm, or real estate {other than {SP}’s
home}. If that were sold today and any debts on it were
paid off, about how much would it bring?

(1) ENTER
COMBINED
AMOUNT
(2) ENTER SP
AND
SPOUSE/PART
IF NEEDED: We don’t need an exact dollar amount.
NER
AMOUNTS
IF NEEDED: We know questions like these may be difficult SEPARATELY
to answer, but we need to know this to understand how (-8) DON’T
people manage financially as they age and what effect this KNOW
might have on their health.
(-9) REFUSED

ENTER SP AND SPOUSE/PARTNER BUSINESS/FARM/REAL
ESTATE COMBINED AMOUNT

SHOW CARD IA26 IA29
LAND_COMBINED3

IAQ44B

code one

Please look at this card and tell me which is closest.
You told me earlier that {you have/SP has} a business, a
farm, or real estate {other than {SP}’s home}. If that were
sold today and any debts on it were paid off, about how
much would it bring?

If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56)), display “you”.
Otherwise, display “SP”.
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display "SP FIRSTNAME LASTNAME".
Otherwise, display "SPOUSE/PARTNER FIRSTNAME LASTNAME".
If HP1 = 1 (OWNS HOME), display “other than {SP}’s home”.

(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED
(1) LESS THAN
$30,000
(2) $30,000
TO LESS THAN
$101,000
(3) $101,000
TO LESS THAN
$247,000
(4) $247,000
TO LESS THAN
$703,000
(5) $703,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED

IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.
LAND_SP1

IAQ45A

quantity unit

ENTER SP BUSINESS/FARM/REAL ESTATE AMOUNT

SHOW CARD IA27 IA30
LAND_SP2

IAQ45B

code one

BOX IAQ12A

routing

Please look at this card and tell me which is closest.
If IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE), go
to IAQ46A.
Otherwise, go to BOX IAQ13.

(1)
[continuous
response]
(-8) DON’T
If SPPROXY = 1(SAMPLE PERSON), display “you have”.
KNOW
Otherwise, display “SP has”.
(-9) REFUSED If HP1 = 1 (OWNS HOME), display “other than {SP}’s home”
(1) LESS THAN
$18,000
(2) $18,000
TO LESS THAN
$68,000
(3) $68,000
TO LESS THAN
$122,000
(4) $122,000
TO LESS THAN
$293,000
(5) $293,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED

(1) IAQ44A
(2) IAQ45A
(-8) IAQ44B
(-9) IAQ44B
Use input
mask in
response
field
($99,999,99
9) so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ13
appropriatel (-8) IAQ44B
y.
(-9) IAQ44B

BOX IAQ13
Use input
mask in
response
field
($99,999,99
9) so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ12A
appropriatel (-8) IAQ45B
y.
(-9) IAQ45B

BOX IAQ12A

You told me earlier that {you have/{SPOUSE/PARTNER
FIRSTNAME LASTNAME} has} a business, a farm, or real
estate {other than {SP}’s home}. If that were sold today
and any debts on it were paid off, about how much would
it bring?
IF NEEDED: We don’t need an exact dollar amount.

LAND_SPOUSE1

IAQ46A

quantity unit

LAND_SPOUSE2

IAQ46B

code one

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how (1)
people manage financially as they age and what effect this [continuous
might have on their health.
response]
(-8) DON’T
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “you have”.
ENTER SPOUSE/PARTNER BUSINESS/FARM/REAL ESTATE KNOW
Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME} has”.
AMOUNT
(-9) REFUSED If HP1 = 1 (OWNS HOME), display “other than {SP}’s home”
(1) LESS THAN
$18,000
(2) $18,000
TO LESS THAN
$68,000
(3) $68,000
TO LESS THAN
$122,000
(4) $122,000
TO LESS THAN
$293,000
(5) $293,000
OR MORE
SHOW CARD IA27 IA30
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED

routing

If [IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE) and IAQ13
= 2 (SPOUSE BUSINESS/FARM/REAL ESTATE)] or IAQ13
= 3 (JOINT BUSINESS/FARM/REAL ESTATE), go to IAQ47.
Else if IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE), go to
IAQ48A.
Else if IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE),
go to IAQ49A.
Otherwise, go to IAQ50.

BOX IAQ13

BOX IAQ13

Now thinking about all of last year, that is calendar year
{CURRENT YEAR – 1}, how much income did {you/SP} and
{SP FIRSTNAME LASTNAME/SPOUSE/PARTNER FIRSTNAME
LASTNAME} receive from these businesses or property
before any federal or state taxes were taken out?

