Quarterly Interview

Consumer Expenditure Surveys: Quarterly Interview and Diary

Attachment B - 2017 CEQ CAPI Instrument Specifications

Quarterly Interview

OMB: 1220-0050

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2017 CEQ CAPI Instrument Specifications


Section

Tag Name

Variable Name

Question Text

Skip Instructions

FRONT

H_HHROS

H_HHROS

RESP LN NAME MEMBER RELATIONSHIP CU SEX AGE


1. Enter 1 to Continue

Return to interview

FRONT

H_PURPOSE

H_PURPOSE

FREQUENTLY ASKED QUESTIONS


1. What is this survey all about?
2. Who uses this information? What good is it?
3. How is the data collected? How many times will I be interviewed?
4. I hesitate to tell some things about myself, what protection do I have?
5. Is this survey authorized by law?
6. Proceed with the interview

1: Goto H_PURPOSE1
2: Goto H_PURPOSE2
3: Goto H_PURPOSE3
4: Goto H_PURPOSE4
5: Goto H_PURPOSE5
6: Return to interivew

FRONT

H_PURPOSE1

H_PURPOSE1

WHAT IS THIS SURVEY ALL ABOUT?

The Consumer Expenditure Survey collects information from the Nation's households and families
on their buying habits (expenditures), income, and characteristics. The strength of the survey is that it allows data users to relate the expenditure and income of consumers to the characteristics of those consumers.


1. Enter 1 to Continue

Return to interview

FRONT

H_PURPOSE2

H_PURPOSE2

WHO USES THIS INFORMATION? WHAT GOOD IS IT?

Data from the Consumer Expenditure Survey are used in a number of different ways by a variety of users. An important use of the survey by the Bureau of Labor Statistics is for the periodic revisions of the Consumer Price Index (CPI). Survey results are used to select new market basket of goods and
services for the CPI, to determine the relative importance of CPI components and to derive new cost weights for the market basket.Government and private agencies use the data to study the welfare of particular segments of the population. Economic policymakers use the data to study the impact of policy changes in the welfare of different socioeconomic groups. Researchers use the data in a variety of studies, including those that focus on the spending behavior of different family types and historical spending trends.


1. Enter 1 to Continue

Return to interview

FRONT

H_PURPOSE3

H_PURPOSE3

HOW IS THE DATA COLLECTED?
HOW MANY TIMES WILL I BE INTERVIEWED?



^H_PURPOSE3


1. Enter 1 to Continue

Return to interview

FRONT

H_PURPOSE4

H_PURPOSE4

I HESITATE TO TELL SOME THINGS ABOUT MYSELF.
WHAT PROTECTION DO I HAVE?


The information that respondents provide is used solely for statistical purposes.
All Census Bureau data collectors take an oath of confidentiality and are subject
to fines and imprisonment for improperly disclosing information provided by respondents. Names and addresses are removed from all forms and that information is not released as part of any statistical data.


1. Enter 1 to Continue

Return to interview

FRONT

H_PURPOSE5

H_PURPOSE5

IS THIS SURVEY AUTHORIZED BY LAW?


The Bureau of Labor Statistics conducts the Consumer Expenditure Survey under the authority of
Title 29 of the U.S. Code. Congress authorizes the financial support for the CE survey through Public Laws 94-439 and 95-205.The Bureau of the Census collects the CE data under the authority of Title 13, U.S. Code, Section 8b, which allows the Census Bureau to undertake surveys for other government agencies. Participation in the survey is voluntary. Under Title 13, the Census Bureau holds all information in strict confidence. We will not release information reported in the survey which would permit the identification of a household or any of its members to anyone outside of the Census Bureau.


1. Enter 1 to Continue

Return to interview

FRONT

H_CHGRESP

H_CHGRESP

Ask if necessary:

With whom am I speaking?

Enter line number


1. ^NAME[1]
2. ^NAME[2]
3. ^NAME[3]
4. ^NAME[4]
5. ^NAME[5]
6. ^NAME[6]
7. ^NAME[7]
8. ^NAME[8]
9. ^NAME[9]
10. ^NAME[10]
11. ^NAME[11]
12. ^NAME[12]
13. ^NAME[13]
14. ^NAME[14]
15. ^NAME[15]
16. ^NAME[16]
17. ^NAME[17]
18. ^NAME[18]
19. ^NAME[19]
20. ^NAME[20]
21. ^NAME[21]
22. ^NAME[22]
23. ^NAME[23]
24. ^NAME[24]
25. ^NAME[25]
26. ^NAME[26]
27. ^NAME[27]
28. ^NAME[28]
29. ^NAME[29]
30. ^NAME[30]

Return to interview

FRONT

H_STATUS

H_STATUS

STATUS OF INTERIVEW (X = Section Complete)


1. Survey Info . . . . . . . . (blank/X) 13. Hospital/Health Insurance .. (blank/X)
2. Rental Liv Quarters (blank/X) 14. Medical/Health expenditures (blank/X)
3. Owned Liv Quarters (blank/X) 15. Insurance . . . . . . . . . . . . . . . (blank/X)
4. Utility & Fuel . . . . . (blank/X) 16. Education expenses . . . . . . . (blank/X)
5. Construct Repairs . . (blank/X) 17. Subscriptions . . . . . . . . . . . . (blank/X)
6. Appliances . . . . . . . (blank/X) 18. Trips & Vacations . . . . . . . . . (blank/X)
7. HH equipment . . . . . (blank/X) 19. Misc. Expenses . . . . . . . . . . . (blank/X)
8. Home furnish . . . . . . (blank/X) 20. Expense patterns . . . . . . . . . . (blank/X)
9. Clothing & Sewing . . (blank/X) 21. Work experience. . . . . . . . . . .(blank/X)
10. Rented & Leased Vehicles . (blank/X) 22. Assets & Liabilities. . . . . . . . (blank/X)
11. Owned Vehicles . . . (blank/X)
12. Vehicle Expenses . . (blank/X)

Return to interview

FRONT

ProductKey

lookupkeyword

Enter the lookup key word to search for in the Product Database


FRONT

StopLooking

Endlooking

Enter 1 to Continue and empty product lookup keyword.
...
Enter nothing to retain current product keyword.

Product = (Fill information from the "Product" column of excel file.)
Item Description = (Fill information from the "ItemDesc" column of excel file.)
Section Part-Item Number = (Fill information from the "Section" "Part"-"ItemNo" columns of the

excel file.)

1. Enter 1 to Continue

Exit Help

FRONT


Product_Index_File

**Non Displayed**


FRONT

H_KEYS

H_KEYS

Function Keys Description:

F1 Question Help
F2 (Unassigned)
F3 (Unassigned)
F4 Jump Menu
F5 Show Status
F6 (Unassigned)
F7 Item Notes/Remarks
F8 Return
F9 Skip to next person/Sec (Currently Unavailable)
F10 Exit
F11 Calculator
F12 Repeat
Shift-F1 Show HH
Shift-F2 FAQ
Shift-F3 (Unassigned)
Shift-F4 (Unassigned)
Shift-F5 Language
Shift-F6 (Unassigned)
Shift-F7 Show Notes/Remarks

Shift-F8 Show Prechart
Shift-F9 Change Respondent
Shift-F10 Show Function Keys
Shift-F11 Show Standard Abbr. (Currently Unavailable)
Shift-F12 (Unassigned)
Ctrl-D Don't Know
Ctrl-F3 Show Question Text
Ctrl-E Blaise Report Error (Currently Unavailable)
Ctrl-F Search Tag
Ctrl-F7 Case Level Notes
Ctrl-H Info
Ctrl-K Show Function Keys
Ctrl-M Show DK & Refused
Ctrl-R Refused

Return to interview

FRONT

H_LQDATA

H_LQDATA

Global Prechart for case (CASEID)
Section (X) - (Part X) - (Description)

Return to interview

FRONT


DATAMODEL_CK

** Non Displayed ITEM AT THE DATA MODEL LEVEL **

Goto SETBASIC

FRONT


SETBASIC

** Non Displayed **

Goto START

FRONT


TRAININGCASE

THIS IS A TRAINING CASE THIS IS A TRAINING CASE THIS IS A TRAINING CASE


THIS

IS A

TRAINING

CASE


THIS IS A TRAINING CASE THIS IS A TRAINING CASE THIS IS A TRAINING CASE



1. Enter 1 to Continue


FRONT

SENSITIVECASE

SENSITIVECASE

WARNING! WARNING! WARNING! WARNING! WARNING! WARNING!

THIS THIS

CASE CASE

CONTAINS

SENSITIVE SENSITIVE

DATA DATA

This case contains data that is considered sensitive and , therefore, you must treat the data as though it is production data and apply appropriate data stewardship safeguards when using the data. These include, but as not limited to, the following:

o Do not store the data to any removable media or to a laptop that is not fully encrypted
o Do not take the data offsite, for telework or other reasons
o Do not e-mail the data unless it is sent as an encrypted attachment
o Do ensure that the data, in electronic or hard copy format, are not viewed by anyone who does not have sworn status

***If you do not agree to these conditions, exit the case as soon as the instrument allows it.***

WARNING! WARNING! WARNING! WARNING! WARNING! WARNING!


1. Enter 1 to Continue


FRONT

START

START

CENSUS CATI/CAPI SYSTEM

CONSUMER EXPENDITURE SURVEYS
QUARTERLY INTERVIEW SURVEY

DATE: (current date) TIME: (time)

INTERVIEW NUMBER: (1/2/3/4/5) CASE STATUS IS: (case status)

(THIS HOUSEHOLD IS A CONFIRMED REFUSAL/ )
(Press END to move to the next unanswered item/ )


1. Continue
2. Skip notes
3. Ready to transmit
4. Quit
5. Non-interview

1: IF INTNMBR = 1 then goto GENINTRO
ELSE goto SHOSTAT

2: Goto GENINTRO

3: IF OUTCOME = 200, 0 (zero), or 202 then goto CK1_START
ELSEIF OUTCOME = 201 then goto CK3_START
ELSE exit block and goto BBACK.TRANS

4: Exit block and goto BBACK.VERIFY_INFO

5: IF OUTCOME = 204 then goto CK2_START
ELSEIF OUTCOME = 201 then goto CK3_START
ELSE exit block and goto BCOVERAGE.NONTYP

FRONT

SHOSTAT

SHOSTAT

(This household was not in sample last quarter. / )

INTERVIEW NUMBER PREVIOUS OUTCOME DESCRIPTION
(1 / ) (1st month outcome #) (outcode description)
(2 / ) (2nd month outcome # ) (Outcome description)
(3 / ) (3rd month outcome # ) (Outcome description)

( BC NAME: (name) / )
(BC TITLE: (title) / )
(BC PHONE NUMBER: ((phone number) / )
(BC ADDRESS: (Street address) / )
(BC ADDRESS: (street - line 2) / )
(BC CITY: (city) / ), (BC STATE: (State) / ) (BC ZIP CODE: (zipcode) / )
(BC OBSERVATION: (Yes/No) / )


1. Enter 1 to Continue

IF ROSTERNAMEONINPUT = Yes then goto SHOWROS
ELSE goto SHOW_NOTES

FRONT

SHOWROS

SHOWROS

STATUS OF HOUSEHOLD COMPOSITION

Resp. LN Name Member Relationship CU Sex Age
(X / ) (Line #) (Name) (Yes/No) (Relationship) ^Cu (1/2) (Age)



1. Enter 1 to Continue

Goto SHOW_NOTES

FRONT

SHOW_NOTES

SHOW_NOTES

INFORMATION FROM PREVIOUS QUARTERS INTERVIEW

PRECHARTS: Press Shift-F8 to view pre-charts

BEST TIME TO CALL: (Bestime code description)
(best time specify)

SUNDAY INTERVIEW: (No Sunday Interview/Sunday interview okay)

Language Spoken Last Quarter: (English/Spanish/(specify) )


Use CNTRL-F7 to view case level notes


1. Enter 1 to Continue

Goto GENINTRO

FRONT

GENINTRO

GENINTRO

Do not read as worded below

o Identify yourself - show I.D.
o (Ask to speak to: (name) / Ask for eligible respondent)
If unavailable use Shift-F1 for HH roster.
o (Ask to speak to: (name) / Ask for eligible respondent)2
o Introduce survey (Ask to speak to: (name) / Ask for eligible respondent)3
o The Household address is:
(House #) (House #)suf (Street name)
(Unit Designation)

o Read if necessary
I am (your name) from the U.S. Census Bureau. Here is my identification card.
We are conducting a Consumer Expenditure Survey for the Bureau of Labor Statistics.
I have some questions I would like to ask you.

Did you receive our letter?


1. Yes
2. No
3. Non-interview

1: Goto INTROB

2: Goto GIVE_LETTER

3: Exit block and goto BCOVERAGE.NONTYP

FRONT

GIVE_LETTER

GIVE_LETTER

Hand the respondent the letter.

Allow time to read



1. Enter 1 to Continue

Goto INTROB

FRONT

INTROB

INTROB

Is Respondent ready to complete the interview?


1. Continue
2. Reluctant Respondent
3. Non-interview
4. Other Outcome
5. Wrong address
6. Inconvenient time

1: IF INTNMBR = 2-4 AND [(NEWCU ne 1) or (NEWCU = 1 AND ROSTERNAMEONINPUT = 'Yes')] AND not a replacement case then goto REPLACE_HH
ELSE goto VERADD

3: IF MARKTWO = 02 AND MARK = 16 then goto CK_INTROB
ELSE exit block and goto BCOVERAGE.NONTYP

2,4: Exit block and goto BBACK.VERIFY_INFO

5: Exit block and goto BBACK.DONE

6: Exit block and goto BBACK.APPTOTH

FRONT

REPLACE_HH

REPLACE_HH

Is this a Replacement Household?

1. Yes
2. No

1: Goto REPLACE_VER

2: Goto VERADD

FRONT

REPLACE_VER

REPLACE_VER

A replacement household means that there are no members of the original household living at this
address. Are you sure that this is a replacement household?

(This case is part of a multi-CU household. Verify that ALL original members in all CU?s no longer live there. / )


LN Name Member Relationship CU Sex Age
(Line #) (Name) (Yes/No) (Relationship) ^Cu (1/2) (Age)


1. Yes
2. No

1: IF RT8500.TOTALCU = 1 then goto ONE_CU
ELSE goto REPLACE_VER2

2: Goto CK_REPLACEVER

FRONT

REPLACE_VER2

REPLACE_VER2

Has a replacement case already been created/spawned for this address?

If unsure, back up to the start screen and Quit out of the instrument so you can check
case management.



1. Yes
2. No

1 Exit block and goto BBACK.DONE

2: Goto MULTI_CU

FRONT

ONE_CU

ONE_CU

A replacement household Case will be spawned.
You will need to exit this case and pull up the new Case
in order to interview the replacement household.

The case you are currently in will automatically become a type C.



1. Enter 1 to Continue

Exit block and goto BBACK.DONE

FRONT

MULTI_CU

MULTI_CU

A Replacement Household Case will be spawned.
You will need to exit this case and pull up the New Case in order to interview the replacement household.

This case is part of a Multi-CU Address.

The case you are currently in will automatically become a type C,
But you MUST manually Type C all other Cases. (There are (Total number of CUs from last quarter) cases that must be Type C'd) If you do not have all these cases on your laptop, contact your supervisor so that the other cases can be located and Type C'd.



1. Enter 1 to Continue

Exit block and goto BBACK.DONE

FRONT

VERADD

VERADD

(* Confirm address information (Only ask if necessary) )
I have your address listed as
READ ADDRESS BELOW. Is that your exact address?

(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)
Phy des: (Physical Description)
GQ unit: (GQ Unit Description) Non-City: (Non-city address)
Building: (Building Name)


1. Yes, address is EXACTLY CORRECT as listed.
2. Address is MOSTLY CORRECT, needs minor changes.
3. INCORRECT ADDRESS

1: Goto MAILAD

2: Goto NADDST1

3,RF: Goto DONE

FRONT

NADDST1

NADDST1

Enter corrections for House Number or press ENTER for Same/No Change.

(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)

Phy des: (Physical Description)
GQ unit: (GQ Unit Description)
Non-City: (Non-city address)
Building: (Building Name)

Goto NADDST2

FRONT

NADDST2

NADDST2

Enter corrections for House # Suffix or Press ENTER for Same/No Change

(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)

Phy des: (Physical Description)
GQ unit: (GQ Unit Description)
Non-City: (Non-city address)
Building: (Building Name)

Goto NADDST3

FRONT

NADDST3

NADDST3

Enter corrections for Street Name or Press ENTER for Same/No Change

(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)

Phy des: (Physical Description)
GQ unit: (GQ Unit Description)
Non-City: (Non-city address)
Building: (Building Name)

Goto NADDST4

FRONT

NADDST4

NADDST4

Enter corrections for Unit Designation or Press ENTER for Same/No Change

(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)

Phy des: (Physical Description)
GQ unit: (GQ Unit Description)
Non-City: (Non-city address)
Building: (Building Name)

IF FRAME = 3 or RT25.GQINAREA = 1 then goto NADDST5
ELSE goto NADDST6

FRONT

NADDST5

NADDST5

Enter corrections for Group Quarters Unit Description or Press ENTER for Same/No Change


(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)

Phy des: (Physical Description)
GQ unit: (GQ Unit Description)
Non-City: (Non-city address)
Building: (Building Name)

Goto NADDST6

FRONT

NADDST6

NADDST6

Enter corrections for Non City Style Address or Press ENTER for Same/No Change


(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)

Phy des: (Physical Description)
GQ unit: (GQ Unit Description)
Non-City: (Non-city address)
Building: (Building Name)

Goto NADDPHYS

FRONT

NADDPHYS

NADDPHYS

Enter corrections for Physical Description or Press ENTER for Same/No Change


(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)

Phy des: (Physical Description)
GQ unit: (GQ Unit Description)
Non-City: (Non-city address)
Building: (Building Name)

Goto NADDCT

FRONT

NADDCT

NADDCT

Enter corrections for City or Press ENTER for Same/No Change

(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)

Phy des: (Physical Description)
GQ unit: (GQ Unit Description)
Non-City: (Non-city address)
Building: (Building Name)

Goto NADDST

FRONT

NADDST

NADDST

? [F1]

Enter corrections for State or Press ENTER for Same/No Change

(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)

Phy des: (Physical Description)
GQ unit: (GQ Unit Description)
Non-City: (Non-city address)
Building: (Building Name)

Goto NADDZP

FRONT

NADDZP

NADDZP

Enter corrections for Zipcode or Press ENTER for Same/No Change


(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)

Phy des: (Physical Description)
GQ unit: (GQ Unit Description)
Non-City: (Non-city address)
Building: (Building Name)

IF entry lt 5 digits then goto CK_NADDZP
ELSE goto NADDBUIL

FRONT

NADDBUIL

NADDBUIL

Enter corrections for Building Name or Press ENTER for Same/No Change

(House #) (House #)SUF (Street Name) (Unit Designation)
(City), (State) (Zipcode)

Phy des: (Physical Description)
GQ unit: (GQ Unit Description)
Non-City: (Non-city address)
Building: (Building Name)

Goto CK_ADDRESS

FRONT

MAILAD

MAILAD

(Is this also your mailing address?/I have your mailing address as *READ ADDRESS BELOW. Is that correct?)

(Mailing address entries / physical address entries)

1. Yes
2. No

1: Goto PHONENUM

2: Goto NMAILST1

FRONT

NMAILST1

NMAILST1

Enter change to Mailing address - House # or Press ENTER for Same/No Change

Address: Mailing Address:
(House #) (House #)SUF (Street Name) (House #) (House #)SUF (Street Name)
(Unit Designation) (Unit Designation)
(City), (State) (Zipcode)
(City), (State) (Zipcode)
Phys des: (Physical Description)
GQ unit: (GQ Unit Description) GQ unit: (GQ Unit Description)
Non-Cty: (Non-city address) Non-city: (Non City Address)
Building: (Building Name)

Goto NMAILST2

FRONT

NMAILST2

NMAILST2

Enter change to Mailing address - House # suffix or Press ENTER for Same/No Change


Address: Mailing Address:
(House #) (House #)SUF (Street Name) (House #) (House #)SUF (Street Name)
(Unit Designation) (Unit Designation)
(City), (State) (Zipcode) (City), (State) (Zipcode)
Phys des: (Physical Description)
GQ unit: (GQ Unit Description) GQ unit: (GQ Unit Description)
Non-Cty: (Non-city address) Non-city: (Non City Address)
Building: (Building Name)

Goto NMAILST3

FRONT

NMAILST3

NMAILST3

Enter change to Mailing address - Street Name or Press ENTER for Same/No Change

Address: Mailing Address:
(House #) (House #)SUF (Street Name) (House #) (House #)SUF (Street Name)
(Unit Designation) (Unit Designation)
(City), (State) (Zipcode) (City), (State) (Zipcode)
Phys des: (Physical Description)
GQ unit: (GQ Unit Description) GQ unit: (GQ Unit Description)
Non-Cty: (Non-city address) Non-city: (Non City Address)
Building: (Building Name)

Goto NMAILST4

FRONT

NMAILST4

NMAILST4

Enter change to Mailing address - Unit Designation or Press ENTER for Same/No Change

Address: Mailing Address:
(House #) (House #)SUF (Street Name) (House #) (House #)SUF (Street Name)
(Unit Designation) (Unit Designation)
(City), (State) (Zipcode) (City), (State) (Zipcode)
Phys des: (Physical Description)
GQ unit: (GQ Unit Description) GQ unit: (GQ Unit Description)
Non-Cty: (Non-city address) Non-city: (Non City Address)
Building: (Building Name)

IF FRAME = 3 OR RT25.GQINAREA = 1 then goto NMAILST5
ELSE goto NMAILST6

FRONT

NMAILST5

NMAILST5

Enter change to Mailing address - GQ Unit Description or Press ENTER for Same/No Change

Address: Mailing Address:
(House #) (House #)SUF (Street Name) (House #) (House #)SUF (Street Name)
(Unit Designation) (Unit Designation)
(City), (State) (Zipcode) (City), (State) (Zipcode)
Phys des: (Physical Description)
GQ unit: ^MGQUNITINFO GQ unit: (GQ Unit Description)
Non-Cty: (Non-city address) Non-city: (Non City Address)
Building: (Building Name)

Goto NMAILST6

FRONT

NMAILST6

NMAILST6

Enter change to Mailing address - Non-City Style Address or Press ENTER for Same/No Change

Address: Mailing Address:
(House #) (House #)SUF (Street Name) (House #) (House #)SUF (Street Name)
(Unit Designation) (Unit Designation)
(City), (State) (Zipcode) (City), (State) (Zipcode)
Phys des: (Physical Description)
GQ unit: (GQ Unit Description) GQ unit: (GQ Unit Description)
Non-Cty: (Non-city address) Non-city: (Non City Address)
Building: (Building Name)

IF no entry in NMAILST1 and NMAILST6 then goto CK_NMAILST6
ELSE goto NMAILCT

FRONT

NMAILCT

NMAILCT

Enter change to Mailing address - City or Press ENTER for Same/No Change

Address: Mailing Address:
(House #) (House #)SUF (Street Name) (House #) (House #)SUF (Street Name)
(Unit Designation) (Unit Designation)
(City), (State) (Zipcode) (City), (State) (Zipcode)
Phys des: (Physical Description)
GQ unit: (GQ Unit Description) GQ unit: (GQ Unit Description)
Non-Cty: (Non-city address) Non-city: (Non City Address)
Building: (Building Name)

Goto NMAILST

FRONT

NMAILST

NMAILST

? [F1]

Enter change to Mailing address -State or Press ENTER for Same/No Change

Address: Mailing Address:
(House #) (House #)SUF (Street Name) (House #) (House #)SUF (Street Name)
(Unit Designation) (Unit Designation)
(City), (State) (Zipcode) (City), (State) (Zipcode)
Phys des: (Physical Description)
GQ unit: (GQ Unit Description) GQ unit: (GQ Unit Description)
Non-Cty: (Non-city address) Non-city: (Non City Address)
Building: (Building Name)

Goto NMAILZP1

FRONT

NMAILZP1

NMAILZP1

Enter change to Mailing address - Zipcode or Press ENTER for Same/No Change

Address: Mailing Address:
(House #) (House #)SUF (Street Name) (House #) (House #)SUF (Street Name)
(Unit Designation) (Unit Designation)
(City), (State) (Zipcode) (City), (State) (Zipcode)
Phys des: (Physical Description)
GQ unit: (GQ Unit Description) GQ unit: (GQ Unit Description)
Non-Cty: (Non-city address) Non-city: (Non City Address)
Building: (Building Name)

IF entry lt 5 digits then goto CK_NMAILZP1
ELSE goto CL_MAILADDRESS

FRONT

PHONENUMBER

PHONENUMBER

Ask or verify, if necessary.

What is your telephone number?

Enter phone number or 0 for None

IF PHONENUMBER lt 10 digits and ne 0 then goto CK_PHONENUMBER
ELSE goto PHONENUMBER2

FRONT

PHONENUMBER2

PHONENUMBER2

Ask or verify, if necessary.

Do you have another phone number where I can reach you?

Enter phone number or 0 for None

IF PHONENUMBER lt 10 digits and ne 0 then goto CK_PHONENUMBER2

ELSE goto EMAILADDRESS

FRONT

EMAILADDR

EMAILADDR

Ask or verify, if necessary

Can I have your e-mail address?

Enter E-Mail or press ENTER for None/Same

Exit block and goto BCOVERAGE

COVERAGE

NONTYP

NONTYP


What type of non-interview do you have?

Type A = No one home, Temporarily absent, or refusal

Type B = Vacant, under construction, occupied by persons with URE

Type C = Demolished, house moved, merged, condemned, located on base, CU moved




1. TYPE A
2. TYPE B
3. TYPE C

1: Goto TYPEA

2: Goto TYPEB

3: Goto TYPEC

COVERAGE

TYPEA

TYPEA

Enter TYPE A noninterview



1. No one home
2. Temporarily Absent
3. Refused
4. Other Type A -specify

1,2: IF RT2501.URRAL = R and (RT2501.FRAME ne 3 or RT2501.GQTYPE = 901 or 903) AND (REPLACE = 1 or ( (INTNMBR = 1 or NEWCU = 1) AND NEWUNIT ne S) then goto FM_SALES
ELSEIF ( (INTNMBR = 1 or _NEWCU_ = 1) and NEWUNIT ne S) then goto GQ_UNIT
ELSE goto RACETYP

3: Goto REF_RSN
4: IF RT25.IMPADD = 1 then goto CK_TYPEA
ELSE goto TYPEASP

COVERAGE

TYPEASP

TYPEASP

Specify other TYPE A

IF RT2501.URRAL = R and (RT2501.FRAME ne 3 or
RT2501.GQTYPE = 901 or 902) AND (REPLACE = 1 or ( (INTNMBR = 1 or _NEWCU_ = 1) AND NEWUNIT ne S) then goto FM_SALES

IF ( (INTNMBR = 1 or _NEWCU_ = 1) and NEWUNIT ne S) then goto GQ_UNIT

ELSE goto RACETYP

COVERAGE

REF_RSN

REF_RSN

Enter type of refusal



1. Hostile Respondent
2. Time Related Excuses
3. Language Problems
4. Other Refusal - specify

1-3: IF RT2501.URRAL = R and (RT2501.FRAME ne 3 or RT2501.GQTYPE = 901 or 902) AND (REPLACE = 1 or ( (INTNMBR = 1 or _NEWCU_ = 1) AND NEWUNIT ne S) then goto FM_SALES
ELSEIF ( (INTNMBR = 1 or _NEWCU_ = 1) and NEWUNIT ne S) then goto GQ_UNIT
ELSE goto RACETYP

4: Goto REASON_S

COVERAGE

REASON_S

REASON_S

Specify type of refusal

IF RT2501.URRAL = R and (RT2501.FRAME ne 3 or RT2501.GQTYPE = 901 or 902) AND (REPLACE = 1 or ( (INTNMBR = 1 or _NEWCU_ = 1) AND NEWUNIT ne S) then goto FM_SALES

ELSEIF ( (INTNMBR = 1 or _NEWCU_ = 1) and NEWUNIT ne S) then goto GQ_UNIT

ELSE goto RACETYP

COVERAGE

TYPEB

TYPEB

Enter TYPE B noninterview



1. Vacant (for rent)
2. Vacant (for sale)
3. Vacant (other)
4. Occupied by persons with URE
5. Under construction, not ready
6. All persons under 16
7. Unfit or to be demolished
8. Unoccupied tent or trailer site
9. Permit granted, construction not started
10. Other Type B -specify

1,2,4-7: IF ( (INTNMBR = 1 or _NEWCU_ = 1) and NEWUNIT ne S) then goto GQ_UNIT
ELSE goto BCONTACT.BYOBS

3: Goto VACANT_S

8,9: Goto BCONTACT.BYOBS

10: Goto TYPEB_SP

COVERAGE

TYPEB_SP

TYPEB_SP

Specify other TYPE B

IF ((INTNMBR = 1 or _NEWCU_ = 1) and NEWUNIT ne S) then goto GQ_UNIT

ELSE goto BCONTACT.BYOBS

COVERAGE

VACANT_S

VACANT_S

Specify type of vacant

IF ((INTNMBR = 1 or _NEWCU_ = 1) and NEWUNIT ne S) then goto GQ_UNIT

ELSE goto BCONTACT.BYOBS

COVERAGE

TYPEC

TYPEC

Enter TYPE C noninterview

1. Demolished
2. House or Mobile Home moved
3. Converted to permanent nonresidential use
4. Merged with units in the same structure
5. Condemned
6. Located on military base (post)
7. Unused serial # on listing sheet
8. CU moved
9. CU merged with another CE CU within same address
10. Spawned in error
11. Unlocatable Sample Address
12. Unit does not exist or Unit is out of scope
13. Other type C - specify

1,2,4-6,8-9: Goto BContact.BYOBS

3,7,10: Goto END_COVERAGE

11: IF (RT25.IMPADD = 0 or blank) then goto CK_TYPEC
ELSE goto END_COVERAGE

12: IF RT25.DESIGN = 00 then goto CK_TYPEC2
ELSE goto END_COVERAGE

13: Goto TYPEC_SP

COVERAGE

TYPEC_SP

TYPEC_SP

Specify other TYPE C

Goto BContact.BYOBS

COVERAGE

FM_SALES

FM_SALES

During the past 12 months did sales of crops, livestock, and other farm products from this place
amount to $1,000 or more?



1. Yes
2. No

Goto GQ_UNIT

COVERAGE

GQ_UNIT

GQ_UNIT

Indicate if the unit is:

1. In a Group Quarters
2. NOT in a Group Quarters

1: Goto HUTYPE

2,DK: IF FRAME ne 3 then goto DIRACC
ELSE goto HUTYPE

COVERAGE

DIRACC

DIRACC

Indicate if access to the household is:

1. Direct
2. Through another unit

1: Goto HUTYPE

2,DK: Goto MERGUA

COVERAGE

MERGUA

MERGUA

? [F1]

Is this a merged unit?



1. Merged
2. Not Merged

1,DK: Goto HUTYPE

2: Goto CK_MERGUA

COVERAGE

HUTYPE

HUTYPE

Enter type of Housing Unit.

1. House, apartment, flat
2. HU in non-transient hotel, motel, etc
3. HU permanent in transient hotel, motel, etc.
4. HU in rooming house
5. Mobile home or trailer with no permanent room added
6. Mobile home or trailer with one or more permanent rooms added
7. HU not specified above
8. Quarters not HU in rooming or boarding house
9. Students quarters in college dormitory
10. Group Quarters unit not specified above

1-6,8,9,DK: Goto UNISTRQ

7,10: IF TYPEB ne 8 then goto HUTYPESP
ELSE goto UNISTRQ

COVERAGE

HUTYPESP

HUTYPESP

Enter other type of housing unit

Goto UNISTRQ

COVERAGE

UNISTRQ

UNISTRQ

Ask if not apparent

How many housing units, both occupied and vacant, are there in this structure?



1. Only Group Quarters units
2. Mobile home or trailer
3. One, detached
4. One, attached
5. 2
6. 3 - 4
7. 5 - 9
8. 10 - 19
9. 20 - 49
10. 50 or more

IF NONTYPE = 2 (type b) then goto BYOBS
ELSEIF NONTYP = 1 then goto RACETYP
ELSE goto END_COVERAGE

COVERAGE

BYOBS

BYOBS

Did you classify this unit by observation only?

PREVIOUS OBSERVATION: (YES/NO)




1. Yes
2. No

1: Exit block and goto END_COVERAGE

2: Goto CP1NAME

COVERAGE

CP1NAME

CP1NAME

Enter contact person name

Press enter if no change is needed

PREVIOUS NAME: (Previous Contact Persons Name)

Goto CP1TITL

COVERAGE

CP1TITL

CP1TITL

Enter contact person title

Press enter if no change is needed

PREVIOUS TITLE: (Title)

Goto PHON

COVERAGE

CP1PHONE

PHON

Enter contact person phone number and extension

Press enter if no change is needed

PREVIOUS PHONE NUMBER: (Previous phone)

PREVIOUS EXTENSION: (Previous extension)

IF entry is less than 10 digits then goto CK_CP1PHONE
ELSE goto CP1ADD1

COVERAGE

CP1ADD1

CP1ADD1

Enter contact person street address

Press enter if no change is needed

PREVIOUS ADDRESS: (Previous address)
(previous address - 2nd line)
(Previous city) (previous state) (previous zipcode) - (previous zipcode extension)

Goto CP1ADD2

COVERAGE

CP1ADD2

CP1ADD2

Enter contact person second line of address, if necessary

Press enter if no change is needed

PREVIOUS ADDRESS: (Previous address)
(previous address - 2nd line)
(Previous city) (previous state) (previous zipcode) - (previous zipcode extension)

Goto CP1PO

COVERAGE

CP1PO

CP1PO

Enter town or city

Press enter if no change is needed

PREVIOUS ADDRESS: (Previous address)
(previous address - 2nd line)
(Previous city) (previous state) (previous zipcode) - (previous zipcode extension)

Goto CP1ST

COVERAGE

CP1ST

CP1ST

? [F1]

Enter state

Press enter if no change is needed

PREVIOUS ADDRESS: (Previous address)
(previous address - 2nd line)
(Previous city) (previous state) (previous zipcode) - (previous zipcode extension)

IF entry is not a valid 2-digit state code then goto CK_CP1ST
ELSE goto CP1ZIP9

COVERAGE

CP1ZIP9

CP1ZIP9

Enter zipcode

Press enter if no change is needed

PREVIOUS ADDRESS: (Previous address)
(previous address - 2nd line)
(Previous city) (previous state) (previous zipcode) - (previous zipcode extension)

IF entry is lt 5 digits then goto CK_CP1ZIP9
ELSEIF CP1ZIP9[6:4] is less than 4 digits then
goto CK2_CP1ZIP9
ELSE exit block and goto END_COVERAGE

COVERAGE

RACETYP

RACETYP

The items below are required information for all TYPE A cases.

Race code



1. White
2. Black or African American
3. American Indian or Alaska native
4. Asian
5. Native Hawaiian
6. Guamanian or Chamorro
7. Samoan
8. Other Pacific Islander
9. Other

Goto HH_MEMQ

COVERAGE

HH_MEMQ

HH_MEMQ

The items below are required information for all TYPE A cases.

Number of household members:

Goto TENURE

COVERAGE

TENURE

TENURE

The items below are required information for all TYPE A cases.

Tenure code



1. Owned
2. Rented

1,2: Goto HHQSRCE

DK: Goto BUILD_A

COVERAGE

BUILD_A

BUILD_A

Which best describes this building?



1. Single family detached
2. Townhouse - inner unit
3. End row or end townhouse
4. Duplex
5. 3-plex or 4-plex
6. Garden
7. High-rise
8. Apartment or flat
9. Mobile home or trailer
10. College dormitory

Goto HHQSRCE

COVERAGE

HHQSRCE

HHQSRCE

What was the source of the information for the household
characteristics?


Enter all that apply, separate with commas



1. Observation
2. Neighbor
3. Building Manager
4. Other (Specify)

1-3: IF TYPE A (outcome is 321-324) then goto REF_SEX
ELSE goto END_COVERAGE

4: Goto HHQ_SP

COVERAGE

HHQ_SPECIFY

HHQ_SPECIFY

Specify other source of information

IF Type A (outcome is 321-324) then goto REF_SEX
ELSE goto END_COVERAGE

COVERAGE

REF_SEX

REF_SEX

Provide the characteristics of the individual who refused to participate.

Sex of individual




1. Male
2. Female

Goto REF_RACE

COVERAGE

REF_RACE

REF_RACE

Provide the characteristics of the individual who
refused to participate.


Race of individual



1. White
2. Black or African American
3. American Indian or Alaska native
4. Asian
5. Native Hawaiian
6. Guamanian or Chamorro
7. Samoan
8. Other Pacific Islander
9. Other

Goto REF_AGED

COVERAGE

REF_AGED

REF_AGED


Provide the characteristics of the individual who
refused to participate.

Approximate age of individual




1. Under 20
2. 21 - 50
3. 51 - 74
4. 75 or older

Goto END_COVERAGE

COVERAGE


END_COVERAGE

** Non Displayed **

IF (TYPEC = 3, 7, 10-12) then goto BBACK.BlkAppt.DONE

ELSEIF (NONTYP = 1 or 2) OR (TYPEC = 1, 2 4-6, 8 or 11) then goto BBACK.BlkAppt.THANK2

All others goto START_DEMOS

DEMOGRAPHICS

STLLIV

STLLIV

I have listed . . . . READ NAMES
(All of these/this) (person/people) still living or staying here?

(This case is part of a Multi-CU address. There are (number) households for this address/ )

(Lis tof persons in the household)


1. Yes
2. No

Goto TUNIT1 Block - PERSTAT

DEMOGRAPHICS

PERSTAT

PERSTAT

(Use up/down arrows to move to the correct row for membership change. When done, REVIEW/Update demographics. Press END key./Use left/right arrows to


7. Delete person
8. CU member deceased
9. Reinstate person
99. Error - Person should not have been listed


DEMOGRAPHICS

FNAME

FNAME

(What is the name of the next person living or staying here?/What are the names of all persons living or staying here?)

Enter 999 if no more persons.

16 characters: Goto LNAME

999: IF ROW = 1 then goto ERR_FNAME
ELSEIF MEMBNO < Nrosize + 1 then goto CK_FNAME
ELSE exit block and goto CHECKS

DEMOGRAPHICS

LNAME

LNAME

Enter Last Name

Goto CU_CODE

DEMOGRAPHICS

CU_CODE

CU_CODE

Ask if not apparent

What is (your/NAME's) relationship to (you/the owner/renter/name of reference person)?

If this is the Reference Person, enter 1
(The Reference person is one of the persons who owns or rents this home.)


1. Reference person
2. Spouse (Husband/Wife)
3. Child or adopted child
4. Grandchild
5. In-Law
6. Brother or Sister
7. Mother or Father
8. Other related person (Aunt, Uncle, etc.)
9. Unrelated Person (Lodger, Lodger's spouse, foster child, etc)
10. Unmarried Partner

IF more than 1 reference person (CU_CODE = 1) has been selected (refpercnt > 1) then goto CK_CHECKS2

ELSEIF 2 or 10 entered and there is another household member with cu_code = 2 or 10 then goto Ck_Spouse

ELSE goto SEX

DEMOGRAPHICS

SEX

SEX

Ask if not apparent

Is ^NAME male or female?


1. Male
2. Female

1,2: IF cu_code = 2 and SEX = sex[refper] then goto CK_SEX1
ELSE goto AWAY_COL

DK,RF: Goto AWAY_COL

DEMOGRAPHICS

AWAY_COL

AWAY_COL

Ask if not apparent

Is ^NAME living away at college?


1. Yes
2. No

1: IF CU_CODE = 1 then goto CK_AWAYCOL
ELSE goto HH_MEM

2,DK,RF,EMPTY: Goto HH_MEM

DEMOGRAPHICS

HH_MEM

HH_MEM

Does ^NAME usually live here?

Probe if usual place of residence is elsewhere.


1. Yes
2. No

1,DK,RF,EMPTY: Goto Set_Flags

2: IF CU_CODE = 2 then goto CK_HHMEM
ELSE goto Set_Flags

DEMOGRAPHICS


CHECKS

** Non Displayed **

IF RefPerCnt = EMPT then goto CK_CHECKS1
IF any CU_CODE = EMPTY then goto CK_CUCODE
IF any SEX = EMPTY then goto CK_SEX
IF any AWAY_COL = EMPTY then goto CK_AWAYCOL
IF any HH_MEM = EMPTY then goto CK_HHMEM

ELSE goto HHRESP

DEMOGRAPHICS

HHRESP

HHRESP

Ask if necessary

With whom am I speaking?

Enter line number


1. NameOnly[1]
2. NameOnly[2]
3. NameOnly[3]
4. NameOnly[4]
5. NameOnly[5]
6. NameOnly[6]
7. NameOnly[7]
8. NameOnly[8]
9. NameOnly[9]
10. NameOnly[10]
11. NameOnly[11]
12. NameOnly[12]
13. NameOnly[13]
14. NameOnly[14]
15. NameOnly[15]
16. NameOnly[16]
17. NameOnly[17]
18. NameOnly[18]
19. NameOnly[19]
20. NameOnly[20]
21. NameOnly[21]
22. NameOnly[22]
23. NameOnly[23]
24. NameOnly[24]
25. NameOnly[25]
26. NameOnly[26]
27. NameOnly[27]
28. NameOnly[28]
29. NameOnly[29]
30. NameOnly[30]
95. Proxy Respondent

IF HHRESP gt NROSIZE then goto CK_HHRESP

ELSEIF (MEMBSTAT[HHRESP] = 1 and PERSTAT[HHRESP] ne 9) OR (MEMBSTAT[HHRESP] = 5) OR (PERSTAT[HHRESP] = 7, 8 or 99) OR (HH_MEM[HHRESP] = 2 or blank) then goto CK_HHRESP2

ELSEIF ((INTNMBR = 1 or NEWCU = 1) and NEWUNIT ne S) OR REPLACE = 1 AND NROSIZE less than 30 then goto MLIVE

ELSEIF ((INTNMBR = 1 or NEWCU = 1) and NEWUNIT ne S) OR REPLACE = 1 AND NROSIZE eq 30 then exit block and goto BSUBFAMILY, BSFMAKEUP or TUNIT2 as appropriate

ELSE goto NEWLIV

DEMOGRAPHICS

MLIVE

MLIVE

So I have listed ^PerNum ^peopleperson living or staying here now.

(Lis tof persons in the household)

Is there anyone else living or staying here now - any babies, small children, non-relatives or anyone else?

Please verify that the information on this screen is correct.

1. Yes
2. No

1: Go back to where FNAME = 999

2,DK,RF: Exit block and goto BSUBFAMILY, BSFMAKEUP or TUNIT2 as appropriate

DEMOGRAPHICS

NEWLIV

NEWLIV

Is anyone else living or staying here, including newborn babies?

(Lis tof persons in the household)


1. Yes, add new person
2. No

1: Go back to where FNAME = 999

2: Exit block and goto BSUBFAMILY, BSFMAKEUP or TUNIT2 as appropriate

DEMOGRAPHICS

SUBFAM1

SUBFAM1

Earlier you said that (Name) was not related to (Name of reference person).
Is (Name) related to anyone else in this household?


1. Yes
2. No

1: Goto SUBFAM2

2: IF no more non-rels then goto SET_SUBFAMS
ELSE goto SUBFAM1 for next unassigned non-rel

DEMOGRAPHICS

SUBFAM2

SUBFAM2

Who is (Name) related to?

PROBE: Anyone else?

Enter line number(s), separate with commas

1. ^NAME[1]
2. ^NAME[2]
3. ^NAME[3]
4. ^NAME[4]
5. ^NAME[5]
6. ^NAME[6]
7. ^NAME[7]
8. ^NAME[8]
9. ^NAME[9]
10. ^NAME[10]
11. ^NAME[11]
12. ^NAME[12]
13. ^NAME[13]
14. ^NAME[14]
15. ^NAME[15]
16. ^NAME[16]
17. ^NAME[17]
18. ^NAME[18]
19. ^NAME[19]
20. ^NAME[20]
21. ^NAME[21]
22. ^NAME[22]
23. ^NAME[23]
24. ^NAME[24]
25. ^NAME[25]
26. ^NAME[26]
27. ^NAME[27]
28. ^NAME[28]
29. ^NAME[29]
30. ^NAME[30]

IF SUBFAM2 gt NROSIZE then goto CK_SUBFAM2

ELSEIF no more non-rels then goto SET_SUBFAMS

ELSE goto SUBFAM, for next unassigned non-rel

DEMOGRAPHICS


SET_SUBFAMS

** Non Displayed **

Goto BFSMAKEUP Block - SHELTX

DEMOGRAPHICS

SHELTX

SHELTX

(Begin financial responsibility questions to determine CU's/ )

(Do/Does)
(READ NAMES) pay for all (his/her/their) housing
expenses with (his/her/their) own money?

(subfamily names)


1. Yes
2. No

Goto FOODX

DEMOGRAPHICS

FOODX

FOODX

(Do/Does) (READ NAMES) pay for all (his/her/their) food
expenses with (his/her/their) own money?

(subfamily names)


1. Yes
2. No

1: IF SHELTX = 1 and there are no more subfams then goto UPDATE_SUBFAM
ELSEIF SHELTX = 1 then goto SHELTX for next subfam
ELSE goto OTHERX

2,DK,RF: Goto OTHERX

DEMOGRAPHICS

OTHERX

OTHERX

(Do/Does) (READ NAMES) pay for all (his/her/their) other living expenses such as clothing, transportation, etc., with (his/her/their) own money?

(subfamily names)


1. Yes
2. No

1: IF SHELTX = 1 OR FOODX = 1 AND there are no more subfamiles then goto UPDATE_SUBFAM
ELSEIF SHELTX = 1 OR FOODX = 1 then goto SHELTX for next subfamily
ELSE goto SUPSRC

2,DK,RF: Goto SUPSRC

DEMOGRAPHICS

SUPSRC

SUPSRC

Does all or part of the money to pay for (READ NAMES) (housing/food/other living expenses...) come from someone in this household?

(subfamily names)


1. Yes
2. No

1: Goto SUPRT1

2,DK,RF: IF no more subfamilies then goto UPDATE_SUBFAM
ELSE goto SHELTX for next subfamily

DEMOGRAPHICS

SUPRT1

SUPRT1

Who is that person(s)?

Enter line number(s), separate with commas

1. ^NAME[1]
2. ^NAME[2]
3. ^NAME[3]
4. ^NAME[4]
5. ^NAME[5]
6. ^NAME[6]
7. ^NAME[7]
8. ^NAME[8]
9. ^NAME[9]
10. ^NAME[10]
11. ^NAME[11]
12. ^NAME[12]
13. ^NAME[13]
14. ^NAME[14]
15. ^NAME[15]
16. ^NAME[16]
17. ^NAME[17]
18. ^NAME[18]
19. ^NAME[19]
20. ^NAME[20]
21. ^NAME[21]
22. ^NAME[22]
23. ^NAME[23]
24. ^NAME[24]
25. ^NAME[25]
26. ^NAME[26]
27. ^NAME[27]
28. ^NAME[28]
29. ^NAME[29]
30. ^NAME[30]

IF SUPRT1 gt NROSIZE then goto CK_SUPRT1

ELSEIF no more subfamilies then goto UPDATE_SUBFAM

ELSE goto SHELTX for next subfamily

DEMOGRAPHICS


UPDATE_SUBFAM

** Non Displayed **

IF more than 1 CU then exit block and goto CONSUMER_UNITS
ELSE goto CU_INTRO

DEMOGRAPHICS

CONSUMER_UNITS

CONSUMER_UNITS

HOUSEHOLD MEMBERS BROKEN INTO APPROPRIATE CU'S

(List CU#, Line number, and name)


1. Enter 1 to Continue

Goto CU_INTRO

DEMOGRAPHICS

CU_INTRO

CU_INTRO

During this interview, I will use the word household to refer to the group of related persons who are independent of all other persons living at this address for payment of their major expenses.

A "household" is considered one Consumer Unit

The (person/ persons) I'm including in your household (are/is)
(READ NAME(S))

(Names of Cu members)


1. Enter 1 to Continue

Goto TUNIT2 block

DEMOGRAPHICS


NAME

** SHOW ONLY **


DEMOGRAPHICS


CU_CODE

** SHOW ONLY **

1. Reference person
2. Spouse (Husband/Wife)
3. Child or adopted child
4. Grandchild
5. In-Law
6. Brother or Sister
7. Mother or Father
8. Other related person (Aunt, Uncle, etc.)
9. Unrelated Person (Lodger, Lodger's spouse, foster child, etc)
10. Unmarried Partner


DEMOGRAPHICS


SEX

** SHOW ONLY **

1. Male
2. Female


DEMOGRAPHICS

AGE

AGE1

As of today, how old (are/is) (you/NAME)?

DK,RF: Goto AGE2

0-109: IF CU_CODE = 1 AND AGE lt 16 then goto CK_AGE
ELSEIF CU_CODE = 1 AND (AGE = 16 or 17 ) AND (there is at least 1 household member with AGE greater than 17) then goto CK_AgeRefPer
ELSEIF RESPLINE = MEMBNO AND AGE lt 16 then goto CK_AGE
ELSEIF AGE = 13 then goto AGESPEC
ELSE goto HORIGIN

110-200: Goto CK_AGE1

DEMOGRAPHICS

AGESPEC

AGESPEC

Some questions are only asked for household members of a certain age.

In what month and year will (you/NAME) be 14 years old?


Enter month and year when household member will turn 14

IF before current month and year then goto VERIFY_AGE

ELSEIF AGESPEC[3:6] after current year + 1 then
goto CK_AGESPEC

ELSE goto HORIGIN

DEMOGRAPHICS

AGE2

AGE2

Ask if necessary

(Are/Is) (you/he/she) under 16?


1. Yes
2. No

1: IF RESPLINE = MEMBNO then goto CK_AGE2
ELSEIF CU_CODE = 1 then goto CK_AGE2
ELSE goto HORIGIN

2,DK,RF: Goto HORIGIN

DEMOGRAPHICS

HORIGIN

HORIGIN

3

(Are/Is) (you/NAME) Hispanic, Latino, or Spanish?


1. Yes
2. No

1: Goto HISPANIC

2,DK,RF: Goto MULTRACE

DEMOGRAPHICS

HISPANIC

HISPANIC

3

(Are/Is) (you/NAME) -


Examples of "other" include - Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard


1. Mexican?
2. Mexican-American?
3. Chicano?
4. Puerto Rican?
5. Cuban?
6. Other (Specify)

1-5,DK,RF: Goto MULTRACE

6: Goto HISPOTH

DEMOGRAPHICS

HISPOTH

HISPOTH

Specify:

Goto MULTRACE

DEMOGRAPHICS

MULTRACE

MULTRACE

3

What is (your/NAME's) race?

Probe if necessary

Enter all that apply, separate with commas

Examples of "Other Pacific Islander" include - Fijian, Tongan


1. White
2. Black or African American
3. American Indian or Alaska native
4. Asian
5. Native Hawaiian
6. Guamanian or Chamorro
7. Samoan
8. Other Pacific Islander
9. Other Specify
10. Don't Know

1-3,5,8,10,RF: IF AGE ge 14 OR AGERNG = 8 or 9 then goto MARITAL
ELSE goto Next Person

4: Goto ASIAN

9: Goto RACESP

DEMOGRAPHICS

ASIAN

ASIAN

3

(Are/Is) (you/NAME) -

Examples of "other" include - Hmong, Laotian, Thai, Pakistani, Cambodian


1. Chinese?
2. Filipino?
3. Japanese?
4. Korean?
5. Vietnamese?
6. Asian Indian?
7. Other (Specify)

1-6,DK,RF: IF AGE ge 14 OR (AGERNG = 8 or 9) then goto MARITAL
ELSE goto Next Person

7: Goto ASIANOTH

DEMOGRAPHICS

ASIANOTH

ASIANOTH

Specify:

IF AGE ge 14 OR (AGERNG = 8 or 9) then goto MARITAL
ELSE goto Next Person

DEMOGRAPHICS

RACESP

RACESP

Specify other race

IF AGE ge 14 OR (AGERNG = 8 or 9) then goto MARITAL
ELSE goto Next Person

DEMOGRAPHICS

MARITAL

MARITAL

Ask if not apparent

(Are/Is) (you/NAME) -


1. Married?
2. Widowed?
3. Divorced?
4. Separated?
5. Never married?

Goto EDUCA

DEMOGRAPHICS

EDUCA

EDUCA

4

What is the highest level of school (you have/ (Name) has) completed or the highest degree (you have/ (Name) has) received?


1. No schooling completed, or less than 1 year
2. Nursery, kindergarten, and elementary (grades 1-8)
3. High school (grades 9-12, no degree)
4. High school graduate - high school diploma or the equivalent (GED)
5. Some college but no degree
6. Associate's degree in college
7. Bachelor's degree (BA, AB, BS, etc.)
8. Master's, professional, or doctorate degree (MA, MS, MBA, MD, JD, PhD, etc.)

1-3,DK,RF: IF AGE = 16-65 or (AGERNG = 8 or 9) then goto ARM_FORC
ELSE goto next member

4-8: Goto IN_COLL

DEMOGRAPHICS

IN_COLL

IN_COLL

(Are/Is) (you/NAME) currently enrolled in a college or university either -


1. Full-time?
2. Part-time?
3. Not at all?

IF AGE = 16-65 or (AGERNG = 8 or 9) then goto ARM_FORC
ELSE goto next member

DEMOGRAPHICS

ARM_FORC

ARM_FORC

4 ? [F1]

(Are/Is) (you/NAME) now in the Armed Forces?


1. Yes
2. No

IF this is the last person then goto CHECKS2
ELSE goto the next person

DEMOGRAPHICS

CE_INTRO

CE_INTRO

As we start, please understand that we ask the same topics of everybody we talk to. I realize some of these questions may not apply to your household.

Most questions that I will be asking refer to a specific time period.

During this interview, the time period, unless I state otherwise is for the
past three months, that is, from the 1st day of (reference month) to today.

Most of my questions are about expenses your household had or bills you've received. You will find it helpful to have your checkbook register, credit card statements and other records as you answer the questions.


1. Enter 1 to Continue

Goto BUSCREEN

DEMOGRAPHICS

BUSCREEN

BUSCREEN

Since the first of (reference month), have (you/you or any members of your household) had any expenses that will be reimbursed or deducted as business expenses?

1. Yes
2. No

1,DK,RF: Goto BUSXPNSE

2: Exit block and goto BSECT01

DEMOGRAPHICS

BUSXPNSE

BUSXPNSE

For certain topics, such as housing, utilities, or vehicles, I will ask you to estimate how much of the expense was or will be deducted as a business expense.

1. Enter 1 to Continue

Exit block and goto BSECT01

01B

ST_HOUS

ST_HOUS

Ask if not apparent.

Are these living quarters presently used as student housing by a
college or university?


1. Yes
2. No

IF COVERAGE.UNISTRQ = 2 or 3 OR (8500.UNISTRQ = 2 or 3) then goto ROOMSQ

ELSE goto BUILDING

01B

BUILDING

BUILDING

5 ? [F1]

Ask if not apparent by observation

Which best describes this building?


1. Single family detached
2. Row or townhouse - inner unit
3. End row or end townhouse
4. Duplex
5. 3-plex or 4-plex
6. Garden
7. High-rise
8. Apartment or flat
9. Mobile home or trailer
10. College dormitory
11. Other - Specify

1-9,DK,RF: Goto ROOMSQ

10: IF ST_HOUS = 2, DK or RF then goto CK_BUILDING
ELSE goto S1B_END

11: Goto BUILDOTH

01B

BUILDOTH

BUILDOTH

Specify:

Goto ROOMSQ

01B

ROOMSQ

ROOMSQ

How many ROOMS are there in this unit, including all finished
living areas and excluding all bathrooms?

1-30,DK,RF: Goto BEDROOMQ

31-99: Goto ERR1_ROOMSQ

01B

BEDROOMQ

BEDROOMQ

How many BEDROOMS are there in this unit?

Count all rooms used mainly for sleeping, even if also used for other purposes.

0-99: IF (BEDROOMQ gt ROOMSQ) AND (ROOMSQ ne DK and ROOMSQ ne RF) then goto CK_BEDROOMQ
ELSEIF BEDROOMQ gt 12 then goto ERR1_BEDROOMQ
ELSE goto BATHRMQ

DK,RF: Goto BATHRMQ

01B

BATHRMQ

BATHRMQ

How many COMPLETE bathrooms are there in this unit?

A complete bathroom has a toilet, a bathtub or shower, and a sink,
all with running water.

0-9: IF (BATHRMQ gt ROOMSQ) AND (ROOMSQ ne DK and ne RF) then goto CK_BATHRMS
ELSE goto HLFBATHQ

DK,RF: Goto HLFBATHQ

01B

HLFBATHQ

HLFBATHQ

How many HALF bathrooms are there in this unit?

A half bathroom has at least a toilet or bathtub or shower, but
does not have all the facilities of a complete bathroom.

0-9: IF (HLFBATHQ gt ROOMSQ) AND (ROOMSQ ne DK and ne RF) then goto CK_HLFBATHQ
ELSE goto S1B_END

DK,RF: Goto S1B_END

01B


S1B_END

** Non Displayed **

Goto Section 2 - BSECT02

02


S2_CHK

** Non Displayed **

IF BSECT01.ST_HOUS (from Section 1B) = 1 OR HUTYPE = 9 (from Coverage) OR (8500.ST_HOUS = 1) OR (HUTYPE = 9) then goto MORERENT.

IF INTNMBR = 2-4 and there is a record with 8500.OWNYB = 100 and 8500.OPB_STAT = 1 then goto S3_INTRO.

IF INTNMBR = 2-4 and (there is no 8500.OWNYB = 100 with 8500.OPB_STAT = 1) and 8500.SectComp23 = 1 AND (8500.ST_HOUS is not 1) then goto STLRENT.

All others goto OWNED.

02

STLRENT

STLRENT

Last time (you/your household) reported renting these living quarters.
Do you still rent?


1. Yes
2. No
3. No -Buying the sample unit

1,DK,RF: Goto RENTED

2: Goto BRENT02.RTASPAY

3: IF 8500.UNITFEAT = EMPTY then goto UNITFEAT
ELSEIF 8500.YRBUILT = EMPTY then goto YRBUILT
ELSE exit block and goto Section 3

02

OWNED

OWNED

Do you own this home?

Include households with mortgages as owners.


1. Yes
2. No

1: IF 8500.UNITFEAT = EMPTY then goto UNITFEAT
ELSEIF 8500.YRBUILT = EMPTY then goto YRBUILT
ELSE exit block and goto Section 3

2,DK,RF: Goto PUBLHOUS

02

UNITFEAT

UNITFEAT

7 ? [F1]

Does this unit have any of the following?

Enter all that apply, separate with commas


0. None
1. Swimming Pool
2. Off Street Parking
3. Porch, terrace, patio, or balcony
4. Apartment or guest house
5. Central air conditioning
6. Window air conditioning
7. Solar panels
77. Don't know

IF 0 is selected with other values then goto CK_UNITFEAT

ELSEIF 8500.YRBUILT = EMPTY then goto YRBUILT

ELSE exit block and goto Section 3

02

YRBUILT

YRBUILT

About when was this building originally built?

Do not consider later remodelings
Probe for best estimate

1700-9999: IF YRBUILT gt current year then goto CK_YRBUILT
ELSE goto Section 3

DK,RF: Goto Section 3

02

PUBLHOUS

PUBLHOUS

Ask if not apparent.

Is this house in a public housing project, that is, is it owned by
a local housing authority or other local public agency?


1. Yes
2. No

1: IF 8500.INCLDRYR = EMPTY then goto INCLSTOV

ELSE goto RENTED

2,DK,RF: Goto GOVTCOST

02

GOVTCOST

GOVTCOST

Are your housing costs lower because the Federal, State, or local
government is paying part of the cost?


1. Yes
2. No

IF 8500.INCLDRYR = EMPTY then goto INCLSTOV

ELSE goto RENTED

02

INCLSTOV

INCLSTOV

6 ? [F1]

Were any of the following appliances included in the home when you moved in . . .

. . . Cooking stove, range, or oven?


1. Yes
2. No

Goto INCLFRIG

02

INCLFRIG

INCLFRIG

6 ? [F1]

Were any of the following appliances included in the home when you moved in . . .

. . . Refrigerator or home freezer?


1. Yes
2. No

Goto INCLBDSH

02

INCLBDSH

INCLBDSH

6 ? [F1]

Were any of the following appliances included in the home when you moved in . . .

. . . Built-in dishwasher?


1. Yes
2. No

Goto INCLPDSH

02

INCLPDSH

INCLPDSH

6 ? [F1]

Were any of the following appliances included in the home when you moved in . . .

. . . Portable dishwasher?


1. Yes
2. No

Goto INCLWSHR

02

INCLWSHR

INCLWSHR

6 ? [F1]

Were any of the following appliances included in the home when you moved in . . .

. . . Clothes washer?


1. Yes
2. No

Goto INCLDRYR

02

INCLDRYR

INCLDRYR

6 ? [F1]

Were any of the following appliances included in the home when you moved in . . .

. . . Clothes dryer?


1. Yes
2. No

Goto RENTED

02

RENTED

RENTED

Do (you/you or any members of your household) (still/ ) pay rent for these living quarters?


1. Yes
2. No

1,DK,RF: Goto BRent02.RENTX1

2: Goto BRent02.RTASPAY

02

MORERENT

MORERENT

Since the first of (reference month) have (you/you or any members of your household) rented any houses, apartments, or temporary living quarters NOT used entirely for business or vacation?

Do NOT include college or university regulated housing.


1. Yes
2. No

1: Goto BRent02.RENTX1

2,DK,RF: Goto S2_END

02

Description

RENTDESC

** SHOW ONLY **


02

RENTX1

RENTX1

What was your total rental payment for (reference month) for this unit?
Include any extra charges for garage or parking facilities, but do not
include direct payments by local, state or federal agencies.

0-9999999: goto RENTX2

DK,RF: Goto RENTX2

02

RENTX2

RENTX2

What was the total rental payment for (month) for this unit?

1-9999999: goto RENTX3

0,DK,RF: Goto RENTX3

02

RENTX3

RENTX3

What was your total rental payment for (last month) for this unit?

1-9999999: goto RTELECT

0,DK,RF: Goto RTELECT

02

RTELECT

RTELECT

6

Does the rental payment include the cost of -

. . . Electricity?


1. Yes
2. No

Goto RTGAS

02

RTGAS

RTGAS

6

Repeat if necessary

Does the rental payment include the cost of -

. . . . Gas?


1. Yes
2. No

Goto RTWATER

02

RTWATER

RTWATER

6

Repeat if necessary
Does the rental payment include the cost of -

. . . Piped in water?


1. Yes
2. No

Goto RTHEAT

02

RTHEAT

RTHEAT

6

Repeat if necessary
Does the rental payment include the cost of -

. . . . Heating?


1. Yes
2. No

Goto RTTRASH

02

RTTRASH

RTTRASH

6

Repeat if necessary
Does the rental payment include the cost of -

. . . Trash/garbage collection?


1. Yes
2. No

Goto RTPARK

02

RTPARK

RTPARK

6

Repeat if necessary
Does the rental payment include the cost of -

. . . Garage and parking facilities?


1. Yes
2. No

Goto RTTELEPH

02

RTTELEPH

RTTELEPH

6

Repeat if necessary
Does the rental payment include the cost of -

. . . Telephone services?


1. Yes
2. No

Goto RTTVCABL

02

RTTVCABL

RTTVCABL

6

Repeat if necessary
Does the rental payment include the cost of -

. . . Television services?


1. Yes
2. No

Goto RTINTRNT

02

RTINTRNT

RTINTRNT

6

Repeat if necessary
Does the rental payment include the cost of -

. . . Internet services?


1. Yes
2. No

Goto RTFUNSH

02

RTFUNSH

RTFUNSH

6

Repeat if necessary
Does the rental payment include the cost of -

. . . Furniture?


1. Yes
2. No

Goto RTASPAY

02

RTASPAY

RTASPAY

Did (you/you or any members of your household) receive any reduced or free rent for this unit as a form of pay since the first of (reference month)?


1. Yes
2. No

1: Goto RTCOMPX

2,DK,RF: IF BCeintro.BUSCREEN ne 2 then goto RTBSNS
ELSEIF BCeintro.BUSCREEN = 2 AND (PSU = 06001, 06013, 06037, 06041, 06059, 06065, 06071, 06081, 06073, 06075, 06087, 06097, 11001, 24021, 24043, 34003, 34013, 34017, 34023, 34027, 34031, 34037, 36005, 36047, 36059, 36061, 36081, 36085, 36087, 36103, 36119) then goto RENTCONT

ELSE goto MORERNT

02

RTCOMPX

RTCOMPX

What is the current monthly rental charge to another tenant for a similar unit?

0-999999: IF RTCOMPX lt 100 or gt 1550 then goto ERR1_RTCOMPX
ELSE goto REGRNTX

DK,RF: Goto REGRNTX

02

REGRNTX

REGRNTX

What is your regular rental payment?

0-999999: IF REGRNTX gt 1463 then goto ERR1_REGRNTX
ELSEIF BCeintro.BUSCREEN ne 2 then goto RTBSNS
ELSEIF BCeintro.BUSCREEN = 2 AND (PSU = 06001, 06013, 06037, 06041, 06059, 06065, 06071, 06081, 06073, 06075, 06087, 06097, 11001, 24021, 24043, 34003, 34013, 34017, 34023, 34027, 34031, 34037, 36005, 36047, 36059, 36061, 36081, 36085, 36087, 36103, 36119) then goto RENTCONT
ELSE goto MORERNT

DK,RF: IF BCeintro.BUSCREEN ne 2 then goto RTBSNS
ELSEIF BCeintro.BUSCREEN = 2 AND (PSU = 06001, 06013, 06037, 06041, 06059, 06065, 06071, 06081, 06073, 06075, 06087, 06097, 11001, 24021, 24043, 34003, 34013, 34017, 34023, 34027, 34031, 34037, 36005, 36047, 36059, 36061, 36081, 36085, 36087, 36103, 36119) then goto RENTCONT

ELSE goto MORERNT

02

RTBSNS

RTBSNS

Is any portion of this unit used for your own business?


1. Yes
2. No

1: Goto RTBSNSZ

2: IF STLRENT = 2 AND RTASPAY = 2 then goto CK_RTBSNS
ELSEIF (PSU = 06001, 06013, 06037, 06041, 06059, 06065, 06071, 06073, 06075, 06081, 06087, 06097, 11001, 24021, 24043, 34003, 34013, 34017,34023, 34027, 34031, 34037, 36005, 36047,36059, 36061, 36081, 36085, 36087, 36103, 36119) goto RENTCONT
ELSE goto MORERNT

DK,RF: IF (PSU = 06001, 06013, 06037, 06041, 06059, 06065, 06071, 06073, 06075, 06081, 06087, 06097, 11001, 24021, 24043, 34003, 34013, 34017,34023, 34027, 34031, 34037, 36005, 36047,36059, 36061, 36081, 36085, 36087, 36103, 36119) goto RENTCONT
ELSE goto MORERNT

02

RTBSNSZ

RTBSNSZ

What percent of the rental payment is counted as a business expense?

Enter to the nearest whole percent.

1-99,DK,RF: IF (PSU = 06001, 06013, 06037, 06041, 06059, 06065, 06071, 06073, 06075, 06081, 06087, 06097, 11001, 24021, 24043, 34003, 34013, 34017, 34023, 34027, 34031, 34037, 36005, 36047, 36059, 36061, 36081, 36085, 36087, 36103,36119), goto RENTCONT
ELSE goto MORERNT

100: Goto ERR2_RTBSNSZ

02

RENTCONT

RENTCONT

Is this unit under rent control?


1. Yes
2. No

Goto MORERNT

02

MORERNT

MORERNT

Since the first of (reference month), have (you/you or any members of your household) rented any other houses, apartments, or temporary living quarters NOT used entirely for business or vacation?

Do NOT include college or university regulated housing.


1. Yes
2. No

1: Goto RENTX1

2,DK,RF: Goto S2_END

02


S2_END

** Non Displayed **

Goto Section 3 - BSECT3

03A2

S3_INTRO

S3_INTRO

(Now I am going to update the information you provided in the last interview for owned living quarters and other owned real estate./Now I am going to

Prop #|Description |Type |# Mort|# LSHEL |# LCHEL

1. Enter 1 to Continue

IF INTNMBR = 2-5 AND NEWCU <> 1 then goto BSect3A1

ELSE goto BSect3A2

03A1

STILOWN

STILOWN

(Do/Does) (you/your household) still own your (property description)?

Prop #|Description |Type |# Mort|# LSHEL |# LCHEL

1. Yes
2. No

1,DK,RF: IF 8500.OWNYB = 600 then exit block and goto BSECT3I.VAC_RNTQ
ELSEIF BCeintro.BUSCREEN = 2 AND (there are previously reported loans with 8500.LOANTYPE = 1, 2 AND 8500.OPF_STAT = 1) then exit block and goto BMCHANGE.Mchange
ELSEIF BCeintro.BUSCREEN = 2 AND 8500.HWMNYLOC >= 1 then exit block and goto THomeEquity.PDLOAN2
ELSEIF BCeintro.BUSCREEN = 2 exit block and goto TAddMort.ADDMORT
ELSE goto BSNSEXPA

2: IF 8500.OWNYB = 600 then exit block and goto PURPROP
ELSEIF BCeintro.BUSCREEN = 2 AND (there are previously reported loans with 8500.LOANTYPE = 1, 2 AND 8500.OPF_STAT = 1) then exit block and goto BMCHANGE.Mchange
ELSEIF BCeintro.BUSCREEN = 2 AND 8500.HWMNYLOC >= 1 then exit block and goto THomeEquity.PDLOAN2
ELSEIF BCeintro.BUSCREEN = 2 exit block and goto TAddMort.ADDMORT
ELSE goto BSNSEXPA

03A1

BSNSEXPA

BSNSEXPA

(Are/Were) any of the expenses for this property deducted
as a farm, rental, or business expense?

Prop # |Description |Type |# Mort|# LSHEL |# LCHEL


1. Yes
2. No

1: Goto OBSNSZBA

2,DK,RF: IF there are previously reported loans with 8500.LOANTYPE = 1, 2 AND 8500.OPF_STAT = 1 then exit block and goto BMCHANGE.Mchange
ELSEIF 8500.HWMNYLOC >= 1 then exit block and goto THomeEquity.PDLOAN2
ELSE exit block and goto TAddMort.ADDMORT

03A1

OBSNSZBA

OBSNSZBA

What percent of the expenses for this property (is/was) deducted?
Include the portion used for business, farming, or rented to someone outside the household.

Prop # |Description |Type |# Mort|# LSHEL |# LCHEL

1-99,DK,RF: IF there are previously reported loans with 8500.LOANTYP = 1, 2 AND 8500.OPF_STAT = 1 then exit block and goto BMCHANGE.Mchange
ELSEIF 8500.HWMNYLOC >= 1 then exit block and goto THomeEquity.PDLOAN2
ELSE exit block and goto TAddMort.ADDMORT

100: Goto ERR2_OBSNSZBA

03A1

MCHANGE

MCHANGE

^MCHANGE_FILL

1. Yes
2. No

1: Goto MORTCHNG

2,DK,RF: IF 8500.Fixedrte = 2, DK or RF then goto PYMTJX1
ELSEIF 8500.FIXEDRTE = 1 and there are more loans for this property with 8500.OPF_STAT = 1 then goto MCHANGE for the next loan ELSEIF 8500.HWMNYLOC >= 1 then exit block and goto THomeequity.PDLOAN2
ELSE exit block and goto TAddmort.ADDMORT

03A1

MORTCHNG

MORTCHNG

What was the reason for the change in your (mortgage/lump sum home equity loan) for your (property description)?


1. Change in escrow payment (include changes in property taxes, insurance)
2. Change in interest rate
3. Paid off
4. Change in amount of the graduated payment for a graduated payment ^MORTGAGE_LUMPSUM
5. ^MORTGAGE_LUMPSUM_C renegotiated (rollover or renegotiable ^MORTGAGE_LUMPSUM)
6. Refinanced ^MORTGAGE_LUMPSUM (this includes changing the term of the ^MORTGAGE_LUMPSUM)
7. Paid less than the required amount
8. Other reasons
9. More than one of the above

1,4: Goto PYRINIJ
2: Goto NEWMRRTJ
3: Goto MORTCHMO

5,6,8,9,DK,RF: Goto ORWHAT

7: Goto PYMTJX1

03A1

ORWHAT

ORWHAT

Is this a 30-year (mortgage/lump sum home equity loan), a 15-year
(mortgage/lump sum home equity loan), or something else?


1. 30-year
2. 15-year
3. Something else

1,2,DK,RF: Goto FIXEDRTJ

3: Goto MRTTERMJ

03A1

MRTTERMJ

MRTTERMJ

Enter number of years.

Goto FIXEDRTJ

03A1

FIXEDRTJ

FIXEDRTJ

Is this a fixed rate (mortgage/lump sum home equity loan)?

1. Yes
2. No

1: Goto ORGMRTJX

2,DK,RF: Goto PAYTYPJ

03A1

PAYTYPJ

PAYTYPJ

? [F1]

There are many different kinds of (mortgages/lump sum home equity loans). Which one of these comes closest to (yours/ your household's)?

Read each item on list.
Mark all that apply, separate with commas.


1. Variable or adjustable rate of interest (ARM)
2. Interest only
3. Other - Specify

IF 1 and 2 selected then goto CK_PAYTYPJ

ELSEIF 3 selected then goto PAYTOTHJ

ELSE goto ORGMRTJX

03A1

PAYTOTHJ

PAYTOTHJ

Specify:

Goto ORGMRTJX

03A1

ORGMRTJX

ORGMRTJX

What was the amount of the (mortgage/lump sum home equity loan) when
(you/your household) first obtained it, not including any interest?

1-99999999: IF (8500.OWNYB = 100 and ORGMRTJX lt 5000 or gt 315000) OR (8500.OWNYB = 200 and ORGMRTJX lt 3000 or gt 350000) OR (8500.OWNYB = 300 and ORGMRTJX lt 3000 or gt 400000) OR (8500.OWNYB = 400 and ORGMRTJX lt 1000 or gt 124900) then goto ERR1_ORGMRTJX
ELSE goto NEWMRRTJ

DK,RF: Goto NEWMRRTJ

03A1

NEWMRRTJ

NEWMRRTJ

? [F1]

What is the current interest rate for this (mortgage/lump sum home equity loan)?

Enter percent including decimal

00.000-99.999: IF entry lt 5 or gt 14 then goto ERR1_NEWMRRT
ELSE goto PYRINIJ

DK,RF: Goto PYRINIJ

03A1

PYRINIJ

PYRINIJ

8 ? [F1]

On (your/your household's) last regular payment, which of these things
were included?

Enter all that apply, separate with commas

1. Principal
2. Interest
3. Property taxes
4. Property insurance
5. Mortgage guarantee insurance (PMI)
6. Any other payments - specify
77. Don't know

1-5,77: IF neither 1 nor 2 were selected then goto CK_PYRINIJ
ELSEIF 8500.FIXEDRTE = 2,DK or RF or FIXEDRTJ = 2,DK or RF then goto MORTCHMO
ELSE goto MRTPMTJX

6: Goto PYJOTH

RF: IF 8500.FIXEDRTE = 2,DK or RF or FIXEDRTJ = 2,DK or RF then goto MORTCHMO
ELSE goto MRTPMTJX

03A1

PYJOTH

PYJOTH

Specify:

IF (8500.FIXEDRTE = 2, DK or RF) or (FIXEDRTJ = 2, DK or RF) then goto MORTCHMO

ELSE goto MRTPMTJX

03A1

MRTPMTJX

MRTPMTJX

How much is (your/your household's) (mortgage/lump sum home equity loan) payment per month?

IF entry lt 70 or gt 3000 and (ne DK or RF) then goto ERR1_MRTPMTJX

ELSEIF any codes 3 - 6 are selected in PYRINIJ then goto PRININJX

ELSE goto MORTCHMO

03A1

PRININJX

PRININJX

How much of that amount is for (principal / interest/principal and interest)?

0-99999999: IF entry lt 40 or gt 2700 then goto ERR1_PRININJX
ELSEIF PRININJX gt MRTPMTJX then goto CK_PRININJX
ELSE goto MORTCHMO

DK,RF: Goto MORTCHMO

03A1

MORTCHMO

MORTCHMO

In what month did (you pay off your (mortgage/lump sum home equity loan)/your (mortgage/lump sum home equity loan) change)?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

IF ENTRY is not in the reference period and ne DK and ne RF then goto CK_MORTCHMO

ELSE IF (FIXEDRTJ = 2, DK or RF) or (FIXEDRTJ ne 1 AND 8500.FIXEDRTE = 2, DK or RF) then goto PYMTJX1

ELSE goto MCHANGE for next loan for this property with 8500.LOANTYPE = 1, 2 and 8500.OPF_STAT = 1

IF no more loans with (8500.LOANTYPE = 1, 2 and 8500.OPF_STAT = 1) for this property AND 8500.HWMNYLOC >= 1 then exit block and goto PDLOAN2 in Thomequity block

ELSE exit block and goto ADDMORT in TAddmort block

03A1

PYMTJX1

PYMTJX1

How much was (your/your household's) payment on this ^mortgage_lumpsum in (reference month)?

1-99999999,DK,RF: IF PYMTJX1 = 1-70 or gt 3000 and (ne DK or RF) then goto ERR1_PYMTJX1
ELSEIF (any codes 3-6 selected in PYRINIJ) or 8500.PAYPROTX = 3 or 8500.PAYPROIN = 4 or 8500.PAYMORIN = 5 or 8500.PAYOTHER = 6 then goto PRNINJX1
ELSE goto PYMTJX2

0: Goto PYMTJX2

03A1

PRNINJX1

PRNINJX1

How much of that amount is for (principal / interest/principal and interest)?

0-99999999: IF PRNINJX1 = 0-40 or gt 2700 then goto ERR1_PRNINJX1
ELSEIF PRNINJX1 gt PYMTJX1 then goto CK_PRNINJX1
ELSE goto PYMTJX2

DK,RF: Goto PYMTJX2

03A1

PYMTJX2

PYMTJX2

How much was (your/your household's) payment on this (mortgage/lump sum home equity loan) in (month)?

1-99999999,DK,RF: IF PYMTJX2 1-70 or gt 3000 and ne DK or RF then goto ERR1_PYMTJX2
ELSEIF any codes 3 to 6 selected in PYRINIJ or 8500.PAYPROTX = 3 or 8500.PAYPROIN = 4 or 8500.PAYMORIN = 5 or 8500.PAYOTHER = 6 then goto PRNINJX2
ELSE goto PYMTJX3

0: Goto PYMTJX3

03A1

PRNINJX2

PRNINJX2

How much of that amount is for (principal / interest/principal and interest)?

0-99999999: IF PRNINJX2 gt PYMTJX2 then goto CK_PRNINJX2
ELSEIF PRNINJX2 = 0-40 or gt 2700 then goto ERR1_PRNINJX2
ELSE goto PYMTJX3

DK,RF: Goto PYMTJX3

03A1

PYMTJX3

PYMTJX3

How much was (your/your household's) payment on this (mortgage/lump sum home equity loan) in (last month)?

IF PYMTJX3 lt 246 or gt 2690 and ne DK or RF then
goto ERR1_PYMTJX3

ELSEIF (any codes 3 to 6 selected in PYRINIJ) or 8500.PAYPROTX = 3 or 8500.PAYPROIN = 4 or 8500.PAYMORIN = 5 or 8500.PAYOTHER = 6) then goto PRNINJX3

ELSEIF there are more loans on this property with 8500.OPF_STAT = 1 then goto MCHANGE for the next loan

ELSEIF 8500.HWMNYLOC >= 1 then exit block and goto THomeequity.PDLOAN2

ELSE exit block and goto TAddmort.ADDMORT

03A1

PRNINJX3

PRNINJX3

How much of that amount is for (principal / interest/principal and interest)?

0-99999999: IF PRNINJX3 gt PYMTJX3 then goto CK_PRNINJX3
ELSEIF PRNINJX3 lt 40 or gt 2700 then goto ERR1_PRNINJX3
ELSEIF there are more loans on this property with 8500.OPF_STAT = 1 then goto MCHANGE for the next loan

ELSEIF 8500.HWMNYLOC >= 1 then exit block and goto THomeequity.PDLOAN2

ELSE exit block and goto TAddmort.ADDMORT

DK,RF: IF there are more loans on this property with 8500.OPF_STAT = 1 then goto MCHANGE for the next loan

ELSEIF 8500.HWMNYLOC >= 1 then exit block and goto THomeequity.PDLOAN2

ELSE exit block and goto TAddmort.ADDMORT

03A1

PDLOAN2

PDLOAN2

Since the first of (reference month), (have/has) (you/your household)
made any payments for your home equity line of credit?


1. Yes
2. No

1: Goto PD2AMTX1

2,DK,RF: Goto TOTOWED2

03A1

PD2AMTX1

PD2AMTX1

What was the total amount paid in (reference month)?

1-99999999: IF (8500.OWNYB = 100 and PD2AMTX1 lt 15 or gt 6000) OR (8500.OWNYB = 200-400 and PD2AMTX1 lt 35 or gt 35000) then goto ERR1_PD2AMTX1
ELSE goto PD2AMTX2

0,DK,RF: Goto PD2AMTX2

03A1

PD2AMTX2

PD2AMTX2

What was the total amount paid in (month)?

1-99999999: IF (8500.OWNYB = 100 and PD2AMTX2 lt 15 or gt 6000) OR (8500.OWNYB = 200-400 and PD2AMTX2 lt 34 or gt 35000) then goto ERR1_PD2AMTX2
ELSE goto PD2AMTX3

0,DK,RF: Goto PD2AMTX3

03A1

PD2AMTX3

PD2AMTX3

What was the total amount paid in (last month)?

1-99999999: IF (8500.OWNYB = 100 and PD2AMTX3 lt 15 or gt 6000) OR (8500.OWNYB = 200-400 and PD2AMTX3 lt 34 or gt 35000) then goto ERR1_PD2AMTX3
ELSE goto TOTOWED2

0,DK,RF: Goto TOTOWED2

03A1

TOTOWED2

TOTOWED2

^TOTOWED2_FILL

IF TOTOWED2 lt PD2AMTX3 then goto CK_TOTOWED2

ELSEIF (8500.OWNYB = 100 and TOTOWED2 = 1-165 or gt 104400) OR (8500.OWNYB = 200-400 and TOTOWED2 = 1-2000 or gt 100000) then goto ERR1_TOTOWED2

ELSE goto PDLOAN2 for next loan for this property with 8500.OPH_STAT = 1

if no more loans for this property with 8500.OPH_STAT = 1 then exit block and goto TAddmort.Baddmort.ADDMORT

03A1

ADDMORT

ADDMORT

Since the first of (reference month), (have/has) (you/your household)
obtained any (additional/ ) mortgages, including second mortgages or home equity loans, for your (property description)?

(Do not include reverse mortgages./ )


1. Yes
2. No

1: Goto HEQUITY

2,DK,RF: Exit block and goto S3A1_CHK1

03A1

HEQUITY

HEQUITY

Was this a mortgage or home equity loan?



1. Mortgage
2. Home equity loan

1,DK,RF: Goto OTHLOAN

2: Goto HELTYPE

03A1

HELTYPE

HELTYPE

There are two basic types of home equity loans:

A loan where (you/your household) received the entire lump-sum
borrowed when (you/your household) took out the loan; or

A line of credit loan where (you/your household) can increase the
amount borrowed by simply writing a check or using a special
credit card.

Which type more closely describes this new home equity loan?


1. Lump sum home equity loan
2. Home equity line of credit

Goto OTHLOAN

03A1

OTHLOAN

OTHLOAN

Did you have any other new mortgages or home equity loans for (property description)?

1. Yes
2. No

1: Goto HEQUITY for the next row

2,DK,RF: Exit block and goto S3A1_CHK1

03A1


S3A1_CHECK

** Non Displayed **

If this property was disposed of in the current interview (OWNSTAT = 4) and OWNYB ne 600, goto Section 3D - BSECT3D

If this property was disposed of in the current interview and it is a residential business property (OWNYB = 600), goto PURPROP

IF the property is still owned (STILOWN = 1, DK or RF AND OBSNSZBA ne 100) check to see if there are any new loans (ADDMORT = 1)
If yes and LOANTYPE = 1 or 2 (of the newly reported loans) goto Section 3FG - BSECT3F
If yes and LOANTYPE = 3 (of the newly reported loans) goto Section 3H - BSECT3HTABLE

IF no, goto Section 3I - BSect3I

03A1


S3CurrentProps_END

** Not Displayed **

IF there are more "good" properties on the SCIF then go back to TStillOwn for the next property

ELSE exit block and goto PURPROP

03A1

PURPROP

PURPROP

7

(Other than the Sample Unit which you recently acquired/ ) ^SinceFill the first of (reference month), (have/has) (you/your household) purchased or otherwise acquired any property or real estate?


1. Yes
2. No

1: Goto PCODE

2,DK,RF: Goto 3A1_END

03A1

PCODE

PCODE

7

What kind of property(ies) is this new property or real estate?

Enter all that apply, separate with commas


1. Other homes, vacation homes, recreational properties including timeshares
2. Commercial real estate or farm land
3. Homes rented out or owned only for investment purposes
4. Land with no buildings on it

if 1 selected then goto NPROP2
if 2 selected then goto CK_PCODE
if 3 selected then goto NPROP6
if 4 selected then goto NPROP4

03A1

NPROP2

NPROP2

7

How many other homes, vacation homes or recreational properties, including timeshares?

Exclude right-to-use timeshares, vacation clubs, or destination clubs.

IF (OnceNProp2 = 1) AND (NPROP2 < ORIGNPROP2) then goto CK_NPROP2

ELSEIF 3 selected in PCODE then goto NPROP6

ELSEIF 4 selected in PCODE then goto NPROP4

ELSE goto S3A1_END

03A1

NPROP6

NPROP6

7

How many homes rented out or owned only for investment purposes?


03A1

NPROP4

NPROP4

7

How many were land with no buildings on it?

IF OnceNprop4 = 1 AND NPROP4 < OrigNprop4 then goto CK_NPROP4

ELSE goto S3A1_END

03A1


S3A1_END

** Non Displayed **

IF (PURPROP = 2, DK, RF) OR ( ONLY 2 entered in PCODE and there is no new sample unit and there are no previously reported active properties ) then exit block and goto ANYRENT

ELSE goto Section 3B (BSect3BDEFGHI)

03A2

OTHERHOM

OTHERHOM

7

Since the first of (reference month), (have/has) (you/your household)
lived in any other home that (you/you or any members of your household) still (own/owns)?


1. Yes
2. No

1: Goto NOPROP

2,DK,RF: Goto BUSPROP3

03A2

NOPROP

NOPROP

7

How many?

IF (Section 3A2 has been completed) AND (the FR attempts to lower the entry) then goto CK_NOPROP

ELSEIF ENTRY gt 5 then goto ERR1_NOPROP
ELSE goto BUSPROP3

03A2

BUSPROP3

BUSPROP3

7

(Do/Does) (you/your household) own any commercial real estate or farm land?


1. Yes
2. No

Goto RESBUSPR

03A2

RESBUSPR

RESBUSPR

7

(In the following questions, please do not include any of the commercial properties (you/your household) ^own_owns only for business or investment purposes.)

(Do/Does) (you/your household) own any homes rented out or owned only for investment purposes?


1. Yes
2. No

1: Goto RES_NUM

2,DK,RF: Goto SECHOME

03A2

RES_NUM

RES_NUM

7

How many?

Goto SECHOME

03A2

SECHOME

SECHOME

7

^FRINSTRUCTION
^PROPERTYOWNERFILL
^Dodoes_sechome (you/your household) own any other homes, vacation homes, or recreational properties, including timeshares?

Exclude right-to-use timeshares, vacation clubs, or destination clubs.


1. Yes
2. No

1: Goto SEC_NUM

2,DK,RF: Goto NOBUILD

03A2

SEC_NUM

SEC_NUM

7

How many?

Exclude right-to-use timeshares, vacation clubs, or destination clubs.

IF (Section 3A2 has been completed) AND (the FR attempts to lower the entry) then goto CK_SECNUM

ELSEIF ENTRY gt 5 then goto ERR1_SECNUM

ELSE goto NOBUILD

03A2

NOBUILD

NOBUILD

7

Other than property you have already mentioned, ^dodoes
(you/your household) own any land without buildings on it?


1. Yes
2. No

1: Goto BUILDNUM

2,DK,RF: Goto NOLONGER

03A2

BUILDNUM

BUILDNUM

7

How many?

IF (Section 3A2 has been completed) AND (the FR attempts to lower the entry) then goto CK_BUILDNUM

ELSEIF ENTRY gt 5 then goto ERR1_BUILDNUM

ELSE goto NOLONGER

03A2

NOLONGER

NOLONGER

7

Are there any properties that (you/your household) owned at the beginning of (reference month) that (you/your household) no longer (own/owns)?


1. Yes
2. No

1: Goto NUMPRPTY

2,DK,RF: Goto S3A2_END

03A2

NUMPRPTY

NUMPRPTY

7

How many different properties?

1-20: IF (Section 3A2 has been completed) AND (the FR attempts to lower the entry) then goto CK_NUMPRPTY
ELSEIF ENTRY gt 5 then goto ERR1_NUMPRPTY
ELSE goto P_TYPE

DK,RF: Goto S3A2_END

03A2

P_TYPE

P_TYPE

7 ? [F1]

What type of ^Propertywaswereit?

Enter all that apply, separate with commas.

1. A home in which ^YOU_YRCU used to live
2. Other homes, vacation homes, recreational properties including timeshares
3. Commercial real estate or farm land
4. Homes rented out or owned only for investment purposes
5. Land with no buildings on it

1-5: IF NUMPRTY = DK or RF then goto S3A2_END
If 1 selected in P_TYPE and NUMPRPTY is greater than 1 then goto HWMANY1
If only 1 selected in P_TYPE and NUMPRPTY = 1 then goto S3A2_END

If 2 selected in P_TYPE and NUMPRPTY is greater than 1 then goto HWMANY2
If only 2 selected in P_TYPE and NUMPRPTY = 1 then goto S3A2_END

If 3 selected in P_TYPE and NUMPRPTY is greater than 1 then goto HWMANY3
If only 3 selected in P_TYPE and NUMPRPTY = 1 then goto S3A2_END

If 4 selected in P_TYPE and NUMPRPTY is greater than 1 then goto HWMANY4
If only 4 selected in P_TYPE and NUMPRPTY = 1 then goto S3A2_END

If 5 selected in P_TYPE and NUMPRPTY is greater than 1 then goto HWMANY5
If only 5 selected in P_TYPE and NUMPRPTY = 1 then goto S3A2_END

RF: Goto S3A2_END

03A2

HWMANY1

HWMANY1

7

How many homes in which (you/your household) used to live did (you/your household) dispose
of since (reference month)?

IF (Section 3A2 has been completed) AND (the FR attempts to lower the entry) then goto CK_HWMANY1

ELSEIF 2 selected in P_TYPE then goto HWMANY2
ELSEIF 3 selected in P_TYPE then goto HWMANY3
ELSEIF 4 selected in P_TYPE then goto HWMANY4
ELSEIF 5 selected in P_TYPE then goto HWMANY5

ELSE goto S3A2_CHK

03A2

HWMANY2

HWMANY2

7

How many other homes, vacation homes, recreational properties, or timeshares did (you/your household) dispose of since (reference month)?

IF (Section 3A2 has been completed) AND (the FR attempts to lower the entry) then goto CK_HWMANY2

ELSEIF 3 selected in P_TYPE then goto HWMANY3
ELSEIF 4 selected in P_TYPE then goto HWMANY4
ELSEIF 5 selected in P_TYPE then goto HWMANY5
ELSE goto S3A2_CHK

03A2

HWMANY3

HWMANY3

7

How many commercial real estate or farm land properties did (you/your household) dispose of since (reference month)?

IF (Section 3A2 has been completed) AND (the FR attempts to lower the entry) then goto CK_HWMANY3
ELSEIF 4 selected in P_TYPE then goto HWMANY4
ELSEIF 5 selected in P_TYPE then goto HWMANY5
ELSE goto S3A2_CHK

03A2

HWMANY4

HWMANY4

7

How many homes rented out or owned only for investment purposes did (you/your household) dispose of since (reference month)?

IF (Section 3A2 has been completed) AND (the FR attempts to lower the entry) then goto CK_HWMANY4

ELSEIF 5 selected in P_TYPE then goto HWMANY5
ELSE goto S3A2_CHK

03A2

HWMANY5

HWMANY5

7

How many land properties with no buildings on them did (you/your household) dispose of since (reference month)?

IF (Section 3A2 has been completed) AND (the FR attempts to lower the entry) then goto CK_HWMANY5

ELSE goto S3A2_CHK

03A2


S3A2_CK

** NON-DISPLAYED FIELD **

IF (HWMANY1 + HWMANY2 + HWMANY3 +HWMANY4 + HWMANY5) ne NUMPRPTY then goto CK_NUMPROP

ELSE goto S3A2_END

03A2


S3A2_END

** Non Displayed **

IF OWNED ne 1 AND ( (OTHERHOM = 2, DK or RF) or (OTHERHOM = 1 AND NOPROP = DK or RF) ) AND ( (RESBUSPR = 2, DK or RF) or (RESBUSPR = 1 AND RES_NUM = DK or RF) ) AND ( (SECHOME = 2, DK or RF) or (SECHOME = 1 AND SEC_NUM = DK or RF) ) AND ( (NOBUILD = 2, DK or RF) or (NOBUILD = 1 AND BUILDNUM = DK or RF)) AND ( (NOLONGER = 2, DK or RF) or (NOLONGER = 1 AND NUMPRPTY = DK or RF) ) then goto S3I_END

03B

WHICH_PROP

WHICH_PROP

(Now I am going to ask about your (owned properties/next property) )

Enter type of property


1. Sample unit
2. ^Form_home
3. ^Oth_home
4. ^Rent_home
5. ^No_build

1: Goto CK_WHICHPROP

2-5: Goto PROPDESC

03B

PROPDESC

PROPDESC

^FILLINTRO

^DESCRIBE_NON_SAMPLEUNIT

^Continue_888

30 characters: IF OWNYB = 300 then goto TIMESHAR
ELSEIF OWNYB = 600 then goto COUNTRY
ELSE goto SHARED2

888: Goto next property

03B

TIMESHAR

TIMESHAR

? [F1]

Is this a time-sharing arrangement where (you/your household) (have/has)
use of the property only for a specified length of time each year?


1. Yes
2. No

1: Goto DEEDED

2,DK,RF: Goto SHARED2

03B

DEEDED

DEEDED

? [F1]

Is this a deeded or right-to-use timeshare?


1. Deeded
2. Right-to-use

1,DK,RF: Goto SHARWKS

2: Goto CK_DEEDED

03B

SHARWKS

SHARWKS

How many weeks are (you/your household) entitled to use your timeshare each year?