INCOME_COMBINED1

INCOME_COMBINED2

IAQ47

IAQ47A

code one

quantity unit

(1) ENTER
COMBINED
AMOUNT
(2) ENTER SP
AND
SPOUSE/PART
IF NEEDED: We don’t need an exact dollar amount.
NER
AMOUNTS
IF NEEDED: We know questions like these may be difficult SEPARATELY
to answer, but we need to know this to understand how (-8) DON’T
people manage financially as they age and what effect this KNOW
might have on their health.
(-9) REFUSED

Use input
mask in
response
field
($99,999,99
9) so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ13
appropriatel (-8) IAQ46B
y.
(-9) IAQ46B

ENTER SP AND SPOUSE/PARTNER FROM
BUSINESS/FARM/REAL ESTATE COMBINED AMOUNT

SHOW CARD IA28 IA31
INCOME_COMBINED3

IAQ47B

code one

Please look at this card and tell me which is closest.

(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED
(1) LESS THAN
$3,600
(2) $3,600 TO
LESS THAN
$12,000
(3) $12,000
TO LESS THAN
$25,000
(4) $25,000
TO LESS THAN
$64,000
(5) $64,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED

If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56)), display “you”.
Otherwise, display “SP”.
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display "SP FIRSTNAME LASTNAME".
Otherwise, display "SPOUSE/PARTNER FIRSTNAME LASTNAME".
Display “In the last year” in underlined text.

(1) IAQ47A
(2) IAQ48A
(-8) IAQ47B
(-9) IAQ47B
Use input
mask in
response
field
($99,999,99
9) so that
dollar sign is
displayed
and
commas are
inserted
(1) IAQ50
appropriatel (-8) IAQ47B
y.
(-9) IAQ47B

IAQ50

Now thinking about all of last year, that is calendar year
{CURRENT YEAR – 1}, how much income did {you/SP}
receive from these businesses or property before any
federal or state taxes were taken out?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.
INCOME_SP1

IAQ48A

quantity unit

ENTER SP BUSINESS/FARM/REAL ESTATE AMOUNT

SHOW CARD IA29 IA32
INCOME_SP2

IAQ48B

code one

BOX IAQ13A

routing

Please look at this card and tell me which is closest.
If IAQ3 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE), go to
IAQ49A.
Otherwise, go to IAQ50.

(1)
[continuous
response]
(-8) DON’T
If SPPROXY = 1(SAMPLE PERSON), display “you”.
KNOW
Otherwise, display “SP”.
(-9) REFUSED Display “In the last year” in underlined text.
(1) LESS THAN
$3,600
(2) $3,600 TO
LESS THAN
$7,200
(3)$7,200 TO
LESS THAN
$14,000
(4) $14,000
TO LESS THAN
$38,000
(5) $38,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED

Now thinking about all of last year, that is calendar year
{CURRENT YEAR – 1}, how much income did
{you/{SPOUSE/PARTNER FIRSTNAME LASTNAME}} receive
from these businesses or property before any federal or
state taxes were taken out?
IF NEEDED: We don’t need an exact dollar amount.

INCOME_SPOUSE1

IAQ49A

quantity unit

INCOME_SPOUSE2

IAQ49B

code one

IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how (1)
people manage financially as they age and what effect this [continuous
might have on their health.
response]
(-8) DON’T
If IN6-ROSTREL = 2(Spouse) or 56(Partner), display “you”.
ENTER SPOUSE/PARTNER BUSINESS/FARM/REAL ESTATE KNOW
Otherwise, display “{SPOUSE/PARTNER FIRSTNAME LASTNAME}”.
AMOUNT
(-9) REFUSED Display “in the last year” in underlined text.
(1) LESS THAN
$3,600
(2) $3,600 TO
LESS THAN
$7,200
(3)$7,200 TO
LESS THAN
$14,000
(4) $14,000
TO LESS THAN
$38,000
(5) $38,000
OR MORE
SHOW CARD IA29 IA32
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED

Use input
mask in
response
field
($99,999,99
9) so that
dollar sign is
displayed
and
commas are
inserted
(1) BOX IAQ13A
appropriatel (-8) IAQ48B
y.
(-9) IAQ48B

BOX IAQ13A

Use input
mask in
response
field
($99,999,99
9) so that
dollar sign is
displayed
and
commas are
inserted
(1) IAQ50
appropriatel (-8) IAQ49B
y.
(-9) IAQ49B

IAQ50

[your] respondent is SP or respondent is proxy and proxy relationship= SPOUSE or PARTNER
[SP's] respondent is proxy and proxy relatonship≠SPOUSE or PARTNER

Now I want to ask about {your/SP’s} {and SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}’s}
total income for last year, that is, for the calendar year
ending in December {CURRENT YEAR - 1} before any
federal or state taxes were taken out.