1-16, DK, RF: Goto SHARED1
17-52: Goto ERR1_SHARWKS

03B

SHARED1

SHARED1

(Do/Does) (you/your household) own the timeshare with anyone else outside your household?

1. Yes
2. No

1: Goto SHARPER1

2,DK,RF: Goto COUNTRY

03B

SHARPER1

SHARPER1

What percent of the timeshare ^dodoes (you/your household) own?

Goto COUNTRY

03B

SHARED2

SHARED2

(Do/Does) (you/your household) share ownership of the property with anyone else?


1. Yes
2. No

1: Goto SHARPER2

2,DK,RF: IF OWNYB = 300 then goto COUNTRY
ELSEIF INTNMBR = 2-5 and NEWCU ne 1 AND OWNYB ne 100 then goto STILOWNB
ELSEIF BCeintro.BUSCREEN = 2 AND OWNYB = 100 then goto BSNEXP2
ELSEIF BCeintro.BUSCREEN = 2 then goto ACQUIRYR
ELSE goto BSNSEXP

03B

SHARPER2

SHARPER2

What percentage of the property (do/does) (you/your household) own?

IF OWNYB = 300 then goto COUNTRY

ELSEIF INTNMBR = 2-5 AND NEWCU ne 1 AND OWNYB ne 100 then goto STILOWNB

ELSEIF BCeintro.BUSCREEN = 2 AND OWNYB = 100 then goto BSNEXP2

ELSEIF BCeintro.BUSCREEN = 2 then goto ACQUIRYR

ELSE goto BSNSEXP

03B

COUNTRY

COUNTRY

Ask if not apparent
If this is a timeshare with multiple locations, select the most often used location.

Where is the property located?


1. United States
2. Foreign Country

1: Goto STATE

2,DK,RF: IF INTNMBR = 2-5 AND NEWCU ne 1 and OWNYB ne 100 then goto STILOWNB
ELSEIF BCeintro.BUSCREEN = 2 AND OWNYB ne 600 then goto ACQUIRYR
ELSEIF OWNYB ne 600 then goto BSNSEXP
ELSE goto S3B_END

03B

STATE

STATE

? [F1]

Enter the two character State abbreviation

IF DK or RF: IF INTNMBR = 2-5 AND NEWCU ne 1 AND OWNYB ne 100 then goto STILOWNB
ELSEIF BCeintro.BUSCREEN = 2 AND OWNYB ne 600 then goto ACQUIRYR
ELSEIF OWNYB ne 600 then goto BSNSEXP
ELSE goto S3B_END

ELSE: Goto CNTYCODE

03B

CNTYCODE

CNTYCODE

What county is the property located in?

If the county name is not found, key X.

30 characters,DK,RF: IF INTNMBR = 2-5 AND NEWCU ne 1 AND OWNYB ne 100 then goto STILOWNB
ELSEIF BCeintro.BUSCREEN = 2 AND OWNYB ne 600 then goto ACQUIRYR
ELSEIF OWNYB ne 600 then goto BSNSEXP
ELSE goto S3B_END

X: Goto OTHCNTY

03B

OTHCNTY

OTHCNTY

Specify other county

IF INTNMBR = 2-5 AND NEWCU ne 1 AND OWNYB ne 100 then goto STILOWNB

ELSEIF BCeintro.BUSCREEN = 2 AND OWNYB ne 600 then goto ACQUIRYR

ELSEIF OWNYB ne 600 then goto BSNSEXP

ELSE goto S3B_END

03B

STILOWNB

STILOWNB

Ask if not apparent

Do you still own this property?


1. Yes
2. No

IF OWNYB = 600 then goto S3B_END
ELSEIF BCeintro.BUSCREEN = 2 AND OWNYB ne 600 then goto ACQUIRYR
ELSE goto BSNSEXP

03B

BSNSEXP

BSNSEXP

(Are/Were) any of the expenses for this property deducted as a farm, rental, or business expense?


1. Yes
2. No

1: Goto OBSNSZB

2,DK,RF: IF OWNYB = 100 then goto BSNEXP2
ELSE goto ACQUIRYR

03B

OBSNSZB

OBSNSZB

What percent of the expenses for this property ^iswas deducted? Include the portion used for business, farming, or rented to someone outside the household.

1-99,DK,RF: Goto ACQUIRYR

100: Goto ERR2_OBSNSZB

03B

BSNEXP2

BSNEXP2

Is any part of this property you own rented to someone outside your household or used for business?

1. Yes
2. No

Goto ACQUIRYR

03B

ACQUIRYR

ACQUIRYR

In what year did (you/your household) close or settle on this property?

1900-9999: If entry = current or previous year, goto ACQUIRMO
Else goto ANPROPTX

DK, RF: goto ANPROPTX

03B

ACQUIRMO

ACQUIRMO

In what month did (you/your household) close or settle on this property?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

1-12: IF ACQUIRMO and ACQUIRYR are in the future, then goto CK_ACQUIRMO
ELSEIF ACQUIRMO/ACQUIRYR are within the reference period then goto GIFTPROP
ELSE goto ANPROPTX

DK,RF: Goto ANPROPTX

03B

GIFTPROP

GIFTPROP

Was this property received as a gift or inheritance?


1. Yes
2. No

1,DK,RF: Goto ANPROPTX

2: Goto OWN_PURX

03B

OWN_PURX

OWN_PURX

7 ? [F1]

What was the total price paid for (this/the) property, not including
closing costs?

0-99999999: IF [(OWNYB = 100-300 and OWN_PURX lt 1500 or gt 485000) OR (OWNYB = 400 and OWN_PURX lt 100 or gt 250000) ]
then goto ERR1_OWNPURX

ELSE goto CLOSECST

DK, RF: goto CLOSECST

03B

CLOSECST

CLOSECST

7 ? [F1]

About how much were the closing costs?

0-99999999: IF CLOSECST gt OWN_PURX then goto CK_CLOSECST
ELSEIF CLOSECST gt 17000 then goto ERR1_CLOSCST
ELSE goto OWNDPMTX

DK,RF: Goto OWNDPMTX

03B

OWNDPMTX

OWNDPMTX

What was the amount of the down payment?

0-99999999: IF gt OWN_PURX then goto CK_OWNDPMTX
ELSEIF OWNDPMTX gt 185000 then goto ERR1_OWNDPMTX
ELSE goto ANPROPTX

DK,RF: Goto ANPROPTX

03B

ANPROPTX

ANPROPTX

What (are/were) the annual property taxes for (this/the) property?

IF (ne DK or RF) AND [(OWNYB = 100 and ANPROPTX gt 15000) OR (OWNYB = 200 and ANPROPTX gt 8000) OR (OWNYB = 300 and ANPROPTX gt 7000) OR (OWNYB = 400 and ANPROPTX gt 3000) ] then goto ERR1_ANPROPTX

ELSEIF OWNYB = 400 then goto S3B_END

ELSEIF OWNYB ne 400 AND NOT (OWNYB = 100 AND SECT01.BUILDING (from Section 1C) = 1, 9 , 10) then goto PROPTYPE

ELSE goto S3B_END

03B

PROPTYPE

PROPTYPE

Ask if not apparent.
If respondent doesn't know or refuses select pre-code 3.

^Is_Was_C this property a -


1. Condominium
2. Cooperative
3. Something else

Goto S3B_END

03B


S3B_END

** Non Displayed **

IF STILOWNB = 2 then exit block and goto Section 3D
ELSE exit block and goto Section 3E

03D

DISPMTHD

DISPMTHD

You said (you/your household) no longer (own/owns) your (property description).
Did (you/your household) sell it, give it to someone outside your household, or do something else with it?


1. Sold the property or traded the property in
2. Gave it to someone outside household
3. Something else, other - specify

1,2,DK,RF: Goto DISPYR

3: Goto DISPOTH

03D

DISPOTH

DISPOTH

Specify:

Goto DISPYR

03D

DISPYR

DISPYR

In what year did (you/your household) (sell( trade) this property/give this property to someone outside your CU/dispose of this property)?

Goto DISPMO

03D

DISPMO

DISPMO

In what month did (you/your household) (sell( trade) this property/give this property to someone outside your CU/dispose of this property)?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

IF DISPMO = DK or RF then goto S3D_END

ELSEIF DISPYR = DK or RF then goto S3D_END

ELSEIF flgError = Yes then goto DISPDATE_ERR

ELSEIF DISPMTHD = 1 then goto DISPX

ELSE goto S3D_END

03D

DISPX

DISPX

What was the selling price (trade-in value)?

IF ENTRY lt 750 or gt 399900 AND (ne DK or RF) then goto ERR1_DISPX

ELSE goto DISPEXPX

03D

DISPEXPX

DISPEXPX

8 ? [F1]

Here is a list of some of the costs people may have when selling
(trading) property. Looking at the list may help you remember
what (your/your household's) expenses were. What were (your/your household's) total expenses in selling (trading) this property?

0-99999999: IF ENTRY gt 28000 then goto ERR1_DISPEXPX
ELSEIF DISPEXPX gt DISPX then goto CK_DISPEXPX
ELSE goto S3D_END

DK,RF: Goto S3D_END

03D


S3D_END

** Non Displayed **

Exit block and goto Section 3E

03E

PRESMORT

PRESMORT

Now I am going to ask about mortgages for your (property description).
Excluding home equity loans, (and reverse mortgages/ ), (do/does) (you/your household) presently have a mortgage on your (property description)?


1. Yes
2. No

1: Goto NUMMORT1

2,DK,RF: Goto HADMORT

03E

NUMMORT1

NUMMORT1

How many mortgages ^havehas (you/your household) had on this
property since the first of (reference month)?

IF (Section 3E has been completed) AND (the FR attempts to lower the entry) then goto CK_NUMMORT1

ELSE goto HOMEQ_YN

03E

HADMORT

HADMORT

(Have/Has) (you/your household) had a mortgage on this property
since the first of (reference month)?


1. Yes
2. No

1: Goto NUMMORT2

2,DK,RF: Goto HOMEQ_YN

03E

NUMMORT2

NUMMORT2

How many mortgages (have/has) (you/your household) had on this
property since the first of (reference month)?

IF (Section 3E has been completed) AND (the FR attempts to lower the entry) then goto CK_NUMMORT2

ELSE goto HOMEQ_YN

03E

MRTCPSHA

MRTCPSHA

Since the first of (reference month), in addition to (your/your household's) share of the cooperative's total costs, did (you/your household) make payments on a mortgage that was obtained from an outside lender for (your/your household's) shares in the cooperative?

1. Yes
2. No

1: Goto NUMMORT3

2,DK,RF: Goto HOMEQ_YN

03E

NUMMORT3

NUMMORT3

How many mortgages (have/has) (you/your household) had on this
property since the first of (reference month)?

IF (Section 3E has been completed) AND (the FR attempts to lower the entry) then goto CK_NUMMORT3

ELSE goto HOMEQ_YN

03E

HOMEQ_YN

HOMEQ_YN

(Do/Does) (you/your household) have a home equity loan or any
other loan which gives the lender claim on this property in case
the loan is not repaid?


1. Yes
2. No

1: Goto LSHEL_YN

2,DK,RF: Goto S3E_END

03E

LSHEL_YN

LSHEL_YN

^LSHEL_YN_FILL_ONCE

(Have/Has) (you/your household) had a lump sum home equity loan on
this property since the first of (reference month)?


1. Yes
2. No

1: Goto NUMLSHEL

2,DK,RF: Goto LCHEL_YN

03E

NUMLSHEL

NUMLSHEL

How many?

IF (Section 3E has been completed) AND (the FR attempts to lower the entry) then goto CK_NUMLSHEL

ELSE goto LCHEL_YN

03E

LCHEL_YN

LCHEL_YN

(Have/Has) (you/your household) had a home equity line of credit
on this property since the first of (reference month)?


1. Yes
2. No

1: Goto NUMLCHEL

2,DK,RF: Goto S3E_END

03E

NUMLCHEL

NUMLCHEL

How many?

IF (section 3E has been completed) AND (the FR attempts to lower the entry) then goto CK_NUMLCHEL

ELSE goto S3E_END

03E


S3E_END

** Non Displayed **

IF (NUMMORT1 gt 0 OR NUMMORT2 gt 0 OR NUMMORT3 gt 0) OR NUMLSHEL gt 0 then goto Section 3FG

ELSEIF NUMLCHEL gt 0 then goto Section 3H

ELSE goto Section 3I

03F

ORG_INTR

ORG_INTR

Now I will ask some questions about your (1st/2nd/3rd/etc.) (mortgage/lump sum home equity loan).
These questions refer to the (mortgage/lump sum home equity loan) you are currently making payments on.


1. Continue
2. Delete the loan

1: Goto REFI

2: Goto S3FG_END

03F

REFI

REFI

(Have/Has) (you/your household) ever refinanced this mortgage?

1. Yes
2. No

Goto FRSTPYYR

03F

FRSTPYYR

FRSTPYYR

In what year did (you/your household) make the first payment
on this (mortgage/lump sum home equity loan)( after refinancing/)?

( * Enter year of first payment after the most recent refinancing/)

1900-9999: IF (entry gt current year) or (entry lt (current year - 30)) then goto ERR1_FRSTPYYR
ELSE goto FRSTPYMO

DK,RF: Goto FRSTPYMO

03F

FRSTPYMO

FRSTPYMO

In what month did (you/your household) make the first payment
on this (mortgage/lump sum home equity loan)( after refinancing/)?

( * Enter year of first payment after the most recent refinancing/)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

IF FRSTPYYR and FRSTPYMO are gt (current month + 2 and year) then goto CK_FRPSTYMO

ELSE ORGMRTX

03F

ORGMRTX

ORGMRTX

What was the amount of this (mortgage/lump sum home equity loan) when (you/your household) obtained it, not including any interest?

IF (ORGMRTX ne DK or RF) AND [ (OWNYB = 100 and ORGMRTX lt 5000 or gt 315000) OR (OWNYB = 200 and ORGMRTX lt 3000 or gt 350000) OR (OWNYB = 300 and ORGMRTX lt 3000 or gt 400000) OR (OWNYB = 400 and ORGMRTX lt 1000 or gt 124900) ] then goto ERR1_ORGMRTX

ELSE goto MTERM

03F

MTERM

MTERM

Is this a 30 year (mortgage/lump sum home equity loan), a 15 year
(mortgage/lump sum home equity loan), or something else?


1. 30-year
2. 15-year
3. Something else

1: IF current year - FRSTPYYR gt 30 then goto CK_S3FG
ELSE goto NEWMRRT

2: IF current year - FRSTPYYR gt 15 then goto CK_S3FG
ELSE goto NEWMRRT

3: Goto MORTTERM

DK,RF: Goto NEWMRRT

03F

MORTTERM

MORTTERM

Enter number of years

1-50: IF (current year - FRSTPYYR) gt MORTTERM then goto CK_S3FG]
ELSEIF ENTRY lt 5 or gt 30 then goto ERR1_MORTTERM
ELSE goto NEWMRRT

DK,RF: Goto NEWMRRT

03F

NEWMRRT

NEWMRRT

What is the current interest rate on this (mortgage/lump sum home equity loan)?

Enter percent including decimal

IF ENTRY lt 2.5 or gt 8.5 AND (ne DK or RF) then goto ERR1_NEWMRRT

ELSE goto FIXEDRTE

03F

FIXEDRTE

FIXEDRTE

Is this a fixed rate (mortgage/lump sum home equity loan)?

1. Yes
2. No

1: Goto PAYINCL

2,DK,RF: Goto PAYTYPE

03F

PAYTYPE

PAYTYPE

? [F1]

There are many different kinds of (mortgages/lump sum home equity loans).
Which of these comes closest to (yours/ your household's)?

Read each item on list
Mark all that apply, separate with commas

1. Variable or adjustable rate of interest (ARM)
2. Interest only
3. Other - Specify

IF 1 and 2 are selected then goto CK_PAYTYPE

ELSEIF 3 is selected then goto PAYTOTHF

ELSE goto PAYINCL

03F

PAYTOTHF

PAYTOTHF

Specify:

Goto PAYINCL

03F

PAYINCL

PAYINCL

8 [F1]

On (your/your household's) last payment, which of these things were included?

Read each item on list

Enter all that apply, separate with commas

1. Principal
2. Interest
3. Property taxes
4. Property insurance
5. Mortgage guarantee insurance (PMI)
6. Any other payments - specify
77. Don't know

IF 1 and 2 were not selected then goto CK_PAYINCL

ELSEIF 6 selected then goto PAYOTHF

ELSEIF FIXEDRTE = 1 then goto MRTPMTX

ELSE goto PAYMTX1

03F

PAYOTHF

PAYOTHF

Specify:

IF FIXEDRTE = 1 then goto MRTPMX

ELSE goto PAYMTX1

03F

MRTPMTX

MRTPMTX

How much is (your/your household's) (mortgage/lump sum home equity loan) payment per month?

1-99999999: IF MRTPMTX gt ORGMRTX then goto CK_MRTPMTX
ELSEIF entry lt 125 or gt 2700 then goto ERR1_MRTPMTX
ELSEIF any codes 3-6 are selected in PAYINCL then goto PRININTX
ELSE goto S3FG_END

DK,RF: IF any codes 3-6 are selected in PAYINCL then goto PRININTX
ELSE goto S3FG_END

03F

PRININTX

PRININTX

How much of that amount was for ^prinint_fill?

0-99999999: IF PRININTX gt MRTPMTX then goto ERR_PRININTX
ELSEIF entry lt 75 or gt 2500 then goto ERR1_PRININTX
ELSE goto S3FG_END

DK,RF: Goto S3FG_END

03F

PAYMTX1

PAYMTX1

How much was (your/your household's) payment on this (mortgage/lump sum home equity loan) in (reference month)?

0: Goto PAYMTX2

1-99999999,DK,RF: IF entry lt 125 or gt 2700 then goto ERR1_PAYMTX1
ELSEIF any codes 3-6 selected in PAYINCL then goto PRNINTX1
ELSE goto PAYMTX2

03F

PRNINTX1

PRNINTX1

How much of that amount was for ^prinint_fill?

0-99999999: IF PRNINTX1 gt PAYMTX1 then goto CK_PRNINTX1
ELSEIF entry lt 75 or gt 2500 then goto ERR1_PRNINTX1
ELSE goto PAYMTX2

DK,RF: Goto PAYMTX2

03F

PAYMTX2

PAYMTX2

How much was (your/your household's) payment on this (mortgage/lump sum home equity loan) in (month)?

0: Goto PAYMTX3

1-99999999,DK,RF: IF entry lt 125 or gt 2700 then goto ERR1_PAYMTX2
ELSEIF any codes 3-6 selected in PAYINCL then goto PRNINTX2
ELSE goto PAYMTX3

03F

PRNINTX2

PRNINTX2

How much of that amount was for ^prinint_fill?

0-99999999: IF PRNINTX2 gt PAYMTX2 then goto ERR_PRNINTX2
ELSEIF entry lt 75 or gt 2500 then goto ERR1_PRNINTX2
ELSE goto PAYMTX3

DK,RF: Goto PAYMTX3

03F

PAYMTX3

PAYMTX3

How much was (your/your household's) payment on this (mortgage/lump sum home equity loan) in (last month)?

0,DK,RF: Goto S3FG_END

1-99999999: IF entry lt 125 or gt 2700 then goto ERR1_PAYMTX3
ELSEIF any codes 3-6 selected in PAYINCL then goto PRNINTX3
ELSE goto S3FG_END

03F

PRNINTX3

PRNINTX3

How much of that amount is for ^prinint_fill?

0-99999999: IF PRNINTX3 gt PAYMTX3 then goto CK_PRNINTX3
ELSEIF PRNINTX3 lt 75 or gt 2500 then goto ERR1_PRNINTX3
ELSE goto S3FG_END

DK,RF: Goto S3FG_END

03F


S3FG_END

** Non Displayed **

Goto ORGMRTX for the next new loan with LOANTYPE = 1 or 2

IF no more new loans with LOANTYPE 1 or 2 AND NUMLCHEL (from 3E) gt 0 then goto Section 3H

ELSE goto Section 3I

03H


AuxPropDesc

** SHOW ONLY **


03H

PAIDLOAN

PAIDLOAN

I'd like to ask some questions about (your/your CUs) home equity line(s) of credit.

Since the first of (reference month), (have/has) (you/your household)
made any payments for (your/your household's) (this loan/1st/2nd/3rd/etc.)?


1. Yes
2. No
888. Delete this loan

1: Goto PDAMTX1

2,DK,RF: Goto TOTOWED

888: Goto next loan

03H

PDAMTX1

PDAMTX1

What was the total amount paid in (reference month)?

1-99999999: IF (OWNYB = 100 and PDAMTX1 lt 15 or gt 6000) OR (OWNYB = 200-400 and PDAMTX1 lt 35 or gt 35000) then goto ERR1_PDAMTX1
ELSE goto PDAMTX2

0,DK,RF: Goto PDAMTX2

03H

PDAMTX2

PDAMTX2

What was the total amount paid in (month)?

1-99999999: IF (OWNYB = 100 and PDAMTX2 lt 15 or gt 6000) OR (OWNYB = 200-400 and PDAMTX2 lt 35 or gt 35000) then goto ERR1_PDAMTX2
ELSE goto PDAMTX3

0,DK,RF: Goto PDAMTX3

03H

PDAMTX3

PDAMTX3

What was the total amount paid in (last month)?

1-99999999: IF (OWNYB = 100 and entry lt 15 or gt 6000) OR (OWNYB = 200-400 and entry lt 15 or gt 6000) then goto ERR1_PDAMTX3 ELSE goto TOTOWED

0: IF PDAMTX1 = 0 and PDAMTX2 = 0 then goto CK_PDAMTX3
ELSE goto TOTOWED

DK,RF: Goto TOTOWED

03H

TOTOWED

TOTOWED

^TOTOWED_FILL

0-99999999: IF (OWNYH = 100 and entry lt 165 or gt 104400) OR (OWNYH = 200-400 and entry lt 2000 or gt 100000) AND (entry ne 0 )then goto ERR1_TOTOWED
IF (entry lt PDAMTX3 AND (PDAMTX3 ne DK and ne RF)) then goto CK_TOTOWED
ELSE goto S3H_END

DK,RF: Goto S3H_END

03H


S3H_END

** Non Displayed **

Goto PAIDLOAN for next new loan with LOANTYPE = 3 for this property.

If no more new loans with LOANTYPE = 3 then exit block and goto Section 3I

03I

MORTSPEC

MORTSPEC

Now I'm going to ask about other ownership costs for your (property description).

Since the first of (reference month) not including this month, have (you/you or any members of your household) paid more than the amount required on any mortgage or lump sum home equity loan for this property?


1. Yes
2. No

1: Goto SPECIALX

2,DK,RF: If PROPTYPE (from 3B or 8500) = 1 then goto PAYCONDO
Elseif PROPTYPE (from 3B or 8500) = 2 then goto COOPPRG3
Elseif PROPTYPE (from 3B or 8500) = 3 AND (TIMESHAR (from 3B or 8500) = 1) then goto PAYHOASS
Elseif PROPTYPE (from 3B or 8500) = 3 AND OWNYB = 400 then goto PAYHOASS
Else goto GRNDRENT

03I

SPECIALX

SPECIALX

Since the first of (reference month) not including this month -

How much EXTRA did (you/your household) pay?

1-99999999: IF lt 8 or gt 14000 then goto ERR1_SPECIALX
ELSEIF PROPTYPE (from 3B or 8500) = 1 then goto PAYCONDO
ELSEIF PROPTYPE (from 3B or 8500) = 2 then goto COOPPRG3
ELSEIF PROPTYPE (from 3B or 8500) = 3 AND (TIMESHAR (from 3B or 8500) = 1) then goto PAYHOASS
ELSEIF PROPTYPE (from 3B or 8500) = 3 AND OWNYB = 400 then goto PAYHOASS
ELSE goto GRNDRENT

DK,RF: IF PROPTYPE (from 3B or 8500) = 1 then goto PAYCONDO
ELSEIF PROPTYPE (from 3B or 8500) = 2 then goto COOPPRG3
ELSEIF PROPTYPE (from 3B or 8500) = 3 AND (TIMESHAR (from 3B or 8500) = 1) then goto PAYHOASS
ELSEIF PROPTYPE (from 3B or 8500) = 3 AND OWNYB = 400 then goto PAYHOASS
ELSE goto GRNDRENT

03I

GRNDRENT

GRNDRENT

(Now I'm going to ask about ownership costs for your (property description)/ )

Since the first of (reference month) not including this month, (have/has) (you/your household) made any payments for ground or land rent for (property description)?


1. Yes
2. No

1: Goto GRNDRNTX

2,DK,RF: Goto PAYHOASS

03I

GRNDRNTX

GRNDRNTX

Since the first of (reference month) not including this month -

What was the total amount paid?

1-99999999: IF GRNDRNTX lt 45 or gt 2465 then goto ERR1_GRNDRNTX
ELSE goto PAYHOASS

DK,RF: Goto PAYHOASS

03I

PAYHOASS

PAYHOASS

(Do/Does) (you/your household) make regular payments to
a homeowner's association?


1. Yes
2. No

1: Goto HORCORG

2,DK,RF: Goto SPCLPAY2

03I

PAYCONDO

PAYCONDO

(Are/Is) (you/your household) required to make regular payments
of condominium fees for general maintenance or management services?


1. Yes
2. No

1: Goto HORCORG

2,DK,RF: Goto SPCLPAY2

03I

COOPRG3

COOPRG3

8 ? [F1]

Now I'd like to ask you about payments (you/your household) (make/makes) directly to the cooperative for (your/your household's) share of its costs.
Since the first of (reference month) not including this month, have (you/you or any members of your household) made any payments for any of the following things -

Read each item on the list
Enter all that apply, separate with commas
Enter 12 for no payments made

1. Repayment of loans owed by cooperative
2. Property taxes
3. Property Insurance
4. Management
5. Repairs or maintenance, including lawn care or snow removal
6. Improvements
7. Recreational including swimming, golf or tennis facilities
8. Security including guards or alarm systems
9. Utilities such as gas, electricity, water, heat
10. Trash collection
11. Other
12. No payments made
77. Don't know

12,RF: Goto SPCLPAY1

1-11,77: IF 11 selected then goto CORGOTH
ELSE goto MGOTHERX

03I

CORGOTH

CORGOTH

Specify:

Goto MGOTHERX

03I

HORCORG

HORCORG

9 ? [F1]

Which of the following services and privileges were included in
those payments?

Read each item on the list.
Enter all that apply---separate with commas.

1. Management
2. Repairs or maintenance, including lawn care or snow removal
3. Improvements
4. Utilities such as gas, electricity, water, heat
5. Parking
6. Recreational including swimming, golf, or tennis facilities
7. Security including guards or alarm systems
8. Maid Services
9. Medical Services
10. Trash collection
11. Other
77. Don't Know

1-11,77: IF 11 selected then goto HORGOTH
ELSEIF there is at least one loan of LOANTYPE = 1 on this property then goto MGOTHER
ELSE goto MGOTHERX

RF: Goto SPCLPAY2

03I

HORGOTH

HORGOTH

Specify:

IF at least one loan of LOANTYPE = 1 for this property then goto MGOTHER

ELSE goto MGOTHERX

03I

MGOTHER

MGOTHER

Since the first of (reference month) not including this month, have you made ANY regular payments for these services?

1. Yes
2. No

1,DK,RF: Goto MGOTHPPD

2: IF PROPTYPE (from 3B or 8500) = 2 then goto SPCLPAY1
ELSE goto SPCLPAY2

03I

MGOTHPPD

MGOTHPPD

How often (do/does) (you/your household) currently pay for these services?

1. Once a month
2. Every 2 months
3. Quarterly (every 3 months)
4. Every 4 months
5. Twice a year (every 6 months)
6. Once a year
7. Other

1-6: Goto MGOTHPYX

7,DK,RF: Goto MGOTHERX

03I

MGOTHPYX

MGOTHPYX

What is the amount currently paid (once a month/every two months/every three months/every four months/every six months/once a year)?

IF PROPTYPE (from 3B or 8500) = 2 then goto SPCLPAY1

ELSE goto SPCLPAY2

03I

MGOTHERX

MGOTHERX

Since the first of (reference month) not including this month, how much (have/has) (you/your household) paid for these services?

1-99999999: IF OWNYB = 100 and MGOTHERX lt 10 or gt 2100 then goto ERR1_MGOTHERX
ELSEIF OWNYB = 200-400 and MGOTHERX lt 5 or gt 2610 then goto ERR1_MGOTHERX
ELSEIF PROPTYPE (from 3B or 8500) = 2 then goto SPCLPAY1
ELSE goto SPCLPAY2

0,DK,RF: IF PROPTYPE (from 3B or 8500) = 2 then goto SPCLPAY1
ELSE goto SPCLPAY2

03I

SPCLPAY1

SPCLPAY1

8 ? [F1]

(Have/Has) (you/your household) made any SPECIAL payments to
a management service?


1. Yes
2. No

1: Goto COOPSP3

2,DK,RF: Goto ASSESSMT

03I

SPCLPAY2

SPCLPAY2

9 ? [F1]

(Have/Has) (you/your household) made any SPECIAL payments to a management service?


1. Yes
2. No

1: Goto HOCOSP3

2,DK,RF: Goto ASSESSMT

03I

COOPSP3

COOPSP3

8 ? [F1]

Since the first of (reference month) not including this month, what services were provided?

Enter all that apply, separate with commas

1. Repayment of loans owed by the cooperative
2. Property taxes
3. Property insurance
4. Management
5. Repairs or maintenance, including lawn care or snow removal
6. Improvements
7. Recreational including swimming, golf, or tennis facilities
8. Security including guards or alarm systems
9. Utilities such as gas, electricity, water, heat
10. Trash collection
11. Other
77. Don't Know

IF 11 is selected then goto COSPOTH

ELSE goto SPECLX

03I

COSPOTH

COSPOTH

Specify:

Goto SPECLX

03I

HOCOSP3

HOCOSP3

9 ? [F1]

Since the first of (reference month) not including this month, what services were provided?

Enter all that apply, separate with commas

1. Management
2. Repairs or maintenance, including lawn care or snow removal
3. Improvements
4. Utilities such as gas, electricity, water, heat
5. Parking
6. Recreational including swimming, golf, or tennis facilities
7. Security including guards or alarm systems
8. Maid Services
9. Medical Services
10. Trash collection
11. Other
77. Don't Know

IF 11 is selected then goto HOSPOTH

ELSE goto SPECLX

03I

HOSPOTH

HOSPOTH

Specify:

Goto SPECLX

03I

SPECLX

SPECLX

Since the first of (reference month) not including this month, how much were these special payments?

1-99999999: IF SPECLX gt 6600 then goto ERR1_SPECLX
ELSE goto ASSESSMT

DK,RF: Goto ASSESSMT

03I

ASSESSMT

ASSESSMT

Since the first of (reference month) not including this month, (have/has) (you/your household) paid any special assessments to a local government for construction or repair of roads, sidewalks, or other things like that?

1. Yes
2. No

1: Goto ASSESSX

2,DK,RF: IF OWNYB = 100 then goto RNTEQVX
ELSEIFIF OWNYB = 300 then goto VAC_OCCQ
ELSE goto S3I_END

03I

ASSESSX

ASSESSX

Since the first of (reference month) not including this month -

What was the total amount paid?

1-99999999: IF ASSESSX lt 6 or gt 77000 then goto ERR1_ASSESSX
ELSEIF OWNYB = 100 then goto RNTEQVX
ELSEIF OWNYB = 300 then goto VAC_OCCQ
ELSE goto S3I_END

DK,RF: IF OWNYB = 100 then goto RNTEQVX
ELSEIF OWNYB = 300 then goto VAC_OCCQ
ELSE goto S3I_END

03I

VAC_OCCQ

VAC_OCCQ

Since the first of (reference month), how much time did you occupy this (timeshare/property)?

Enter quantity and select period on next screen.

0,DK,RF: IF ((TIMESHAR (from 3B or 8500) = 2, DK or RF)) then goto VAC_SEC
ELSEIF (TIMESHAR (from 3B or 8500) = 1) then goto TIME_RNT
ELSE goto S3I_END

1-150: Goto VAC_OCCY

03I

VAC_OCCY

VAC_OCCY

Enter time period.

1. Days
2. Weeks
3. Months
4. Percent
5. Other, specify

1-4,DK,RF: IF ((TIMESHAR (from 3B or 8500) = 2, DK or RF)) then goto VAC_SEC
ELSEIF (TIMESHAR (from 3B or 8500) = 1) then goto TIME_RNT
ELSE goto S3I_END

5: Goto VAC_OTH

03I

VAC_OTH

VAC_OTH

Specify:

IF (TIMESHAR (from 3B or 8500) = 2, DK or RF) then goto VAC_SEC

ELSEIF (TIMESHAR (from 3B or 8500) = 1) then goto TIME_RNT

ELSE goto S3I_END

03I

VAC_SEC

VAC_SEC

Since the first of (reference month), was this property either rented by someone outside your household or available to be rented?


1. Yes
2. No

1: Goto VAC_RNTQ

2,DK,RF: Goto RNTEQVX

03I

VAC_RNTQ

VAC_RNTQ

Since the first of (reference month), how much time was this property rented by someone outside your household?

Enter quantity and select period on next screen.

0,DK,RF: Goto VAC_AVAQ

1-150: Goto VAC_RNTY

03I

VAC_RNTY

VAC_RNTY

Enter time period.


1. Days
2. Weeks
3. Months
4. Percent
5. Other, specify

1: IF VAC_RNTQ ge 91 AND OWNYB = 300 then goto RNTEQV2X
ELSEIF VAC_RNTQ ge 91 then goto S3I_END
ELSE goto VAC_AVAQ

2: IF VAC_RNTQ ge 13 AND OWNYB = 300 then goto RNTEQV2X
ELSEIF VAC_RNTQ ge 13 then goto S3I_END
ELSE goto VAC_AVAQ

3: IF VAC_RNTQ ge 3 AND OWNYB = 300 then goto RNTEQV2X
ELSEIF VAC_RNTQ ge 3 then goto S3I_END
ELSE goto VAC_AVAQ

4: IF VAC_RNTQ = 100 AND OWNYB = 300 then goto RNTEQV2X
ELSEIF VAC_RNTQ = 100 then goto S3I_END
ELSE goto VAC_AVAQ

5: Goto VAC_ROTH

DK,RF: Goto VAC_AVAQ

03I

VAC_ROTH

VAC_ROTH

Specify:

Goto VAC_AVAQ

03I

VAC_AVAQ

VAC_AVAQ

Since the first of (reference month), how much time was this property available to be rented, but not rented out?

Enter quantity and select period on next screen.

0,DK,RF: IF OWNYB = 300 then goto RNTEQV2X
ELSE goto S3I_END

1-150: Goto VAC_AVAY

03I

VAC_AVAY

VAC_AVAY

Specify

1. Days
2. Weeks
3. Months
4. Percent
5. Other, specify

1-4: IF (VAC_RNTY = VAC_AVAY) AND (VAC_RNTQ not equal DK and not equal RF) AND (VAC_AVAQ not equal DK and not equal RF) AND [ (VAC_RNTY = 1 and ((VAC_RNTQ + VAC_AVAQ) gt total number of days from the 1st of the reference month and today)) OR (VAC_RNTY = 2 and ((VAC_RNTQ + VAC_AVAQ) gt total number of weeks from the 1st of the reference month and today)) OR (VAC_RNTY = 3 and ((VAC_RNTQ + VAC_AVAQ) gt 3) ) OR (VAC_RNTY = 4 and ((VAC_RNTQ + VAC_AVAQ) gt 100)) ] Then goto CK_RNTQ_AVAQ
ELSEIF OWNYB = 300 then goto RNTEQV2X
ELSE goto S3I_END

DK,RF: IF OWNYB = 300 then goto RNTEQV2X
ELSE goto S3I_END

5: Goto VAC_AOTH

03I

VACAOTH

VACAOTH

Specify

IF OWNYB = 300 then goto RNTEQV2X

ELSE goto S3I_END

03I

RNTEQV2X

RNTEQV2X

If someone were to rent this home today, how much do you think it would rent for?

IF (RNTEQV2X lt 200 or gt 800) AND (ne DK and ne RF) then goto ERR1_RNTEQV2X

ELSE goto RENTPERD

03I

RENTPERD

RENTPERD

Ask if not already stated.

What period of time does this rental amount cover?


1. Week
2. Month
3. Quarter
4. Other specify

1-3,DK,RF: Goto RENTUTIL

4: Goto RNPEROTH

03I

RNPEROTH

RNPEROTH

Specify:

Goto RENTUTIL

03I

RENTUTIL

RENTUTIL

Does this amount include utilities?


1. Yes
2. No

Goto PROPVALX

03I

RNTEQVX

RNTEQVX

If someone were to rent this (including part of the property currently being used for business, farming, or rented/home today) how much do you think it would rent for monthly, unfurnished and without utilities?

1-999999: IF (OWNYB = 100 and RNTEQVX lt 300 or gt 3000) OR (OWNYB = 200 and RNTEQVX lt 200 or gt 4000) OR (OWNYB = 300 and RNTEQVX lt 200 or gt 8000) then goto ERR1_RNTEQVX
ELSEIF OWNYB = 100 OR (OWNYB = 300 AND ((TIMESHAR (from 3B or 8500) = 2, DK or RF)) then goto PROPVALX
ELSE goto S3I_END

DK,RF: IF OWNYB = 100 OR (OWNYB = 300 AND ((TIMESHAR (from 3B or 8500) = 2, DK or RF)) thengoto PROPVALX
ELSE goto S3I_END

03I

PROPVALX

PROPVALX

About how much do you think this property would sell for on today's market?

0-99999999: IF OWNYB = 100 and PROPVALX lt 1000 or gt 600000 OR (OWNYB = 300 and PROPVALX lt 3000 or gt 800000) then goto ERR1_PROPVALX
ELSE goto S3I_END

DK,RF: Goto S3I_END

03I

TIME_RNT

TIME_RNT

Since the first of (reference month), did you rent this timeshare to someone outside your household?

1. Yes
2. No

Goto RNTEQV3X

03I

RNTEQV3X

RNTEQV3X

If you were to rent this timeshare today to someone else, instead of using it yourself, how much would it rent for weekly?

1-99999: IF OWNYB = 300 and RNTEQV3X lt 200 or gt 8000 then goto ERR1_RNTEQV3X
ELSE goto PRPVAL2X

DK,RF: Goto PRPVAL2X

03I

PRPVAL2X

PRPVAL2X

If you were able to sell this timeshare, about how much do you think it would sell for on today's market?

0-99999999: IF OWNYB = 300 and PRPVL2X lt 3000 or gt 800000 then goto ERR1_PRPVL2X
ELSE goto S3I_END

DK,RF: Goto S3I_END

03I


S3I_END

** Non Displayed **

Goto Section 3B for the next new property.

If no more new properties (OR NO New Properties) AND OWNED = 1 then exit block and goto ANYRENT

ELSE exit section 3 block and goto Section 4 - BSECTION4

03

ANYRENT

ANYRENT

Since the first of (reference month) have (you/you or any members of your household) rented any houses, apartments, or temporary living quarters NOT used entirely for business or vacation?

Do NOT include college or university regulated housing.


1. Yes
2. No

1: Goto RENTX1

2,DK,RF: Goto Section 4

02

Description

RENTDESC

** SHOW ONLY **


02

RENTX1

RENTX1

What was your total rental payment for (reference month) for this unit?
Include any extra charges for garage or parking facilities, but do not
include direct payments by local, state or federal agencies.

0-9999999: IF RENTX1 gt 3000 then goto ERR1_RENTX1
ELSE goto RENTX2

DK,RF: Goto RENTX2

02

RENTX2

RENTX2

What was the total rental payment for (month) for this unit?

1-9999999: IF RENTX2 gt 3000 then goto ERR1_RENTX2
ELSEIF (RENTX1 ne 0,DK or RF) and ((RENTX2 le (0.6 x RENTX1)) or (RENTX2 ge (1.4 x RENTX1))) then goto ERR2_RENTX2
ELSE goto RENTX3

0,DK,RF: Goto RENTX3

02

RENTX3

RENTX3

What was your total rental payment for (last month) for this unit?

1-9999999: IF RENTX3 gt 3000 then goto ERR1_RENTX3
ELSEIF (RENTX2 ne 0,DK or RF) and ((RENTX3 le (0.6 x RENTX2)) or (RENTX3 ge (1.4 x RENTX2))) then goto ERR2_RENTX3
ELSE goto RTELECT

0,DK,RF: Goto RTELECT

02

RTELECT

RTELECT

6

Does the rental payment include the cost of -

. . . Electricity?


1. Yes
2. No

Goto RTGAS

02

RTGAS

RTGAS

6

Repeat if necessary

Does the rental payment include the cost of -

. . . . Gas?


1. Yes
2. No

Goto RTWATER

02

RTWATER

RTWATER

6

Repeat if necessary

Does the rental payment include the cost of -

. . . Piped in water?


1. Yes
2. No

Goto RTHEAT

02

RTHEAT

RTHEAT

6

Repeat if necessary

Does the rental payment include the cost of -

. . . . Heating?


1. Yes
2. No

Goto RTTRASH

02

RTTRASH

RTTRASH

6

Repeat if necessary

Does the rental payment include the cost of -

. . . Trash/garbage collection?


1. Yes
2. No

Goto RTPARK

02

RTPARK

RTPARK

6

Repeat if necessary

Does the rental payment include the cost of -

. . . Garage and parking facilities?


1. Yes
2. No

Goto RTTELEPH

02

RTTELEPH

RTTELEPH

6

Repeat if necessary
Does the rental payment include the cost of -

. . . Telephone services?


1. Yes
2. No

Goto RTTVCABL

02

RTTVCABL

RTTVCABL

6

Repeat if necessary
Does the rental payment include the cost of -

. . . Television services?


1. Yes
2. No

Goto RTINTRNT

02

RTINTRNT

RTINTRNT

6

Repeat if necessary
Does the rental payment include the cost of -

. . . Internet services?


1. Yes
2. No

Goto RTFUNSH

02

RTFUNSH

RTFUNSH

6

Repeat if necessary
Does the rental payment include the cost of -

. . . Furniture?


1. Yes
2. No

Goto RTASPAY

02

RTASPAY

RTASPAY

Did (you/you or any members of your household) receive any reduced or free rent for
this unit as a form of pay since the first of (reference month)?


1. Yes
2. No

1: Goto RTCOMPX

2,DK,RF: IF BCeintro.BUSCREEN ne 2 then goto RTBSNS
ELSEIF BCeintro.BUSCREEN = 2 AND (PSU = 06001, 06013, 06037, 06041, 06059, 06065, 06071, 06081, 06073, 06075, 06087, 06097, 11001, 24021, 24043, 34003, 34013, 34017, 34023, 34027, 34031, 34037, 36005, 36047, 36059, 36061, 36081, 36085, 36087, 36103, 36119) then goto RENTCONT

ELSE goto MORERNT

02

RTCOMPX

RTCOMPX

What is the current monthly rental charge to another tenant for a similar unit?

0-999999: IF RTCOMPX lt 100 or gt 1550 then goto
ERR1_RTCOMPX
ELSE goto REGRNTX

DK,RF: Goto REGRNTX

02

REGRNTX

REGRNTX

What is your regular rental payment?

0-999999: IF REGRNTX gt 1463 then goto ERR1_REGRNTX
ELSEIF BCeintro.BUSCREEN ne 2 then goto RTBSNS
ELSEIF BCeintro.BUSCREEN = 2 AND (PSU = 06001, 06013, 06037, 06041, 06059, 06065, 06071, 06081, 06073, 06075, 06087, 06097, 11001, 24021, 24043, 34003, 34013, 34017, 34023, 34027, 34031, 34037, 36005, 36047, 36059, 36061, 36081, 36085, 36087, 36103, 36119) then goto RENTCONT
ELSE goto MORERNT

DK,RF: IF BCeintro.BUSCREEN ne 2 then goto RTBSNS
ELSEIF BCeintro.BUSCREEN = 2 AND (PSU = 06001, 06013, 06037, 06041, 06059, 06065, 06071, 06081, 06073, 06075, 06087, 06097, 11001, 24021, 24043, 34003, 34013, 34017, 34023, 34027, 34031, 34037, 36005, 36047, 36059, 36061, 36081, 36085, 36087, 36103, 36119) then goto RENTCONT
ELSE goto MORERNT

02

RTBSNS

RTBSNS

Is any portion of this unit used for your own business?


1. Yes
2. No

1: Goto RTBSNSZ

2,DK,RF: IF STLRENT = 2 AND RTASPAY = 2 AND RTBSNS = 2 then goto CK_RTBSNS
ELSEIF PSU = 06001, 06013, 06037, 06041, 06059, 06065, 06071, 06073, 06075, 06081 06087, 06097, 11001, 24021, 24043, 34003, 34013, 34017, 34023, 34027, 34031, 34037, 36005, 36047, 36059, 36061, 36081, 36085, 36087, 36103, 36119, then goto RENTCONT
ELSE goto MORERNT

02

RTBSNSZ

RTBSNSZ

What percent of the rental payment is counted as a business expense?

Enter to the nearest whole percent.

1-99,DK,RF: IF PSU = 06001, 06013, 06037, 06041, 06059, 06065, 06071, 06073, 06075, 06081, 06087, 06097, 11001, 24021, 24043, 34003, 34013, 34017, 34023, 34027, 34031, 34037, 36005, 36047, 36059, 36061, 36081, 36085, 36087, 36103, 36119 then goto RENTCONT
ELSE goto MORERNT

100: Goto ERR2_RTBSNSZ

02

RENTCONT

RENTCONT

Is this unit under rent control?


1. Yes
2. No

Goto MORERNT

02

MORERNT

MORERNT

Since the first of (reference month), have (you/you or any members of your household)
rented any other houses, apartments, or temporary living
quarters NOT used entirely for business or vacation?

Do NOT include college or university regulated housing.


1. Yes
2. No

1: Goto RENTX1

2,DK,RF: Goto S2_END

02


S2_END

** Non Displayed **

Goto Section 4 - BSECTION4

04A

S4A_INTRO

S4A_INTRO

10

Now I am going to ask about utilities including telephone bills. Please refer to any billing statements or other records you have when answering these questions.

Please remember to include any bills you receive or pay online or have automatically deducted.

Report any bill you have received, even if the bill has not been paid.

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)



1. Enter 1 to Continue

Goto TELEBILL

04A

TELEBILL

TELEBILL

10 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) received any bills for telephone, internet, cable TV, or satellite TV services, including cellular and Voice Over IP? Do not include bills for telephones used entirely for business purposes.


1. Yes
2. No

1: Goto TblPhone Block

2,DK,RF: Goto TblPhone.S4A_END

04A

PREVCOMP

PREVCOMP

^PREVCOMP_fill?

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)


1. ^Temprevcomp[1]
2. ^Temprevcomp[2]
3. ^Temprevcomp[3]
4. ^Temprevcomp[4]
5. ^Temprevcomp[5]
6. ^Temprevcomp[6]
7. ^Temprevcomp[7]
8. ^Temprevcomp[8]
9. ^Temprevcomp[9]
10. ^Temprevcomp[10]
11. ^Temprevcomp[11]
12. ^Temprevcomp[12]
13. ^Temprevcomp[13]
14. ^Temprevcomp[14]
15. ^Temprevcomp[15]
16. ^Temprevcomp[16]
17. ^Temprevcomp[17]
18. ^Temprevcomp[18]
19. ^Temprevcomp[19]
20. ^Temprevcomp[20]
55. Company name not listed
888. Delete the line

1-20: IF BCeintro.BUSCREEN = 2 goto TELCHGX1
ELSE goto TELBSNS

55: Goto TELCOMP

888: Goto TELOTH

04A

TELCOMP

TELCOMP

(What is the name of the company which provides the service?/"* Enter company name)

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)


Enter 888 to delete the line

888: Goto TELOTH

All others: IF Uppercase version of the entry is "NETFLIX" or "HULU" then goto CK_TELCOMP
ELSEIF BCeintro.BUSCREEN = 2 goto TELCHGX1
ELSE goto TELBSNS

04A

TELBSNS

TELBSNS

Will any of the charges be deducted as a business expense?

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)


1. Yes
2. No

1: Goto TELBSNZ

2,DK,RF: Goto TELCHGX1

04A

TELBSNZ

TELBSNZ

What percentage will be deducted?

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)


1-99,DK,RF: Goto TELCHGX1

100: Goto CK_TELBSNZ

04A

TELCHGX1

TELCHGX1

How much were you billed for in (reference month)?
Do not include any unpaid charges from a previous billing period.

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)


1-999999: IF entry lt 7 or gt 400 then goto ERR1_TELCHGX1
ELSE goto TELCHGX2

0,DK,RF: Goto TELCHGX2

04A

TELCHGX2

TELCHGX2

How much were you billed for in (month)?
Do not include any unpaid charges from a previous billing period.

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)


1-999999: IF entry lt 7 or gt 400 then goto ERR1_TELCHGX2
ELSE goto TELCHGX3

0,DK,RF: Goto TELCHGX3

04A

TELCHGX3

TELCHGX3

How much were you billed for in (last month)?
Do not include any unpaid charges from a previous billing period.

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)

1-999999: IF entry lt 7 or gt 400 then goto ERR1_TELCHGX3
ELSEIF TELCHGX1 = 0 OR TELCHGX2 = 0 then goto BILPERD
ELSE goto TELSERV

0: Goto BILPERD

DK,RF: IF TELCHGX1 = 0 OR TELCHGX2 = 0 then goto BILPERD
ELSE goto TELSERV

04A

BILPERD

BILPERD

What is your usual billing period for this service?


Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)


1. Month
2. 2 months
3. Quarter
4. Annual
5. Other

Goto TELSERV

04A

TELSERV

TELSERV

Which of the following telephone service items were included in the bill(s) -

Read each item on list.
Enter all that apply, separate with commas.

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)


1. Telephone service (mobile, residential, or Voiceover IP)?
2. Internet service (including broadband, DSL, and dial-up)?
3. Cable or satellite television service?

IF 1 is selected goto TYPETEL
ELSEIF more than one item is selected then goto TELBLPRS
ELSE goto TELOTH

04A

TYPETEL

TYPETEL

10 ? [F1]

What types of telephone services did the bill include -

Read each item on list.
Enter all that apply, separate with commas.

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)



1. Residential Service including Voice over IP?
2. Mobile or Cellular Service including prepaid?

IF more than 1 item is selected in TELSERV then goto TELBLPRS
ELSE goto TELOTH

04A

TELBLPRS

TELBLPRS

Is respondent referring to a detailed bill, including online or digital?
Do not include checkbooks


1. Yes
2. No

1: IF 2 selected in TELSERV and TELCHGX1 =1-999999, DK or RF then goto TINTNTX1
ELSEIF 2 selected in TELSERV and TELCHGX2 =1-999999, DK or RF then goto TINTNTX2
ELSEIF 2 selected in TELSERV and TELCHGX3 =1-999999, DK or RF then goto TINTNTX3
ELSEIF 3 selected in TELSERV and TELCHGX1 =1-999999, DK or RF then goto TCABLEX1
ELSEIF 3 selected in TELSERV and TELCHGX2 =1-999999, DK or RF then goto TCABLEX2
ELSEIF 3 selected in TELSERV and TELCHGX3 =1-999999, DK or RF then goto TCABLEX3
ELSE goto TELOTH

2: Goto TELOTH

04A

TINTNTX1

TINTNTX1

How much of the ^TELCHGX1_Fill in (reference month) charges were for internet access?

(* Do not include data plans for mobile phones./ )

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)

IF TINTNTX1 = 1-5 OR gt 60 then goto ERR1_TINTNTX1
ELSEIF TINTNTX1 gt TELCHGX1 then goto CK_TINTNTX1
ELSEIF TELCHGX2 = 1-999999, DK or RF then goto TINTNTX2
ELSEIF TELCHGX3 = 1-999999, DK or RF then goto TINTNTX3
ELSEIF 3 selected in TELSERV and TELCHGX1 = 1-999999, DK or RF then goto TCABLEX1
ELSEIF 3 selected in TELSERV and TELCHGX2 = 1-999999, DK or RF then goto TCABLEX2
ELSEIF 3 selected in TELSERV and TELCHGX3 = 1-999999, DK or RF then goto TCABLEX3
ELSE goto TELOTH

04A

TINTNTX2

TINTNTX2

How much of the ^TELCHGX2_Fill in (month) charges were for internet access?

(* Do not include data plans for mobile phones./ )

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)

IF TINTNTX2 = 1-5 or gt 60 then goto ERR1_TINTNTX2
ELSEIF TINTNTX2 gt TELCHGX2 then goto CK_TINTNTX2
ELSEIF TELCHGX3 = 1-999999, DK or RF goto TINTNTX3
ELSEIF 3 selected in TELSERV and TELCHGX1 = 1-999999, DK or RF then goto TCABLEX1
ELSEIF 3 selected in TELSERV and TELCHGX2 = 1-999999, DK or RF then goto TCABLEX2
ELSEIF 3 selected in TELSERV and TELCHGX3 = 1-999999, DK or RF then goto TCABLEX3
ELSE goto TELOTH

04A

TINTNTX3

TINTNTX3

How much of the ^TELCHGX3_Fill in (last month) charges were for internet access?

(* Do not include data plans for mobile phones./ )

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)

IF TINTNTX3 = 1-5 or gt 60 then goto ERR1_TINTNTX3
ELSEIF TINTNTX3 gt TELCHGX3 then goto CK_TINTNTX3
ELSEIF 3 selected in TELSERV and TELCHGX1 = 1-999999, DK or RF then goto TCABLEX1
ELSEIF 3 selected in TELSERV and TELCHGX2 = 1-999999, DK or RF then goto TCABLEX2
ELSEIF 3 selected in TELSERV and TELCHGX3 = 1-999999, DK or RF then goto TCABLEX3
ELSE goto TELOTH

04A

TCABLEX1

TCABLEX1

How much of the ^TELCHGX1_Fill in (reference month) charges were for cable or satellite television service?

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)

IF TCABLEX1 = 1-5 or gt 90 then goto ERR1_TCABLEX1
ELSEIF TCABLEX1 gt TELCHGX1 then goto CK_TCABLEX1
ELSEIF (TCABLEX1 + TINTNTX1) gt TELCHGX1 then goto CK2_TCABLEX1
ELSEIF TELCHGX2 = 1-999999, DK or RF then goto TCABLEX2
ELSEIF TELCHGX3 = 1-999999, DK or RF then goto TCABLEX3
ELSE goto TELOTH

04A

TCABLEX2

TCABLEX2

How much of the ^TELCHGX2_Fill in (month) charges were for cable or satellite television service?

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)

IF TCABLEX2 = 1-5 or gt 90 then goto ERR1_TCABLEX2
ELSEIF TCABLEX2 gt TELCHGX2 then goto CK_TCABLEX2
ELSEIF TCABLEX2 + TINTNTX2 gt TELCHGX2 then goto CK2_TCABLEX2
ELSEIF TELCHGX3 = 1-999999, DK or RF then goto TCABLEX3
ELSE goto TELOTH

04A

TCABLEX3

TCABLEX3

How much of the ^TELCHGX3_Fill in (last month) charges were for cable or satellite television service?

Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)

1-999999: IF TCABLEX3 lt 5 or gt 90 then goto ERR1_TCABLEX3
ELSEIF TCABLEX3 gt TELCHGX3 then goto CK_TCABLEX3
ELSEIF TCABLEX3 + TINTNTX3 gt TELCHGX3 then goto CK2_TCABLEX3
ELSE goto TELOTH

0,DK,RF: Goto TELOTH

04A

TELOTH

TELOTH

Did (you/you or any members of your household) receive any other bills for telephones, internet, cable TV, or satellite TV not used entirely for business purposes?


Description Amount1 Amount2 Amount3
(TELCOMP) (TELCHGX1) (TELCHGX2) (TELCHGX3)



1. Yes
2. No

1: IF row number = 20 then goto ERR_MAX
ELSEIF any 850005.TELCOMP = 1-20 then goto PREVCOMP, next row of the table
ELSE goto TELCOMP, next row of the table

2: IF Answer is changed from a 1 to a 2 then goto CK_TELOTH
ELSE exit block goto TblPhone.S4A_END

04A


S4A_END

** Not Displayed **

Exit block and goto Section 4B - BSection04B

04B

FONCARD

FONCARD

10

Since the first of (reference month) not including this month, have (you/you or any members of your household) purchased any pre-paid long distance telephone cards/minutes, not already reported?

Do not include prepaid cellular minutes


1. Yes
2. No

1: Goto FONCARDX

2,DK,RF: Goto INTAWAY

04B

FONCARDX

FONCARDX

Since the first of (reference month) not including this month -

What was the total amount paid?

1-9999: IF FONCRDX lt 5 or gt 300 then goto ERR1_FONCARDX
ELSEIF RT8100.POPGRP = 11 then goto FONSTORE
ELSE goto INTAWAY

DK,RF: Goto INTAWAY

04B

FONSTORE

FONSTORE

Where were the long distance phone cards purchased?

Enter store, website, or company name

IF uppercase version of the entry = "GROUPON" or "GROUPON.COM" then goto ERR_GROUPON

ELSEIF ENTRY contains ".com", ".Com", ".cOm", ".coM", ".COm", ".CoM", ".cOM", or ".COM", then goto INTAWAY

ELSEIF ENTRY = DK or RF then goto INTAWAY

ELSE goto FONPURCH

04B

FONPURCH

FONPURCH

Ask if not apparent

Was this purchased online or in-person?


1. Online
2. In person
3. Other (phone, mail, catalog)

1,3,DK,RF: Goto INTAWAY

2: Goto FONLOC

04B

FONLOC

FONLOC

Where is (store name) located?

Enter city and state

Goto INTAWAY

04B

INTAWAY

INTAWAY

Since the first of (reference month) not including this month, have (you/you or any members of your household) paid for internet or wireless internet access away from home, at places such as cafés, hotels, or airplanes?


1. Yes
2. No

1: Goto INTAWYX

2,DK,RF: Goto S4B_END

04B

INTAWYX

INTAWYX

Since the first of (reference month) not including this month -

What was the total amount paid?

1-9999: IF INTAWYX lt 1 or gt 50 then goto ERR1_INTAWYX
ELSE goto S4B_END

DK,RF: Goto S4B_END

04B


S4B_END

** Not Displayed **

Exit block and goto Section 4C - S4C_INTRO

04C

S4C_INTRO

S4C_INTRO

11

Now I am going to ask about utility bills.

Prop # Property Description Company Name Utility Amount1 Amount2 Amount3
(WHATPROP) (UTLPDESC) (COMPNAME) UTILY) (UTLCHGX1)(UTLCHGX2) (UTLCHGX3)



1. Enter 1 to Continue

Goto TBLPROPT.Bsection04C.UTC_ITEM

04C

UTC_ITEM

UTC_ITEM

11 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) received any bills for any of the following utilities, fuels, or services? Do not include bills for properties used entirely for business.

Read each item on list:


1. Electricity
2. Natural or utility gas
3. Fuel oil
4. Bottled or tank gas
5. Other fuels including wood
6. Piped-in water and sewerage maintenance
7. Garbage and recycling collection
8. Water softening service
9. Septic tank cleaning
99. None/No more entries
888. Delete the line

1-9: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto WHATPROP

99: Goto S4C_END

888: Goto next row of table

04C


DESCPR_AX

** SHOW ONLY **


04C

WHATPROP

WHATPROP

Which property was the bill for?


1. ^Prop_display[1]
2. ^Prop_display[2]
3. ^Prop_display[3]
4. ^Prop_display[4]
5. ^Prop_display[5]
6. ^Prop_display[6]
7. ^Prop_display[7]
8. ^Prop_display[8]
9. ^Prop_display[9]
10. ^Prop_display[10]
11. ^Prop_display[11]
12. ^Prop_display[12]
13. ^Prop_display[13]
14. ^Prop_display[14]
15. ^Prop_display[15]
16. ^Prop_display[16]
17. ^Prop_display[17]
18. ^Prop_display[18]
19. ^Prop_display[19]
20. ^Prop_display[20]
40. ^Prop_display[40]
41. ^Prop_display[41]
42. Rented vacation Property
43. Property not owned or rented by household

1-20,40: IF entry greater than the number of owned properties or deleted properties are selected. (PROPDESC = 888 OR OPB_STAT = 3 from section 3) then goto CK_WHATPROP
ELSEIF UTC_ITEM = 1-3, 6-7 and no data in any 850007.COMPNAME [1]-[40] then goto COMPNAME
ELSEIF UTC_ITEM = 1-3, 6-7 and any data in 850007.COMPNAME [1]-[40] then goto LASTCOMP
ELSEIF BCeintro.BUSCREEN = 2 goto UTLCHGX1
ELSE goto UTILBUSN

41,42,43,DK,RF: Goto UTLPDESC

04C

UTLPDESC

UTLPDESC

Briefly describe the property.

IF UTC_ITEM = 1-3, 6-7 AND no data in any 850006.COMPNAME [1]-[40] then goto COMPNAME

ELSEIF UTC_ITEM = 1-3, 6-7 and any data in 850006.COMPNAME [1]-[40] then goto LASTCOMP

ELSEIF BCeintro.BUSCREEN = 2 goto UTLCHGX1

ELSE goto UTILBUSN

04C

LASTCOMP

LASTCOMP

What is the name of the company or government agency which provides (Utility description)?

Prop # Property Description Company Name Utility Amount1 Amount2 Amount3
(WHATPROP)(UTLPDESC) (COMPNAME) (UTILY) (UTLCHGX1)(UTLCHGX2)(UTLCHGX3)


1. ^Comp_display[1]
2. ^Comp_display[2]
3. ^Comp_display[3]
4. ^Comp_display[4]
5. ^Comp_display[5]
6. ^Comp_display[6]
7. ^Comp_display[7]
8. ^Comp_display[8]
9. ^Comp_display[9]
10. ^Comp_display[10]
11. ^Comp_display[11]
12. ^Comp_display[12]
13. ^Comp_display[13]
14. ^Comp_display[14]
15. ^Comp_display[15]
16. ^Comp_display[16]
17. ^Comp_display[17]
18. ^Comp_display[18]
19. ^Comp_display[19]
20. ^Comp_display[20]
55. Company name not listed

1-20: IF BCeintro.BUSCREEN = 2 goto UTLCHGX1 ELSE goto UTILBUSN

55: Goto COMPNAME

04C

COMPNAME

COMPNAME

What is the name of the company or government agency which provides (Utility description)?

Prop # Property Description Company Name Utility Amount1 Amount2 Amount3
(WHATPROP) (UTLPDESC) (COMPNAME) (UTILY) (UTLCHGX1)(UTLCHGX2) (UTLCHGX3)

IF BCeintro.BUSCREEN = 2 goto UTLCHGX1

ELSE goto UTILBUSN

04C

UTILBUSN

UTILBUSN

Will any part of the (Utility Description) charges be deducted as a business expense?

Prop # Property Description Company Name Utility Amount1 Amount2 Amount3
(WHATPROP) (UTLPDESC) (COMPNAME) (UTILY) (UTLCHGX1)(UTLCHGX2) (UTLCHGX3)



1. Yes
2. No

Goto UTLCHGX1

04C

UTLCHGX1

UTLCHGX1

How much were you billed for in (reference month)?

Prop # Property Description Company Name Utility Amount1 Amount2 Amount3
(WHATPROP) (UTLPDESC) (COMPNAME) (UTILY) (UTLCHGX1)(UTLCHGX2) (UTLCHGX3)

1-999999: IF (UTILY = 100 and UTLCHGX1 lt 15 or UTLCHGX1 gt 500)OR (UTILY = 110 and UTLCHGX1 lt 8 or UTLCHGX1 gt 500)OR (UTILY = 130 and UTLCHGX1 lt 34 or UTLCHGX1 gt 722) OR (UTILY = 150 and UTLCHGX1 lt 7 or UTLCHGX1 gt 600) OR (UTILY = 180 and UTLCHGX1 lt 19 or UTLCHGX1 gt 700) OR (UTILY = 205 and UTLCHGX1 lt 6 or UTLCHGX1 gt 250) OR (UTILY = 210 and UTLCHGX1 lt 6 or UTLCHGX1 gt 150) OR (UTILY = 270 and UTLCHGX1 lt 7 or UTLCHGX1 gt 106) OR (UTILY = 280 and UTLCHGX1 lt 5 or UTLCHGX1 gt 600) then goto ERR1_UTLCHGX1
ELSE goto UTILCHGX2

0,DK,RF: Goto UTILCHGX2

04C

UTLCHGX2

UTLCHGX2

How much were you billed for in (month)?

Prop # Property Description Company Name Utility Amount1 Amount2 Amount3
(WHATPROP) (UTLPDESC) (COMPNAME) (UTILY) (UTLCHGX1)(UTLCHGX2) (UTLCHGX3)

1-999999: IF (UTILY = 100 and UTLCHGX2 lt 15 or UTLCHGX2 gt 500) or (UTILY = 110 and UTLCHGX2 lt 8 or UTLCHGX2 gt 500) or (UTILY = 130 and UTLCHGX2 lt 34 or UTLCHGX2 gt 722) or (UTILY = 150 and UTLCHGX2 lt 7 or UTLCHGX2 gt 600) or (UTILY = 180 and UTLCHGX2 lt 19 or UTLCHGX2 gt 700) or (UTILY = 205 and UTLCHGX2 lt 6 or UTLCHGX2 gt 250) or (UTILY = 210 and UTLCHGX2 lt 6 or UTLCHGX2 gt 150) or (UTILY = 270 and UTLCHGX2 lt 7 or UTLCHGX2 gt 106) or (UTILY = 280 and UTLCHGX2 lt 5 or UTLCHGX2 gt 600) then goto ERR1_ UTLCHGX2
ELSE goto UTILCHGX3

0,DK,RF: Goto UTILCHGX3

04C

UTLCHGX3

UTLCHGX3

How much were you billed for in (last month)?

Prop # Property Description Company Name Utility Amount1 Amount2 Amount3
(WHATPROP) (UTLPDESC) (COMPNAME) (UTILY) (UTLCHGX1)(UTLCHGX2) (UTLCHGX3)

1-999999: IF (UTILY = 100 and UTLCHGX3 lt 15 or UTLCHGX3 gt 500) or (UTILY = 110 and UTLCHGX3 lt 8 or UTLCHGX3 gt 500) or (UTILY = 130 and UTLCHGX3 lt 34 or UTLCHGX3 gt 722) or (UTILY = 150 and UTLCHGX3 lt 7 or UTLCHGX3 gt 600) or (UTILY = 180 and UTLCHGX3lt 19 or UTLCHGX3 gt 700) or (UTILY = 205 and UTLCHGX3 lt 6 or UTLCHGX3 gt 250) or (UTILY = 210 and UTLCHGX3 lt 6 or UTLCHGX3 gt 150) or (UTILY = 270 and UTLCHGX3 lt 7 or UTLCHGX3 gt 106) or (UTILY = 280 and UTLCHGX3 lt 5 or UTLCHGX3 gt 600) then goto ERR1_UTLCHGX3
ELSEIF UTLCHGX1 = 0 OR UTLCHGX2 = 0 then goto BLPERIOD
ELSE goto UTILCMB_S

0: Goto BLPERIOD

DK,RF: Goto UTILCMB_S

04C

BLPERIOD

BLPERIOD

What is your usual billing period for the service?

Prop # Property Description Company Name Utility Amount1 Amount2 Amount3
(WHATPROP) (UTLPDESC) (COMPNAME) (UTILY) (UTLCHGX1)(UTLCHGX2) (UTLCHGX3)


1. Month
2. 2 months
3. Quarter
4. Annual
5. Other

1-4,DK,RF: Goto UTILCMB_S

5: Goto BLPEROTH

04C

BLPEROTH

BLPEROTH

Specify:

Prop # Property Description Company Name Utility Amount1 Amount2 Amount3
(WHATPROP) (UTLPDESC) (COMPNAME) (UTILY) (UTLCHGX1)(UTLCHGX2) (UTLCHGX3)

Goto UTILCMB_S

04C

UTILCMB_S

UTILCMB_S

Enter 'C' for a combined expense

C: Goto UTILCMB

EMPTY: Goto MOREBILL

IF anything other than a 'C' or empty is entered then
goto CK_C

04C

UTILCMB

UTILCMB

11 ? [F1]

What other utilities, fuels, or services was (Utility Description) combined with?

Enter all that apply, separate with commas.

Prop # Property Description Company Name Utility Amount1 Amount2 Amount3
(WHATPROP)(UTLPDESC) (COMPNAME) (UTILY) (UTLCHGX1)(UTLCHGX2) (UTLCHGX3)



1. Electricity
2. Natural or utility gas
3. Fuel oil
4. Bottled or tank gas
5. Other fuels including wood
6. Piped-in water and sewerage maintenance
7. Garbage and recycling collection
8. Water softening service
9. Septic tank cleaning
77. Misc. combined (unable to specify/DK)

Goto MOREBILL

04C

MOREBILL

MOREBILL

Did you receive any other (Utility Description) bills?

Prop # Property Description Company Name Utility Amount1 Amount2 Amount3
(WHATPROP) (UTLPDESC) (COMPNAME) (UTILY) (UTLCHGX1)(UTLCHGX2) (UTLCHGX3)



1. Yes
2. No

1: IF ROW number = 40 then goto ERR_MAX
ELSE goto UTC_ITEM, next row in the table

2,DK,RF: IF ROW number = 40 then goto S4C_END
ELSE goto UTC_ITEM, next row in the table

04C


S4C_END

** Non Displayed **

Exit block and goto Section 5 - BSECT5

05

S5_INTRO

S5_INTRO

12-14

Now I am going to ask about expenses for construction, repairs, alterations and maintenance of property.

Prop. Description Work Desc.
(PRP5DESC) (WRKDESC)


1. Enter 1 to Continue

Goto BBLOCKA.ITEM

05

CRB_ITEM

ITEM

SCREEN 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
12 ? [F1]

First, let's talk about the construction or alteration of property you (owned/rent/own or rent). (You should not include jobs that have been or will be totally reimbursed by someone outside your household such as a landlord./ )

Since the first of (reference month), have (you/you or any members of your household) had expenses for -

Read each item on list.


SCREEN 2 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
13 ? [F1]

Now, let's talk about maintenance and repairs for property you (owned/rent/own or rent). (You should not include jobs that have been or will be totally reimbursed by someone outside your household such as a landlord./ )2

Read each item on list.


SCREEN 3 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
12-13 ? [F1]

Have there been any expenses for any other property, such as property that you do not (owned/rent/own or rent),
paid for by (you/you or any members of your household)?

If Yes -

Which type of job were those expenses for?


1. ^S5a_Fill1
2. ^S5a_Fill2
3. ^S5a_Fill3
4. ^S5a_Fill4
5. ^S5a_Fill5
6. ^S5a_Fill6
7. ^S5a_Fill7
8. ^S5a_Fill8
9. ^S5a_Fill9
10. ^S5a_Fill10
11. ^S5a_Fill11
12. ^S5a_Fill12
13. ^S5a_Fill13
14. ^S5a_Fill14
15. ^S5a_Fill15
16. ^S5a_Fill16
17. ^S5a_Fill17
18. ^S5a_Fill18
19. ^S5a_Fill19
95. Continue List
99. None/No more entries
888. Delete the line

1-19: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto CRMPROPI

95: Goto next row

99: Goto ADVMATER

888: IF no more grid lines then goto ADVMATER
ELSE goto ITEM - next line of grid

05


PreFill

** SHOW ONLY **


05

CRMPROPI

CRMPROPI

On which property was the work done?


Prop Description Work Desc
(WRKDESC) (PRP5DESC)


1. ^tempprop[1]
2. ^tempprop[2]
3. ^tempprop[3]
4. ^tempprop[4]
5. ^tempprop[5]
6. ^tempprop[6]
7. ^tempprop[7]
8. ^tempprop[8]
9. ^tempprop[9]
10. ^tempprop[10]
11. ^tempprop[11]
12. ^tempprop[12]
13. ^tempprop[13]
14. ^tempprop[14]
15. ^tempprop[15]
16. ^tempprop[16]
17. ^tempprop[17]
18. ^Property[18]
19. ^Property[19]
20. ^tempprop[20]
97. ^tempprop[21]
98. ^tempprop[22]
99. Property not owned or rented by household

1-20: IF entry gt total number of properties then goto CK_CRMPROPI
ELSE goto WRKDESC

97: Goto WRKDESC

98,99,DK,RF: Goto PRP5DESC

05

PRP5DESC

PRP5DESC

Briefly describe the property.

Prop Description Work Desc
(WRKDESC) (PRP5DESC)

Goto WRKDESC

05

WRKDESC

WRKDESC

What work was done?

The description should be adequate to classify "alteration", "repair", etc., and to identify in next
interview.


Prop Description Work Desc
(WRKDESC) (PRP5DESC)

IF ITEM = 1 or 3 then goto S5_INCL

ELSEIF ITEM = 5 then goto S5BCMB_S

ELSEIF ITEM = 2, 4, 6 or 8 then goto TEMPCODE

ELSE goto CRMTYPE

05

CRMTYPE

CRMTYPE

? [F1]

Enter the appropriate job classification code.

Prop Description Work Desc
(WRKDESC) (PRP5DESC)


2. Alteration
3. Replacement
4. Maintenance and repair

2: IF ITEM = 9, 12, 14, or 16 then goto S5BCMB_S
ELSE goto TEMPCODE

3: IF ITEM = 9, 11-12, 16, 18, or 19 then goto S5BCMB_S
ELSE goto TEMPCODE

4: IF ITEM = 10-11, 16, or 18 then goto S5BCMB_S
ELSE goto TEMPCODE

DK,RF: Goto S5BCMB_S

05

TEMPCODE

TEMPCODE

Enter the appropriate detailed job code.

Prop Description Work Desc
(WRKDESC) (PRP5DESC)


1. ^S5a_Tempcode1
2. ^S5a_Tempcode2
3. ^S5a_Tempcode3
4. ^S5a_Tempcode4
5. ^S5a_Tempcode5
6. ^S5a_Tempcode6
7. ^S5a_Tempcode7
8. ^S5a_Tempcode8
9. ^S5a_Tempcode9
10. ^S5a_Tempcode10

If ITEM = 2 or 4 then goto S5_INCL
ELSE goto S5BCMB_S

05

S5BCMB_S

S5BCMB_S

Enter 'C' for a combined expense

C: Goto S5B_COMB

EMPTY: Goto S5_INCL

IF any entry other than a 'C' or the enter key is entered,
then goto CK_C

05

S5B_COMB

S5B_COMB

12-13 ? [F1]

What other work was included in this job?

Enter all that apply, separate with commas.

5. Landscaping
6. Building outdoor patios
7. Repair outdoor patios
8. Painting/wallpapering
9. Plastering or paneling
10. Plumbing
11. Electrical work
12. Heat or air conditioning
13. Flooring installation/repair/replacement
14. Insulation
15. Roofing, gutters or downspouts
16. Siding
17. Install/Repair/Replace windows, etc
18. Masonry, brick or stucco
19. Other improvements or repairs
77. Misc. combined (unable to specify/DK)

Goto S5_INCL

05

S5_INCL

S5_INCL

Since the first of (reference month), did (you/your household) -

Read each item on list
Enter all that apply, separate with commas.


1. Pay someone else to do all or part of the work?
2. Purchase any materials, supplies, tools or equipment for doing this job?
3. Rent any tools or equipment for doing this job?

IF 1 selected goto CONTRCTX
ELSEIF 2 selected goto SUPPLYX
ELSE goto TOOLX

05

CONTRCTX

CONTRCTX

Since the first of (reference month), what is the total amount you paid to someone else for this job?

Prop Description Work Desc
(WRKDESC) (PRP5DESC)

0-999999: IF (CRMCODEB = 100 and CONTRCTX gt 109445) OR (CRMCODEB = 110-150 and CONTRCTX gt 28000) OR (CRMCODEB = 160-300 and CONTRCTX gt 8000) then goto ERR1_CONTRCTX
ELSE goto CONT_MO

DK,RF: Goto CONT_MO

05

CONT_MO

CONT_MO

In what month or months did you pay someone else for this job?

Enter all that apply, separate with commas.

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

REF_MONTH - CUR_MONTH: IF CONT_MO not in reference period then goto ERR3_CONT_MO ELSEIF ITEM = 1-4, 10-12, or 19 then goto MAJ_APPL
ELSEIF 2 selected in S5_INCL then goto SUPPLYX
ELSEIF 3 selected in S5_INCL then goto TOOLRTX
ELSE goto REIMBRS

DK, RF: IF ITEM = 1-4, 10-12, or 19 then goto MAJ_APPL
ELSEIF 2 selected in S5_INCL then goto SUPPLYX
ELSEIF 3 selected in S5_INCL then goto TOOLRTX
ELSE goto REIMBRS

05

MAJ_APPL

MAJ_APPL

14 ? [F1]

Did any of the cost since (reference month) include the cost of any appliances or equipment?

Prop Description Work Desc
(WRKDESC) (PRP5DESC)


1. Yes
2. No

1: Goto APP_SCR

2,DK,RF: IF 2 selected in S5_INCL then goto SUPPLYX
ELSEIF 3 selected in S5_INCL then goto TOOLRTX
ELSE goto REIMBRS

05

APP_SCR

APP_SCR

14 ? [F1]

Which of the following appliances or equipment were included?

Enter up to six, separate with commas.

Prop Description Work Desc
(WRKDESC) (PRP5DESC)


1. Cooking stove, range, or oven
2. Microwave oven
3. Refrigerator or home freezer
4. Built-in dishwasher
5. Portable dishwasher
6. Garbage disposal
7. Clothes washer or dryer
8. Range hood
9. Smoke alarms and detectors
10. Window air conditioner
11. Portable cooling and heating equipment
12. Lamps, lighting fixtures, or ceiling fans
13. Other major home appliances and equipment

1-13; Goto APPL_X

DK: IF 2 selected in S5_INCL then goto SUPPLYX
ELSEIF 3 selected in S5_INCL then goto TOOLRTX
ELSE goto REIMBRS

05

APPL_X

APPL_X

What was the total cost for (description)?

Prop Description Work Desc
(WRKDESC) (PRP5DESC)

1-999999: IF lt 5 or gt 4000 then goto ERR1_APPLX
ELSEIF 2 is selected in S5_INCL then goto SUPPLYX
ELSEIF 3 is selected in S5_INCL then goto TOOLRTX
ELSE goto REIMBRS

DK,RF: IF 2 is selected in S5_INCL then goto SUPPLYX
ELSEIF 3 is selected in S5_INCL then goto TOOLRTX
ELSE goto REIMBRS

05

SUPPLYX

SUPPLYX

Since the first of (reference month), what was the total cost of all materials, supplies, tools, or equipment (you/your household) purchased for this job?

Prop Description Work Desc
(WRKDESC) (PRP5DESC)

0-999999: IF (CRMCODEB = 100 and SUPPLYX gt 7000) OR (CRMCODEB = 110-150 and SUPPLYX gt 2500) OR (CRMCODEB = 160-300 and SUPPLYX gt 1000) then goto ERR1_SUPPLYX

ELSE goto SUPPLYMO

DK,RF: Goto SUPPLYMO

05

SUPPLYMO

SUPPLYMO

In what month or months did you make these purchases?

Enter all that apply, separate with commas.

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

REF_MONTH - CUR_MONTH: IF SUPPLYMO not in reference period then goto ERR3_SUPPLYMO
ELSEIF 3 selected in BSECT5.BBLOCKA.BROW.S5_INCL then goto TOOLRTX
ELSE goto REIMBRS

DK, RF: IF 3 selected in BSECT5.BBLOCKA.BROW.S5_INCL then goto TOOLRTX
ELSE goto REIMBRS

05

TOOLRTX

TOOLRTX

Since the first of (reference month), what was the total cost for all tools or equipment (you/your household) rented for this job?

Prop Description Work Desc
(WRKDESC) (PRP5DESC)

0-999999: IF TOOLRTX gt 518 then goto ERR1_TOOLRTX
ELSE goto TOOL_MO

DK,RF: Goto TOOL_MO

05

TOOL_MO

TOOL_MO

In what month or months did you rent these items?

Enter all that apply, separate with commas.

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

REF_MONTH - CUR_MONTH: IF TOOL_MO not in reference period then goto ERR3_TOOL_MO
ELSE goto REIMBRS

DK, RF: Goto REIMBRS

05

REIMBRS

REIMBRS

Was or will any of the total cost of this job be reimbursed or paid by someone outside of your household?

Prop Description Work Desc
(WRKDESC) (PRP5DESC)


1. Yes
2. No

1: Goto REIMBRSZ

2,DK,RF: IF BCeintro.BUSCREEN = 2 then goto MORE
ELSE goto CRMBSNSD

05

REIMBRSZ

REIMBRSZ

What percent of the total cost was or will be reimbursed or paid by someone outside of your household?

Prop Description Work Desc
(WRKDESC) (PRP5DESC)

1-99,DK,RF: IF BCeintro.BUSCREEN = 2 then goto MORE
ELSE goto CRMBSNSD

100: Goto ERR2_REIMBRSZ

05

CRMBSNSD

CRMBSNSD

Were or will any of these expenses for this job be deducted as a business expense?

Prop Description Work Desc
(WRKDESC) (PRP5DESC)


1. Yes
2. No

1: Goto CRMBSNSZ

2,DK,RF: Goto BSECT5.BBLOCKA.BROW.MORE

05

CRMBSNSZ

CRMBSNSZ

What percent was or will be deducted?

Prop Description Work Desc
(WRKDESC) (PRP5DESC)

1-99,DK,RF: Exit block and goto MORE

100: Goto ERR2_CRMBSNSZ

05

ANY5MORE

MORE

Did you have any other expenses for ^S5_desc?

Prop Description Work Desc
(WRKDESC) (PRP5DESC)



1. Yes
2. No

1: IF ROW number = 12 then goto ERR_MAX
ELSE goto ITEM, next row

2,DK,RF: Goto ITEM, next row

05

ADVMATER

ADVMATER

12-13

Since the first of (reference month), excluding this month, have (you/you or any members of your household) purchased
any materials or supplies for JOBS NOT YET STARTED?


1. Yes
2. No

1: Goto ADVDESC
2,DK,RF: Goto MATNSPEC

05

ADVDESC

ADVDESC

What kind of job will the materials be used for?

Enter a brief description.

Goto JOBCODE

05

JOBCODE

JOBCODE

12-13 ? [F1]

Select a job type below.

1. Homes under construction
2. Building an addition
3. Finishing a basement
4. Remodeling
5. Landscaping
6. Build outdoor patios
7. Repair outdoor patios
8. Painting/wallpapering
9. Plastering or paneling
10. Plumbing
11. Electrical work
12. Heat or air conditioning
13. Flooring installation/repair/replacement
14. Insulation
15. Roofing, gutters or downspouts
16. Siding
17. Install/Repair/Replace windows, etc
18. Masonry, brick or stucco
19. Other improvements or repairs

Goto ADVMATX

05

ADVMATX

ADVMATX

What was the total cost of these materials and supplies?

1-999999: IF lt 8 or gt 3865 then goto ERR1_ADVMATX
ELSE goto S5ACMB_S

DK,RF: Goto S5ACMB_S

05

S5ACMB_S

S5ACMB_S

Enter 'C' for a combined expense

C: Goto S5A_COMB

Empty: Goto MATNSPEC

IF anything other than "C" or blank is entered then goto CK_C

05

S5A_COMB

S5A_COMB

12-13 ? [F1]

What other work will be included in this job?

Enter all that apply, separate with commas.


5. Landscaping
6. Building outdoor patios
7. Repair outdoor patios
8. Painting/wallpapering
9. Plastering or paneling
10. Plumbing
11. Electrical work
12. Heat or air conditioning
13. Flooring installation/repair/replacement
14. Insulation
15. Roofing, gutters or downspouts
16. Siding
17. Install/Repair/Replace windows, etc
18. Masonry, brick or stucco
19. Other improvements or repairs
77. Misc. combined (unable to specify/DK)

Goto MATNSPEC

05

MATNSPEC

MATNSPEC

Since the first of (reference month), excluding this month, have (you/you or any members of your household) purchased
any materials or supplies NOT FOR ANY SPECIFIC JOB?


1. Yes
2. No

1: Goto MATNSPCX

2,DK,RF: Goto S5_END

05

MATNSPCX

MATNSPCX

What was the total cost?

1-999999: IF lt 5 or gt 600 then goto ERR1_MATNSPCX
ELSE goto S5_END

DK,RF: Goto S5_END

06A

S6A_INTRO

INTROA

15

Now I am going to ask about the purchase or rental of major household appliances.
Please include any shipping and handling charges with the cost of any item that was shipped.


Description Type Month Amount
(MAJTYPE) (Purchased/ (MAJ_MO) (MAJPURX/
Rented) MAJRENTX)


1. Enter 1 to Continue

Goto BTABLEA.BROW.ITEM

06A

APA_ITEM

ITEM

15 ? [F1]

Since the first of (reference month), have (you/you or any members of your household)
purchased or rented any of the following items for your household
or for someone outside of your household?

Read each item on list.


1. Microwave oven
2. Cooking stove, range or oven
3. Range hood
4. Refrigerator or home freezer
5. Built-in dishwasher
6. Portable dishwasher
7. Garbage disposal
8. Clothes washer or dryer
99. None/No more entries
888. Delete the line

1-8: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

99: Goto S6A_END

888: IF no more grid lines then goto S6A_END
ELSE goto ITEM - next line of grid

06A


PreFill

** SHOW ONLY **


06A

MAJTYPE

DESCRIPTION

What did you purchase(or rent/ )?

Enter brief description of the item

Description Type Month Amount
(MAJTYPE) (Purchased/ (MAJ_MO) (MAJPURX/
Rented) MAJRENTX

Goto WHO

06A

GFTC_MAJ

WHO

Was this item -

Description Type Month Amount
(MAJTYPE) (Purchased/ (MAJ_MO) (MAJPURX/
Rented) MAJRENTX


1. Purchased for someone inside the household?
2. ^S6ARENT
3. Purchased for someone outside your household?

1,3,DK,RF: Goto MONTH

2: Goto AMOUNT

06A

MAJ_MO

MONTH

When did you purchase it?

Description Type Month Amount
(MAJTYPE) (Purchased/ (MAJ_MO) (MAJPURX/
Rented) MAJRENTX


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

REF_MONTH - CUR_MONTH: IF entry is not in the reference period then goto ERR3_MONTH
ELSE goto AMOUNT

DK,RF: Goto AMOUNT

06A

MAJ_AMOUNT

AMOUNT

(What was the total rental expense since the first of (reference month) not including (current month

Description Type Month Amount
(MAJTYPE) (Purchased/ (MAJ_MO) (MAJPURX/
Rented) MAJRENTX

1-999999: IF WHO = 1, 3, DK or RF) AND [(MAJAPPLY = 100 and AMOUNT lt 27 or gt 1915) OR (MAJAPPLY = 120 and AMOUNT lt 20 or gt 473) OR (MAJAPPLY = 140 and AMOUNT lt 40 or gt 1822) OR (MAJAPPLY = 160 and AMOUNT lt 81 or gt 1000) OR (MAJAPPLY = 170 and AMOUNT lt 10 or gt 530) OR (MAJAPPLY = 180 and AMOUNT lt 35 or gt 450) OR (MAJAPPLY = 195 and AMOUNT lt 41 or gt 1184) OR (MAJAPPLY = 210 and AMOUNT lt 10 or gt 600)] then goto ERR1_AMOUNT
ELSEIF (WHO = 2) AND (AMOUNT lt 5 or gt 362) then goto ERR1_AMOUNT
ELSEIF MAJAPPLY and the entry in AMOUNT for this record are equal to any records data on the pre-chart/input then goto ERR_DUP
ELSE goto TAX

DK,RF: Goto INSTALL

06A

MAJTAX

TAX

Did this include sales tax?

Description Type Month Amount
(MAJTYPE) (Purchased/ (MAJ_MO) (MAJPURX/
Rented) MAJRENTX


1. Yes
2. No

Goto INSTALL

06A

INSTALL

INSTALL

Were there any extra charges for installation or delivery?

Include charges for disposal of old appliances.

Description Type Month Amount
(MAJTYPE) (Purchased/ (MAJ_MO) (MAJPURX/
Rented) MAJRENTX


1. Yes
2. No

1: Goto INST

2,DK,RF: Goto C

06A

MAJINSTX

INST

How much?

Description Type Month Amount
(MAJTYPE) (Purchased/ (MAJ_MO) (MAJPURX/
Rented) MAJRENTX

1-999999: IF (MAJAPPLY = 100 and INST gt 800) OR (MAJAPPLY = 120 and INST gt 250) OR (MAJAPPLY = 140 and INST gt 275) OR (MAJAPPLY = 160 and INST gt 200) OR (MAJAPPLY = 170 and INST gt 50) OR (MAJAPPLY = 180 and INST gt 400) OR (MAJAPPLY = 195 and INST gt 50) OR (MAJAPPLY = 210 and INST gt 50) THEN goto ERR1_INST
ELSE goto C

DK,RF: Goto C

06A

MAJCMB_S

C

Enter 'C' for a combined expense.

C: Goto COMBCODE

empty: Goto MORE

IF anything other than a 'C' or the Enter key is entered then goto CK_C

06A

MAJCMB

COMBCODE

15 ? [F1]

What other appliances is the (Appliance description) combined with?

Enter all that apply, separate with commas


1. Microwave oven
2. Cooking stove, range or oven
3. Range hood
4. Refrigerator or home freezer
5. Built-in dishwasher
6. Portable dishwasher
7. Garbage disposal
8. Clothes washer or dryer
77. Misc. combined (unable to specify/DK)

Goto MORE

06A

MAJOTHER

MORE

Did you purchase(or rent/ ) any other (Appliance Description)?

Description Type Month Amount
(MAJTYPE) (Purchased/ (MAJ_MO) (MAJPURX/
Rented) MAJRENTX


1. Yes
2. No

1: IF ROW number = 7 then goto ERR_MAX
ELSE goto ITEM, next row of grid

2,DK,RF: IF Row number = 7 then goto S6A_END
ELSE goto ITEM, next row of grid

06B


S6A_END

** Non Displayed **

Goto Section 6B - S6B_INTRO

06B

S6B_INTRO

INTROB

16 - 21

Now I am going to ask about expenses for the purchase or rental of household appliances and other selected items. Please include any shipping and handling charges with the cost of any item that was shipped.

Description Type Month Amount
MINTYPE) (Purchased/ (MIN_MO) (MINPURX/
Rented) MINRENTX)


1. Enter 1 to Continue

Goto BTableB.BROW.ITEM

06B

APB_ITEM

ITEM


SCREEN 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
16 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) purchased or rented any of the following items?


Read each item on list


SCREEN 2 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

17 ? [F1]

Have (you/you or any members of your household) purchased or rented any --

Read each item on list


SCREEN 3 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

18 ? [F1]

Have (you/you or any members of your household) purchased or rented any --

Read each item on list



SCREEN 4 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
19 ? [F1]

Have (you/you or any members of your household) purchased or rented any --

Read each item on list


Screen 5----------------------------------------------------------------------------------------
20 ? [F1]

Have (you/you or any members of your household) purchased or rented any --

Read each item on list


Screen 6----------------------------------------------------------------------------------------
21 ? [F1]

Have (you/you or any members of your household) purchased any --
1. Small electrical kitchen appliances
2. Electrical personal care appliances
3. Electric floor cleaning equipment
4. Other household appliances
5. Sewing machines
6. GPS devices, calculators, and fax machines
7. Digital book readers or tablets
8. Computers, computer systems, or related hardware
9. Computer software including computer games^FOR_NON_BUS
10. Computer accessories
11. Portable memory such as flash drives, memory cards, and recordable discs and tapes
12. Video game hardware or accessories
13. Telephones or accessories
14. Photographic equipment
15. Musical instruments, supplies, or accessories
16. Lawn mowing machinery, or other yard equipment
17. Power Tools
18. Non-power tools
19. Window air conditioners
20. Portable cooling or heating equipment
21. Televisions, all types including those installed in vehicles
22. DVD Players, VCRs, DVRs, or video cameras
23. Satellite dishes, receivers or accessories
24. Handheld personal music players
25. Stereos, radios, speakers, and sound components, including those installed in vehicles
26. Other sound or video equipment, including accessories
27. General sports equipment (exclude athletic shoes for sports related use, such as football, baseball, soccer or bowling)
28. Health and exercise equipment
29. Camping equipment
30. Hunting and fishing equipment, including all guns
31. Winter sports equipment
32. Water sports equipment
33. Outboard motors
34. Bicycles or bicycle equipment
35. Tricycles or battery powered riders
36. Playground equipment
37. Other sports or recreation equipment

1-37: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

95: Goto ITEM - next line of grid

99: Goto S6B_END

888: IF no more grid lines then goto S6B_END
ELSE goto ITEM - next line of grid

06B


PreFill

** SHOW ONLY **


06B

MINTYPE

DESCRIPTION

What did you purchase(or rent/ )?

Enter a brief description of item.

(* Report items such as flash drives, memory cards, recordable discs, and tapes as code 13, Portable memory cards, recordable discs, and tapes as cod


Description Type Month Amount
(MINTYPE) (Purchased/ (MIN_MO) (MINPURX/
Rented) MINRENTX)

Goto WHO

06B

GFTCMIN

WHO

Was this item ...


1. Purchased for someone inside the household?
2. ^S6BRENT
3. Purchased for someone outside your household?

1,3,DK,RF: Goto MONTH

2: Goto AMOUNT

06B

MIN_MO

MONTH

When did you purchase it?

Description Type Month Amount
(MINTYPE) (Purchased/ (MIN_MO) (MINPURX/
Rented) MINRENTX)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

REF_MONTH - CUR_MONTH: IF MONTH not in reference period then goto ERR3_MONTH
ELSE goto AMOUNT

DK,RF: Goto AMOUNT

06B

MIN_AMOUNT

AMOUNT

(What was the total rental expense since the first of (reference month) not including (current month)?/What did it cost?)