[and {SP FIRSTNAME LASTNAME/SPOUSE/PARTNER FIRTNAME LASTNAME}'s] SP is married or living with a partner
otherwise do not display
[SP FIRSTNAME LASTNAME] respondent is proxy and proxy relationship=SPOUSE or PARTNER
[SPOUSE/PARTNER FIRSTNAME LASTNAME] respondent is SP or respondent is proxy and proxy relationship≠SPOUSE or PARTNER

Now think about that total income from:
{Social Security or Railroad Retirement} {Supplemental
Security Income} {the Veteran’s Administration} {a pension
plan} {any retirement accounts} {mutual funds or stocks}
{bonds}
{bank accounts} {CDs} {business, farm or real estate} {jobs}
and from any other sources.

[Social Security or Railroad Retirement] IAQ1=1 or 2
otherwise do not display
[Supplemental Security Income] IAQ4=1 or 2
otherwise do not display

How much was {your/SP’s} {and SP FIRSTNAME
LASTNAME/SPOUSE/PARTNER FIRSTNAME LASTNAME}’s}
total income before taxes for last year (this is, for the 12
months ending in December {CURRENT YEAR - 1})?

[the Veteran’s Administration] IAQ5=1 or 2
otherwise do not display
[a pension plan] IAQ6=1 or 2
otherwise do not display

IF NEEDED: We don’t need an exact dollar amount – the
nearest $1,000 is fine.
IF NEEDED: We know questions like these may be difficult
to answer, but we need to know this to understand how
people manage financially as they age and what effect this
might have on their health.
TOTAL_COMBINED1

IAQ50

quantity unit

BOX IAQ14

routing

ENTER TOTAL INCOME FOR LAST YEAR
If SPMARSTA = 1 (MARRIED) go to IAQ51A.
Otherwise, go to IAQ51B.

SHOW CARD IA30 IA33
TOTAL_COMBINED2

IAQ51A

code one

Please look at this card and tell me which is closest.

SHOW CARD IA31 IA34
TOTAL_SP1

IAQ51B

code one

Please look at this card and tell me which is closest.

[any retirement accounts] IAQ7=1 or 2
otherwise do not display
(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED

[mutual funds or stocks] IAQ8=1, 2 or 3
otherwise do not display
[bonds] IAQ9=1, 2, or 3
otherwise do not display

(1) LESS THAN
$30,000
(2) $30,000
TO LESS THAN
$43,000
(3) $43,000
TO LESS THAN
$66,000
(4) $66,000
TO LESS THAN
$109,000
(5) $109,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED
(1) LESS THAN
$18,000
(2) $18,000
TO LESS THAN
$22,000
(3) $22,000
TO LESS THAN
$36,000
(4) $36,000
TO LESS THAN
$56,000
(5) $56,000
OR MORE
(-8) DON’T
KNOW
(-9) REFUSED

Use input
mask in
response
field
($99,999,99
9) so that
dollar sign is
displayed
and
commas are
inserted
(1) CO1
appropriatel (-8) BOX IAQ14
y.
(-9) BOX IAQ14

CO1

CO1
[you own] if SPPROXY = 1 or (SPPROXY = 2 and IN6-ROSTREL in(2,56))
[SP owns] if SPPROXY = 2 and IN6-ROSTREL not in (2,56)

Now, I would like to change topics and talk about
automobiles {you own/SP owns} {or {your/his/her}
{husband/wife/partner owns}}.
{Do you/Does SP} {or {your/his/her}
{husband/wife/partner}} own any cars, trucks, or vans?

OWNCAR

CO1

yes/no

IF NEEDED: Do not include recreational vehicles, such as
motorcycles, trailers, motor homes, boats, or airplanes.