Description Type Month Amount
MINTYPE) (Purchased/ (MIN_MO) (MINPURX/
Rented) MINRENTX

1-999999: IF (WHO = 1, 3, DK or RF) AND ( (MINAPPLY = 230 and AMOUNT lt 6 or gt 200) OR (MINAPPLY = 240 and AMOUNT lt 5 or gt 125) OR (MINAPPLY = 260 and AMOUNT lt 15 or gt 600) OR (MINAPPLY = 270 and AMOUNT lt 6 or gt 896) OR (MINAPPLY = 280 and AMOUNT lt 8 or gt 4000) OR (MINAPPLY = 300 and AMOUNT lt 6 or gt 1068) OR (MINAPPLY = 310 and AMOUNT lt 5 or gt 2500) OR (MINAPPLY = 320 and AMOUNT lt 11 or gt 700) OR (MINAPPLY = 330 and AMOUNT lt 5 or gt 250) OR (MINAPPLY = 340 and AMOUNT lt 15 or gt 940) OR (MINAPPLY = 350 and AMOUNT lt 5 or gt 400) OR (MINAPPLY = 365 and AMOUNT lt 10 or gt 4200) OR (MINAPPLY = 390 and AMOUNT lt 25 or gt 886) OR (MINAPPLY = 395 and AMOUNT lt 25 or gt 650) OR (MINAPPLY = 425 and AMOUNT lt 5 or gt 1590) OR (MINAPPLY = 440 and AMOUNT lt 5 or gt 749) OR (MINAPPLY = 460 and AMOUNT lt 5 or gt 950) OR (MINAPPLY = 470 and AMOUNT lt 5 or gt 441) OR (MINAPPLY = 480 and AMOUNT lt 5 or gt 1850) OR (MINAPPLY = 490 and AMOUNT lt 5 or gt 336) OR (MINAPPLY = 500 and AMOUNT lt 5 or gt 646) OR (MINAPPLY = 510 and AMOUNT lt 10 or gt 1150) OR (MINAPPLY = 520 and AMOUNT lt 5 or gt 1870) OR (MINAPPLY = 530 and AMOUNT lt 40 or gt 8480) OR (MINAPPLY = 540 and AMOUNT lt 5 or gt 924) OR (MINAPPLY = 550 and AMOUNT lt 10 or gt 700) OR (MINAPPLY = 560 and AMOUNT lt 6 or gt 1200) OR (MINAPPLY = 570 and AMOUNT lt 5 or gt 1000) OR (MINAPPLY = 620 and AMOUNT lt 5 or gt 705) OR (MINAPPLY = 640 and AMOUNT lt 12 or gt 2500) OR (MINAPPLY = 650 and AMOUNT lt 6 or gt 403) OR (MINAPPLY = 660 and AMOUNT lt 3 or gt 300) OR (MINAPPLY = 670 and AMOUNT lt 25 or gt 2800) OR (MINAPPLY = 700 and AMOUNT lt 8 or gt 450) OR (MINAPPLY = 750 and AMOUNT lt 5 or gt 200) OR (MINAPPLY = 655 and AMOUNT lt 6 or gt 800) OR (MINAPPLY = 645 and AMOUNT lt 6 or gt 403)) then goto ERR1_AMOUNT

ELSEIF (WHO = 2) AND AMOUNT lt 8 or gt 390, then goto ERR1_AMOUNT
ELSEIF MINAPPLY and the entry in AMOUNT are equal to any records data on the pre-chart/input then goto ERR_DUP
ELSE goto TAX

DK,RF: Goto C

06B

MINTAX

TAX

Did this include sales tax?

Description Type Month Amount
(MINTYPE) (Purchased/ (MIN_MO) (MINPURX/
Rented) MINRENTX)



1. Yes
2. No

Goto C

06B

MINCMB_S

C

Enter 'C' for a combined expense.

C: Goto COMBCODE

empty: IF ITEM = 8, 21, 23, 25, or 26 then goto INSTLSCR
ELSEIF (WHO = 1 or 3) AND [ (RT8100.POPGRP = 01 AND (ITEM = 12, 17, 18, 27-37)) or (RT8100.POPGRP = 05 and (ITEM = 22 or 24)) ] then goto APBSTORE

ELSE goto MORE

If anything other than a 'C' or the Enter key is entered then goto CK_C

06B

MINCMB

COMBCODE

16-21 ?[F1]

What other item is the (Item description) combined with?

Enter all that apply, separate with commas.


1. Small electrical kitchen appliances
2. Electrical personal care appliances
3. Electric floor cleaning equipment
4. Other household appliances
5. Sewing machines
6. GPS devices, calculators, and fax machines
7. Digital book readers or tablets
8. Computers, computer systems, or related hardware
9. Computer software including computer games^FOR_NON_BUS
10. Computer accessories
11. Portable memory such as flash drives, memory cards, and recordable discs and tapes
12. Video game hardware or accessories
13. Telephones or accessories
14. Photographic equipment
15. Musical instruments, supplies, or accessories
16. Lawn mowing machinery, or other yard equipment
17. Power Tools
18. Non-power tools
19. Window air conditioners
20. Portable cooling or heating equipment
21. Televisions, all types including those installed in vehicles
22. DVD Players, VCRs, DVRs, or video cameras
23. Satellite dishes, receivers or accessories
24. Handheld personal music players
25. Stereos, radios, speakers, and sound components, including those installed in vehicles
26. Other sound or video equipment, including accessories
27. General sports equipment (exclude athletic shoes for sports related use, such as football, baseball, soccer or bowling)
28. Health and exercise equipment
29. Camping equipment
30. Hunting and fishing equipment, including all guns
31. Winter sports equipment
32. Water sports equipment
33. Outboard motors
34. Bicycles or bicycle equipment
35. Tricycles or battery powered riders
36. Playground equipment
37. Other sports or recreation equipment
77. Misc. combined (unable to specify/DK)

IF ITEM = 8, 21, 23, 25, 26 then goto INSTLSCR

ELSEIF (WHO = 1 or 3) AND [ (RT8100.POPGRP = 01 AND (ITEM = 12, 17, 18, 27-37)) or (RT8100.POPGRP = 05 and (ITEM = 22 or 24)) ] then goto APBSTORE

ELSE goto MORE

06B

INSTLSCR

INSTLSCR

Were there any additional charges for installation or set-up?

Description Type Month Amount
(MINTYPE) (Purchased/ (MIN_MO) (MINPURX/
Rented) MINRENTX)


1. Yes
2. No

1: Goto INSTLLEX

2,DK,RF: IF (WHO = 1 or 3) AND (RT8100.POPGRP = 05 and (ITEM = 21, 23, 25, or 26)) then goto APBSTORE
ELSE goto MORE

06B

INSTLLEX

INSTLLEX

How much?

Description Type Month Amount
(MINTYPE) (Purchased/ (MIN_MO) (MINPURX/
Rented) MINRENTX)

1-99999: IF INSTLLEX lt 40 or gt 1000 then goto ERR1_INSTLLEX
ELSEIF (WHO = 1 or 3) AND (RT8100.POPGRP = 05 and (ITEM = 21, 23, 25, or 26)) then goto APBSTORE
ELSE goto MORE

DK,RF: IF (WHO = 1 or 3) AND (RT8100.POPGRP = 05 and (ITEM = 21, 23, 25, or 26)) then goto APBSTORE
ELSE goto MORE

06B

APBSTORE

APBSTORE

Where was the (Item description) purchased?

Enter store, website, or company name

IF uppercase version of the entry = "GROUPON" or "GROUPON.COM" then goto ERR_GROUPON

ELSEIF ENTRY contains ".com", ".Com", ".cOm", ".coM", ".COm", ".CoM", ".cOM", or ".COM", then goto MORE

ELSEIF ENTRY = DK or RF then goto MORE

ELSE goto APBPURCH

06B

APBPURCH

APBPURCH

Ask if not apparent

Was this purchased online or in-person?


1. Online
2. In person
3. Other (phone, mail, catalog)

1,3,DK,RF: Goto MORE

2: Goto APBLOC

06B

APBLOC

APBLOC

Where is (Store) located?

Enter city and state

Goto MORE

06B

S6BOTHER

MORE

Did you purchase(or rent/ ) any other (description)?

Description Type Month Amount
(MINTYPE) (Purchased/ (MIN_MO) (MINPURX/
Rented) MINRENTX)



1. Yes
2. No

1: IF Row number = 34 then goto ERR_MAX
ELSE goto ITEM, next line on the grid

2,DK,RF: IF row number = 34 then goto S6B_END
ELSE goto ITEM, next line on the grid

06B


S6B_END

** Non Displayed **

Goto Section 7A - BSECT7

07

S7_INTRO

S7_INTRO

22

Now I will ask about expenditures for household item maintenance or repairs and service contracts.

Description Month Amount
(RPRDESC) (SRVCMOB) (REPAIRX)

1. Enter 1 to Continue

Goto BTable.Brow.ITEM

07

EQB_ITEM

ITEM

22 ? [F1]

Since the first of (reference month), did (you/you or any members of your household) have any expenses for service contracts, maintenance, or repairs for any of the following items?

Read each item on list


1. Garbage disposal, range hood, or built-in dishwasher
2. Other household appliances, such as washer, refrigerator, or range/oven
3. Television, radio, video, or sound equipment, including those installed in autos or other vehicles
4. Computers, computer systems, or related equipment for non-business use
5. Lawn or garden equipment
6. Musical instruments or accessories
7. Hand or power tools
8. Photographic equipment
9. Sport or recreational equipment
10. Termite or pest control
11. Heating or air conditioning service contracts
99. None/No more entries
888. Delete the line

1-11: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

95: Goto next row

99: Goto S7_END

888: IF ROW number = 13 then goto S7_END
ELSE goto ITEM - next line of grid

07


PreFill

** SHOW ONLY **


07

RPRDESC

DESCRIPTION

What did the service contract(or repair/ ) cover?

Description Month Amount
(RPRDESC) (SRVCMOB) (REPAIRX)

Goto MONTH

07

SRVCMOB

MONTH

In what month was the expense?

Description Month Amount
(RPRDESC) (SRVCMOB) (REPAIRX)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

REF_MONTH-CUR_MONTH: IF entry is not in the reference period then goto ERR3_MONTH
ELSE goto AMOUNT

DK,RF: Goto AMOUNT

07

REPAIRX

AMOUNT

What was the total cost?

Description Month Amount
(RPRDESC) (SRVCMOB) (REPAIRX)

1-999999: IF (APPRPRYB = 100 and AMOUNT lt 7 or gt 285) OR (APPRPRYB = 110 and AMOUNT lt 5 or gt 324) OR (APPRPRYB = 120 and AMOUNT lt 5 or gt 478) OR (APPRPRYB = 130 and AMOUNT lt 5 or gt 400) OR (APPRPRYB = 140 and AMOUNT lt 5 or gt 600) OR (APPRPRYB = 150 and AMOUNT lt 5 or gt 550) OR (APPRPRYB = 160 and AMOUNT lt 20 or gt 398) OR (APPRPRYB = 170 and AMOUNT lt 5 or gt 1332) OR (APPRPRYB = 190 and AMOUNT lt 16 or gt 742) OR (APPRPRYB = 200 and AMOUNT lt 8 or gt 900) OR (APPRPRYB = 220 and AMOUNT lt 11 or gt 413) then goto ERR1_AMOUNT
ELSEIF APPRPRYB and the entry in AMOUNT for this record are equal to any records data in the prechart/input then goto ERR_DUP
ELSE goto REPAIRTX

DK,RF: Goto C

07

REPAIRTX

REPAIRTX

Did this include sales tax?

Description Month Amount
(RPRDESC) (SRVCMOB) (REPAIRX)


1. Yes
2. No

Goto C

07

RPRCB_S

C

Enter 'C' for a combined expense.

C: Goto COMBCODE

Empty: IF (ITEM = 1 or 2) AND RT8100.POPGRP = 01 then goto EQBSTORE
ELSE goto MORE

IF anything other than a 'C' or the Enter key is entered, goto CK_C

07

REPAIRCM

COMBCODE

22 ? [F1]

What other service contracts, maintenance, or repairs was (Description) combined with?

Enter all that apply, separate with commas

Description Month Amount
(RPRDESC) (SRVCMOB) (REPAIRX)


1. Garbage disposal, range hood, or built-in dishwasher
2. Other household appliances, such as washer, refrigerator, or range/oven
3. Television, radio, video, or sound equipment, including those installed in autos or other vehicles
4. Computers, computer systems, or related equipment for non-business use
5. Lawn or garden equipment
6. Musical instruments or accessories
7. Hand or power tools
8. Photographic equipment
9. Sport or recreational equipment
10. Termite or pest control
11. Heating or air conditioning service contracts
77. Misc. Combined (unable to specify/DK)

IF (ITEM = 1 or 2) AND RT8100.POPGRP = 01 then goto EQBSTORE

ELSE goto MORE

07

EQBSTORE

EQBSTORE

What is the name of the business that provided the service contract, maintenance, or repair?

Enter store, website, or company name

IF uppercase version of the entry = "GROUPON" or "GROUPON.COM" then goto ERR_GROUPON

ELSEIF ENTRY contains ".com", ".Com", ".cOm", ".coM", ".COm", ".CoM", ".cOM", or ".COM", then goto MORE

ELSEIF ENTRY = DK or RF then goto MORE

ELSE goto EQBPURCH

07

EQBPURCH

EQBPURCH

Ask if not apparent

Was this purchased online or in-person?


1. Online
2. In person
3. Other (phone, mail, catalog)

1,3,DK,RF: Goto MORE

2: Goto EQBLOC

07

EQBLOC

EQBLOC

Where is (Store) located?

Enter city and state

Goto MORE

07

RPRMORE

MORE

Did you pay for any other (service contracts, maintenance, or repairs/service contracts) for (Description)?


Description Month Amount
(RPRDESC) (SRVCMOB) (REPAIRX)


1. Yes
2. No

1: IF ROW number = 13 then goto ERR_MAX
ELSE goto ITEM, next line on grid

2,DK,RF: IF ROW number = 13 then goto S7_END
ELSE goto ITEM, next line on grid

07


S7_END

** Non Displayed **

Exit block and goto Section 8A - BSECT08

08A

S8A_INTRO

INTROA

23-26

Now I am going to ask about expenses for home furnishings and related household items.
Please include any shipping and handling charges with the cost of any item that was shipped.

Item Month Amount
(FURNDESC) (FURNMO) (FURNPURX)



1. Enter 1 to Continue

Goto BSect08L1.BTableA.Brow.ITEM

08A

FRA_ITEM

ITEM

SCREEN 1 -----------------------------------------------------------------------------

23 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) purchased for (you/your household) or for someone outside of your household any --

Read each item on list


SCREEN 2 ------------------------------------------------------------------------------

24 ? [F1]

Have (you/you or any members of your household) purchased any --

Read each item on list

SCREEN 3 -------------------------------------------------------------------------------

25 ?[F1]

Have (you/you or any members of your household) purchased any --

Read each item on list


SCREEN 4 -------------------------------------------------------------------------------

26 ? [F1]

Have (you/you or any members of your household) purchased any --

Read each item on list


1. Sofas?
2. Living room chairs?
3. Living room tables?
4. Ping-pong, pool tables or other similar recreation room items?
5. Other living room, family, or recreation room furniture including desks, wall units, and shelving?
6. Living room furniture combinations?
7. Dining room or kitchen furniture?
8. Mattresses or box springs?
9. Bedroom furniture other than mattresses or box springs?
10. Infants furniture?
11. Infants equipment
12. Patio, porch, or outdoor furniture
13. Barbeque grills or outdoor decorative items
14. Office furniture for home use
15. Lamps, lighting fixtures, or ceiling fans
16. Other household decorative items
17. Closet and storage items
18. Travel items including luggage
19. Stainless, silver or other flatware
20. Non-electric cookware
21. Dishes, glasses, or serving pieces
22. Bedroom linens
23. Bathroom linens
24. Kitchen, dining room, or other linens
25. Slipcovers, decorative pillows or cushions
26. Rugs or other non-permanent floor coverings, including carpet squares
27. Curtains or drapes
28. Blinds, shades or other window coverings

1-28: IF ITEM ne Item2Shadow then goto CK_ITEM
Goto DESCRIPTION

95: Goto next row

99: Goto S8A_END

888: IF ROW number = 34 then goto S8A_END
ELSE goto ITEM - next line of grid

08A


PreFill

** SHOW ONLY **


08A

FURNDESC

DESCRIPTION

What did you purchase?

Item Month Amount
(FURNDESC)(FURNMO) (FURNPURX)

Goto MONTH

08A

FURNMO

MONTH

In what month did you purchase it?

Item Month Amount
(FURNDESC)(FURNMO) (FURNPURX)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

REF_MONTH - CUR_MONTH: IF entry is not in reference period then goto ERR3_MONTH
ELSE goto WHO

DK,RF: Goto WHO

08A

FURNGFTC

WHO

Was this purchased for your household or for someone outside of your household?

Item Month Amount
(FURNDESC) (FURNMO) (FURNPURX)


1. For use by household
2. For someone outside the household

Goto AMOUNT

08A

FURNPURX

AMOUNT

What was the purchase price?

Item Month Amount
(FURNDESC)(FURNMO) (FURNPURX)

1-999999: IF (FURNPURY = 100 and AMOUNT lt 21 or gt 3000) OR (FURNPURY = 101 and AMOUNT lt 10 or gt 1939) OR (FURNPURY = 102 and AMOUNT lt 5 or gt 1500) OR (FURNPURY = 104 and AMOUNT lt 21 or gt 3500) OR (FURNPURY = 107 and AMOUNT lt 11 or gt 2400) OR (FURNPURY = 106 and AMOUNT lt 73 or gt 7000) OR (FURNPURY = 110 and AMOUNT lt 15 or gt 4309) OR (FURNPURY = 120 and AMOUNT lt 25 or gt 1679) OR (FURNPURY = 121 and AMOUNT lt 10 or gt 3500) OR (FURNPURY = 130 and AMOUNT lt 10 or gt 1065) OR (FURNPURY = 131 and AMOUNT lt 7 or gt 500) OR (FURNPURY = 140 and AMOUNT lt 5 or gt 900) OR (FURNPURY = 141 and AMOUNT lt 6 or gt 965) OR (FURNPURY = 150 and AMOUNT lt 10 or gt 1300) OR (FURNPURY = 171 and AMOUNT lt 5 or gt 450) OR (FURNPURY = 173 and AMOUNT lt 5 or gt 531) OR (FURNPURY = 180 and AMOUNT lt 5 or gt 317) OR (FURNPURY = 181 and AMOUNT lt 5 or gt 423) OR (FURNPURY = 192 and AMOUNT lt 5 or gt 298) OR (FURNPURY = 196 and AMOUNT lt 5 or gt 300) OR (FURNPURY = 199 and AMOUNT lt 5 or gt 416) OR (FURNPURY = 200 and AMOUNT lt 6 or gt 374) OR (FURNPURY = 201 and AMOUNT lt 5 or gt 200) OR (FURNPURY = 206 and AMOUNT lt 5 or gt 300) OR (FURNPURY = 205 and AMOUNT lt 5 or gt 290) OR (FURNPURY = 212 and AMOUNT lt 5 or gt 1100) OR (FURNPURY = 214 and AMOUNT lt 5 or gt 1035) OR (FURNPURY = 215 and AMOUNT lt 5 or gt 1643) then goto ERR1_AMOUNT
ELSEIF FURNPURY and the entry in AMOUNT for this record are equal to any records data on the pre-chart/input then goto ERR_DUP
ELSE goto TAX

DK,RF: Goto C

08A

FRNPURTX

TAX

Did this include sales tax?

Item Month Amount
(FURNDESC)(FURNMO) (FURNPURX)


1. Yes
2. No

Goto C

08A

S8ACMB_S

C

Enter 'C' for a combined expense.

C: Goto COMBCODE

Empty: Goto MORE

IF anything other than an 'C' or the Enter key is entered then goto CK_C

08A

S8A_CMB

COMBCODE

23-26 ?[F1]

What was combined with fill for COMBCODE?

Enter all that apply, separate with commas.

Item Month Amount
(FURNDESC)(FURNMO) (FURNPURX)


1. Sofas
2. Living room chairs
3. Living room tables
4. Ping-pong, pool tables or other similar recreation room items
5. Other living room, family, or recreation room furniture including desks, wall units, and shelving
6. Living room furniture combinations
7. Dinning room or kitchen furniture
8. Mattresses or box springs
9. Bedroom furniture other than mattresses or box springs
10. Infants furniture
11. Infants equipment
12. Patio, porch, or outdoor furniture
13. Barbeque grills or outdoor decorative items
14. Office furniture for home use
15. Lamps, lighting fixtures, or ceiling fans
16. Other household decorative items
17. Closet and storage items
18. Travel items including luggage
19. Stainless, silver or other flatware
20. Non-electric cookware
21. Dishes, glasses, or serving pieces
22. Bedroom linens
23. Bathroom linens
24. Kitchen, dining room, or other linens
25. Slipcovers, decorative pillows or cushions
26. Rugs or other non-permanent floor coverings, including carpet squares
27. Curtains or drapes
28. Blinds, shades or other window coverings
77. Misc. Combined (unable to specify/DK)

Goto MORE

08A

ANYOTH8

MORE

Did you purchase any other (description)?

Item Month Amount
(FURNDESC)(FURNMO) (FURNPURX)


1. Yes
2. No

1: IF ROW number = 34 then goto ERR_MAX
ELSE goto ITEM, next line of grid

2,DK,RF: IF ROW number = 34 then goto S8_END
ELSE goto ITEM, next line of grid

08A


S8A_END

** Non Displayed **

Exit block and goto Section 8B - BlkSect08_Furniture

08B

FURNRNTL

FURNRNTL

Since the first of (reference month) not including this month, have (you/you or any members of your household) rented or leased any furniture?

1. Yes
2. No

1: Goto FURNRNTX

2,DK,RF: Goto REPFURN

08B

FURNRNTX

FURNRNTX

Since the first of (reference month) not including this month -

What was the total expense?

1-99999: IF FURNRNTX lt 5 or gt 1340 then goto ERR1_FURNRNTX
ELSE goto REPFURN

DK,RF: Goto REPFURN

08B

REPFURN

REPFURN

Since the first of (reference month) not including this month, have (you/you or any members of your household) had any expenses for repairing, refinishing or reupholstering furniture, including the cost for fabric?

1. Yes
2. No

1: Goto REPFURNX

2,DK,RF: Goto S8B_END

08B

REPFURNX

REPFURNX

Since the first of (reference month) not including this month -

What was the total expense?

1-999999: IF REPFURNX lt 5 or gt 1900 then goto ERR1_REPFURNX
ELSEIF RT8100.POPGRP = 01 then goto REPSTORE
ELSE goto S8B_END

DK,RF: Goto S8B_END

08B

REPSTORE

REPSTORE

What is the name of the business that repaired, refinished, or reupholstered the furniture?

Enter store, website, or company name

IF uppercase version of the entry = "GROUPON" or "GROUPON.COM" then goto ERR_GROUPON

ELSEIF ENTRY contains ".com", ".Com", ".cOm", ".coM", ".COm", ".CoM", ".cOM", or ".COM", then goto S8B_END

ELSEIF ENTRY = DK or RF then goto S8B_END

ELSE goto REPPURCH

08B

REPPURCH

REPPURCH

Ask if not apparent

Was this purchased online or in-person?


1. Online
2. In person
3. Other (phone, mail, catalog)

1,3,DK,RF: Goto S8B_END

2: Goto REPLOC

08B

REPLOC

REPLOC

Where is (Store) located?

Enter city and state

Goto S8B_END

08B


S8B_END

** Non Displayed **

Exit block and goto section 9 - BSECT09

09A

S9A_INTRO

INTROA

27-28

Now I am going to ask about clothing, footwear, and accessories, for infants, children, and adults. You may find it helpful to refer to receipts, credit card statements or other records to answer the questions. Please include any shipping and handling charges with the cost of any item that was shipped.

Description Name Month Amount
(CLODESCA) (CLONAME) (CLOTHMOA) (CLOTHXA)


1. Enter 1 to Continue

Goto BSECT09.BTABLEA.BROW.ITEM

09A

CLA_ITEM

ITEM

SCREEN 1 ---------------------------------------------------------------------------
27 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) purchased any of the following items either for members of your household or for someone outside your household?

Read each item on list.

SCREEN 2 ----------------------------------------
28 ? [F1]

Have (you/you or any members of your household) purchased any --

Read each item on list.


1. Coats, jackets or furs
2. Sport coats, tailored jackets, or blazers
3. Suits
4. Vests
5. Shirts, sweaters, blouses, or tops
6. Pants, jeans or shorts
7. Dresses
8. Skirts
9. Undergarments
10. Hosiery
11. Nightwear or loungewear
12. Accessories
13. Swimsuits or warm-up or ski suits
14. Uniforms, for which the cost is not reimbursed
15. Costumes
16. Footwear, including athletic footwear
17. Diapers
18. Layettes
19. Watchers
20. Jewelry
95. Continue List
99. None/No more entries
888. Delete the line

1-20: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

95: Goto next row

99: Goto S9A_END

888: IF no more rows then goto S9A_END
ELSE goto ITEM - next row of the table

09A


PreFill

** SHOW ONLY **


09A

CLODESCA

DESCRIPTION

What did you buy?

Describe briefly the item purchased.

Description Name Month Amount
(CLODESCA) (AgeSex_Desc) (CLOTHMOA) (CLOTHXA)

Goto CLOINOUT

09A

CLOINOUT

CLOINOUT

Was this (were these) purchased for someone inside or outside of your household?

1. Inside your household
2. Outside your household
3. Both inside and outside your household

IF ITEM = 1-17 then goto AGESEX

ELSE goto MONTH

09A

AGESEX

AGESEX

Ask if not apparent

Was this (Were these) purchased for...

Enter all age/sex categories that apply to the purchase, separate with commas.

1. Man, age 16 and over
2. Woman, age 16 and over
3. Boy, age 2 to 15
4. Girl, age 2 to 15
5. Child under 2 years old
77. Don't know

Goto MONTH

09A

CLOTHMOA

MONTH

When did you purchase it?

(* Enter 13 for same amount each month/ )

Description Name Month Amount
(CLODESCA) (AgeSex_Desc) (CLOTHMOA) (CLOTHXA)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
13. ^S09_13Option

ref_month-cur_month: IF month not in reference period then goto ERR3_Month
ELSE goto AMOUNT

13, DK,RF: Goto AMOUNT

09A

CLOTHXA

AMOUNT

(What is your monthly expense?/How much did it cost?)

Description Name Month Amount
(CLODESCA) (AgeSex_Desc) (CLOTHMOA) (CLOTHXA)

1-999999: IF (CLOTHYA = 100 And AMOUNT lt 9 or gt 400) OR (CLOTHYA = 110 and AMOUNT lt 10 or gt 500) OR (CLOTHYA = 120 and AMOUNT lt 18 or gt 1000)OR (CLOTHYA = 130 and AMOUNT lt 5 or gt 200) OR (CLOTHYA = 145 and AMOUNT lt 5 or gt 300) OR (CLOTHYA = 150 and AMOUNT lt 10 or gt 269) OR (CLOTHYA = 170 and AMOUNT lt 8 or gt 455) OR (CLOTHYA = 180 and AMOUNT lt 5 or gt 220) OR (CLOTHYA = 200 and AMOUNT lt 5 or gt 109) OR (CLOTHYA = 210 and AMOUNT lt 5 or gt 60) OR (CLOTHYA = 220 and AMOUNT lt 5 or gt 107) OR (CLOTHYA = 230 and AMOUNT lt 5 or gt 159) OR (CLOTHYA = 240 and AMOUNT lt 5 or gt 200) OR (CLOTHYA = 250 and AMOUNT lt 9 or gt 418) OR (CLOTHYA = 260 and AMOUNT lt 5 or gt 448) OR (CLOTHYA = 280 and AMOUNT lt 5 or gt 210) OR (CLOTHYA = 310 and AMOUNT lt 9 or gt 150) OR (CLOTHYA = 330 and AMOUNT lt 5 or gt 330) OR (CLOTHYA = 370 and AMOUNT lt 5 or gt 450) OR (CLOTHYA = 380 and AMOUNT lt 5 or gt 1800) then goto ERR1_AMOUNT
ELSEIF CLOTHYA and the entry in AMOUNT for this record are equal to any record data in the prechart/input then display ERR_DUP
ELSE goto TAX

DK,RF: Goto C

09A

CLOTHTXA

TAX

Did this include sales tax?

Description Name Month Amount
(CLODESCA) (AgeSex_Desc) (CLOTHMOA) (CLOTHXA)


1. Yes
2. No

Goto C

09A

CLOCMBA_S

C

Enter 'C' for a combined expense.

C: Goto COMBCODE

EMPTY: IF ITEM = 1-6 AND RT8100.POPGRP = 05 AND (1 selected in AGESEX) then goto CLASTORE
ELSE goto MORE

IF anything other than a 'C' or the enter key is entered, goto CK_C

09A

CLOCMBA

COMBCODE

27-28 ? [F1]

What other clothing is (Clothing purchase description) combined with?

Enter all that apply, separate with commas.


Description Name Month Amount
(CLODESCA) (AgeSex_Desc) (CLOTHMOA) (CLOTHXA)


1. Coats, jackets or furs
2. Sport coats, tailored jackets, or blazers
3. Suits
4. Vests
5. Shirts, sweaters, blouses, or tops
6. Pants, jeans, or shorts
7. Dresses
8. Skirts
9. Undergarments
10. Hosiery
11. Nightware or loungewear
12. Accessories
13. Swimsuits or warm-up or ski suits
14. Uniforms, for which the cost is not reimbursed
15. Costumes
16. Footwear, including athletic footwear
17. Diapers
18. Layettes
19. Watches
20. Jewelry
77. Misc. combined (unable to specify/DK)

IF ITEM = 1-6 AND RT8100.POPGRP = 05 AND (1 selected in AGESEX) then goto CLASTORE

ELSE goto MORE

09A

CLASTORE

CLASTORE

Where was (Entry in CLODESCA) purchased?

Enter store, website, or company name

IF uppercase version of the entry = "GROUPON" or "GROUPON.COM" then goto ERR_GROUPON

ELSEIF ENTRY contains ".com", ".Com", ".cOm", ".coM", ".COm", ".CoM", ".cOM", or ".COM", then goto MORE

ELSEIF ENTRY = DK or RF then goto MORE

ELSE goto CLAPURCH

09A

CLAPURCH

CLAPURCH

Ask if not apparent

Was this purchased online or in-person?


1. Online
2. In person
3. Other (phone, mail, catalog)

1,3,DK,RF: Goto MORE

2: Goto CLALOC

09A

CLALOC

CLALOC

Where is (store) located?

Enter city and state

Goto MORE

09A

CLOMOREA

MORE

Did you purchase any other (description)?

Description Name Month Amount
(CLODESCA) (AgeSex_Desc) (CLOTHMOA) (CLOTHXA)


1. Yes
2. No

1: IF ROW number = 84 then goto ERR_MAX
ELSE goto ITEM, next row in the table

2,DK,RF: IF row number = 84 then goto S9A_END
ELSE goto ITEM, next row in the table

09A


S9A_END

** Non Displayed **

Goto Section 9B - S9B_INTRO

09B

S9D_INTRO

INTROB

29

Now I am going to ask about expenditures for clothing services.

Description Month Amount
(CLODESCD) (CLOTHMOD) (CLOTHXD)


1. Enter 1 to Continue

Goto BSECT09.BTABLEB.BROW.ITEM

09B

CLD_ITEM

ITEM

29 ? [F1]

Have (you/you or any members of your household) had expenses for any of the following, either for members of your household
or for someone outside your household?

Read each item on list.


1. Repair, alteration or tailoring for clothing and accessories
2. Shoe repair or other shoe services
3. Watch or jewelry repair
4. Clothing or accessory rental
5. Clothing storage outside the home
99. None/No more entries
888. Delete the line

1-5: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

99: Goto S9D_END

888: IF no more row then goto S9D_END
ELSE goto ITEM - next row in the table

09B


PreFill

** SHOW ONLY **


09B

CLODESCD

DESCRIPTION

What kind of service was this?

Describe briefly the service.


Description Month Amount
(CLODESCD) (CLOTHMOD) (CLSRVCX)

Goto WHO

09B

CLSVGFTC

WHO

Was this service for (you/your household) or for someone outside your household?

Description Month Amount
(CLODESCD) (CLOTHMOD) (CLSRVCX)



1. Your household
2. Someone outside your household

Goto MONTH

09B

CLOTHMOD

MONTH

When did you purchase this service?

Description Month Amount
(CLODESCD) (CLOTHMOD) (CLSRVCX)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

REF_MONTH-CUR_MONTH: IF Entry is not within reference period then goto ERR3_MONTH
ELSE goto AMOUNT

DK,RF: Goto AMOUNT

09B

CLSRVCX

AMOUNT

How much did it cost?

Description Month Amount
(CLODESCD) (CLOTHMOD) (CLSRVCX)


1-999999: IF AMOUNT lt 5 or gt 249 then goto ERR1_AMOUNT
ELSEIF CLOTHYD and entry in AMOUNT for this record are equal to any record data in the prechart/input then goto ERR_DUP
ELSE goto TAX

DK,RF: Goto C

09B

CLSRVCTX

TAX

Did this include sales tax?

Description Month Amount
(CLODESCD) (CLOTHMOD) (CLSRVCX)



1. Yes
2. No

Goto C

09B

CLOCMBD_S

C

Enter 'C' for a combined expense.

C: Goto COMBCODE

Empty: Goto MORE

IF anything other than a 'C' or the enter key is entered then goto CK_C

09B

CLOCMBD

COMBCODE

29 ? [F1]

What other clothing services is
(Clothing Service Description) combined with?

Enter all that apply, separate with commas.

Description Month Amount
(CLODESCD) (CLOTHMOD) (CLSRVCX)



1. Repair, alteration or tailoring for clothing and accessories
2. Shoe repair or other shoe services
3. Watch or jewelry repair
4. Clothing or accessory rental
5. Clothing storage outside the home
77. Misc. combined (unable to specify/ DK)

Goto MORE

09B

CLOMORED

MORE

Did you have any other expenses for (Clothing Service Description)?

Description Month Amount
(CLODESCD) (CLOTHMOD) (CLSRVCX)



1. Yes
2. No

1: IF ROW number = 10 then goto ERR_MAX
ELSE goto ITEM next row in the table

2,DK,RF: IF ROW number = 10 then goto S9D_END
ELSE goto ITEM next row in the table

09B


S9D_END

** Not Displayed **

Exit block and goto Section 10 - BSECT10

10

S10_INTRO

S10_INTRO

30

Now I am going to ask about expenses for vehicle rentals and leases.

Vehicle number Vehicle year Vehicle make/model Business
(LSDNUM) (MODELYR) (MKMD_SCR) (ANYBUSIN)


1. Enter 1 to Continue

Goto RLV_ITEM in BSect10L1 Block

10

RLV_ITEM

ITEM

SCREEN 1 ------------------------------------------------------------------------------------
30 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) rented any automobiles, trucks, vans, minivans, or SUVs, which were not used entirely for business? Do not include leased vehicles.


SCREEN 2 --------------------------------------------------------------------------
30 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) rented any other types of vehicles which were not used entirely for business?

IF YES -

Did you rent any -


1. Automobiles, trucks, vans, minivans, or SUVs
2. Motor homes
3. Trailer-type campers
4. Other attachable-type campers
5. Motorcycles, motor scooters, or mopeds (motorized bicycles)
6. Boats, with motor
7. Boats, without a motor
8. Trailers other than a camper type, such as for a boat or cycle
9. Private aircraft
10. Other vehicles
95. Continue list
99. None/No More Entries
888. Delete the Line

1-10: IF ITEM <> Item2Shadow then goto CK_ITEM
ELSE goto ANYVACAT

95: Goto ITEM - next row

99: IF no vehicles on inventory chart or all vehicles have 8500.LSD_STAT = 3 then exit block and goto BLEASE.BROW.ITEM
ELSE exit block and goto the TblInventory block

888: IF no more table rows THEN if no vehicles on inventory chart or all vehicles have 8500.LSD_STAT = 3 then exit block and goto BSECT10L2.BLEASE.BROW.ITEM else exit block and goto the TBLINVENTORY block
ELSE goto ITEM - next row of table

10


PreFill

** SHOW ONLY **


10

ANYVACAT

ANYVACAT

Was the (description) rented solely for use on a vacation, overnight
trip, or a trip of 75 miles or more one way?


1. Yes
2. No

Goto AMOUNT

10

RENTEXPX

AMOUNT

Since the first of (reference month), not including (current month), what has been your expense for renting this vehicle?

1-99999: IF entry lt 10 or gt 1200 then goto ERR1_AMOUNT
ELSEIF BCeintro.BUSCREEN = 2 then goto MORE
ELSE goto ANYBSNRM

DK,RF: IF BCeintro.BUSCREEN = 2 then goto MORE
ELSE goto ANYBSNRM

10

ANYBSNRM

ANYBSNRM

Were or will any of the rental expenses be deducted as business expenses, reimbursed, or paid by someone outside of the household?


1. Yes
2. No

1: Goto BSNSPCTZ

2,DK,RF: Goto MORE

10

BSNSPCTZ

BSNSPCTZ

What percent of the total expense will this cover?

1-99,DK,RF: Goto MORE

100: Goto ERR2_BSNSPCTZ

10

RENT_MORE

MORE

Did you rent any other (description)?


1. Yes
2. No

1: IF ROW number = 10 then goto ERR_MAX
ELSE goto RLV_ITEM

2,DK,RF: IF row number = 10 then IF no vehicles on inventory chart or all vehicles have 8500.LSD_STAT = 3 then exit block and goto BLEASE.BROW.ITEM
ELSE exit block and goto TblInventory block
ELSE goto RLV_ITEM

10

LVIHAVE

LVIHAVE

Now I am going to ask about leased vehicles you mentioned previously.

Are you still leasing the (model year) (vehicle make and model)?

If the vehicle was purchased at the end of the lease, collect the new vehicle in Section 11.


Vehicle Number Vehicle Year Vehicle Make/Model Business
(LSDNUM) (MODELYR) (MKMD_SCR) (ANYBUSIN)


1. Yes
2. No

1,DK,RF: Goto S10INV_END

2: Goto LVIENDMO

10

LVIENDMO

LVIENDMO

What month was the lease terminated?

Vehicle Number Vehicle Year Vehicle Make/Model Business
(LSDNUM) (MODELYR) (MKMD_SCR) (ANYBUSIN)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

Goto TERMFEE

10

TERMFEE

TERMFEE

? [F1]

Were any fees incurred at the termination of the lease?

Vehicle Number Vehicle Year Vehicle Make/Model Business
(LSDNUM) (MODELYR) (MKMD_SCR) (ANYBUSIN)



1. Yes
2. No

1: Goto TERMFEEX

2,DK,RF: Goto S10INV_END

10

TERMFEEX

TERMFEEX

How much?

Vehicle Number Vehicle Year Vehicle Make/Model Business
(LSDNUM) (MODELYR) (MKMD_SCR) (ANYBUSIN)

1-99999: IF entry lt 25 or gt 7000 then goto ERR1_TERMFEEX
ELSE goto S10INV_END

DK,RF: Goto S10INV_END

10


S10INV_END

** Not Displayed **

IF no more vehicles on the inventory table then exit block and goto the BSECT10L2 Block

ELSE goto LVIHAVE for next appropriate vehicle on the
inventory table

10

LSD_ITEM

ITEM

Since the first of (reference month), have (you/you or any members of your household) ^LSD_ITEM_FILL


1. Automobiles, trucks, vans, minivans, or SUVs
99. None/No more entries
888. Delete the line

1: Goto MODELYR

99: Goto S10_END

888: IF no more rows then goto S10_END
ELSE goto ITEM - next row of the table

10

MODELYR

MODELYR

Ask if necessary

What is the model year of the vehicle?

1900-current year + 1: IF MODELYR gt (current year + 1) then goto CK_MODELYR
ELSE goto MKMD_SCR

DK,RF: Goto MKMD_SCR

10

MKMD_SCR

MKMD_SCR

What is the make and model of this vehicle?

If vehicle make and model is not found, key X

X: Goto OTHMODEL

30 characters besides X, DK, RF: IF BCeintro.BUSCREEN = 2 then goto NUMPAY
ELSE goto ANYBUSIN

10

OTHMODEL

OTHMODEL

Specify other make and model

IF BCeintro.BUSCREEN = 2 then goto NUMPAY
ELSE goto ANYBUSIN

10

ANYBUSIN

ANYBUSIN

Is it used for business?


1. Yes
2. No

1: Goto PRCBSNSZ

2,DK,RF: Goto NUMPAY

10

PRCBSNSZ

PRCBSNSZ

What percentage of the mileage is counted as a business expense?

1-99,DK,RF: Goto NUMPAY

100: Goto ERR2_PRCBSNSZ

10

NUMPAY

NUMPAY

What was the number of payments contracted for?

1-999: IF entry lt 12 or gt 60 then goto ERR1_NUMPAY
ELSE goto PMTMONTH

DK,RF: Goto PMTMONTH

10

PMTMONTH

PMTMONTH

In what month was or will the first payment be made?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

Goto PMTYEAR

10

PMTYEAR

PMTYEAR

In what year was or will the first payment be made?

IF pmtyear gt current year + 1 then goto CK_PMTYEAR

ELSE goto PAYEXPX

10

PAYEXPX

PAYEXPX

(What is your monthly payment amount?/What is the amount of each payment?)

IF NUMPAY ge 12 AND entry lt 158 or gt 700 then goto ERR1_PAYEXPX

ELSEIF NUMPAY lt 12 then goto PAYTIME

ELSE goto ANYEXTRA

10

PAYTIME

PAYTIME

What period is covered by each payment?


1. Week
2. 2 Weeks
3. Month
4. Quarter
5. Semiannually
6. Annually
7. One time payment
8. Other

1: IF PAYEXPX lt 40 or gt 189 then goto ERR1_PAYTIME
ELSE goto ANYEXTRA

2: IF PAYEXPX lt 79 or gt 377 then goto ERR1_PAYTIME
ELSE goto ANYEXTRA

3: IF PAYEXPX lt 158 or gt 700 then goto ERR1_PAYTIME
ELSE goto ANYEXTRA

4: IF PAYEXPX lt 474 or gt 2262 then goto ERR1_PAYTIME
ELSE goto ANYEXTRA

5: IF PAYEXPX lt 948 or gt 4524 then goto ERR1_PAYTIME
ELSE goto ANYEXTRA

6: IF PAYEXPX lt 1500 or gt 9000 then goto ERR1_PAYTIME
ELSE goto ANYEXTRA

7: IF PAYEXPX lt 5000 or gt 10000 then goto ERR1_PAYTIME
ELSE goto ANYEXTRA

8: IF PAYEXPX lt 5 or gt 9000 then goto ERR1_PAYTIME
ELSE goto PAYOTH

DK,RF: IF PAYEXPX lt 5 or gt 9000 then goto ERR1_PAYTIME
ELSE goto ANYEXTRA

10

PAYOTH

PAYOTH

Specify:

Goto ANYEXTRA

10

ANYEXTRA

ANYEXTRA

Does the ($(entry in PAYEXPX) payment / payment) include any charges other than the lease amount such as auto insurance or maintenance?

1. Yes
2. No

1: Goto EXTRAEXP

2,DK,RF: Goto ANYEMPLY

10

EXTRAEXP

EXTRAEXP

How much of the payment is for these extra charges?

1-99999: IF EXTRAEXP gt PAYEXPX then goto CK_EXTRA
ELSEIF (PAYTIME = 1 and EXTRAEXP lt 5 or gt 100) OR (PAYTIME = 2 and EXTRAEXP lt 5 or gt 200) OR (PAYTIME = 3 and EXTRAEXP lt 5 or gt 400) OR (PAYTIME = 4 and EXTRAEXP lt 5 or gt 1200) OR (PAYTIME = 5 and EXTRAEXP lt 5 or gt 2400) OR (PAYTIME = 6 and EXTRAEXP lt 5 or gt 4800) OR (PAYTIME = 7 and EXTRAEXP lt 5 or gt 3000) OR (PAYTIME = 8 and EXTRAEXP lt 5 or gt 3000) OR (PAYTIME = DK or RF and EXTRAEXP lt 5 or gt 3000) then goto ERR1_EXTRAEXP
ELSE goto ANYEMPLY

DK,RF: Goto ANYEMPLY

10

ANYEMPLY

ANYEMPLY

Is any of the ($ (amount in PAYEXPX) ) lease payment paid by an employer?

1. Yes
2. No

1: Goto EMPLYEXP

2,DK,RF: Goto ANYTRADE

10

EMPLYEXP

EMPLYEXP

How much?

1-99999: IF lt 5 or gt 525 then goto ERR1_EMPLYEXP
ELSEIF EMPLYEXP gt PAYEXPX then goto CK_EMPLYEXP
ELSE goto ANYTRADE

DK,RF: Goto ANYTRADE

10

ANYTRADE

ANYTRADE

Was a trade-in allowance received?

1. Yes
2. No

1: Goto TRADEEXP

2,DK,RF: Goto ANYDOWN

10

TRADEEXP

TRADEEXP

How much?

1-999999: IF entry lt 400 or gt 26000 then goto ERR1_TRADEEXP
ELSE goto ANYDOWN

DK,RF: Goto ANYDOWN

10

ANYDOWN

ANYDOWN

Was a cash down payment made?

Read if necessary -

Your lease agreement may list this as a capitalized cost reduction.


1. Yes
2. No

1: Goto DOWNEXP

2,DK,RF: Goto ANYHAVE

10

DOWNEXP

DOWNEXP

How much?

1-999999: IF lt 262 or gt 10000 then goto ERR1_DOWNEXP
ELSE goto ANYDNEMP

DK,RF: Goto ANYDNEMP

10

ANYDNEMP

ANYDNEMP

Was any portion of the cash down payment paid by an employer?


1. Yes
2. No

1: Goto DNEMPEXP

2,DK,RF: Goto ANYHAVE

10

DNEMPEXP

DNEMPEXP

How much?

1-999999: IF lt 5 or gt 2500 then goto ERR1_DNEMPEXP
ELSEIF DNEMPEXP gt DOWNEXP then goto CK_DNEMPEXP
ELSE goto ANYHAVE

DK,RF: Goto ANYHAVE

10

ANYHAVE

ANYHAVE

Are you still leasing this vehicle?

If the vehicle was purchased at the end of the lease, collect the new vehicle in Section 11.

1. Yes
2. No

1,DK,RF: Goto MORE

2: Goto LSDENDMO

10

LSDENDMO

LSDENDMO

In what month was the lease terminated?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

Goto LSDENDYR

10

LSDENDYR

LSDENDYR

In what year was the lease terminated?

IF lsdendyr gt current year + 1 then goto CK_LSDENDYR

ELSE goto ANYFEES

10

ANYFEES

ANYFEES

? [F1]

Were any fees incurred at the termination of the lease?


1. Yes
2. No

1: Goto FEESEXP

2,DK,RF: Goto ANYOTH

10

FEESEXP

FEESEXP

How much?

1-999999: IF lt 50 or gt 3000 then goto ERR1_FEESEXP
ELSE goto MORE

DK,RF: Goto MORE

10

ANYOTH

MORE

Did you lease any other automobiles, trucks, vans, minivans, or SUVs?

1. Yes
2. No

1: IF ROW number = 6 then goto ERR_MAX
ELSE goto ITEM, next row

2,DK,RF: Exit block and goto S10_END

10


S10_END

** Non Displayed **

Exit block and goto BSect11 (Section 11)

11

S11_INTRO

S11_INTRO

30

Now I'm going to ask about owned vehicles.

(Prechart information)

1. Enter 1 to Continue

IF there are vehicles on the chart with 8500.OVB_STAT ne 3 then goto TBLInv.Binv.OVAHAVE

ELSE goto BVehicle.Brow.ITEM

11

OVAHAVE

OVAHAVE

(Do/Does) (you/your household) still have the (Car Description)?

(Prechart information)


1. Yes
2. No

1,DK,RF: Goto OVAHAVE for next appropriate vehicle on chart, if no more vehicles exit block and goto ITEM

2: Goto BDisposed.VEHDISP

11


MATCHID

** OUTPUT ONLY VARIABLE **


11

VEHDISP

VEHDISP

How did you dispose of the (Car description)?


1. Sold
2. Traded in
3. Given away or donated to someone outside the household, including students away at school
4. Totaled (damaged beyond repair)
5. Stolen
6. Other

1-5,DK,RF: Goto VDISPMO

6: Goto DISPOTHV

11

DISPOTHV

DISPOTHV

Specify:

Goto VDISPMO

11

VDISPMO

VDISPMO

In what month was it (sold/traded in/given away to someone outside the CU/damaged beyond repair/stolen/disposed of)?


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

IF not in reference period then goto ERR3_VDISPMO
ELSEIF VEHDISP = 1 then goto SALEX
ELSEIF VEHDISP = 2, 3, 6, DK or RF then goto LOANSTAT
ELSEIF VEHDISP = 4 or 5 then goto REIMBURS

11

SALEX

SALEX

How much did you sell it for?

1-999999: IF (VEHICYB = 100 and SALEX lt 5 or gt 17400) or (VEHICYB = 105 and SALEX lt 5 or gt 17400) or (VEHICYB = 110 and SALEX lt 5 or gt 17400) or (VEHICYB = 120 and SALEX lt 35 or gt 23000) or (VEHICYB = 130 and SALEX lt 35 or gt 23000) or (VEHICYB = 140 and SALEX lt 35 or gt 23000) or (VEHICYB = 150 and SALEX lt 35 or gt 23000) or (VEHICYB = 160 and SALEX lt 35 or gt 23000) or (VEHICYB = 170 and SALEX lt 35 or gt 23000) or (VEHICYB = 180 and SALEX lt 35 or gt 23000) or (VEHICYB = 190 and SALEX lt 35 or gt 23000) or (VEHICYB = 200 and SALEX lt 35 or gt 23000) then goto ERR1_SALEX
ELSE goto LOANSTAT

DK,RF: Goto LOANSTAT

11

REIMBURS

REIMBURS

Were you reimbursed for the value of the (Car description)?


1. Yes
2. No

1: Goto REIMBURX

2,DK,RF: Goto EXREIMB

11

REIMBURX

REIMBURX

How much did you receive?

1-999999: IF lt 20 or gt 23742 then goto ERR1_REIMBURX
ELSE goto LOANSTAT

DK,RF: Goto LOANSTAT

11

EXREIMB

EXREIMB

Do you expect to be reimbursed for the value of the (Car description)?


1. Yes
2. No

1: Goto EXREIMBX

2,DK,RF: Goto LOANSTAT

11

EXREIMBX

EXREIMBX

How much will you receive?

1-999999: IF lt 300 or gt 9000 then goto ERR1_EXREIMBX
ELSE goto LOANSTAT

DK,RF: Goto LOANSTAT

11

LOANSTAT

LOANSTAT

Were there any outstanding loans on the (Car description) when it was (sold/traded in/given away to someone outside the CU/damaged beyond repair/stolen/disposed of)?


1. Yes
2. No

1: Goto FINPAYMT

2,DK,RF: IF no more vehicles, exit block and goto ITEM
ELSE goto OVAHAVE next line on grid

11

FINPAYMT

FINPAYMT

Were any final payments made on the loan?


1. Yes
2. No

1: Goto FINPAYMX

2,DK,RF: IF no more vehicles, exit block and goto ITEM
ELSE goto OVAHAVE next line on grid

11

FINPAYMX

FINPAYMX

How much was the final payment?

1-999999: IF lt 384 or gt 26500 then goto ERR1_FINPAYMX
ELSEIF no more vehicles, exit block and goto ITEM
ELSE goto OVAHAVE next line on grid

DK,RF: IF no more vehicles, exit block and goto ITEM
ELSE goto OVAHAVE, next line on grid

11

OVB_ITEM

ITEM

30 ? [F1]

SCREEN 1A -----------------------------------------------------------------------------------

(Since the first of (REF_MONTH), (have/has) (you/your household) purchased or acquired any vehicle that is not used entirely for business? Include th

IF YES - What kind of vehicle was it?


SCREEN 1B ----------------------------------------------------------------------------

(Do/Does) (you/your household) own any automobiles, trucks, minivans, vans or SUV's which were not used entirely for business?


SCREEN 2 ------------------------------------------------------------------------------------

(Do/Does) (you/your household) own any other types of vehicles including boats and planes which are not used entirely for business?

IF YES- Read each item on list

Do you own any. . .


SCREEN 3-------------------------------------------------------------------------

(Have/Has) (you/your household) purchased any (other/ ) vehicles since the first of (reference month) for someone outside of your household?

IF YES -

What kind of vehicle(s) did you purchase?


SCREEN 4 ---------------------------------------------------------------------------

(Have/Has) (you/your household) disposed of (any/any automobiles or) other vehicles since the first of (reference month)?

IF YES -

Which kind of vehicle(s) did you dispose of?


1. ^AutoOrTruck
2. Motor home
3. Trailer-type camper
4. Other attachable-type camper
5. Motorcycle, motor scooter, or moped (motorized bicycle)
6. Boat, with motor
7. Boat, without a motor
8. Trailer other than a camper type, such as for a boat or cycle
9. Private aircraft
10. Any other vehicle
95. Continue list
99. None/No more entries
888. Delete the line

1: Goto VEHICYR

2-10: IF BCeintro.BUSCREEN = 2 goto VEHNEWU
ELSE goto VEHBSNS

95: Goto ITEM, next screen

99: Goto S11_END

888: IF no more grid lines goto S11_END
ELSE goto ITEM - next line of grid

11


PreFill

** SHOW ONLY **


11

VEHICYR

VEHICYR

What ^S11B_iswas the model year of the vehicle?

1900-current year + 2: IF entry gt (current year+2) then goto CK_VEHICYR
ELSE goto MKMDL_SC

DK,RF: Goto MKMDL_SC

11

MKMDL_SC

MKMDL_SC

What ^S11B_iswas the make and model of this vehicle?

If vehicle make and model is not found, key X.

30 characters: IF MKMDLY(4:5) = XX or ZZ then goto AUTOTRK
ELSE goto FUELTYPE

DK,RF: Goto AUTOTRK

X: Goto OTHMDLY

11

OTHMDLY

OTHMDLY

Specify:

Goto AUTOTRK

11

AUTOTRK

AUTOTRK

Is this vehicle an automobile or a truck, minivan, van or SUV?


1. Automobile
2. Truck, van, minivan, or SUV

Goto FUELTYPE

11

FUELTYPE

FUELTYPE

Is it fueled by -

Read each item on list.

1. Gasoline only?
2. Diesel fuel?
3. Hybrid electric/gasoline?
4. Electric only?
5. FlexFuel/E85?
6. Other - specify?

1-5,DK,RF: IF BCeintro.BUSCREEN = 2 goto VEHNEWU
ELSE goto VEHBSNS

6: Goto FUELOTH

11

FUELOTH

FUELOTH

Specify:

IF BCeintro.BUSCREEN = 2 goto VEHNEWU
ELSE goto VEHBSNS

11

VEHBSNS

VEHBSNS

(Was/Is) it used for business?

1. Yes
2. No

1: Goto VEHBSNZ

2,DK,RF: Goto VEHNEWU

11

VEHBSNZ

VEHBSNZ

What percentage of the mileage ^S11B_iswas counted as a business expense?

1-99,DK,RF: Goto VEHNEWU

100: Goto ERR2_VEHBSNZ

11

VEHNEWU

VEHNEWU

Was it new or used when acquired?


1. New
2. Used

1: IF coming from ITEM screen 1A, 1B, 2, or 4 then goto VEHGFTC
ELSE goto VEHPURMO

2,DK,RF: IF coming from ITEM screen 1A, 1B, 2, or 4 then goto VEHGFTC
ELSE goto VPURINDV

11

VEHGFTC

VEHGFTC

Was this vehicle -

1. Purchase for own use?
2. Purchased for someone outside of your household?
3. Received as a gift?

1,2,DK,RF: IF VEHNEWU = 1 then goto VEHPURMO
ELSE goto VPURINDV

3: IF DISPOSED = 1 then goto VEHDISP
ELSE goto ANYOTHR

11

VPURINDV

VPURINDV

Was this vehicle purchased from a private individual?

1. Yes
2. No

IF ITEM = 1-2 or 5 AND VEHGFTC = 3 AND DISPOSED ne 1 then goto ANYOTHR

ELSEIF ITEM = 1-2 or 5 AND VEHGFTC = 3 AND DISPOSED = 1 then goto VEHDISP

ELSE goto VEHPURMO

11

VEHPURMO

VEHPURMO

In what month was it purchased?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

Goto VEHPURYR

11

VEHPURYR

VEHPURYR

In what year was it purchased?

1900 - current year: IF the month and year (VEHPURMO and VEHPURYR) are more than one month in the future then goto CK_VEHPURYR
ELSEIF (VPURINDV = 2, DK or RF) AND (CURRENT YEAR - VEHPURYR le 5) AND (ITEM = 3, 4, 6, 7, 8, or 10) then goto OVBSTORE
ELSE goto VFINANCE

DK,RF: Goto VFINANCE

11

OVBSTORE

OVBSTORE

Where was this vehicle purchased?

Enter store, website, or company name

IF uppercase version of the entry = "GROUPON" or "GROUPON.COM" then goto ERR_GROUPON

ELSEIF ENTRY contains ".com", ".Com", ".cOm", ".coM", ".COm", ".CoM", ".cOM", or ".COM", then goto VFINANCE

ELSEIF ENTRY = DK or RF then goto VFINANCE

ELSE goto OVBPURCH

11

OVBPURCH

OVBPURCH

Ask if not apparent

Was this purchased online or in-person?


1. Online
2. In person
3. Other (phone, mail, catalog)

1,3,DK,RF: Goto VFINANCE

2: Goto OVBLOC

11

OVBLOC

OVBLOC

Where is (store) located?

Enter city and state

Goto VFINANCE

11

VFINANCE

VFINANCE

Was any portion of the purchase price financed?

1. Yes
2. No

1: Goto VLOANST

2,DK,RF: IF VEHPURMO + VEHPURYR is prior to 3 months ago AND DISPOSED = 1 then goto VEHDISP
ELSIF VEHPURMO + VEHPURYR is prior to 3 months ago AND DISPOSED ne 1 then goto ANYOTHR
ELSE goto TRADE

11

VLOANST

VLOANST

On the first of (reference month), were there remaining loan payments?


1. Yes
2. No

1,DK,RF: Goto TRADE

2: IF VEHPURMO + VEHPURYR is prior to 3 months ago AND DISPOSED = 1 then goto VEHDISP
ELSEIF VEHPURMO + VEHPURYR is prior to 3 months ago AND DISPOSED ne 1 then goto ANYOTHR
ELSE goto TRADE

11

TRADE

TRADE

Was a trade-in allowance received?


1. Yes
2. No

1: Goto TRADEX

2,DK,RF: Goto NETPURX

11

TRADEX

TRADEX

How much?

0-999999: IF lt 200 or gt 19000 then goto ERR1_TRADEX
ELSE goto NETPURX

DK,RF: Goto NETPURX

11

NETPURX

NETPURX

What was the amount paid for the vehicle after ^trade_in rebate, and discount?

Include destination fee in the price.

0-999999: IF (VEHICYB = 100 and NETPURX lt 500 or gt 50000) or (VEHICYB = 105 and NETPURX lt 500 or gt 50000) or (VEHICYB = 110 and NETPURX lt 500 or gt 50000) or (VEHICYB = 120 and NETPURX lt 2500 or gt 69000) or (VEHICYB = 130 and NETPURX lt 751 or gt 47000) or (VEHICYB = 140 and NETPURX lt 533 or gt 12051) or (VEHICYB = 150 and NETPURX lt 420 or gt 20000) or (VEHICYB = 160 and NETPURX lt 200 or gt 63000) or (VEHICYB = 170 and NETPURX lt 200 or gt 63000) or (VEHICYB = 180 and NETPURX lt 240 or gt 7500) or (VEHICYB = 190 and NETPURX lt 4000 or gt 120000) or (VEHICYB = 200 and NETPURX lt 250 or gt 23700) then goto ERR1_NETPURX
ELSE goto SALESTAX

DK,RF: IF VLOANST = 1 then goto DNPAYMTX
ELSE goto ANYOTHR

11

SALESTAX

SALESTAX

Did this include sales tax?

1. Yes
2. No

IF VLOANST = 1 then goto DNPAYMTX
ELSE goto ANYOTHR

11

DNPAYMTX

DNPAYMTX

What was the amount of the cash down payment?

0-999999: IF (VEHICYB = 100 and DNPAYMTX gt 11500) OR (VEHICYB = 105 and DNPAYMTX gt 11500) OR (VEHICYB = 110 and DNPAYMTX gt 11500) OR (VEHICYB = 120 and DNPAYMTX gt 15000) OR (VEHICYB = 130 and DNPAYMTX gt 15000) OR (VEHICYB = 140 and DNPAYMTX gt 15000) OR (VEHICYB = 150 and DNPAYMTX gt 15000) OR (VEHICYB = 160 and DNPAYMTX gt 15000) OR (VEHICYB = 170 and DNPAYMTX gt 15000) OR (VEHICYB = 180 and DNPAYMTX gt 15000) OR (VEHICYB = 190 and DNPAYMTX gt 15000) OR (VEHICYB = 200 and DNPAYMTX gt 15000) then goto ERR1_DNPAYMTX
ELSEIF gt NETPURX and netpurx ne D and ne R then goto CK_DNPAYMTX
ELSE goto VEHEQTLN

DK,RF: Goto VEHEQTLN

11

VEHEQTLN

VEHEQTLN

Was the source of credit a Home Equity Loan?

1. Yes
2. No

Goto PRINCIPX

11

PRINCIPX

PRINCIPX

How much was borrowed, excluding any interest?

1-999999: IF (VEHICYB = 100 and PRINCIPX lt 2500 or gt 50000) OR (VEHICYB = 105 and PRINCIPX lt 2500 or gt 50000) OR (VEHICYB = 110 and PRINCIPX lt 2500 or gt 50000) OR (VEHICYB = 120 and PRINCIPX lt 1472 or gt 60645) OR (VEHICYB = 130 and PRINCIPX lt 1472 or gt 60645) OR (VEHICYB = 140 and PRINCIPX lt 1472 or gt 60645) OR (VEHICYB = 150 and PRINCIPX lt 1472 or gt 60645) OR (VEHICYB = 160 and PRINCIPX lt 1472 or gt 60645) OR (VEHICYB = 170 and PRINCIPX lt 1472 or gt 60645) OR (VEHICYB = 180 and PRINCIPX lt 1472 or gt 60645) OR (VEHICYB = 190 and PRINCIPX lt 1472 or gt 60645) OR (VEHICYB = 200 and PRINCIPX lt 1472 or gt 60645) then goto ERR1_PRINCIPX
ELSE goto VINTRATE

DK,RF: Goto VINTRATE

11

VINTRATE

VINTRATE

What was the interest rate?

Enter percent including decimal.

00.000-99.999: IF gt 12 then goto ERR1_VINTRATE
ELSE goto PMT1YR

DK,RF: Goto PMT1YR

11

PMT1YR

PMT1YR

In what year was or will the first payment be made?

Goto PMT1MO

11

PMT1MO

PMT1MO

In what month was or will the first payment be made?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

Goto VEHQPMT

11

VEHQPMT

VEHQPMT

For how many months was the payment contract?

1-999: IF gt 144 then goto ERR1_VEHQPMT
ELSE goto PAYMENTX

DK,RF: Goto PAYMENTX

11

PAYMENTX

PAYMENTX

What is your monthly payment amount?

1-99999: IF (VEHICYB = 100 and PAYMENTX lt 105 or gt 679) OR (VEHICYB = 105 and PAYMENTX lt 105 or gt 679) OR (VEHICYB = 110 and PAYMENTX lt 105 or gt 679) OR (VEHICYB = 120 and PAYMENTX lt 77 or gt 721) OR (VEHICYB = 130 and PAYMENTX lt 77 or gt 721) OR (VEHICYB = 140 and PAYMENTX lt 77 or gt 721) OR (VEHICYB = 150 and PAYMENTX lt 77 or gt 721) OR (VEHICYB = 160 and PAYMENTX lt 77 or gt 721) OR (VEHICYB = 170 and PAYMENTX lt 77 or gt 721) OR (VEHICYB = 180 and PAYMENTX lt 77 or gt 721) OR (VEHICYB = 190 and PAYMENTX lt 77 or gt 721) OR (VEHICYB = 200 and PAYMENTX lt 77 or gt 721) then goto ERR1_PAYMENTX
ELSEIF DISPOSED = 1 then goto VEHDISP
ELSE goto ANYOTHR

DK,RF: IF DISPOSED = 1 then goto VEHDISP
ELSE goto ANYOTHR

11

VEHDISP

VEHDISP

How did you dispose of the (Car description)?


1. Sold
2. Traded in
3. Given away or donated to someone outside the household, including students away at school
4. Totaled (damaged beyond repair)
5. Stolen
6. Other

1-5,DK,RF: Goto VDISPMO

6: Goto DISPOTHV

11

DISPOTHV

DISPOTHV

Specify:

Goto VDISPMO

11

VDISPMO

VDISPMO

In what month was it ^Vehdisp_fill?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

IF VDISPMO is not within the reference period then goto ERR3_VDISPMO
ELSEIF VEHDISP = 1 then goto SALEX
ELSEIF VEHDISP = 2, 3, 6, DK or RF then goto LOANSTAT
ELSEIF VEHDISP = 4 or 5 then goto REIMBURS

11

SALEX

SALEX

How much did you sell it for?

1-999999: IF (VEHICYB = 100 and SALEX lt 5 or gt 17400) OR (VEHICYB = 105 and SALEX lt 5 or gt 17400) OR (VEHICYB = 110 and SALEX lt 5 or gt 17400) OR (VEHICYB = 120 and SALEX lt 35 or gt 23000) OR (VEHICYB = 130 and SALEX lt 35 or gt 23000) OR (VEHICYB = 140 and SALEX lt 35 or gt 23000) OR (VEHICYB = 150 and SALEX lt 35 or gt 23000) OR (VEHICYB = 160 and SALEX lt 35 or gt 23000) OR (VEHICYB = 170 and SALEX lt 35 or gt 23000) OR (VEHICYB = 180 and SALEX lt 35 or gt 23000) OR (VEHICYB = 190 and SALEX lt 35 or gt 23000) OR (VEHICYB = 200 and SALEX lt 35 or gt 23000) then goto ERR1_SALEX
ELSE goto LOANSTAT

DK,RF: Goto LOANSTAT

11

REIMBURS

REIMBURS

Were you reimbursed for the value of the (Car description)?


1. Yes
2. No

1: Goto REIMBURX

2,DK,RF: Goto EXREIMB

11

REIMBURX

REIMBURX

How much did you receive?

1-999999: IF lt 20 or gt 23742 then goto ERR1_REIMBURX
ELSE goto LOANSTAT

DK,RF: Goto LOANSTAT

11

EXREIMB

EXREIMB

Do you expect to be reimbursed for the value of the (Car description)?


1. Yes
2. No

1: Goto EXREIMBX

2,DK,RF: Goto LOANSTAT

11

EXREIMBX

EXREIMBX

How much will you receive?

1-999999: IF lt 300 or gt 9000 then goto ERR1_EXTREIMBX
ELSE goto LOANSTAT

DK,RF: Goto LOANSTAT

11

LOANSTAT

LOANSTAT

Were there any outstanding loans on the (Car description) when it was (sold/traded in/given away to someone outside the CU/damaged beyond repair/stolen/disposed of)?


1. Yes
2. No

1: Goto FINPAYMT

2,DK,RF: Goto ANYOTHR

11

FINPAYMT

FINPAYMT

Were any final payments made on the loan?

1. Yes
2. No

1: Goto FINPAYMX

2,DK,RF: Goto ANYOTHR

11

FINPAYMX

FINPAYMX

How much was the final payment?

1-999999: IF lt 384 or gt 26500 then goto ERR1_FINPAYMX
ELSE goto ANYOTHR

DK,RF: Goto ANYOTHR

11

ANYOTHR

ANYOTHR

(Did (you/you household) purchase or acquire any other (vehicle description)?/(Do/Does) (you/your household) own any other (vehicle description)?/Did


1. Yes
2. No

1: IF Row number = 25 then goto ERR_MAX
ELSE goto ITEM, next screen as appropriate

2,DK,RF: goto ITEM, next screen as appropriate

11


S11_End

** Non-Displayed item **

Goto section 12 - BSect12

12A

S12A_INTRO

S12A_INTRO

31

I will now ask about expenses for vehicle services, parts, and equipment. Please do not include expenses for vehicles used entirely for business.

Description Month Amount
(VOPDESC) (VOPMOA) (VOPEXPX)


1. Enter 1 to Continue

Goto BTABLEA.BROW.ITEM

12A

VEQ_ITEM

ITEM

31 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) had
expenses for any of the following?

Read each item on list

1. Oil change, lubrication, or oil filter
2. Motor tune-up
3. Battery purchases or installation
4. Tire purchases or mounting
5. Tire repair
6. Front end alignment, wheel balancing, or wheel rotation
7. Shock absorber replacement
8. Body work or painting
9. Any other vehicle or engine repairs
10. Vehicle accessories or customizing
11. Other vehicle services, parts, or equipment
12. Vehicle cleaning services including car washes
99. None/No more entries
888. Delete a line

1-12: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

99: Goto S12A_END

888: IF no more rows then goto S12A_END
ELSE goto ITEM - next row of the table

12A

VOPDESC

DESCRIPTION

What was the expense for?

Description Month Amount
(VOPDESC) (VOPMOA) (VOPEXPX)

IF ITEM = 3, 4, or 5 then goto MONTH
ELSE goto VOPLABOR

12A

VOPLABOR

VOPLABOR

Did this expense include labor?

Description Month Amount
(VOPDESC) (VOPMOA) (VOPEXPX)


1. Yes
2. No

Goto MONTH

12A

VOPMOA

MONTH

In what month did you have this expense?

Description Month Amount
(VOPDESC) (VOPMOA) (VOPEXPX)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

REF_MONTH - CUR_MONTH: IF MONTH not within reference period then goto ERR3_MONTH
ELSE goto AMOUNT

DK,RF: Goto AMOUNT

12A

VOPEXPX

AMOUNT

What was the total cost?

Description Month Amount
(VOPDESC) (VOPMOA) (VOPEXPX)

1-99999: IF (VOPSERVY = 100 and AMOUNT lt 8 or gt 89) OR (VOPSERVY = 110 and AMOUNT lt 10 or gt 1500) OR (VOPSERVY = 130 and AMOUNT lt 16 or gt 211) OR (VOPSERVY = 140 and AMOUNT lt 20 or gt 1000)OR (VOPSERVY = 150 and AMOUNT lt 5 or gt 100) OR (VOPSERVY = 160 and AMOUNT lt 8 or gt 690) OR (VOPSERVY = 380 and AMOUNT lt 6 or gt 3000) OR (VOPSERVY = 320 and AMOUNT lt 15 or gt 4000) OR (VOPSERVY = 330 and AMOUNT lt 22 or gt 1000) OR (VOPSERVY = 360 and AMOUNT lt 5 or gt 1700) OR (VOPSERVY = 367 and AMOUNT lt 2 or gt 100)OR (VOPSERVY = 370 and AMOUNT lt 5 or gt 1000) then goto ERR1_AMOUNT
ELSEIF (VOPSERVY and the entry in AMOUNT for this record are equal to any records data on the pre-chart/input then goto ERR_DUP
ELSE goto VOPTAX

DK,RF: Goto C

12A

VOPTAX

VOPTAX

Did this include sales tax?


Description Month Amount
(VOPDESC) (VOPMOA) (VOPEXPX)


1. Yes
2. No

Goto C

12A

VOPCMB_C

C

Enter 'C' for combined expense

C: Goto COMBCODE

EMPTY: Goto VOPREIMB

IF anything other than a 'C' or blank is entered then goto CK_C

12A

VOPCMB

COMBCODE

31 ?[F1]

What expense was combined with the ^VOPCMB expense?

Enter all that apply, separate with commas.

Description Month Amount
(VOPDESC) (VOPMOA) (VOPEXPX)


1. Oil change, lubrication, or oil filter
2. Motor tune-up
3. Battery purchases or installation
4. Tire purchases or mounting
5. Tire repair
6. Front end alignment, wheel balancing, or wheel rotation
7. Shock absorber replacement
8. Body work or painting
9. Any other vehicle or engine repairs
10. Vehicle accessories or customizing
11. Other vehicle services, parts, or equipment
12. Vehicle cleaning services including car washes
77. Misc combined (unable to specify/DK)

Goto VOPREIMB

12A

VOPREIMB

VOPREIMB

Has any of this expense been, or will any of it be, reimbursed?

Description Month Amount
(VOPDESC) (VOPMOA) (VOPEXPX)



1. Yes
2. No

1: Goto VOPRMBXA

2,DK,RF: Goto MORE

12A

VOPRMBXA

VOPRMBXA

How much?

Description Month Amount
(VOPDESC) (VOPMOA) (VOPEXPX)


1-99999: IF VOPRMBXA gt 5000 then goto ERR1_VOPRMBXA
ELSEIF (VOPRMBXA gt AMOUNT) then goto CK_VOPRMBXA
ELSE goto MORE

DK,RF: Goto MORE

12A

MOREVEOP

MORE

Did you have any other expenses for (description)?

Description Month Amount
(VOPDESC) (VOPMOA) (VOPEXPX)


1. Yes
2. No

1: IF ROW number = 26 then goto ERR_MAX
ELSE goto ITEM, next row of the table

2,DK,RF: IF Row number = 26 then goto S12A_END
ELSE goto ITEM, next row of the table

12A


S12A_END

** NOT DISPLAYED**

IF INTNMBR = 1 or NEWCU = 1 then exit block and goto BTABLEB.Brow.ITEM

ELSE exit block and goto INTROB

12B

S12B_INTRO

INTROB

32

Drivers licenses, vehicle inspection, vehicle registration, and personal property taxes for vehicles
collected in the previous interview:



Description Month Amount
(VREGDESC) (VOPMO_C) (VOPREGX)


1. Enter 1 to Continue

Goto BTABLEB.BROW.ITEM

12B

VLR_ITEM

ITEM

32 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) had any expenses for -

Read each item on list


1. Driver's licenses?
2. Vehicle inspection?
3. State vehicle registration?
4. Local vehicle registration?
5. Personal property taxes for vehicles?
99. None/No more entries
888. Delete line

1-5: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

99: Goto S12B_END

888: IF no more rows then goto S12B_END
ELSE goto ITEM - next row of the table

12B


PreFill

** SHOW ONLY **


12B

VREGDESC

DESCRIPTION

What was the expense for?

Description Month Amount
(VREGDESC) (VOPMO_C) (VOPREGX)

Goto MONTH

12B

VOPMO_C

MONTH

In what month did you have this expense?

Description Month Amount
(VREGDESC) (VOPMO_C) (VOPREGX)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

REF_MONTH - CUR_MONTH: IF MONTH not within reference period then goto ERR3_MONTH
ELSE goto AMOUNT

DK,RF: Goto AMOUNT

12B

VOPREGX

AMOUNT

What was the total amount of the expense?

Description Month Amount
(VREGDESC) (VOPMO_C) (VOPREGX)

1-9999: IF (ITEM = 1 and AMOUNT lt 5 or gt 86) OR (ITEM = 2 and AMOUNT lt 5 or gt 120) OR (ITEM = 3 and AMOUNT lt 10 or gt 423) OR (ITEM = 4 and AMOUNT lt 8 or gt 442) OR (ITEM = 5 and AMOUNT lt 18 or gt 3213) then goto ERR1_AMOUNT
ELSEIF ITEM and the entry in AMOUNT for the record are equal to any records data on the prechart/input) then goto ERR_DUP
ELSE goto C

DK,RF: Goto C

12B

S12BCMB_C

C

Enter 'C' for combined expense

C: Goto COMBCODE

EMPTY: Goto MORE

IF anything other than a 'C' or blank is entered then goto CK_C

12B

S12B_CMB

COMBCODE

32 ? [F1]

What was combined with the (Description) expense?

Enter all that apply, separate with commas

Description Month Amount
(VREGDESC) (VOPMO_C) (VOPREGX)


1. Driver's license
2. Vehicle inspection
3. State Vehicle registration
4. Local Vehicle registration
5. Personal property taxes for vehicles

Goto MORE

12B

MOREREG

MORE

Did you have any other (Description) expenses?

Description Month Amount
(VREGDESC) (VOPMO_C) (VOPREGX)


1. Yes
2. No

1: IF ROW number = 11 then goto ERR_MAX
ELSE goto ITEM, next row or the table

2,DK,RF: IF ROW number = 11 then goto S12B_END
ELSE goto ITEM, next row of the table

12B


S12B_END

**NOT DISPLAYED**

Goto Section 12C

12C

VOPGASX

VOPGASX

? [F1]

Since the first of (reference month) not including this month --

What has been (your/your household's) AVERAGE MONTHLY expense for gasoline and other fuels for all vehicles?

0,RF: IF S11Electric_Flag = 1 then goto VOPELEC
ELSE goto VOPOIL

1-9999: IF VOPGASX gt 400 then goto ERR1_VOPGASX
ELSE goto VOPDIES

DK: Goto VOPDIES

12C

VOPDIES

VOPDIES

? [F1]

Was any of this expense for diesel fuel?


1. Yes
2. No

1: Goto VOPDIESX

2,DK,RF: IF S11FlexFuel_Flag = 1 then goto VOPETH
ELSEIF RT8100.POPGRP = 11 then goto GASSTORE
ELSEIF S11Electric_Flag = 1 and BCeintro.BUSCREEN = 2 then goto VOPELEC
ELSEIF BCeintro.BUSCREEN = 2 then goto VOPOIL
ELSE goto VOPBSNS

12C

VOPDIESX

VOPDIESX

How much?

1-9999: IF (VOPDIESX lt 5 or gt 400) then goto ERR1_VOPDIESX
ELSEIF (VOPDIESX gt VOPGASX) then goto CK_VOPDIESX
ELSEIF S11FlexFuel_Flag = 1 then goto VOPETH
ELSEIF RT8100.POPGRP = 11 then goto GASSTORE
ELSEIF S11Electric_Flag = 1 and BCeintro.BUSCREEN = 2 then goto VOPELEC
ELSEIF BCeintro.BUSCREEN = 2 then goto VOPOIL
ELSE goto VOPBSNS

DK,RF: IF S11FlexFuel_Flag = 1 then goto VOPETH
ELSEIF RT8100.POPGRP = 11 then goto GASSTORE
ELSEIF S11Electric_Flag = 1 and BCeintro.BUSCREEN = 2 then goto VOPELEC
ELSEIF BCeintro.BUSCREEN = 2 then goto VOPOIL
ELSE goto VOPBSNS

12C

VOPETH

VOPETH

Was any of this expense for the purchase of E85?

1. Yes
2. No

1: Goto VOPETHX

2,DK,RF: IF RT8100.POPGRP = 11 then goto GASSTORE
ELSEIF S11Electric_Flag = 1 and BCeintro.BUSCREEN = 2 then goto VOPELEC
ELSEIF BCeintro.BUSCREEN = 2 then goto VOPOIL
ELSE goto VOPBSNS

12C

VOPETHX

VOPETHX

How much?

1-9999: IF (VOPETHX lt 5 or gt 400) then goto ERR1_VOPETHX
ELSEIF RT8100.POPGRP = 11 then goto GASSTORE
ELSEIF S11Electric_Flag = 1 and BCeintro.BUSCREEN = 2 then goto VOPELEC
ELSEIF BCeintro.BUSCREEN = 2 then goto VOPOIL
ELSE goto VOPBSNS

DK,RF: IF RT8100.POPGRP = 11 then goto GASSTORE
ELSEIF S11Electric_Flag = 1 and BCeintro.BUSCREEN = 2 then goto VOPELEC
ELSEIF BCeintro.BUSCREEN = 2 then goto VOPOIL
ELSE goto VOPBSNS

12C

GASSTORE

GASSTORE

At what station or store did (you/you or any members of your household) last purchase (gas, diesel, or E85?/gas or diesel?/gas or E85?/gas?)

Enter store or station name

ENTRY: Goto GASLOC

DK, RF: IF S11Electric_Flag = 1 and BCeintro.BUSCREEN = 2 then goto VOPELEC
ELSEIF BCeintro.BUSCREEN = 2 then goto VOPOIL
ELSE goto VOPBSNS

12C

GASLOC

GASLOC

Where is (store) located?

Enter city and state

IF S11Electric_Flag = 1 and BCeintro.BUSCREEN = 2 then goto VOPELEC

ELSEIF BCeintro.BUSCREEN = 2 then goto VOPOIL

ELSE goto VOPBSNS

12C

VOPBSNS

VOPBSNS

Was any of the AVERAGE MONTHLY cost counted as a business expense?


1. Yes
2. No

1: Goto VOPBSPER

2,DK,RF: IF S11Electric_Flag = 1 then goto VOPELEC
ELSE goto VOPOIL

12C

VOPBSPER

VOPBSPER

What percentage of the AVERAGE MONTHLY COST was counted as a business expense?

1-99,DK,RF: IF S11Electric_Flag = 1 then goto VOPELEC
ELSE goto VOPOIL

100: Goto ERR2_VOPBSPER

12C

VOPELEC

VOPELEC

Since the first of (reference month) not including this month --

Have (you/you or any members of your household) paid for electric vehicle charging away from home?


1. Yes
2. No

1: Goto VOPELECX

2,DK,RF: Goto VOPOIL

12C

VOPELECX

VOPELECX

How much?

1-9999: IF (VOPELECX lt 5 or gt 400) then goto ERR1_VOPELECX
ELSEIF BCeintro.BUSCREEN = 2 then goto VOPOIL
ELSE goto VOPELBS

DK,RF: IF BCeintro.BUSCREEN = 2 then goto VOPOIL
ELSE goto VOPELBS

12C

VOPELBS

VOPELBS

Was any of this amount counted as a business expense?


1. Yes
2. No

1: Goto VOPELBPR

2,DK,RF: Goto VOPOIL

12C

VOPELBPR

VOPELBPR

What percentage of (the amount/(entry in VOPELECX)) was counted as a business expense?

1-99,DK,RF: Goto VOPOIL

100: Goto ERR2_VOPELBPR

12C

VOPOIL

VOPOIL

? [F1]

Since the first of (reference month) not including this month --

Have (you/you or any members of your household)
purchased any oil for operating vehicles?


1. Yes
2. No

1: Goto VOPOILX

2,DK,RF: Goto VOPFLUID

12C

VOPOILX

VOPOILX

? [F1]

What was the total cost?

1-9999: IF VOPOILX lt 5 or gt 65 then goto ERR1_VOPOILX
Else goto VOPFLUID

DK,RF: Goto VOPFLUID

12C

VOPFLUID

VOPFLUID

? [F1]

Since the first of (reference month), not including this month --

Have (you/you or any members of your household) purchased any antifreeze, brake fluid, transmission fluid, windshield wiper fluid, or additives, except if purchased with a tune-up?


1. Yes
2. No

1: Goto VOPFLUDX

2,DK,RF: Goto VOPPARK

12C

VOPFLUDX

VOPFLUDX

What was the total cost of these purchases?

1-9999: IF VOPFLUDX lt 5 or gt 50 then goto ERR1_VOPFLUDX
ELSE goto VOPPARK

DK,RF: Goto VOPPARK

12C

VOPPARK

VOPPARK

? [F1]

Since the first of (reference month) not including this month --

Have (you/you or any members of your household) had expenses for parking, such as parking garages, parking lot fees, or parking meters?

Do not include expenses that are part of your property ownership or
rental costs, a business expense or expenses that will be totally reimbursed.


1. Yes
2. No

1: Goto VOPPARKX

2,DK,RF: Goto VOPTOLL

12C

VOPPARKX

VOPPARKX

How much was paid, not including any payments made this month?

1-99999: IF VOPPARKX gt 390 then goto ERR1_VOPPARKX
ELSEIF RT8100.POPGRP = 14 then goto PRKPLACE
ELSE goto VOPTOLL

DK,RF: IF RT8100.POPGRP = 14 then goto PRKPLACE
ELSE goto VOPTOLL

12C

PRKPLACE

PRKPLACE

Where was the last place (you/you or any members of your household) had an expense for parking, such as parking garages, parking lot fees, or parking meters?

Enter name of location (such as Anytown Shopping Center) or approximate address
(such as First Street & Main Street)

ENTRY: Goto PRKLOC

DK, RF: Goto VOPTOLL

12C

PRKLOC

PRKLOC

And what is the city and state?

Enter city and state

Goto VOPTOLL

12C

VOPTOLL

VOPTOLL

? [F1]

Since the first of (reference month) not including this month, have (you/you or any members of your household) had expenses for -

Local tolls or electronic toll passes?


1. Yes
2. No

1: Goto VOPTOLLX

2,DK,RF: Goto VOPDOCK

12C

VOPTOLLX

VOPTOLLX

How much was paid, not including any payments made this month?

1-99999: IF VOPTOLLX gt 200 then goto ERR1_VOPTOLLX
ELSEIF RT8100.POPGRP = 14 then goto TOLPLACE
ELSE goto VOPDOCK

DK,RF: IF RT8100.POPGRP = 14 then goto TOLPLACE
ELSE goto VOPDOCK

12C

TOLPLACE

TOLPLACE

What is the last road, bridge, ferry, or tunnel (you/you or any members of your household) paid a toll for?

Enter name or description of road, bridge, ferry, or tunnel

ENTRY: Goto TOLLOC

DK, RF: VOPDOCK

12C

TOLLOC

TOLLOC

And what is the city and state?

Enter city and state

Goto VOPDOCK

12C

VOPDOCK

VOPDOCK

? [F1]

Since the first of (reference month) not including this month, have (you/you or any members of your household) had expenses for -

Docking and landing fees for boats and planes?


1. Yes
2. No

1: Goto VOPDOCKX

2,DK,RF: Goto VOPPOLCY

12C

VOPDOCKX

VOPDOCKX

How much was paid, not including any payments made this month?

1-9999: IF VOPDOCKX gt 1752 then goto ERR1_VOPDOCKX
ELSE goto VOPPOLCY

DK,RF: Goto VOPPOLCY

12C

VOPPOLCY

VOPPOLCY

? [F1]

Since the first of (reference month) not including this month, have (you/you or any members of your household) had any expenses for --

Auto repair service policies such as extended warranties?
Do not include service policies for vehicles used entirely for business.


1. Yes
2. No

1: Goto VOPPLCYX

2,DK,RF: Goto VOPAUTO

12C

VOPPLCYX

VOPPLCYX

How much?

1-9999: IF VOPPLCYX lt 5 or gt 1800 then goto ERR1_VOPPLCYX
ELSE goto VOPAUTO

DK,RF: Goto VOPAUTO

12C

VOPAUTO

VOPAUTO

? [F1]

Since the first of (reference month) not including this month, have (you/you or any members of your household) had any expenses
for --


Automobile service clubs, such as AAA or services such as OnStar or LoJack?


1. Yes
2. No

1: Goto VOPCLUBX

2,DK,RF: Goto VOPTOW

12C

VOPCLUBX

VOPCLUBX

How much?

1-9999: IF VOPCLUBX lt 6 or gt 155 then goto ERR1_VOPCLUBX
ELSEIF RT8100.POPGRP = 14 then goto CLUBNAME
ELSE goto VOPTOW

DK,RF: IF RT8100.POPGRP = 14 then goto CLUBNAME
ELSE goto VOPTOW

12C

CLUBNAME

CLUBNAME

What is the name of the club or service?

Goto VOPTOW

12C

VOPTOW

VOPTOW

? [F1]

Since the first of (reference month) not including this month, have (you/you or any members of your household)
had expenses for -


Towing charges, not already reported?


1. Yes
2. No

1: Goto VOPTOWX

2,DK,RF: Goto TANKGAS

12C

VOPTOWX

VOPTOWX

How much was paid, not including any payments made this month?

1-9999: IF VOPTOWX gt 315 then goto ERR1_VOPTOWX
ELSE goto TANKGAS

DK,RF: Goto TANKGAS

12C

TANKGAS

TANKGAS

? [F1]

Since the first of (reference month) not including this month, have (you/you or any members of your household) had any expenses
for --


Bottled or tank gas for recreational vehicles, including
vans, campers, and boats?


1. Yes
2. No

1: Goto TANKGASX

2,DK,RF: Goto S12C_END

12C

TANKGASX

TANKGASX

How much?

1-9999: IF TANKGASX lt 5 or gt 200 then goto ERR1_TANKGASX
ELSE goto S12C_END

DK,RF: Goto S12C_END

12C


S12C_END

** NOT DISPLAYED **

Goto section 13 - BSECT13

13

S13_INTRO

S13_INTRO

The next questions are about health insurance. Include health insurance obtained through employment or purchased directly as well as government programs like Medicare and Medicaid that provide Medical care or help pay medical bills.

1. Enter 1 to Continue

IF there are Medicare inventory records goto Medicare inventory block

ELSEIF there are 8500.MEDICAID = 1 OR 8500.CHIP = 1 OR 8500.IHS = 1 goto Medicaid/CHIP/IHS inventory block

ELSEIF there are single service or private insurance inventory records goto their inventory block

ELSEIF 8500.MILITARY = 1 goto their inventory block

ELSE goto screener block for new policies/coverage (detailed section)

13A - Medicare


MEM_NAME

** SHOW ONLY **


13A - Medicare

MDCRSTLL

MDCRSTLL

(Are/Is) (you/NAME) still enrolled in Medicare?

1. Yes
2. No

1: Goto MCCHOICA

2, DK, RF: goto MDCRSTLL for next person with HIC_STAT = 1
If no other active records then exit Medicare inventory block and goto next appropriate block

13A - Medicare

MCCHOICA

MCCHOICA

^MCCHOICA_NAME (are/is) (you/NAME) ^MCCHOICA_STILL in a Medicare Advantage plan?

^MCCHOICA_MedAdv

1. Yes
2. No

1: Goto MCPREMA

2,DK,RF: Goto MCHMOPLA

13A - Medicare

MCHMOPLA

MCHMOPLA

(are/is) (you/NAME) ^MCHMOPLA_STILL under a Medicare managed care arrangement, such as an HMO, that is, a Health Maintenance Organization? (With an HMO, you must generally receive care from HMO doctors, otherwise the expense is not covered unless you were referred by the HMO or there was a medical emergency.)

^MCHMOPLA_HMO

1. Yes
2. No

1: Goto MCPREMA

2,DK,RF: Goto MCPARTDA

13A - Medicare

MCPREMA

MCPREMA

Besides (your/NAME's) Medicare Part B payment, (are/is) (you/NAME) ^MCPREMA_still paying a premium for ^Yourhisher ^MCPREMA_advhmo plan?

1. Yes
2. No

1: Goto MCPRPTCA

2,DK,RF: Goto MCPARTDA

13A - Medicare

MCPRPTCA

MCPRPTCA

What is (your/NAME's) monthly premium for ^Yourhisher ^MCPREMA_advhmo plan?

IF ENTRY lt 5 or gt 1080 then goto ERR1_MCPRPTCA

ELSE goto MCPARTDA

13A - Medicare

MCPARTDA

MCPARTDA

(are/is) (you/NAME) ^MCPARTDA_still in Medicare Part D, also known as the Medicare Prescription Drug Plan?

Enter 'Yes' if the member changed to a different Medicare Part D plan.

1. Yes
2. No

1: Goto MCPRPTDA

2,DK,RF: Goto MDCRSTLL for next person with HIC_STAT = 1
If no other active records then exit Medicare inventory block and goto next appropriate block

13A - Medicare

MCPRPTDA

MCPRPTDA

What is (your/NAME's) monthly premium for ^Yourhisher Medicare Part D prescription drug plan?

IF ENTRY lt 5 or gt 100 then goto ERR1_MCPRPTDA

ELSE goto MDCRSTLL for next person with HIC_STAT = 1
If no other active records then exit Medicare inventory block and goto next appropriate block

13A - Medicaid

MDCRSTLL

MDCDSTLL

^Areis_CU_C (you/your household) still covered by Medicaid^MDCDSTfill?

1. Yes
2. No

1: Goto MEDPREMA

2,DK,RF: IF 8500.CHIP = 1 then goto CHIPSTLL
ELSEIF 8500.IHS = 1 then goto IHSSTLL
ELSE exit Medicaid/CHIP/IHS block and goto next appropriate block

13A - Medicaid

MEDPREMA

MEDPREMA

^MEDPREMA_fill (you/you or any members of your household) (still pay/pay) a premium for your Medicaid plan?

1. Yes
2. No

1: Goto MDCDPRXA

2,DK,RF: IF 8500.CHIP = 1 then goto CHIPSTLL
ELSEIF 8500.IHS = 1 then goto IHSSTLL
ELSE exit Medicaid/CHIP/IHS block and goto next appropriate block

13A - Medicaid

MDCDPRXA

MDCDPRXA

What is the monthly premium for this Medicaid plan?

IF ENTRY gt 100 then goto ERR1_MDCDPRXA

ELSEIF 8500.CHIP = 1 then goto CHIPSTLL

ELSEIF 8500.IHS = 1 then goto IHSSTLL

ELSE exit Medicaid/CHIP/IHS block and goto next appropriate block

13A - Medicaid

CHIPSTLL

CHIPSTLL

^Areis_CU_C (you/your household) still covered by the Children's Health Insurance Program (CHIP)^ST_CHIP?

1. Yes
2. No

1: Goto CHIPRMA

2,DK,RF: IF 8500.IHS = 1 then goto IHSSTLL
ELSE exit Medicaid/CHIP/IHS block and goto next appropriate block

13A - Medicaid

CHIPRMA

CHIPRMA

^CHIPRMA_fill (you/you or any members of your household) (still pay/pay) a premium for your CHIP^ST_CHIP plan?

1. Yes
2. No

1: Goto CHIPPRXA

2,DK,RF: IF 8500.IHS = 1 then goto IHSSTLL
ELSE exit Medicaid/CHIP/IHS block and goto next appropriate block

13A - Medicaid

CHIPPRXA

CHIPPRXA

What is the monthly premium for this CHIP^ST_CHIP plan?

IF ENTRY gt 100 then goto ERR1_CHIPPRXA

ELSEIF 8500.IHS = 1 then goto IHSSTLL

ELSE exit Medicaid/CHIP/IHS block and goto next appropriate block

13A - Medicaid

IHSSTLL

IHSSTLL

^Areis_CU_C (you/your household) still covered by the Indian Health Service (IHS)?

1. Yes
2. No

Exit Medicaid/CHIP/IHS block and goto next appropriate block

13A – Private Ins

HHISTILL

HHISTILL

(Do/Does) (you/your household) still have your ^PLNMGD_fill from (insurance company name)?

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type |Company |Deduction|Period|Payment|Total|Non-CU

1. Yes
2. No

IF 8500.HHIPRYOU = 2 then goto HHISTILL for the next active policy. If no more active policies, exit block and goto the next appropriate inventory block.

ELSE goto HHIANYPD

13A – Private Ins

HHIANYPD

HHIANYPD

Since the first of (reference month), have (you/you or any members of your household) made any payments on this policy (including payroll deductions/ )?

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type |Company |Deduction|Period|Payment|Total|Non-CU

1. Yes
2. No

1: IF 8500.HHIRPMPD = 1-9 then goto HHILSTTM
ELSE goto HHIRPMPA

2,DK,RF: Goto HHISTILL for the next active policy. If no more active policies, exit block and goto the next appropriate inventory block.

13A – Private Ins

HHILSTTM

HHILSTTM

Last time, I recorded that payments are made (periodicity). Is this still correct?

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type |Company |Deduction|Period|Payment|Total|Non-CU

1. Yes
2. No

1: Goto HHIREGXA

2, DK, RF: Goto HHIRPMPA

13A – Private Ins

HHIRPMPA

HHIRPMPA

How often are payments made (including payroll deductions/ )?

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type |Company |Deduction|Period|Payment|Total|Non-CU

1. Once a week
2. Once every 2 weeks
3. Twice a month
4. Once a month
5. Every 2 months
6. Quarterly (every 3 months)
7. Once every 4 months
8. Twice a year (every 6 months)
9. Once a year
10. Other

1-9: Goto HHIREGXA

10, DK, RF: Goto HHIPDAMT

13A – Private Ins

HHIREGXA

HHIREGXA

What is the amount currently paid (periodicity)? ^HHIRPMXB_fill

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type |Company |Deduction|Period|Payment|Total|Non-CU

If (HHIREGXA = ???) and (HHIREGXA ne DK or RF) then goto ERR1_HHIREGXA

ELSE goto HHISTILL for the next active policy. If no more active policies, exit block and goto the next appropriate inventory block.