[or your husband] (if SPPROXY = 1 and IN13-SPMARSTA=1 (married) and spouse gender is male) or (if SPPROXY = 2 and IN6-ROSTREL = 2
and IN13-SPMARSTA=1 (married) and spouse gender is male)
[or his husband] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and IN13-SPMARSTA=1 (married) and spouse gender is male and IN11ROSTSEX = 1 (male))
[or her husband] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and IN13-SPMARSTA=1 (married) and spouse gender is male and IN11ROSTSEX = 2 (female)
[or your wife] (if SPPROXY = 1 and IN13-SPMARSTA=1 (married) and spouse gender is female) or (if SPPROXY = 2 and IN6-ROSTREL = 2 and
and IN13-SPMARSTA=1 (married) and spouse gender is female)
[or his wife] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and IN13-SPMARSTA=1 (married) and spouse gender is female and IN11ROSTSEX = 1 (male))
[or her wife] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and IN13-SPMARSTA=1 (married) and spouse gender is female and IN11ROSTSEX = 2 (female)
[or your partner] (if SPPROXY = 1 and someone on person roster rostrel = 56 and hhflag = 1 ) or (if SPPROXY = 2 and IN6-ROSTREL = 56)
[or his partner] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and someone on person roster rostrel = 56 and hhflag = 1 and IN11-ROSTSEX
= 1 (male))
[or her partner] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and someone on person roster rostrel = 56 and hhflag = 1 and IN11ROSTSEX = 2 (female))

(1) YES
(2) NO
(-8) DON’T
KNOW
[Do you] if SPPROXY = 1 or (SPPROXY = 2 and IN6-ROSTREL in(2,56))
(-9) REFUSED [Does SP] if SPPROXY = 2 and IN6-ROSTREL not in (2,56)

(1) CO2
(2) FSINTRO1
(-8) FSINTRO1
(-9) FSINTRO1

[do you] if SPPROXY = 1 or (SPPROXY = 2 and IN6-ROSTREL in(2,56))
[does SP] if SPPROXY = 2 and IN6-ROSTREL not in (2,56)

How many vehicles {do you/does SP} {or {your/his/her}
{husband/wife/partner}} own?
NUMCAR

CO2
BOX CO2

quantity unit
routing

PVCAR1

CO3

quantity unit

PVCAR2

CO3A

code one

ENTER NUMBER OF VEHICLES
if CO2 GE 2 go to CO3 else go to FSINTRO1

(1)
[continuous
response]
(-8) DON’T
KNOW
(-9) REFUSED

[or your husband] (if SPPROXY = 1 and IN13-SPMARSTA=1 (married) and spouse gender is male) or (if SPPROXY = 2 and IN6-ROSTREL = 2
and IN13-SPMARSTA=1 (married) and spouse gender is male)
[or his husband] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and IN13-SPMARSTA=1 (married) and spouse gender is male and IN11ROSTSEX = 1 (male))
[or her husband] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and IN13-SPMARSTA=1 (married) and spouse gender is male and IN11ROSTSEX = 2 (female)
[or your wife] (if SPPROXY = 1 and IN13-SPMARSTA=1 (married) and spouse gender is female) or (if SPPROXY = 2 and IN6-ROSTREL = 2 and
and IN13-SPMARSTA=1 (married) and spouse gender is female)
[or his wife] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and IN13-SPMARSTA=1 (married) and spouse gender is female and IN11ROSTSEX = 1 (male))
[or her wife] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and IN13-SPMARSTA=1 (married) and spouse gender is female and IN11ROSTSEX = 2 (female)
[or your partner] (if SPPROXY = 1 and someone on person roster rostrel = 56 and hhflag = 1 ) or (if SPPROXY = 2 and IN6-ROSTREL = 56)
[or his partner] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and someone on person roster rostrel = 56 and hhflag = 1 and IN11-ROSTSEX
= 1 (male))
[or her partner] if SPPROXY = 2 and IN6-ROSTREL not in (2,56) and someone on person roster rostrel = 56 and hhflag = 1 and IN11ROSTSEX = 2 (female))