13A – Private Ins

HHIPDAMT

HHIPDAMT

How much was paid since the first of (reference month) not including this month? ^HHIRPMXB_fill

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type |Company |Deduction|Period|Payment|Total|Non-CU

1-99999: IF (HHIPDAMT lt 6 or gt 1882) then goto ERR1_HHIPDAMT

ELSE goto HHISTILL for the next active policy. If no more active policies, exit block and goto the next appropriate inventory block.

DK,RF: Goto HHISTILL for the next active policy. If no more active policies, exit block and goto the next appropriate inventory block.

13A – Single Serv.

SSSTILL

SSSTILL

(Do/Does) (you/your household) still have your (dental care/long-term care/prescription/vision care/other) policy from (Single service insurance company name)?

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type | Company |Deduction|Period|Payment|Total|Non-CU

1. Yes
2. No

IF 8500.SSPRYOU = 2 then goto SSSTILL for the next active policy
If no more active policies, exit block and goto next appropriate inventory block.
ELSE goto SSANYPD

13A – Single Serv.

SSANYPD

SSANYPD

Since the first of (reference month), have (you/you or any members of your household) made any payments on this policy(including payroll deductions?/? )

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type | Company |Deduction|Period|Payment|Total|Non-CU

1. Yes
2. No

1: IF 8500.SSRPMPD = 1-9 then goto SSLSTTM
ELSE goto SSRPMPA

2,DK,RF: Goto SSSTILL for the next active policy
If no more active policies, exit block and
goto next appropriate inventory block.

13A – Single Serv.

SSLSTTM

SSLSTTM

Last time, I recorded that payments are made (periodicity). Is this still correct?

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type | Company |Deduction|Period|Payment|Total|Non-CU

1. Yes
2. No

1: Goto SSREGXA

2, DK, RF: Goto SSRPMPA

13A – Single Serv.

SSRPMPA

SSRPMPA

How often are payments made(including payroll deductions?/? )

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type | Company |Deduction|Period|Payment|Total|Non-CU


1. Once a week
2. Once every 2 weeks
3. Twice a month
4. Once a month
5. Every 2 months
6. Quarterly (every 3 months)
7. Once every 4 months
8. Twice a year (every 6 months)
9. Once a year
10. Other

1-9: Goto SSREGXA

10, DK, RF: Goto SSPDAMT

13A – Single Serv.

SSREGXA

SSREGXA

What is the amount currently paid (periodicity)?

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type | Company |Deduction|Period|Payment|Total|Non-CU

If ((8500.SSTYPE2 = 1 and SSREGXA lt 5 or gt 1700) or (8500.SSTYPE2 = 2 and SSREGXA lt 5 or gt 1882) or (8500.SSTYPE2 = 3 and SSREGXA lt 10 or gt 1341) or (8500.SSTYPE2 = 4 and SSREGXA lt 5 or gt 1080) or (8500.SSTYPE2 = 5 and SSREGXA lt 5 or gt 1080)) and (SSREGXA ne DK or RF) then goto ERR1_SSREGXA

Else goto SSSTILL for the next active policy
If no more active policies, exit block and goto next appropriate inventory block.

13A – Single Serv.

SSPDAMT

SSPDAMT

How much was paid since the first of (reference month)?

Policy|Insurance |Insurance|Payroll |Time | |Paid |Paid
# |Type | Company |Deduction|Period|Payment|Total|Non-CU

1-99999: IF (8500.SSTYPE2 = 1 and SSPDAMT lt 20 or gt 1700) OR (8500.SSTYPE2 = 2 and SSPDAMT lt 15 or gt 1882) OR (8500.SSTYPE2 = 3 and SSPDAMT lt 25 or gt 1341) OR (8500.SSTYPE2 = 4 and SSPDAMT lt 6 or gt 1080) OR (8500.SSTYPE2 = 5 and SSPDAMT lt 6 or gt 1080) then goto ERR1_SSPDAMT

ELSE goto SSSTILL for the next active policy
If no more active policies, exit block and
goto next appropriate inventory block.

DK,RF: Goto SSSTILL for the next active policy
If no more active policies, exit block and goto next appropriate inventory block.

13A - Military

MILOTSTL

MILOTSTL

^Areis_CU_C (you/your household) still covered by ^MILSPCOT_fill_Inv?

1. Yes
2. No

IF 8500.VACHAMP = 1 then goto MILVASTL

ELSEIF 8500.TRICARE = 1 then goto TRICRSTL

ELSE exit military inventory block and goto Part B

13A - Military

MILVASTL

MILVASTL

^Areis_CU_C (you/your household) still covered by (VA or CHAMP-VA/VA/CHAMP-VA)?

1. Yes
2. No

IF 8500.TRICARE = 1 then goto TRICRSTL

ELSE exit military inventory block and goto Part B

13A - Military

TRICRSTL

TRICRSTL

^Areis_CU_C (you/your household) still covered by (TRICARE Prime/TRICARE Extra/TRICARE Standard/TRICARE for Life/(other)/?

1. Yes
2. No

1: IF 8500.MILMAN = 4 then exit military inventory block and goto Part B
ELSE goto TRIANYPD

2,DK,RF: Exit military inventory block and goto Part B

13A - Military

TRIANYPD

TRIANYPD

Since the first of (reference month), have (you/you or any members of your household) made any payments for Tricare including payroll deductions?

1. Yes
2. No

1: IF 8500.TRIRPMPD = 1-9 then goto TRILSTTM
ELSE goto TRIRPMPA

2,DK,RF: Exit military inventory block and goto Part B

13A - Military

TRILSTTM

TRILSTTM

Last time, I recorded that payments are made ^PERIOD_Tri_Inv. Is this still correct?

1. Yes
2. No

1: Goto TRIREGXA

2,DK,RF: Goto TRIRPMPA

13A - Military

TRIRPMPA

TRIRPMPA

How often are payments made including any payroll deductions?


1. Once a week
2. Once every 2 weeks
3. Twice a month
4. Once a month
5. Every 2 months
6. Quarterly (every 3 months)
7. Once every 4 months
8. Twice a year (every 6 months)
9. Once a year
10. Other

1-9: Goto TRIREGXA

10, DK, RF: Goto TRIPDAMT

13A - Military

TRIREGXA

TRIREGXA

What is the amount currently paid ^PERIOD2_Tri_Inv?

IF ENTRY = ??? then goto ERR1_TRIREGXA

ELSE exit military inventory block and goto Part B

13A - Military

TRIPDAMT

TRIPDAMT

How much was paid since the first of (reference month) not including this month?

IF ENTRY = ??? then goto ERR1_TRIPDAMT

ELSE exit military inventory block and goto Part B

13B - Screening

FHICOV

FHICOV

(question text)

1. Yes
2. No

1, DK, RF: Goto HIKIND

2: IF NumPers65 ge 1 AND NumMCareInv = 0 then goto MCAREPRB
ELSEIF AnyInv = 0 then goto MCAIDPRB
ELSE goto Screener_END

13B - Screening

HIKIND

HIKIND

What (other kind/kind) of health insurance or health care coverage (do/does) (you/your household) have or pay for? INCLUDE those that pay for only one type of service (nursing home care, vision care, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.

Read each item on list
Enter all that apply, separate with commas

1. Private health insurance, including employer and healthcare exchange plans?
2. ^HIKINDOpt2_Fill
3. Medicare Supplemental Insurance (Medi-Gap)?
4. ^HIKINDOpt4_Fill
5. ^HIKINDOpt5_Fill
6. Military health care (Tricare/VA/CHAMP-VA)?
7. ^HIKINDOpt7_Fill
8. Single service plan (e.g., dental, vision, long-term care)?
9. No coverage of any type

DK,RF: IF NumPers65 ge 1 AND NumMCareInv = 0 then goto MCAREPRB
ELSEIF AnyInv = 0 then goto MCAIDPRB
ELSE goto Screener_END

1-8: IF (3 selected without 2 AND NumMCareInv = 0 then goto CK_HIKIND
ELSEIF (NumPers65 ge 1) AND (2 not selected in HIKIND) AND (NumMCareInv = 0) then goto MCAREPRB
ELSEIF (8 not selected in HIKIND) AND (NumSSInv = 0) then goto SINCOV
ELSE goto Screener_END

9: IF 1-8 also selected in HIKIND then goto ERR_HIKIND
ELSEIF (NumPers65 ge 1) AND (2 not selected in HIKIND) AND (NumMCareInv = 0) then goto MCAREPRB
ELSEIF AnyInv = 0 then goto MCAIDPRB
ELSE goto Screener_END

13B - Screening

MCAREPRB

MCAREPRB

^Areyou_Isanyone covered by Medicare?

1. Yes
2. No

IF (HIKIND = 9, DK, or RF) AND AnyInv = 0 then goto MCAIDPRB

ELSEIF 8 not selected in HIKIND AND NumSSInv = 0 then goto SINCOV

ELSE goto Screener_End

13B - Screening

MCAIDPRB

MCAIDPRB

There is a program called Medicaid that pays for health care for persons in need.
(In this state it is also called (program name). / )
^Areyou_Isanyone covered by Medicaid?


1. Yes
2. No

IF NumSSInv = 0 then goto SINCOV

ELSE goto Screener_END

13B - Screening

SINCOV

SINCOV

^Doyou_Doesanyone have or pay for a separate insurance plan that pays for only one type of service such as dental, vision, or long-term care?

1. Yes
2. No

Goto Screener_End

13B - Screening


Screener_End

** Not Displayed **

IF 2 selected in HIKIND OR MCAREPRB = 1 then goto MEDICARE
ELSEIF 4, 5, OR 7 selected in HIKIND OR MCAIDPRB = 1 then goto BlkMedicaid
ELSEIF 8 selected in HIKIND OR SINCOV = 1 then goto Tblsingleserv
ELSEIF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End

13B - Medicare

MEDICARE

MEDICARE

Who (else is/else) enrolled in Medicare?

Enter line numbers for all that apply, separate with commas.

1. Person 1
2. Person 2
3. Person 3
4. Person 4
5. Person 5
6. Person 6
7. Person 7
8. Person 8
9. Person 9
10. Person 10
11. Person 11
12. Person 12
13. Person 13
14. Person 14
15. Person 15
16. Person 16
17. Person 17
18. Person 18
19. Person 19
20. Person 20
21. Person 21
22. Person 22
23. Person 23
24. Person 24
25. Person 25
26. Person 26
27. Person 27
28. Person 28
29. Person 29
30. Person 30

Goto TblMEDICARE

13B - Medicare

MCCHOICE

MCCHOICE

Medicare Advantage is the new name for Medicare Plus Choice plans. (Are/Is) (you/NAME) enrolled in a Medicare Advantage plan?

1. Yes
2. No

1: Goto MCPREM

2, DK, RF: Goto MCHMOPLN

13B - Medicare

MCHMOPLN

MCHMOPLN

(Are/Is) (you/NAME) under a Medicare managed care arrangement, such as an HMO, that is, a Health Maintenance Organization? (With an HMO, you must generally receive care from HMO doctors, otherwise the expense is not covered unless you were referred by the HMO or there was a medical emergency.)

1. Yes
2. No

1: Goto MCPREM

2, DK, RF: Goto MCPARTD

13B - Medicare

MCPREM

MCPREM

Besides (your/NAME's) Medicare Part B payment, (are/is) (you/NAME) paying a premium for ^Yourhisher ^MCPREMA_advhmo plan?

1. Yes
2. No

1: Goto MCPRPTCX

2, DK, RF: Goto MCPARTD

13B - Medicare

MCPRPTCX

MCPRPTCX

What is (your/NAME's) monthly premium for ^Yourhisher ^MCPREMA_advhmo plan?

IF entry lt 5 or gt 1080 then goto ERR1_MCPRPTCX

ELSE goto MCPARTD

13B - Medicare

MCPARTD

MCPARTD

(Are/Is) (you/NAME) enrolled in Medicare Part D, also known as the Medicare Prescription Drug Plan?

1. Yes
2. No

1: Goto MCPRPTDX

2,DK,RF: Goto End_Person

13B - Medicare

MCPRPTDX

MCPRPTDX

What is (your/NAME's) monthly premium for ^Yourhisher Medicare Part D prescription drug plan?

IF entry lt 5 or gt 100 then goto ERR1_MCPRPTDX

ELSE goto End_Person

13B - Medicare


End_Person

** Not Displayed **

Goto MCCHOICE for the next appropriate person.

If no more persons than exit the medicare block and

IF 4, 5, OR 7 selected in HIKIND OR MCAIDPRB = 1 then goto BlkMedicaid
ELSEIF 8 selected in HIKIND OR SINCOV = 1 then goto Tblsingleserv
ELSEIF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto Partb_End

13B - Medicaid

MEDICAID

MEDICAID

Earlier I recorded that (you/your household) (are/is) covered by Medicaid^MDCDSTfill. Is that correct?

1. Yes
2. No

1: IF NUMHOUSE = 1 then goto MXCHNG
ELSE goto MDCDCOV

2,DK,RF: IF 5 selected in HIKIND then goto CHIP
ELSEIF 7 selected in HIKIND then goto IHS
ELSE exit Medicaid/CHIP/IHS block and
IF 8 selected in HIKIND OR SINCOV = 1 then goto Tblsingleserv
ELSEIF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End

13B - Medicaid

MDCDCOV

MDCDCOV

How many members of your household are covered by Medicaid^MDCDSTfill?

IF MDCDCOV gt number of CU members then goto CK_MDCDCOV

ELSE goto MXCHNG

13B - Medicaid

MXCHNG

MXCHNG

Was (your/your household's) Medicaid obtained through Healthcare.gov or the (Health Insurance Marketplace, such as (state name)/Health Insurance Marketplace)?

1. Yes
2. No

Goto MEDPREM

13B - Medicaid

MEDPREM

MEDPREM

A health insurance premium is the amount you or a family member pays each month for healthcare coverage. Do (you/you or anyone in your household) pay a premium for your Medicaid^MDCDSTfill plan?

1. Yes
2. No

1: Goto MDCDPRMX

2,DK,RF: IF 5 selected in HIKIND then goto CHIP
ELSEIF 7 selected in HIKIND then goto IHS
ELSE exit Medicaid/CHIP/IHS block and IF 8 selected in HIKIND OR SINCOV = 1 then goto Tblsingleserv
ELSEIF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End

13B - Medicaid

MDCDPRMX

MDCDPRMX

What is the monthly premium for this Medicaid^MDCDSTfill plan?

IF entry gt 100 then goto ERR1_MDCDPRMX
ELSEIF 5 selected in HIKIND then goto CHIP
ELSEIF 7 selected in HIKIND then goto IHS
ELSE exit Medicaid/CHIP/IHS block and IF 8 selected in HIKIND OR SINCOV = 1 then goto Tblsingleserv
ELSEIF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End

13B - Medicaid

CHIP

CHIP

Earlier I recorded that (you/your household) (are/is) covered by the Children's Health Insurance Program (CHIP)^ST_CHIP. Is that correct?

1. Yes
2. No

1: IF NUMHOUSE = 1 then goto CHXCHNG
ELSE goto CHIPCOV

2,DK,RF: IF 7 selected in HIKIND then goto IHS
ELSE exit Medicaid/CHIP/IHS block and IF 8 selected in HIKIND OR SINCOV = 1 then goto Tblsingleserv
ELSEIF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End

13B - Medicaid

CHIPCOV

CHIPCOV

How many members of your household are covered by CHIP^ST_CHIP?

IF CHIPCOV gt number of CU members then goto CK_CHIPCOV

ELSE goto CHXCHNG

13B - Medicaid

CHXCHNG

CHXCHNG

Was (your/your household's) CHIP plan obtained through Healthcare.gov or the (Health Insurance Marketplace, such as (state name)/Health Insurance Marketplace)?

1. Yes
2. No

Goto STRFPRM1

13B - Medicaid

STRFPRM1

STRFPRM1

A health insurance premium is the amount you or a family member pays each month for healthcare coverage. Do (you/you or anyone in your household) pay a premium for CHIP^ST_CHIP?

1. Yes
2. No

1: Goto CHIPPRMX

2,DK,RF: IF 7 selected in HIKIND then goto IHS
ELSE exit Medicaid/CHIP/IHS block and
IF 8 selected in HIKIND OR SINCOV = 1 then goto Tblsingleserv
ELSEIF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End

13B - Medicaid

CHIPPRMX

CHIPPRMX

What is the monthly premium for CHIP^ST_CHIP?

IF entry gt 100 then goto ERR1_CHIPPRMX
ELSEIF 7 selected in HIKIND then goto IHS
ELSE exit Medicaid/CHIP/IHS block and
IF 8 selected in HIKIND OR SINCOV = 1 then goto Tblsingleserv
ELSEIF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End

13B - Medicaid

IHS

IHS

Earlier I recorded that (you/your household) (are/is) covered by the Indian Health Service (IHS).
Is that correct?


1. Yes
2. No

1: IF NUMHOUSE = 1 then exit Medicaid/CHIP/IHS block and IF 8 selected in HIKIND OR SINCOV = 1 then goto Tblsingleserv
ELSEIF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End
ELSE goto IHSCOV

2,DK,RF: Exit Medicaid/CHIP/IHS block and IF 8 selected in HIKIND OR SINCOV = 1 then goto Tblsingleserv
ELSEIF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End

13B - Medicaid

IHSCOV

IHSCOV

How many members of your household are covered by IHS?

IF IHSCOV gt number of CU members then goto CK_IHSCOV

ELSE Exit Medicaid/CHIP/IHS block and IF 8 selected in HIKIND OR SINCOV = 1 then goto Tblsingleserv
ELSEIF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End

13B - Medicaid

SSTYPE

SSTYPE

(You mentioned that (you have/your household has) a single-service plan - that is, an insurance plan that provides one specific type of coverage.) Let's talk about your (first/next) single-service plan.
What type of service or care does your single-service plan pay for?


1. Dental care
2. Long-term care
3. Prescriptions
4. Vision care
5. Other (specify)
888. Delete the Line

1-4, DK, RF: Goto SSNSCMP

5: Goto SSOTHER

888: Goto SSMORE

13B – Single Serv.


PreFill

** SHOW ONLY **


13B – Single Serv.

SSOTHER

SSOTHER

Other type of single-service plan

Goto SSNSCMP

13B – Single Serv.

SSNSCMP

SSNSCMP

What is the name of the insurance company for this plan?

Enter name of insurance company, not the insurance agent

IF NUMHOUSE = 1 then goto SSGROUP
ELSE goto SSCOVQ

13B – Single Serv.

SSCOVQ

SSCOVQ

How many household members are/were covered by this plan?

1-30: IF SSCOVQ gt NUMHOUSE then goto CK_SSCOVQ
ELSE goto SSGROUP

DK,RF: Goto SSGROUP

13B – Single Serv.

SSGROUP

SSGROUP

Was the plan obtained on an individual or group basis?


1. Individually obtained
2. Group through place of employment
3. Group through other organization

Goto SSPRYOU

13B – Single Serv.

SSPRYOU

SSPRYOU

(Do/Does) (you/your household) pay ANY portion of the premiums for this plan?

1. Yes
2. No

1,DK,RF: Goto SSPRDED

2: Goto SSPROUT

13B – Single Serv.

SSPROUT

SSPROUT

Who pays the plan premiums?

1. An employer or union?
2. Another group or persons outside your household?

Goto SSMORE

13B – Single Serv.

SSPRDED

SSPRDED

Are any premiums paid through payroll deductions?


1. Yes
2. No

Goto SSRPMPD

13B – Single Serv.

SSRPMPD

SSRPMPD

How often are payments made for (entry for SSNSCMP/this plan ) (including payroll deductions/ )?


1. Once a week
2. Once every 2 weeks
3. Twice a month
4. Once a month
5. Every 2 months
6. Quarterly (every 3 months)
7. Once every 4 months
8. Twice a year (every 6 months)
9. Once a year
10. Other

1-9: Goto SSRPMXB

10,DK,RF: Goto SSRGXB

13B – Single Serv.

SSRPMXB

SSRPMXB

What is the amount currently paid (periodicity)?

1-99999: IF SSRPMXB = ??? then goto ERR1_SSRPMXB
ELSE goto SSMORE

DK,RF: Goto SSMORE

13B – Single Serv.

SSRGXB

SSRGXB

What was the total expense paid for this plan since (reference month) not including this month?

1-99999: IF SSRGXB = ??? then goto ERR1_SSRGXB
ELSE goto SSMORE

DK,RF: Goto SSMORE

13B – Single Serv.

SSMORE

SSMORE

(Do/Does) (you/your household) have any other single-service plans - that is, any other insurance plans that provide one specific type of coverage?



1. Yes
2. No

1: IF ROW number = 12 then goto ERR_MAX
ELSE goto SSTYPE for next plan, next line of grid

2,DK,RF: Exit single service block and
IF 1 OR 3 selected in HIKIND goto BlkPrivate
ELSEIF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End

13B – Private Ins.

HINSCMP

HINSCMP

^HINSCMP_fill
Let's talk about your (first/next) private health insurance plan.
What is the name of the insurance company for this plan?

Enter name of insurance company, not the insurance agent
Enter 888 to delete the line

IF 888 then goto HHIMORE
ELSEIF 3 selected in HIKIND then goto MEDIGAP
ELSEIF NUMHOUSE = 1 then goto PLNMGD
ELSE goto HHICOVQ

13B – Private Ins.

MEDIGAP

MEDIGAP

Is this a Medicare Supplemental Insurance plan?

Medicare Supplemental Insurance is also known as "Medi-Gap" insurance

1. Yes
2. No

IF NUMHOUSE = 1 then goto PLNMGD
ELSE goto HHICOVQ

13B – Private Ins.

HHICOVQ

HHICOVQ

How many household members are/were covered by this plan?

0-30: IF HHICOVQ greater than NUMHOUSE then goto CK_HHICOVQ
ELSEIF ((MEDIGAP = 1) AND (HHICOVQ gt TotalMedicare) then goto CK_HHICOVQ2
ELSE goto PLNMGD

DK,RF: Goto PLNMGD

13B – Private Ins.

PLNMGD

PLNMGD

Is this plan an HMO (Health Maintenance Organization), an IPA (Individual Practice Association), a PPO (Preferred Provider Organization), or fee-for-service?

1. HMO/IPA
2. PPO/Fee-for-service

1: Goto FSA

2,DK,RF: Goto HSAHRA

13B – Private Ins.

HSAHRA

HSAHRA

With this plan, is there a special account or fund that can be used to pay for medical expenses? The accounts are sometimes referred to as Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs), Personal Care accounts, Personal Medical funds, or Choice funds, and are different from Flexible Spending Accounts.

1. Yes
2. No

Goto FSA

13B – Private Ins.

FSA

FSA

Do (you/you or any members of your household) have a Flexible Spending Account for health expenses? These accounts are offered by some employers to allow employees to set aside pre-tax dollars of their own money for their use throughout the year to reimburse themselves for their out-of-pocket expenses for health care. With this type of account, any money remaining in the account at the end of the year, following a short grace period, is lost to the employee.

1. Yes
2. No

Goto HHIGROUP

13B – Private Ins.

HHIGROUP

HHIGROUP

Was the plan obtained on an individual or group basis?

1. Individually obtained
2. Group through place of employment
3. Group through other organization

1,3,DK,RF: Goto PORTAL

2: Goto HHIPRYOU

13B – Private Ins.

PORTAL

PORTAL

Was the plan obtained through ^ST_PORTAL Healthcare.gov?

1. Yes
2. No

1: Goto PORTPLAN

2,DK,RF: Goto HHIPRYOU

13B – Private Ins.

PORTPLAN

PORTPLAN

Is this plan a platinum, gold, silver, bronze, or catastrophic plan?

1. Platinum plan
2. Gold plan
3. Silver plan
4. Bronze plan
5. Catastrophic plan

Goto HHIPRYOU

13B – Private Ins.

HHIPRYOU

HHIPRYOU

(Do/Does) (you/your household) pay ANY portion of the premiums for this plan?

1. Yes
2. No

1,DK,RF: Goto HHIPRDED

2: Goto HHIPROUT

13B – Private Ins.

HHIPROUT

HHIPROUT

Who pays the policy premiums?

1. An employer or union?
2. Another group or persons outside your household?

IF PORTAL = 1 goto PREMSUBS
ELSE goto HHIMORE

13B – Private Ins.

HHIPRDED

HHIPRDED

Are any premiums paid through payroll deductions?


1. Yes
2. No

Goto HHIRPMPD

13B – Private Ins.

HHIRPMPD

HHIRPMPD

How often are payments made for (entry for HINSCMP/this plan ) (including payroll deductions/ )?


1. Once a week
2. Once every 2 weeks
3. Twice a month
4. Once a month
5. Every 2 months
6. Quarterly (every 3 months)
7. Once every 4 months
8. Twice a year (every 6 months)
9. Once a year
10. Other

1-9: Goto HHIRPMXB

10,DK,RF: Goto HHIIRGXB

13B – Private Ins.

HHIRPMXB

HHIRPMXB

What is the amount currently paid ^PERIOD_PI? ^HHIRPMXB_fill

1-99999: IF HHIRPMXB = ??? then goto ERR1_HHIRPMXB
ELSEIF PORTAL = 1 then goto PREMSUBS
ELSE goto HHIMORE

DK,RF: IF PORTAL = 1 then goto PREMSUBS
ELSE goto HHIMORE

13B – Private Ins.

HHIIRGXB

HHIIRGXB

What was the total expense paid for this plan since (reference month) not including this month? ^HHIRPMXB_fill

1-99999: IF HHIIRGXB = ??? then goto ERR1_HHIIRGXB
ELSEIF PORTAL = 1 then goto PREMSUBS
ELSE goto HHIMORE

DK,RF: IF PORTAL = 1 then goto PREMSUBS
ELSE goto HHIMORE

13B – Private Ins.

PREMSUBS

PREMSUBS

Is the cost of the premium subsidized based on (your/your household's) income?

Subsidized health coverage is insurance with a reduced premium. Low
and middle income families are eligible to receive tax credits that allow
them to pay lower premiums for insurance bought through healthcare
exchanges or marketplaces.


1. Yes
2. No

1: goto HHISUBPD

2, DK, RF: goto HHIMORE

13B – Private Ins.

HHISUBPD

HHISUBPD

Is the subsidy paid directly to the health insurance company?

1. Yes
2. No

Goto HHIMORE

13B – Private Ins.

HHIMORE

HHIMORE

(Do/Does) (you/you or any members of your household) have any other private health insurance plans?


1. Yes
2. No

1: IF ROW number = 12 then goto ERR_MAX
ELSE goto HINSCMP for next plan, next line of grid

2,DK,RF: Exit private insurance table and
IF 6 selected in HIKIND goto BlkMilitary
ELSE goto PartB_End

13B - Military

MILITARY

MILITARY

Earlier I recorded that (you/your household) are covered by military health care. Is that correct?

1. Yes
2. No

1: Goto MILSPC

2,DK,RF: Exit Military ins block and goto PartB_End

13B - Military

MILSPC

MILSPC

What (other types/types) of military health care (are/is) (you/your household) covered by?

Enter all that apply, separate with commas

1. ^MILSPCOpt1_fill
2. ^MILSPCOpt2_fill
3. ^MILSPCOpt3_fill
4. ^MILSPCOpt4_fill

1-4: IF 4 selected then goto MILSPCOT
ELSEIF 2 or 3 selected AND NUMHOUSE gt 1 then goto MILVACOV
ELSEIF 1 selected then goto MILMAN


DK, RF: Exit military block and goto PartB_End

13B - Military

MILSPCOT

MILSPCOT

Other military coverage - specify:

IF NUMHOUSE gt 1 then goto MILOTCOV

ELSEIF 1 selected in MILSPC then goto MILMAN

ELSE exit military block and goto PartB_End

13B - Military

MILOTCOV

MILOTCOV

How many members of your household are covered by ^MILSPCOT_fill?

IF MILOTCOV gt the number of CU members then goto CK_MILOTCOV

ELSEIF 2 or 3 selected in MILSPC then goto MILVACOV

ELSEIF 1 selected in MILSPC then goto MILMAN

ELSE exit military block and goto PartB_End

13B - Military

MILVACOV

MILVACOV

How many members of your household are covered by (VA or CHAMP-VA/VA/CHAMP-VA)?

IF MILVACOV gt the number of CU members then goto CK_MILVACOV

ELSEIF 1 selected in MILSPC then goto MILMAN

ELSE exit military block and goto PartB_End

13B - Military

MILMAN

MILMAN

Is your TRICARE plan - TRICARE Prime, TRICARE Extra, TRICARE Standard, or TRICARE for Life?

If more than one plan type, select 'other (specify)'

1. TRICARE Prime
2. TRICARE Extra
3. TRICARE Standard
4. TRICARE for Life
5. TRICARE other (specify)

1-3,DK,RF: Goto TRIRPMPD

4: Exit Military block and goto PartB_End

5: Goto MILMANOT

13B - Military

MILMANOT

MILMANOT

Other type of TRICARE coverage - specify:

Goto TRIRPMPD

13B - Military

TRIRPMPD

TRIRPMPD

How often are payments made for ^TRICARE_fill including payroll deductions?


1. Once a week
2. Once every 2 weeks
3. Twice a month
4. Once a month
5. Every 2 months
6. Quarterly (every 3 months)
7. Once every 4 months
8. Twice a year (every 6 months)
9. Once a year
10. Other

1-9: Goto TRIRPMXB

10,DK,RF: Goto TRIIRGXB

13B - Military

TRIRPMXB

TRIRPMXB

What is the amount currently paid (periodicity)?

If entry = ??? then goto ERR1_TRIRPMXB

Exit military block and goto PartB_End

13B - Military

TRIIRGXB

TRIIRGXB

What was the total expense paid for ^TRICARE_fill since (reference month) not including this month?

IF ENTRY = ??? then goto ERR1_TRIIRGXB

Else exit military block and goto PartB_End

13B


PartB_END

** Not displayed **

Exit Sect13 block and goto Section 14

14A

S14A_INTRO

S14AINTRO

35-36

Now I am going to ask some questions about medical payments and reimbursements. I will begin with your payments.

By payments I mean any co-pays and out-of-pocket expenses.
Include all payments, even those for persons who are outside of your household.

Description Amount Month
(MEDPDESC) (MEDPMTX) (MEDPMTMO)


1. Enter 1 to Continue

Goto BSect14.BTABLEA.BROW.ITEM

14A

MDB_ITEM

ITEM

SCREEN 1--------------------------------------------------------------
35 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) made any payments for the following?

Read each item on list

SCREEN 2 -------------------------------------------------------------------------
36 ? [F1]

Have (you/you or any members of your household) made any payments for --
Read each item on list

1. Eye examinations, treatment, or surgery
2. Purchase of eye glasses or contact lenses
3. Dental care
4. Hospital room or hospital services
5. Services by medical professionals other than physicians
6. Physician services
7. Lab tests or x-rays
8. Care in convalescent or nursing homes
9. Care for invalids, convalescents, handicapped, or elderly persons in the home
10. Adult day care centers
11. Other medical care and services
12. Hearing aids
13. Prescription drugs
14. Purchase or rental of supportive or rehabilitative equipment
15. Purchase or rental of medical or surgical equipment for general use
95. Continue List
99. None/No more entries
888. Delete a line

1-15: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

95: Goto next ROW

99: Goto S14A_END

888: IF no more rows then goto S14A_END
ELSE goto ITEM - next row of the table

14A


ServiceOrItem

** SHOW ONLY **


14A

MEDPDESC

DESCRIPTION

Ask if not apparent

Describe the care/service/item.

Description Amount Month
(MEDPDESC) (MEDPMTX) (MEDPMTMO)

IF ITEM = 5 then goto MEDPNOUT

ELSEIF ITEM = 14 or 15 then goto MEDPPRNT

ELSE goto MEDPGFTC

14A

MEDPNOUT

MEDPNOUT

Was this service provided inside or outside the home?

Description Amount Month
(MEDPDESC) (MEDPMTX) (MEDPMTMO)


1. Inside the home
2. Outside the home

Goto MEDPGFTC

14A

MEDPPRNT

MEDPPRNT

Ask if not apparent

Was this for a purchase or rental?

Description Amount Month
(MEDPDESC) (MEDPMTX) (MEDPMTMO)


1. Purchase
2. Rental

Goto MEDPGFTC

14A

MEDPGFTC

MEDPGFTC

Ask if not apparent

(Was/Were) the (description) for a member of your household or someone outside of your household?


Description Amount Month
(MEDPDESC) (MEDPMTX) (MEDPMTMO)


1. Household member
2. Non-household member

Goto MONTH

14A

MEDPMTMO

MONTH

In what month was(were) the payment(s) made?

^S15A_13Fill

Description Amount Month
(MEDPDESC) (MEDPMTX) (MEDPMTMO)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
13. ^S14_13Option

REF_MONTH - CUR_MONTH: IF (MONTH is not within the reference period) then goto ERR3_MONTH
ELSE goto AMOUNT

13,DK,RF: Goto AMOUNT

14A

MEDPMTX

AMOUNT

(What was the total amount paid in (month)?/What was the total amount paid?/What is your monthly expense?)

Description Amount Month
(MEDPDESC) (MEDPMTX) (MEDPMTMO)

1-999999: IF [(MEDPCARY = 110 and AMOUNT lt 5 or gt 2000) or (MEDPCARY = 120 and AMOUNT lt 10 or gt 450) or (MEDPCARY = 200 and AMOUNT lt 6 or gt 1400) or (MEDPCARY = 330 and AMOUNT lt 5 or gt 5000) or (MEDPCARY = 410 and AMOUNT lt 5 or gt 800) or (MEDPCARY = 420 and AMOUNT lt 5 or gt 379) or (MEDPCARY = 510 and AMOUNT lt 5 or gt 800) or (MEDPCARY = 520 and AMOUNT lt 15 or gt 8000) or (MEDPCARY = 530 and AMOUNT lt 5 or gt 650) or (MEDPCARY = 610 and AMOUNT lt 5 or gt 5000) or (MEDPCARY = 620 and AMOUNT lt 5 or gt 333) or (MEDPCARY = 635 and AMOUNT lt 6 or gt 1350) or (MEDPCARY = 655 and AMOUNT lt 5 or gt 500) or (MEDPCARY = 700 and AMOUNT lt 20 or gt 10,700) or (MEDPCARY = 710 and AMOUNT lt 5 or gt 1200) ] AND (MONTH ne 13) then goto ERR1_AMOUNT

ELSEIF MEDPCARY and AMOUNT for this record = data on the prechart/input AND (that prechart records MEDPMTMO does not equal 13) then goto ERR_DUP

ELSE goto C

DK,RF: Goto C

14A

MEDPCB_S

C

Enter 'C' for a combined expense

C: Goto COMBCODE

EMPTY: Goto MORE

IF anything other than 'C' or blank is entered then goto CK_C

14A

MEDPCMB

COMBCODE

35-36 ? [F1]

What is (description) combined with?

Enter all that apply, separate with commas

Description Amount Month
(MEDPDESC) (MEDPMTX) (MEDPMTMO)


1. Eye examinations, treatments, or surgery
2. Purchase of eye glasses or contact lenses
3. Dental care
4. Hospital room or hospital services
5. Services by medical professionals other than physicians
6. Physician services
7. Lab tests or x-rays
8. Care in convalescent or nursing homes
9. Care for invalids, convalescents, handicapped, or elderly persons in the home
10. Adult day care centers
11. Other medical care and services
12. Hearing aids
13. Prescription drugs
14. Purchase or rental of supportive or rehabilitative equipment
15. Purchase or rental of medical or surgical equipment for general use
77. Misc. combined (unable to specify/DK)

Goto MORE

14A

MEDPMORE

MORE

Did (you/you or any members of your household) make any other payments for (description)?

Description Amount Month
(MEDPDESC) (MEDPMTX) (MEDPMTMO)



1. Yes
2. No

1: IF ROW number = 40 then goto ERR_MAX
ELSE goto ITEM, next line on the grid

2,DK,RF: IF ROW number = 40 then goto S14A_END
ELSE goto ITEM, next line on the grid

14A


S14A_END

** Not Displayed **

Exit block and goto S14BINTRO

14B

S14B_INTRO

S14BINTRO

35-36

Now I am going to ask some questions about your reimbursements.

By reimbursements I mean any money received for any members of your household from an insurance company, medical care provider or non-household member for medical expenses which you previously paid or will pay.

^HSAHRAFSA_Fill

Description Amount Month
(MEDRDESC) (MEDRMBX) (MEDRMBMO)


1. Enter 1 to Continue

Goto ITEM

14B

MDC_ITEM

ITEM

SCREEN 1 ---------------------------------------------------------------------------------------

35 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) received any medical reimbursements for the items I just asked about?

IF YES - What did you get reimbursed for?

Read each item on list

SCREEN 2 ----------------------------------------------------------------------------------------
36 ? [F1]

IF YES - Have you received any reimbursements for --

Read each item on list

1. Eye examinations, treatment, or surgery
2. Purchase of eye glasses or contact lenses
3. Dental care
4. Hospital room or hospital services
5. Services by medical professionals other than physicians
6. Physician services
7. Lab tests or x-rays
8. Care in convalescent or nursing homes
9. Care for invalids, convalescents, handicapped, or elderly persons in the home
10. Adult day care centers
11. Other medical care and services
12. Hearing aids
13. Prescription drugs
14. Purchase or rental of supportive or rehabilitative equipment
15. Purchase or rental of medical or surgical equipment for general use
95. Continue List
99. None/No more entries
888. Delete a line

1-15: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

95: Goto next ROW

99: Goto S14B_END

888: IF no more grid lines then goto S14B_END
ELSE goto ITEM - next line of grid

14B


ServiceOrItem

** SHOW ONLY **


14B

MEDRDESC

DESCRIPTION

Ask if not apparent

Describe the care/service/item.

Description Amount Month
(MEDRDESC) (MEDRMBX) (MEDRMBMO)

IF ITEM = 5 then goto MEDRNOUT
ELSEIF ITEM = 14 or 15 then goto MEDRPRNT
ELSE goto MEDRGFTC

14B

MEDRPRNT

MEDRPRNT

Ask if not apparent

Was this for a purchase or rental?

Description Amount Month
(MEDRDESC) (MEDRMBX) (MEDRMBMO)



1. Purchase
2. Rental

Goto MEDRGFTC

14B

MEDRPNOUT

MEDRNOUT

Was this service provided inside or outside the home?

Description Amount Month
(MEDPDESC) (MEDPMTX) (MEDPMTMO)


1. Inside the home
2. Outside the home

Goto MEDRGFTC

14B

MEDRGFTC

MEDRGFTC

Ask if not apparent

(Was/Were) the (description) for a member of your household or someone outside of your household?

Description Amount Month
(MEDRDESC) (MEDRMBX) (MEDRMBMO)



1. Household member
2. Non-household member

Goto MONTH

14B

MEDRMBMO

MONTH

In what month was(were) the reimbursement(s) received?

Description Amount Month
(MEDRDESC) (MEDRMBX) (MEDRMBMO)



1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

REF_MONTH - CUR_MONTH: IF entry not within the reference period then goto ERR3_MONTH
ELSE goto AMOUNT

DK,RF: Goto AMOUNT

14B

MEDRMBX

AMOUNT

What was the total amount received (in month)?

Description Amount Month
(MEDRDESC) (MEDRMBX) (MEDRMBMO)

1-999999: IF (MEDRCARY = 110 and AMOUNT lt 5 or gt 2300) OR (MEDRCARY = 120 and AMOUNT lt 13 or gt 450) OR (MEDRCARY = 200 and AMOUNT lt 20 or gt 1400) OR (MEDRCARY = 330 and AMOUNT lt 5 or gt 5000) OR (MEDRCARY = 410 and AMOUNT lt 8 or gt 800) OR (MEDRCARY = 420 and AMOUNT lt 5 or gt 980) OR (MEDRCARY = 510 and AMOUNT lt 5 or gt 800) OR (MEDRCARY = 520 and AMOUNT lt 5 or gt 8000) OR (MEDRCARY = 530 and AMOUNT lt 5 or gt 650) OR (MEDRCARY = 610 and AMOUNT lt 10 or gt 3208) OR (MEDRCARY = 620 and AMOUNT lt 7 or gt 850) OR (MEDRCARY = 635 and AMOUNT lt 15 or gt 1350) OR (MEDRCARY = 655 and AMOUNT lt 32 or gt 500) OR (MEDRCARY = 700 and AMOUNT lt 20 or gt 10700) or (MEDRCARY = 710 and AMOUNT lt 5 or gt 1200) then goto ERR1_AMOUNT
ELSEIF MEDRCARY and the entry in AMOUNT for this record are equal to any records data in the pre-chart/input then goto ERR_DUP
ELSE goto C

DK,RF: Goto C

14B

MEDRCB_S

C

Enter 'C' for a combined reimbursement

C: Goto COMBCODE

EMPTY: Goto MORE

IF anything other than 'C' or the enter key is entered then goto CK_C

14B

MEDRCMB

COMBCODE

35-36 ? [F1]

What other medical reimbursement is (description) combined with?

Enter all that apply, separate with commas

Description Amount Month
(MEDRDESC) (MEDRMBX) (MEDRMBMO)



1. Eye examinations, treatments, or surgery
2. Purchase of eye glasses or contact lenses
3. Dental care
4. Hospital room or hospital services
5. Services by medical professionals other than physicians
6. Physician services
7. Lab tests or x-rays
8. Care in convalescent or nursing homes
9. Care for invalids, convalescents, handicapped, or elderly persons in the home
10. Adult day care centers
11. Other medical care and services
12. Hearing aids
13. Prescription drugs
14. Purchase or rental of supportive or rehabilitative equipment
15. Purchase or rental of medical or surgical equipment for general use
77. Misc. combined (unable to specify/DK)

Goto MORE

14B

MEDRMORE

MORE

Did (you/you or any members of your household) receive any other reimbursements for (description)?

Description Amount Month
(MEDRDESC) (MEDRMBX) (MEDRMBMO)


1. Yes
2. No

1: IF ROW number = 22 then goto ERR_MAX
ELSE goto ITEM, next line of grid

2,DK,RF: IF ROW number = 22 then goto S14B_END
ELSE goto ITEM, next line of grid

14B


S14B_END

** Not Displayed **

Exit block and goto Section 15 - BSect15

15A

S15A1_INTRO

S15A1_INTRO

33

Now I am going to ask about your non-health insurance policies.
(Include policies paid by your household for someone outside your household./ )

Policy|Insurance | |Insurance|Paid|Payroll |Payment|Paid |Time
Number|Description|Type| Company | By |Deduction|Period |Total|Period |Payment


1. Enter 1 to Continue

IF there are any active Policies listed on the inventory chart (850023.PLCYSTAB <> 1) then goto BSect15A Block

ELSE goto S13A_END

15A

PLCYSTIL

PLCYSTIL

Do (you/you or any members of your household) still have or make payments for the (life or disability/auto/homeowner's/tenants'/other type of non-health) insurance policy from (Insurance Company)?

Policy|Insurance | |Insurance|Paid|Payroll |Payment|Paid |Time
Number|Description|Type| Company | By |Deduction|Period |Total|Period |Payment


1. Yes
2. No

IF 850025.PREMYOU = 2 then goto S15A_END
ELSE goto INSEX3A

15A

INSEX3A

INSEX3A

Since the first of (reference month) not including this month, have you had any expenses for this policy?

Policy|Insurance | |Insurance|Paid|Payroll |Payment|Paid |Time
Number|Description|Type| Company | By |Deduction|Period |Total|Period|Payment



1. Yes
2. No

1: IF 850025.INSRPMPD = 1-9 then goto INSLSTTM
ELSE goto INSRPMPA

2,DK,RF: Goto S15A_END

15A

INSLSTTM

INSLSTTM

Last time, I recorded that payments are made (once a week/once every 2 weeks/twice a month/once a month/every 2 months/every 3 months/every 4 months/every 6 months/once a year).
Is that still correct?

Policy|Insurance | |Insurance|Paid|Payroll |Payment|Paid |Time
Number|Description|Type| Company | By |Deduction|Period |Total|Period|Payment



1. Yes
2. No

1: Goto INSREGXA

2,DK,RF: Goto INSRPMPA

15A

INSRPMPA

INSRPMPA

How often are payments made( including payroll deductions?/?)

Policy |Insurance | |Insurance |Paid|Payroll |Payment|Paid | Time
Number|Description|Type| Company | By |Deduction|Period |Total | Period |Payment



1. Once a week
2. Once every 2 weeks
3. Twice a month
4. Once a month
5. Every 2 months
6. Quarterly (every 3 months)
7. Once every 4 months
8. Twice a year (every 6 months)
9. Once a year
10. Other

1-9: Goto INSREGXA

10,DK,RF: Goto INSEX3AX

15A

INSREGXA

INSREGXA

What is the amount currently paid(Periodicity)?/?)

Policy|Insurance | |Insurance|Paid|Payroll |Payment|Paid |Time
Number|Description|Type| Company | By |Deduction|Period |Total|Period|Payment


Goto S15A_END

15A

INSEX3AX

INSEX3AX

Since the first of (reference month) not including this month, how much was paid?

Policy|Insurance | |Insurance|Paid|Payroll |Payment|Paid |Time
Number|Description|Type| Company | By |Deduction|Period |Total|Period|Payment

1-99999: IF (850025.POLICYYB = 100 and INSEX3AX gt 750) OR (850025.POLICYYB = 200 and INSEX3AX gt 1100) OR (850025.POLICYYB = 300 and INSEX3AX gt 1000) OR (850025.POLICYYB = 400 and INSEX3AX gt 340) OR (850025.POLICYYB = 500 and INSEX3AX gt 936) then goto ERR1_INSEX3AX
ELSE goto S15A_END

DK,RF: Goto S15A_END

15A


S15A_END

** Non Displayed **

IF no more active policies in the table then exit block and goto BTableB - S15B

ELSE goto PLCYSTIL for then next active policy

15B

INB_ITEM

ITEM

33 ? [F1]

(Do ^YOU_ANYMEM have any or pay for any -/Since the first of ^REF_MONTH have ^YOU_ANYMEM purchased o

Read each item on list

1. Life insurance or other policies which provide benefits in case of death or disability?
2. Homeowners' insurance?
3. Renters' insurance?
4. Automobile or other vehicle insurance?
5. Other types of non-health insurance?
99. None/No more entries
888. Delete a line

1-5: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto INSCOMP

99: Goto S15B_END

888: IF no more rows in the table then goto S15B_END
ELSE goto ITEM - next row of the table

15B


PreFill

** SHOW ONLY **


15B

INSCOMP

INSCOMP

What is the name of the insurance company for your (long term care/life or disability/homeowners'/tenants'/vehicle/other type of insurance) policy?

Enter name of insurance company, not the insurance agent.

Goto INSDESC

15B

INSDESC

DESCRIPTION

Briefly describe the policy.

IF ITEM = 2 then goto INSPROP
ELSE goto PREMYOU

15B

INSPROP

INSPROP

Which property (ies) does this policy cover?

Enter number of each property covered, separate with commas.


1. PROPDESC[1]
2. PROPDESC[2]
3. PROPDESC[3]
4. PROPDESC[4]
5. PROPDESC[5]
6. PROPDESC[6]
7. PROPDESC[7]
8. PROPDESC[8]
9. PROPDESC[9]
10. PROPDESC[10]
11. PROPDESC[11]
12. PROPDESC[12]
13. PROPDESC[13
14. PROPDESC[14]
15. PROPDESC[15]
16. PROPDESC[16]
17. PROPDESC[17]
18. PROPDESC[18]
19. PROPDESC[19]
20. PROPDESC[20]
99. Property not owned or rented by the household

1-20: IF any entry is higher than the number of properties or a blank answer list option then goto CK_INSPROP
ELSE goto PREMYOU

99,DK,RF: Goto PREMYOU

15B

PREMYOU

PREMYOU

(Do/Does) (you/your household) pay ANY portion of the premiums for this policy?