(1)
Altogether, what is their present value, that is, about how [continuous
much would they bring if {you/SP} sold them on today’s
response]
market?
(-8) DON’T
KNOW
[you] if SPPROXY = 1 or (SPPROXY = 2 and IN6-ROSTREL in(2,56))
ENTER DOLLAR AMOUNT
(-9) REFUSED [SP] if SPPROXY = 2 and IN6-ROSTREL not in (2,56)
(1) LESS THAN
$2,500
(2) $2,500 TO
LESS THAN
$5,000
(3) $5,000 TO
LESS THAN
$7,500
(4) $7,500 TO
LESS THAN
$10,000
(5) $10,000
TO LESS THAN
$20,000
(6) $20,000
OR MORE
SHOW CARD IA32 IA35
(-8) DON’T
KNOW
Please look at this card and tell me which is closest.
(-9) REFUSED
[your] If SPPROXY = 1 (SAMPLE PERSON) or (SPPROXY = 2(PROXY) and IN6-ROSTREL in(2,56))
[(SP)'s] If SPPROXY = 2(PROXY) and IN6-ROSTREL not in(2,56))

(1) BOX CO2
(-8) FSINTRO1
(-9) FSINTRO1
Use input
mask in
response
field
($99,999,99
9) so that
dollar sign is
displayed
and
commas are
inserted
(1) FSINTRO1
appropriatel (-8) CO3A
y.
(-9) CO3A

FSINTRO1

[you were] (If SPPROXY = 1 (SAMPLE PERSON) or ((SPPROXY = 2(PROXY) and the proxy's HHFLAG = 1)
[he was] IF SPPROXY = 2(proxy) and SP lives alone and SP is male
[she was] IF SPPROXY = 2(proxy) and SP lives alone and SP is female
[they were] If SPPROXY = 2(proxy) and count of persons with HHFLAG = 1 is more than one and proxy's HHFLAG ne 1

FSINTRO1

FSINTRO1

no entry

These next questions are about the food eaten in
[your/(SP)'s] household in the last 12 months, since
{current month} of last year and whether [you were/he
was/she was/they were] able to afford the food [you
need/he needs/she needs/they need].

[you need] (If SPPROXY = 1 (SAMPLE PERSON) or ((SPPROXY = 2(PROXY) and the proxy's HHFLAG = 1)
[he needs] IF SPPROXY = 2(proxy) and SP lives alone and SP is male
[she needs] IF SPPROXY = 2(proxy) and SP lives alone and SP is female
[they need] If SPPROXY = 2(proxy) and count of persons with HHFLAG = 1 is more than one and proxy's HHFLAG ne 1

FS1

[you] SPPROXY = 1(sample person) and SP lives alone
[your household] (If SPPROXY = 1 (SAMPLE PERSON) or ((SPPROXY = 2(PROXY) and the proxy's HHFLAG = 1)) and count of persons with
HHFLAG = 1 is more than one
[(SP)] IF SPPROXY = 2(proxy) and SP lives alone
[(SP)'s household] If SPPROXY = 2(proxy) and count of persons with HHFLAG = 1 is more than one and proxy's HHFLAG ne 1
[I] SPPROXY = 1(sample person) and SP lives alone
[We] (If SPPROXY = 1 (SAMPLE PERSON) or ((SPPROXY = 2(PROXY) and the proxy's HHFLAG = 1)) and count of persons with HHFLAG = 1 is
more than one
[(SP)] IF SPPROXY = 2(proxy) and SP lives alone and SP is male
[(SP) or other adults in (SP)'s household] If SPPROXY = 2(proxy) and count of persons with HHFLAG = 1 is more than one and proxy's
HHFLAG ne 1
I’m going to read you some statements that people have
made about their food situation. For these statements,
please tell me whether the statement was often true,
sometimes true, or never true for [you/your
household/(SP)/(SP)'s household] in the last 12
months—that is, since last {name of current month}.
The first statement is, The food that [I/we/(SP)/(SP) or
other adults in (SP)'s household] bought just didn’t last,
and [I/we/he/she/they] didn’t have money to get more.

FOODLAST

FS1

code one

Was that often, sometimes, or never true for [you/your
household/(SP)/(SP)'s household] in the last 12 months?

(1) OFTEN
TRUE
(2)
SOMETIMES
TRUE
(3) NEVER
TRUE
(-8) DON’T
KNOW
(-9) REFUSED

The next statement is: [I/we/(SP)/(SP or other adults in
(SP)'s household] couldn’t afford to eat balanced meals.

FOODLAST_OFTEN

SKIPMEAL

SKIPMEAL_OFTEN

EATLESS

HUNGRY

FS2

FS3

FS3A

FS4

FS5

code one

code one

code one

(1) OFTEN
TRUE
Was that often, sometimes, or never true for [you/your
(2)
household/(SP)/(SP)'s household] in the last 12 months? SOMETIMES
TRUE
[IF NEEDED: For these statements, please tell me whether (3) NEVER
the statement was often true, sometimes true, or never TRUE
true for [you/your household/(SP)/(SP)'s household] in the (-8) DON’T
last 12 months—that is, since last {name of current
KNOW
month}.]
(-9) REFUSED

[I] SPPROXY = 1(sample person) and SP lives alone
[We] (If SPPROXY = 1 (SAMPLE PERSON) or ((SPPROXY = 2(PROXY) and the proxy's HHFLAG = 1)) and count of persons with HHFLAG = 1 is
more than one
[he] IF SPPROXY = 2(proxy) and SP lives alone and SP is male
[she] IF SPPROXY = 2(proxy) and SP lives alone and SP is female
[they] If SPPROXY = 2(proxy) and count of persons with HHFLAG = 1 is more than one and proxy's HHFLAG ne 1
[you] SPPROXY = 1(sample person) and SP lives alone
[your household] (If SPPROXY = 1 (SAMPLE PERSON) or ((SPPROXY = 2(PROXY) and the proxy's HHFLAG = 1)) and count of persons with
HHFLAG = 1 is more than one
[(SP)] IF SPPROXY = 2(proxy) and SP lives alone
[(SP)'s household] If SPPROXY = 2(proxy) and count of persons with HHFLAG = 1 is more than one and proxy's HHFLAG ne 1
[I] SPPROXY = 1(sample person) and SP lives alone
[We] (If SPPROXY = 1 (SAMPLE PERSON) or ((SPPROXY = 2(PROXY) and the proxy's HHFLAG = 1)) and count of persons with HHFLAG = 1 is
more than one
[(SP)] IF SPPROXY = 2(proxy) and SP lives alone
[(SP) or other adults in (SP)'s household] If SPPROXY = 2(proxy) and count of persons with HHFLAG = 1 is more than one and proxy's
HHFLAG ne 1

[you] SPPROXY = 1(sample person) and SP lives alone
[your household] (If SPPROXY = 1 (SAMPLE PERSON) or ((SPPROXY = 2(PROXY) and the proxy's HHFLAG = 1)) and count of persons with
HHFLAG = 1 is more than one
[(SP)] IF SPPROXY = 2(proxy) and SP lives alone
[(SP)'s household] If SPPROXY = 2(proxy) and count of persons with HHFLAG = 1 is more than one and proxy's HHFLAG ne 1
[you] SPPROXY = 1(sample person) and SP lives alone
In the last 12 months, since last (name of current month), (1) YES
[your household] (If SPPROXY = 1 (SAMPLE PERSON) or ((SPPROXY = 2(PROXY) and the proxy's HHFLAG = 1)) and count of persons with
did [you/you or other adults in your household/(SP)/((SP) (2) NO
HHFLAG = 1 is more than one
or other adults in (SP)'s household] ever cut the size of
(-8) DON’T
[(SP)] IF SPPROXY = 2(proxy) and SP lives alone
your meals or skip meals because there wasn't enough
KNOW
[(SP) or other adults in (SP)'s household] If SPPROXY = 2(proxy) and count of persons with HHFLAG = 1 is more than one and proxy's
money for food?
(-9) REFUSED HHFLAG ne 1

How often did this happen—almost every month, some
months but not every month, or in only 1 or 2 months?

code one

In the last 12 months, did [you/(SP)] ever eat less than
[you/he/she] felt [you/he/she] should because there
wasn't enough money for food?

code one

In the last 12 months, [were you/was (SP)] ever hungry
but didn't eat because there wasn't enough money for
food?

(1) ALMOST
EVERY
MONTH
(2) SOME
MONTHS BUT
NOT EVERY
MONTH
(3) IN ONLY 1
OR 2 MONTHS
(-8) DON’T
KNOW
(-9) REFUSED
(1) YES
(2) NO
(-8) DON’T
KNOW
(-9) REFUSED
(1) YES
(2) NO
(-8) DON’T
KNOW
(-9) REFUSED

FS2

FS3

(1) FS3A
(2) FS4
(-8) FS4
(-9) FS4

FS4
[you] SPPROXY = 1(sample person)
[(SP)] SPPROXY = 2(proxy)
[you] SPPROXY = 1(sample person)
[he] SPPROXY = 2(proxy) and SP is male
[she] SPPROXY = 2(proxy) and SP is female

FS5

[were you] SPPROXY = 1(sample person)
[was (SP)] SPPROXY = 2(proxy)

BOX ENDIAQ