1. Yes
2. No

1, DK, RF: Goto PAYDEDPR

2: Goto PREMOUT

15B

PREMOUT

PREMOUT

Who pays the policy premiums?

1. An employer or union?
2. Another group or persons outside your household?

Goto C

15B

PAYDEDPR

PAYDEDPR

Are any premiums paid through payroll deductions?


1. Yes
2. No

Goto INSRPMPD

15B

INSRPMPD

INSRPMPD

How often are payments made( including payroll deductions?/?)

1. Once a week
2. Once every 2 weeks
3. Twice a month
4. Once a month
5. Every 2 months
6. Quarterly (every 3 months)
7. Once every 4 months
8. Twice a year (every 6 months)
9. Once a year
10. Other

1-9: Goto INSRPMXB

10,DK,RF: Goto INSEXPBX

15B

INSRPMXB

INSRPMXB

What is the amount currently paid (once a week/once every 2 weeks/twice a month/once a month/every 2 months/every 3 months/every 4 months/every 6 months/once a year)( including payroll deductions?/?)

Goto C

15B

INSEXPBX

INSEXPBX

Since the first of (reference month) not including this month, what was (your/your household's) total expense for this insurance policy?

Enter the actual amount the household paid. Do not include any expenses paid for the household by others.

1-99999: IF (ITEM = 1 and INSEXPBX gt 750) OR (ITEM = 2 and INSEXPBX gt 1000) OR (ITEM = 3 and INSEXPBX gt 340) OR (ITEM = 4 and INSEXPBX gt 1100) OR (ITEM = 5 and INSEXPBX gt 936) then goto ERR1_INSEXPBX
ELSE goto C

0,DK,RF: Goto C

15B

S15_S

C

Enter "C" for a combined expense

C: Goto COMBCODE

EMPTY: Goto MORE

IF anything other than a 'C' or the enter key is entered then goto CK_C

15B

S15CMB

COMBCODE

33 ? [F1]

What other type of policy is the (Insurance type) combined with?

Enter all that apply, separate with commas.


1. Life insurance or other policies which provide benefits in case of death or disability
2. Homeowners' insurance
3. Renters' insurance
4. Automobile or other vehicle insurance
5. Other types of non-health insurance
77. Misc. combined (unable to specify/DK)

IF 2 is selected then goto COMBPROP
ELSE goto MORE

15B

S15CMBPROP

COMBPROP

Which property (ies) did this policy cover?

Enter number of each property covered, separate with commas.


1. PROPDESC[1]
2. PROPDESC[2]
3. PROPDESC[3]
4. PROPDESC[4]
5. PROPDESC[5]
6. PROPDESC[6]
7. PROPDESC[7]
8. PROPDESC[8]
9. PROPDESC[9]
10. PROPDESC[10]
11. PROPDESC[11]
12. PROPDESC[12]
13. PROPDESC[13
14. PROPDESC[14]
15. PROPDESC[15]
16. PROPDESC[16]
17. PROPDESC[17]
18. PROPDESC[18]
19. PROPDESC[19]
20. PROPDESC[20]
99. Property not owned or rented by the household

1-20: IF any entry is higher than the number of properties or a blank answer list option then goto CK_COMBPROP
ELSE goto MORE

99,DK,RF: Goto MORE

15B

INSMORE

MORE

(Do ^You_Anymem have any or make payments for any other ^inbdescription policy?/Did ^you_Anymem purchase or begin paying for any other ^inbdescritpion

1. Yes
2. No

1: IF Row number = 100 then goto ERR_MAX
ELSE goto ITEM, next row of the table

2,DK,RF: IF Row number = 100 then goto S15B_END
ELSE goto ITEM, next row of the table

16

EDA_INTRO

EDA_INTRO

37

Now I am going to ask about education expenses. Please include any direct payments made for any members of your household or for anyone outside your household and any payments you made online or had automatically deducted.

Do NOT include payments made on student loans

Description Type Month Amount
(EDUDESC) (EDSHL_A) (EDMONTHA) (EDEXOXA)



1. Enter 1 to Continue

Goto BTableA.Brow.ITEM

16

EDA_ITEM

ITEM

37 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) paid for any -

Read each item on list.
Baby sitting and in home day care are collected in Section 19A
Do not include payments on student loans. They are collected in Section 22.

1. Recreational lessons or other instructions?
2. Preschool or child day care centers?
3. Tuition, including pre-paid tuition?
4. Housing while attending school?
5. Food or board while attending school?
6. Private school bus service?
7. Test preparation or tutoring services?
8. Purchase of any school books, supplies, or equipment which has not already been reported?
9. Other school related expenses not already reported?
99. None/No more entries
888. Delete the line

1-9: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

99: Goto S16_END

888: IF no more grid lines then goto S16_END
ELSE goto ITEM - next line of grid

16


PreFill

** SHOW ONLY **


16

EDUDESC

DESCRIPTION

What was the expense for?

Description Type Month Amount
(EDUDESC) (EDSHL_A) (EDMONTHA) (EDEXOXA)

Goto WHO

16

EDUCGFTC

WHO

Was this expense for?

Description Type Month Amount
(EDUDESC) (EDSHL_A) (EDMONTHA) (EDEXOXA)



1. Someone inside the household?
2. Someone outside the household?

IF ITEM = 3 or 8 then goto SCHOOL
ELSE goto MONTH

16

EDSCHL_A

SCHOOL

Ask if not apparent.

What kind of school or facility was it?


Description Type Month Amount
(EDUDESC) (EDSHL_A) (EDMONTHA) (EDEXOXA)



1. College or university
2. Elementary through high school
3. Child day care center
4. Nursery school or preschool
5. Vocational or technical school
6. Other

Goto MONTH

16

EDMONTHA

MONTH

In what month was the payment made?

Enter 13 for same amount each month of the reference period.

Description Type Month Amount
(EDUDESC) (EDSHL_A) (EDMONTHA) (EDEXOXA)



1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
13. Same amount each month.

REF_MONTH - CUR_MONTH: IF entry not in reference period then goto ERR3_MONTH
ELSE goto AMOUNT

13,DK,RF: Goto AMOUNT

16

EDEXOXA

AMOUNT

(How much was paid?/How much is paid monthly?)

Description Type Month Amount
(EDUDESC) (EDSHL_A) (EDMONTHA) (EDEXOXA)

1-999999: IF (EDUC_AY = 100 and AMOUNT lt 10 or gt 544) OR (EDUC_AY = 200 and AMOUNT lt 20 or gt 1120) OR (EDUC_AY = 300 and AMOUNT lt 28 or gt 6000) OR (EDUC_AY = 310 and AMOUNT lt 35 or gt 3000) OR (EDUC_AY = 320 and AMOUNT lt 10 or gt 1980) OR (EDUC_AY = 340 and AMOUNT lt 10 or gt 465) OR (EDUC_AY = 345 and AMOUNT lt 5 or gt 600) OR (EDUC_AY = 350 and AMOUNT lt 5 or gt 500) OR (EDUC_AY = 360 and AMOUNT lt 5 or gt 600) then goto ERR1_AMOUNT
ELSEIF EDUC_AY and the entry in AMOUNT for this record are equal to any records data in the prechart/input AND (that prechart records EDMONTHA does not equal 13) then goto ERR_DUP
ELSE goto C

DK,RF: Goto C

16

EDUCMB_S

C

Enter 'C' for a combined expense

C: Goto COMBCODE

EMPTY: Goto REIMB

IF any entry other than a 'C' or the enter key is entered then goto CK_C

16

EDUCMB

COMBCODE

37 ? [F1]

What was combined with (Description)?

Enter all that apply, separate with commas

Description Type Month Amount
(EDUDESC) (EDSHL_A) (EDMONTHA) (EDEXOXA)



1. Recreational lessons or other instructions
2. Preschool or child day care centers
3. Tuition, including pre-paid tuition
4. Housing while attending school
5. Food or board while attending school
6. Private school bus service
7. Test preparation or tutoring services
8. Purchase of any school books, supplies, or equipment which has not already been reported
9. Other school related expenses not already reported
77. Misc. combined (unable to specify/DK)

Goto REIMB

16

EDREIMB

REIMB

Has any of this amount been or will any of it be reimbursed
by an employer, agency, or other person?

Do not include reimbursements from dependent flexible spending accounts (FSA).

Description Type Month Amount
(EDUDESC) (EDSHL_A) (EDMONTHA) (EDEXOXA)



1. Yes
2. No

1: Goto REIMBX

2,DK,RF: Goto MORE

16

EDREIMBX

REIMBX

How much was or will be reimbursed?

Do not include reimbursements from dependent flexible spending accounts (FSA).

Description Type Month Amount
(EDUDESC) (EDSHL_A) (EDMONTHA) (EDEXOXA)

1-999999: IF entry lt 15 or gt 6000 then goto ERR1_REIMBX
ELSE goto MORE

DK,RF: Goto MORE

16

EDUMORE

MORE

Did you make any other payments for (Description)?

Description Type Month Amount
(EDUDESC) (EDSHL_A) (EDMONTHA) (EDEXOXA)



1. Yes
2. No

1: IF ROW number = 34 then goto ERR_MAX
ELSE goto ITEM, next line of grid

2,DK,RF: IF ROW number = 34 then goto S16_END
ELSE goto ITEM, next line of grid

16


S16_END

** Non displayed **

Goto Section 17 - BSECT17

17

SUB_INTRO

SUB_INTRO

38-39

Now I am going to ask about expenses for subscriptions, memberships, books, and entertainment. Please remember to include any payments you made online or had automatically deducted. Also, include any shipping and handling charges with the cost of any item that was shipped.

Description Month Amount
(SUBDESC) (SUBMO) (SUBEXPX)



1. Enter 1 to Continue

Goto BTableA.Brow.ITEM

17

SUB_ITEM

ITEM

SCREEN 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

38 ? [F1]

Since the first of (reference month) have (you/you or any members of your household) had any membership costs or other expenses related to any of the following? Do not include contributions to or membership in religious, professional, business, or other tax deductible organizations.

Read each item on list.


SCREEN 2 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

38 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) purchased any of the following items for your household or for someone outside your household?

Read each item on list


SCREEN 3 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

39 ? [F1]

Have you purchased any -

Read each item on list
Report blank tapes, CDs, and DVDs in Section 6B under item code 11

1. Golf courses or country clubs
2. Health clubs, fitness centers, swimming pools, weight loss centers, or other sports or recreational organizations
3. Fees for participating in sports such as golf, bowling, biking, hockey, football, or swimming
4. Vacation clubs
5. Civic, service, fraternal, or other social organizations
6. Credit card membership fees
7. Shopping club memberships including warehouse clubs like Sam's Club and discount memberships like Amazon Prime
8. Direct or online dating services
9. Single or season tickets to spectator sports events such as football, baseball, hockey racing, or track events
10. Single or season tickets to plays, operas, or concerts
11. Movie tickets
12. Tickets to parks or museums
13. Single copies of newspapers, magazines, or periodicals, including digital
14. Subscriptions to newspapers, magazines, or periodicals, including digital
15. Books, digital books, or book subscriptions. Do not include school books or reference books.
16. Photo printing or processing
17. Photographic film or disposable cameras
18. Purchased music files, CDs, or records
19. Sirius or XM satellite radio service
20. Subscription music services such as Spotify or Pandora
21. Purchased video files, Blu-Ray discs, or DVDs
22. Rented video files or DVDs or streaming video subscriptions
23. Purchased video games, not including computer games
24. Rented video games
25. Applications, games, or ringtones for a cellphone or mobile device, not already reported
26. Online games or other internet entertainment sites

1-26: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

95: Goto next row

99: Goto S17A_END

888: IF no more grid lines goto S17A_END
ELSE goto ITEM - next line of grid

17


PreFill

** SHOW ONLY **


17

SUBDESC

DESCRIPTION

(What is the name of the (Description))? / )

(* Ask if not apparent: Describe the item./ )

Description Month Amount
(SUBDESC) (SUBMO) (SUBEXPX)


Goto WHO

17

S17GFTCA

WHO

Was this purchase for your household or someone outside your household?

Description Month Amount
(SUBDESC) (SUBMO) (SUBEXPX)



1. For household
2. For someone outside your household

Goto MONTH

17

SUBMO

MONTH

In what month did you have this expense?

(* Enter 13 for same amount each month of the reference period/ )

Description Month Amount
(SUBDESC) (SUBMO) (SUBEXPX)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
13. ^S17_13Option

REF_MONTH - CUR_MONTH: Goto AMOUNT

13: IF ITEM = 3-7, 9-14, 16-18, 21, 23, 25, or 26 then
goto CK_MONTH
ELSE goto AMOUNT

DK, RF: go to AMOUNT

17

SUBEXPX

AMOUNT

(What was the total amount of this expense?/What is ^YR_YRCUS monthly expense?) ((Include shipping and handling fees./ ))

(Include ticket/admission service fees and surcharges/ )

Description Month Amount
(SUBDESC) (SUBMO) (SUBEXPX)

If (ITEM = 1 or 2 and AMOUNT lt 5 or gt 1060) OR (ITEM = 3 and AMOUNT lt 6 or gt 750) OR (ITEM = 4 and AMOUNT lt 800 or gt 10,000) OR (ITEM = 5 and AMOUNT lt 5 or gt 300) OR (ITEM = 6 and AMOUNT lt 5 or gt 300) OR (ITEM = 7 and AMOUNT lt 5 or gt 300) OR (ITEM = 8 and AMOUNT lt 5 or gt 1200) OR (ITEM = 9 and AMOUNT lt 5 or gt 2500) OR (ITEM = 10 and AMOUNT lt 5 or gt 720) OR (ITEM = 11 and AMOUNT lt 1 or gt 100) OR (ITEM = 12 and AMOUNT lt 5 or gt 320) OR (ITEM = 13 and AMOUNT lt 5 or gt 250) OR (ITEM = 14 and AMOUNT lt 7 or gt 145) OR (ITEM = 15 and AMOUNT lt 5 or gt 300) OR (ITEM = 16 and AMOUNT lt 5 or gt 150) OR (ITEM = 17 and AMOUNT lt 5 or gt 100) OR (ITEM = 18 and AMOUNT lt 1 or gt 250) OR (ITEM = 19 and AMOUNT lt 5 or gt 500) OR (ITEM = 20 and AMOUNT lt 1 or gt 100) OR (ITEM = 21 and AMOUNT lt 1 or gt 209) OR (ITEM = 22 and AMOUNT lt 1 or gt 150) OR (ITEM = 23 and AMOUNT lt 8 or gt 200) OR (ITEM = 24 and AMOUNT lt 8 or gt 390) OR (ITEM = 25 and AMOUNT lt 1 or gt 30) OR (ITEM = 26 and AMOUNT lt 1 or gt 50) then goto ERR1_AMOUNT

ELSEIF ITEMCODEOUT and the entry in AMOUNT for this record are equal to any records data on the pre-chart/Input then goto ERR_DUP

ELSEIF ITEM = 18, 21, 22, or 25, goto C

ELSE goto MORE

17

S17ACM_S

C

Enter a 'C' for a combined expense.

Description Month Amount
(SUBDESC) (SUBMO) (SUBEXPX)

C: goto COMBCODE
empty: IF (ITEM = 18 or 21) AND RT8100.POPGRP = 11 then goto SUBSTORE
ELSE goto MORE

If anything other than a 'C' or the Enter key is entered goto CK_C

17

S17ACMB

COMBCODE

39 ? [F1]

What other expense is the (description) combined with?

Enter all that apply, separate with commas.

Description Month Amount
(SUBDESC) (SUBMO) (SUBEXPX)


18. Purchased music files, CDs, or records
21. Purchased video files, Blu-Ray discs, or DVDs
22. Rented video files or DVDs or streaming video subscriptions
25. Applications, games, or ringtones for a cellphone or mobile device not already reported

IF (ITEM = 18 or 21) AND RT8100.POPGRP = 11 then goto SUBSTORE
ELSE goto MORE

17

SUBSTORE

SUBSTORE

Where were the (description) purchased?

Enter store, website, or company name

IF uppercase version of the entry = "GROUPON" or "GROUPON.COM" then goto ERR_GROUPON

ELSEIF ENTRY contains ".com", ".Com", ".cOm", ".coM", ".COm", ".CoM", ".cOM", or ".COM", then goto MORE

ELSEIF ENTRY = DK or RF then goto MORE

ELSE goto SUBPURCH

17

SUBPURCH

SUBPURCH

Ask if not apparent:

Was this purchased online or in-person?


1. Online
2. In person
3. Other (phone, mail, catalog)

1,3,DK,RF: Goto MORE

2: Goto SUBLOC

17

SUBLOC

SUBLOC

Where is ^SUBSTORE_fill located?

Enter city and state

Goto MORE

17

S17AOTHR

MORE

Did you (purchase/pay for renting/pay for) any other (description)?

Description Month Amount
(SUBDESC) (SUBMO) (SUBEXPX)



1. Yes
2. No

1: IF ROW number = 40 then goto ERR_MAX
ELSE goto ITEM, next line of grid

2,DK,RF: Goto ITEM, next line of grid

17


S17A_END

** Non Displayed **

Goto Section 18 - BSect18

18A

ANYOUTSD

ANYOUTSD

Now I am going to ask about trips and vacations.
Since the first of (reference month) have (you/you or any members of your household) taken any trips entirely paid for by anyone outside your household, such as a business, employer, or relative?


1. Yes
2. No

1: Goto NUMOUTSD

2,DK,RF: IF I_18Acoun gt 0 then goto TBLSECT18A_1
ELSE goto ANYTRIPS

18A

NUMOUTSD

NUMOUTSD

How many?

Goto ANYYUPD

18A

ANYYUPD

ANYYUPD

Even on trips entirely paid for by someone outside of your household there are sometimes miscellaneous expenses which are not paid for. Did (you/your household) have any expenses on (this trip/these trips) that will not be covered by a business, employer or other non-household member?


1. Yes
2. No

1: Goto FOODYUPD

2,DK,RF: Goto CHKUNTRP

18A

FOODYUPD

FOODYUPD

Did these expenses include anything for . . .

. . . Food and beverages?


1. Yes
2. No

Goto LODGYUPD

18A

LODGYUPD

LODGYUPD

Did these expenses include anything for . . .

. . . Lodging?


1. Yes
2. No

Goto TRANYUPD

18A

TRANYUPD

TRANYUPD

Did these expenses include anything for . . .

. . . Transportation?


1. Yes
2. No

Goto ELSEYUPD

18A

ELSEYUPD

ELSEYUPD

Did these expenses include . . .

. . . Anything else?


1. Yes
2. No

1: Goto S18AELSE

2,DK,RF: Goto TOTYUPDX

18A

S18AELSE

S18AELSE

Specify:

Goto TOTYUPDX

18A

TOTYUPDX

TOTYUPDX

What was the total amount of these expenses?

1-99999999: IF entry lt 5 or gt 1200 then goto ERR1_TOTYUPDX
ELSE goto CHKUNTRP

DK,RF: Goto CHKUNTRP

18A1


PLACENAME

** SHOW ONLY **


18A1

ENDTRP1

ENDTRP1

(Last interview you reported (# of unfinished trips) (trip/trips) which had not yet ended. I'd like to ask about (that trip/those trips) now. / )

In what month did your trip to (place word for 8500.TRIPPLAC) end?

Destination Ended How paid Number of trips
(TRPPLACE) (ENDTRP2) (ANYBOTH2) (NUMTRIPS)



0. Trip not ended
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

0: IF no more unended trips then exit block and
goto ANYTRIPS
ELSE goto next line on grid


REF_MONTH - CUR_MONTH: IF ENDTRP1 is not within reference period then goto ERR3_ENDTRP1
ELSE goto ANYBOTH1

DK,RF: Goto ANYBOTH1

18A1

ANYBOTH1

ANYBOTH1

Did a business, employer, or any other non-household member pay any of
the costs for this trip?


1. Yes
2. No

IF no more unended trips then exit the block and goto ANYTRIPS

ELSE goto ENDTRP1, next line of grid

18A2

ANYTRIPS

ANYTRIPS

40 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) taken (any trips/any other trips) for reasons such as:

* Visiting relatives or friends?
* Business?
* Recreational trips?
* Other trips overnight or longer?
* Day trips of at least 75 miles away from home?



1. Yes
2. No

1: Goto TRPPLACE

2,DK,RF: Goto S18A_END

18A2

TRIPPLAC

TRIPPLAC

Where did (you/your household) go?

Enter 888 to delete the trip

Destination Ended How paid Number of trips
(TRPPLACE) (ENDTRP2) (ANYBOTH2) (NUMTRIPS)

30 characters: Goto DESTCODE

888: Goto S18MORE

18A2

DESTCODE

DESTCODE

? [F1]

Type state abbreviation for a U.S. destination or X for foreign country destination

Destination Ended How paid Number of trips
(TRPPLACE) (ENDTRP2) (ANYBOTH2) (NUMTRIPS)

2 character state abbrev.,DK,RF: Goto ENDTRP2

X: Goto FOREIGN

18A2


PLACE

** SHOW ONLY **


18A2

FOREIGN

FOREIGN

Select the country or region.


1. Africa
2. Asia
3. Australia
4. Canada
5. Caribbean
6. Central America
7. Europe
8. Mexico
9. Middle East
10. South America
11. South Pacific

Goto ENDTRP2

18A2

ENDTRP2

ENDTRP2

In what month did this trip end?

(0) Trip not ended

Destination Ended How paid Number of trips
(TRPPLACE) (ENDTRP2) (ANYBOTH2) (NUMTRIPS)



0. Trip not ended
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

0: Goto S18MORE

REF_MONTH-CUR_MONTH: IF trip is not within the reference period, then goto ERR3_ENDTRP2
ELSE goto MORTHONE

DK,RF: Goto MORTHONE

18A2

MORTHONE

MORTHONE

Did you take more than one trip to (trip destination) in (month trip ended)?

Destination Ended How paid Number of trips
(TRPPLACE) (ENDTRP2) (ANYBOTH2) (NUMTRIPS)



1. Yes
2. No

1: Goto NUMTRIPS

2,DK,RF: Goto ANYBOTH2

18A2

NUMTRIPS

NUMTRIPS

How many times did you go to (trip destination)
in (month trip ended)?

Destination Ended How paid Number of trips
(TRPPLACE) (ENDTRP2) (ANYBOTH2) (NUMTRIPS)

Goto ANYBOTH2

18A2

ANYBOTH2

ANYBOTH2

Were any of the expenses for ^ANYBOTH2_FILL paid for
by anyone outside of your household?

Destination Ended How paid Number of trips
(TRPPLACE) (ENDTRP2) (ANYBOTH2) (NUMTRIPS)



1. Yes
2. No

Goto S18MORE

18A2

S18MORE

S18MORE

40 ? [F1]

Since the first of (reference month) , have you taken any other trips for reasons such as:

* Visiting relatives or friends?
* Business?
* Recreational trips?
* Other trips overnight or longer?
* Day trips of at least 75 miles away from home?


1. Yes
2. No

1: Goto TRIPPLAC, next line on the grid

2,DK,RF: Goto S18A_END

18A


S18A_END

** Non Displayed **

IF (ANYBOTH1 = 1,2,DK or RF) or (ANYBOTH2 = 1,2,DK or RF) for any trips goto Section 18BC

ELSE goto Section 18E

18BC

NUMNIGHT

NUMNIGHT

(Now I'm going to ask you about the ^TRIP that ^YOU_YRCU took to ^TRPPLACE ending in ^NUMNIGHTC/You

(Since (you/your CU) took a set of similar trips to (Trip destination) in (month trip ended) , I wil

How many nights did (you/you or any members of your household) spend away from home on (these trips/this trip)?

Enter 0 for none
Enter 888 to delete this trip

0-800: IF entry gt 90 then goto ERR1_NUMNIGHT
ELSE goto PKGTRIP

DK,RF: Goto PKGTRIP

888: Goto S18BC_END

18BC

PKGTRIP

PKGTRIP

^PKGTRIP

Was all or part of (these trips/this trip) covered by a package deal?


1. Yes
2. No

1: Goto FOODDEAL

2,DK,RF: Goto TRPTRNS

18BC

FOODDEAL

FOODDEAL

Did the package deal include . . .

. . . Food and beverages?


1. Yes
2. No

Goto LODGDEAL

18BC

LODGDEAL

LODGDEAL

Did the package deal include . . .

. . . Lodging?


1. Yes
2. No

Goto TRANDEAL

18BC

TRANDEAL

TRANDEAL

Did the package deal include . . .

. . . Transportation?


1. Yes
2. No

Goto ELSEDEAL

18BC

ELSEDEAL

ELSEDEAL

Did the package deal include . . .

. . . Anything else?


1. Yes
2. No

1: Goto S18BELSE

2,DK,RF: Goto PKGTRIPX

18BC

S18BELSE

S18BELSE

Specify:

Goto PKGTRIPX

18BC

PKGTRIPX

PKGTRIPX

How much did (you/your household) pay for the package deal?

1-999999: IF entry lt 5 or gt 7000 then goto ERR1_PKGTRIPX
ELSE goto TRPTRNS

DK,RF: Goto TRPTRNS

18BC

TRPTRNS

TRPTRNS

40 ? [F1]

Starting at the beginning of this trip, please tell me all the kinds of transportation (you/you or any members of your household) used from the time you (they) left home to the time you (they) got back home.

Enter all that apply, separate with commas

1. Local (taxi, etc.)
2. Airplane
3. Train
4. Bus
5. Ship
6. Automobile, truck, van (Rented)
7. Motorcycle, moped (Rented)
8. Private plane (Rented)
9. Boat, trailer (Rented)
10. Camper (Rented)
11. Other vehicles (Rented)
12. Automobiles or other vehicles privately owned or leased by household
13. Vehicle owned by someone else (Private)
14. Other transport (Private)

1-14: IF 1 is selected then goto CMLOCALX
ELSEIF 2 is selected then goto CMPLANEX
ELSEIF 3 is selected then goto CMTRAINX
ELSEIF 4 is selected then goto CMBUSX
ELSEIF 5 is selected then goto CMSHIPX
ELSEIF 6 is selected then goto RTCARX
ELSEIF 7 is selected then goto RTMOPEDX
ELSEIF 8 is selected then goto RTPLANEX
ELSEIF 9 is selected then goto RTBOATX
ELSEIF 10 is selected then goto RTCAMPX
ELSEIF 11 is selected then goto RTOTHERX
ELSEIF 12-14 is selected then goto ANYGAS

DK,RF: Goto LODGING

18BC

CMLOCALX

CMLOCALX

How much did (you/you or any members of your household) spend for local transportation (taxi, etc.)
^FillOtherThanPackage?

IF entry gt 640 and ne DK or RF then goto ERR1_CMLOCALX
ELSEIF 2 is selected in TRPTRNS then goto CMPLANEX
ELSEIF 3 is selected in TRPTRNS then goto CMTRAINX
ELSEIF 4 is selected in TRPTRNS then goto CMBUSX
ELSEIF 5 is selected in TRPTRNS then goto CMSHIPX
ELSEIF 6 is selected in TRPTRNS then goto RTCARX
ELSEIF 7 is selected in TRPTRNS then goto RTMOPEDX
ELSEIF 8 is selected in TRPTRNS then goto RTPLANEX
ELSEIF 9 is selected in TRPTRNS then goto RTBOATX
ELSEIF 10 is selected in TRPTRNS then goto RTCAMPX
ELSEIF 11 is selected in TRPTRNS then goto RTOTHERX
ELSEIF 12-14 are selected in TRPTRNS then goto ANYGAS
ELSE goto LODGING

18BC

CMPLANEX

CMPLANEX

How much did (you/you or any members of your household) spend for airfare ^FillOtherThanPackage?

IF entry gt 2000 and ne DK or RF then goto ERR1_COMPLANEX
ELSEIF 3 is selected in TRPTRNS then goto CMTRAINX
ELSEIF 4 is selected in TRPTRNS then goto CMBUSX
ELSEIF 5 is selected in TRPTRNS then goto CMSHIPX
ELSEIF 6 is selected in TRPTRNS then goto RTCARX
ELSEIF 7 is selected in TRPTRNS then goto RTMOPEDX
ELSEIF 8 is selected in TRPTRNS then goto RTPLANEX
ELSEIF 9 is selected in TRPTRNS then goto RTBOATX
ELSEIF 10 is selected in TRPTRNS then goto RTCAMPX
ELSEIF 11 is selected in TRPTRNS then goto RTOTHERX
ELSEIF 12-14 are selected in TRPTRNS then goto ANYGAS
ELSE goto LODGING

18BC

CMTRAINX

CMTRAINX

How much did (you/you or any members of your household) spend for train fare ^FillOtherThanPackage?

IF entry gt 800 and ne DK or RF then goto ERR1_CMTRAINX
ELSEIF 4 is selected in TRPTRNS then goto CMBUSX
ELSEIF 5 is selected in TRPTRNS then goto CMSHIPX
ELSEIF 6 is selected in TRPTRNS then goto RTCARX
ELSEIF 7 is selected in TRPTRNS then goto RTMOPEDX
ELSEIF 8 is selected in TRPTRNS then goto RTPLANEX
ELSEIF 9 is selected in TRPTRNS then goto RTBOATX
ELSEIF 10 is selected in TRPTRNS then goto RTCAMPX
ELSEIF 11 is selected in TRPTRNS then goto RTOTHERX
ELSEIF 12-14 are selected in TRPTRNS then goto ANYGAS
ELSE goto LODGING

18BC

CMBUSX

CMBUSX

How much did (you/you or any members of your household) spend for bus fare ^FillOtherThanPackage?

IF entry gt 315 and ne DK or RF then goto ERR1_CMBUSX
ELSEIF 5 is selected in TRPTRNS then goto CMSHIPX
ELSEIF 6 is selected in TRPTRNS then goto RTCARX
ELSEIF 7 is selected in TRPTRNS then goto RTMOPEDX
ELSEIF 8 is selected in TRPTRNS then goto RTPLANEX
ELSEIF 9 is selected in TRPTRNS then goto RTBOATX
ELSEIF 10 is selected in TRPTRNS then goto RTCAMPX
ELSEIF 11 is selected in TRPTRNS then goto RTOTHERX
ELSEIF 12-14 are selected in TRPTRNS then goto ANYGAS
ELSE goto LODGING

18BC

CMSHIPX

CMSHIPX

How much did (you/you or any members of your household) spend for ship fare ^FillOtherThanPackage?

IF entry gt 2800 and ne DK or RF, then goto ERR1_CMSHIPX
ELSEIF 6 is selected in TRPTRNS then goto RTCARX
ELSEIF 7 is selected in TRPTRNS then goto RTMOPEDX
ELSEIF 8 is selected in TRPTRNS then goto RTPLANEX
ELSEIF 9 is selected in TRPTRNS then goto RTBOATX
ELSEIF 10 is selected in TRPTRNS then goto RTCAMPX
ELSEIF 11 is selected in TRPTRNS then goto RTOTHERX
ELSEIF 12-14 are selected in TRPTRNS then goto ANYGAS
ELSE goto LODGING

18BC

RTCARX

RTCARX

How much did (you/you or any members of your household) spend for rented automobiles, trucks or vans, not including
gas (you/you or any members of your household) bought ^FillOtherThanPackage?

^RTCARX_Fill

IF entry gt 1400 and ne DK or RF then goto ERR1_RTCARX
ELSEIF 7 is selected in TRPTRNS then goto RTMOPEDX
ELSEIF 8 is selected in TRPTRNS then goto RTPLANEX
ELSEIF 9 is selected in TRPTRNS then goto RTBOATX
ELSEIF 10 is selected in TRPTRNS then goto RTCAMPX
ELSEIF 11 is selected in TRPTRNS then goto RTOTHERX
ELSE goto ANYGAS

18BC

RTMOPEDX

RTMOPEDX

How much did (you/you or any members of your household) spend for rented motorcycles or mopeds, not including gas (you/you or any members of your household) bought ^FillOtherThanPackage?

^RTMOPEDX_Fill

IF entry gt 250 and ne DK or RF then goto ERR1_RTMOPEDX
ELSEIF 8 is selected in TRPTRNS then goto RTPLANEX
ELSEIF 9 is selected in TRPTRNS then goto RTBOATX
ELSEIF 10 is selected in TRPTRNS then goto RTCAMPX
ELSEIF 11 is selected in TRPTRNS then goto RTOTHERX
ELSE goto ANYGAS

18BC

RTPLANEX

RTPLANEX

How much did (you/you or any members of your household) spend for rented private planes,
not including gas (you/you or any members of your household) bought ^FillOtherThanPackage?

^RTPLANEX_Fill

IF entry gt 6000 and ne DK or RF then goto ERR1_RTPLANEX
ELSEIF 9 is selected in TRPTRNS then goto RTBOATX
ELSEIF 10 is selected in TRPTRNS then goto RTCAMPX
ELSEIF 11 is selected in TRPTRNS then goto RTOTHERX
ELSE goto ANYGAS

18BC

RTBOATX

RTBOATX

How much did (you/you or any members of your household) spend for rented boats or trailers,
not including gas (you/you or any members of your household) bought ^FillOtherThanPackage?

^RTBOATX_Fill

IF entry gt 400 and ne DK or RF then goto ERR1_RTBOATX
ELSEIF 10 is selected in TRPTRNS then goto RTCAMPX
ELSEIF 11 is selected in TRPTRNS then goto RTOTHERX
ELSE goto ANYGAS

18BC

RTCAMPX

RTCAMPX

How much did (you/you or any members of your household) spend for rented campers,
not including gas (you/you or any members of your household) bought ^FillOtherThanPackage?

^RTCAMPX_Fill

IF entry gt 1375 and ne DK or RF then goto ERR1_RTCAMPX
ELSEIF 11 is selected in TRPTRNS then goto RTOTHERX
ELSE goto ANYGAS

18BC

RTOTHERX

RTOTHERX

How much did (you/you or any members of your household) spend for other rented vehicle transportation,
not including gas (you/you or any members of your household) bought ^FillOtherThanPackage?

^RTOTHERX_Fill

IF entry gt 870 and ne DK or RF then goto ERR1_RTOTHERX
ELSE goto ANYGAS

18BC

ANYGAS

ANYGAS

While on the trip did (you/you or any members of your household) stop to buy any gasoline, diesel fuel, or any other fuels?


1. Yes
2. No

1: Goto GASOILX

2,DK,RF: Goto ANYTOLL

18BC

GASOILX

GASOILX

(How much did ^YOU_ANYMEM spend for that?/What costs for gasoline or other fuels won't be reimbursed?)

IF entry gt 256 and ne DK or RF then goto ERR1_GASOILX
ELSE goto ANYTOLL

18BC

ANYTOLL

ANYTOLL

While on the trip, did (you/you or any members of your household) spend anything for tolls, not already reported?

1. Yes
2. No

1: Goto TRPTOLLX

2,DK,RF Goto ANYPARK

18BC

TRPTOLLX

TRPTOLLX

^FillHowMuch_WhatCosts_Tolls

IF entry gt 50 and (ne DK or RF) then goto ERR1_TRPTOLLX
ELSE goto ANYPARK

18BC

ANYPARK

ANYPARK

Did (you/you or any members of your household) have any parking fees?


1. Yes
2. No

1: Goto PARKINGX

2,DK,RF: Goto LODGING

18BC

PARKINGX

PARKINGX

^FillHowMuch_WhatCosts_Parking

IF entry gt 100 and (ne DK or RF) then goto ERR1_PARKINGX
ELSE goto LODGING

18BC

LODGING

LODGING

Did (you/you or any members of your household) spend anything for hotels, cottages, trailer camps, or other lodging (not counting what the package deal covered/ )?
(Do not include expenses previously reported for vacation clubs.)


1. Yes
2. No

1: Goto LDGCOSTX

2,DK,RF: Goto TRPFOOD

18BC

LDGCOSTX

LDGCOSTX

^FillLdgcostx

IF entry gt 1600 and (ne DK or RF) then goto ERR1_LDGCOSTX
ELSE goto TRPFOOD

18BC

TRPFOOD

TRPFOOD

Did (you/you or any members of your household) spend anything for meals, snacks, or drinks at restaurants, bars, or fast food places ^NotCountingTrpFood?


1. Yes
2. No

1: Goto TRPFOODX

2,DK,RF: Goto ANYGROC

18BC

TRPFOODX

TRPFOODX

^FillTrpFoodx

IF entry gt 700 and (ne DK or RF) then goto ERR1_TRPFOODX
ELSE goto TRPALCIN

18BC

TRPALCIN

TRPALCIN

Was any of the ^FillTrpalcin for alcoholic beverages?

1. Yes
2. No

1: Goto TRPALCHX

2,DK,RF: Goto ANYGROC

18BC

TRPALCHX

TRPALCHX

(What was the cost for alcoholic beverages, including taxes and trips?/What costs for alcoholic beverages, including taxes and tips, won't be reimburs

IF entry gt 210 and (ne DK or RF) then goto ERR1_TRPALCHX
ELSE goto ANYGROC

18BC

ANYGROC

ANYGROC

Did (you/you or any members of your household) spend anything for food or beverages at grocery stores, convenience stores, or liquor stores on this trip?

1. Yes
2. No

1: Goto TRPGROCX

2,DK,RF: Goto ANYSPEQP

18BC

TRPGROCX

TRPGROCX

^FillTrpgrocx

IF entry gt 300 and (ne DK or RF) then goto ERR1_TRPGROCX
ELSE goto ANYALC

18BC

ANYALC

ANYALC

Was any of the ^FillAnyalc for alcoholic beverages?

1. Yes
2. No

1: Goto TRPALCGX

2,DK,RF: Goto ANYSPEQP

18BC

TRPALCGX

TRPALCGX

^FillTrpalcgx

IF entry gt 150 and (ne DK or RF) then goto ERR1_TRPALCGX
ELSE goto ANYSPEQP

18BC

ANYSPEQP

ANYSPEQP

41 ? [F1]

Did (you/you or any members of your household) pay any fees to play sports, exercise, or rent an sports equipment
(not counting what the package deal covered/ )?


1. Yes
2. No

1: Goto TRPSPRTX

2,DK,RF: Goto ANYENTER

18BC

TRPSPRTX

TRPSPRTX

41

(How much did (you/you or any member of your CU) pay?/What costs for playing sports or renting sports equipment won't be reimbursed?)

IF entry gt 600 and (ne DK or RF) then goto ERR1_TRPSPRTX
ELSE goto ANYENTER

18BC

ANYENTER

ANYENTER

41 ? [F1]

Did (you/you or any members of your household) spend anything on this trip for entertainment or admissions (not counting what the package deal covered/ )?


1. Yes
2. No

1: Goto TRPETRTX

2,DK,RF: Goto ANYMISC

18BC

TRPETRTX

TRPETRTX

^FillTrpetrtx

IF entry gt 682 and (ne DK or RF) then goto ERR1_TRPETRTX
ELSE goto ANYMISC

18BC

ANYMISC

ANYMISC

Did (you/you or any members of your household) have any expenses for this trip such as for souvenirs, tourist booklets, and so on?

1. Yes
2. No

1: Goto TRMISCX

2,DK,RF: Gxit block and goto BlkSect18_BC_3.CHKTCOMB

18BC

TRMISCX

TRMISCX

^FillTrmiscx

IF entry gt 600 and (ne DK or RF) then goto ERR1_TRMISCX
ELSE exit block and goto BlkSect18_BC_3.CHKTCOMB

18BC

CHKTCOMB

CHKTCOMB

Are there combined expenses for this trip the respondent
was not able to separate?



1. Yes
2. No

1: Goto TCOMBEST

2: Goto TRPGFTC

18BC

TCOMBEST

TCOMBEST

^FillTcombest

IF entry gt 6000 and (ne DK or RF) then goto ERR1_TCOMBEST
ELSE goto FOODCOMB

18BC

FOODCOMB

FOODCOMB

Does this ^COMBQUEX include anything for . . .

. . . Food?


1. Yes
2. No

Goto LODGCOMB

18BC

LODGCOMB

LODGCOMB

Does this ^COMBQUEX include anything for . . .

. . . Lodging



1. Yes
2. No

Goto TRANCOMB

18BC

TRANCOMB

TRANCOMB

Does this ^COMBQUEX include anything for . . .

. . .Transportation?


1. Yes
2. No

Goto ELSECOMB

18BC

ELSECOMB

ELSECOMB

Does this ^COMBQUEX include anything for . . .

. . . Other expenses?


1. Yes
2. No

Goto OTHRCOMB

18BC

OTHRCOMB

OTHRCOMB

Does this ^COMBQUEX include . . .

. . . Any expenses for others?


1. Yes
2. No

Goto TRPGFTC

18BC

TRPGFTC

TRPGFTC

(You've told me about many expenses (you/you or your CU) had on this trip. Were any of these expens

1. Yes
2. No

1: Goto TRPGTCX

2,DK,RF: Goto S18BC_END

18BC

TRPGFTCX

TRPGFTCX

(How much of the total expenses for this trip were for persons outside your CU?/How much of the tota

IF entry gt 1100 and (ne DK or RF) then goto ERR1_TRPGFTCX
ELSE goto S18BC_END

18BC


S18BC_END

** Non Displayed **

IF more trips with BSECT18.TBLSECT18A_1.BLKROW.ANYBOTH1 = 2 OR BSECT18.TBLSECT18A_2.BLKROW.ANYBOTH2 = 2 then go to NUMNIGHT for the next trip

ELSEIF more trips with BSECT18.TBLSECT18A_1.BLKROW.ANYBOTH1 = 1 OR BSECT18.TBLSECT18A_2.BLKROW.ANYBOTH2 = 1 then go to NUMNIGHT for the next trip

ELSE goto Section 18E - BlkSect18_E

18E

ANYNONCU

ANYNONCU

Sometimes people in a household don't take a trip themselves, but pay for part or all of a trip that someone else takes. Since the first of
(reference month), have (you/you or any members of your household) paid for part or all of such a trip for any non-household members?


1. Yes
2. No

1: Goto FOODNOCU

2,DK,RF: Goto S18E_END

18E

FOODNOCU

FOODNOCU

Did these expenses include anything for...

. . . Food and beverages?


1. Yes
2. No

Goto LODGNOCU

18E

LODGNOCU

LODGNOCU

Did these expenses include anything for...

. . . Lodging?


1. Yes
2. No

Goto TRANNOCU

18E

TRANNOCU

TRANNOCU

Did these expenses include anything for...

. . . Transportation?


1. Yes
2. No

Goto ELSENOCU

18E

ELSENOCU

ELSENOCU

Did these expenses include ...

. . . Anything else?


1. Yes
2. No

Goto TRNONCUX

18E

TRNONCUX

TRNONCUX

What was the total amount that (you/your household) paid for those trips?

IF entry lt 25 or gt 3000 and (ne DK or RF) then goto ERR1_TRNONCUX

ELSE goto S18E_END

18E


S18E_END

** Non Displayed **

Exit block and goto ANYLOC

18F

ANYLOC

ANYLOC

Sometimes people stay overnight in a local hotel or motel during holidays, family getaways, moves, or home repair. Since the first of (reference month), have (you/you or any members of your household) stayed overnight in a local hotel or motel?


1. Yes
2. No

1: Goto BlkSect18_F.NUMLOC

2,DK,RF: Goto S18F_END

18F

NUMLOC

NUMLOC

How many nights did (you/you or any members of your household) spend away from home on this stay?

Goto ANYLOCDL

18F

ANYLOCDL

ANYLOCDL

Sometimes when people stay away from home overnight they have some
sort of package deal that covers some or all of the costs. Was all
or part of this stay covered by anything like that?


1. Yes
2. No

1: Goto FOODLCDL

2,DK,RF: Goto ANYLODGE

18F

FOODLCDL

FOODLCDL

Did the package deal include anything for. . .

. . . Food and beverages?


1. Yes
2. No

Goto LODGLCDL

18F

LODGLCDL

LODGLCDL

Did the package deal include anything for. . .

. . .Lodging?


1. Yes
2. No

Goto ENTRLCDL

18F

ENTRLCDL

ENTRLCDL

Did the package deal include anything for. . .

. . . Entertainment?


1. Yes
2. No

Goto ELSELCDL

18F

ELSELCDL

ELSELCDL

Did the package deal include . . .

. . . Anything else?


1. Yes
2. No

1: Goto S18FELSE

2,DK,RF: Goto LOCDEALX

18F

S18FELSE

S18FELSE

Specify:

Goto LOCDEALX

18F

LOCDEALX

LOCDEALX

How much did (you/you or any members of your household) pay for the package deal?

IF entry gt 1500 and (ne DK or RF) then goto ERR1_LOCDEALX
ELSE goto ANYLODGE

18F

ANYLODGE

ANYLODGE

Did (you/you or any members of your household) spend anything for hotels, motels, cottages, trailer camps, or other lodging (not counting what the package deal covered/ )?

1. Yes
2. No

1: Goto LOCLODGX

2,DK,RF: Goto ANYMEAL

18F

LOCLODGX

LOCLODGX

What was the cost, including taxes and tips?

IF entry lt 22 or gt 648 and (ne DK or RF) then goto ERR1_LOCLODGX

ELSE goto ANYMEAL

18F

ANYMEAL

ANYMEAL

Did (you/you or any members of your household) spend anything for meals, snacks, or drinks at restaurants, bars, or fast food places (not counting what the package deal covered/ )?

1. Yes
2. No

1: Goto LOCMEALX

2,DK,RF: Goto ANYLCGR

18F

LOCMEALX

LOCMEALX

What was the cost, including taxes and tips?

IF entry lt 6 or gt 1000 and (ne DK or RF) then goto ERR1_LOCMEALX

ELSE goto ANYALCML

18F

ANYALCML

ANYALCML

Was any of the (amount/(entry in LOCMEALX)) for alcoholic beverages?

1. Yes
2. No

1: Goto ALCMEALX

2,DK,RF: Goto ANYLCGR

18F

ALCMEALX

ALCMEALX

What was the cost for alcoholic beverages, including taxes and tips?

IF entry lt 5 or gt 388 and (ne DK or RF) then goto ERR1_ALCMEALX

ELSE goto ANYLCGR

18F

ANYLCGR

ANYLCGR

Did (you/you or any members of your household) spend anything for food or beverages at grocery stores, convenience stores, or liquor stores?


1. Yes
2. No

1: Goto LOCGROCX

2,DK,RF: Goto ANYADMIS

18F

LOCGROCX

LOCGROCX

What were the expenses, including taxes?

IF entry lt 5 or gt 600 and (Ne DK or RF) then goto ERR1_LOCGROCX

ELSE goto ANYALCGR

18F

ANYALCGR

ANYALCGR

Was any of the (amount/ entry in LOCGROCX) for alcoholic beverages?


1. Yes
2. No

1: Goto ALCGROCX

2,DK,RF: Goto ANYADMIS

18F

ALCGROCX

ALCGROCX

What was the cost for alcoholic beverages, including taxes?

IF entry lt 5 or gt 270 and (Ne DK or RF) then goto ERR1_ALCGROCX

ELSE goto ANYADMIS

18F

ANYADMIS

ANYADMIS

41 ? [F1]

Did (you/you or any members of your household) spend anything on this stay for entertainment or admissions (not counting what the package deal covered/ )?


1. Yes
2. No

1: Goto LOCADMSX

2,DK,RF: Goto LOCCOMBX

18F

LOCADMSX

LOCADMSX

How much did (you/you or any members of your household) pay?

IF entry lt 5 or gt 290 and (Ne DK or RF) then goto ERR1_LOCADMSX

ELSE goto LOCCOMBX

18F

CHKFCOMB

CHKFCOMB

Are there combined expenses for food/beverages, lodging,
transportation, or other things?



1. Yes
2. No

1: Goto LOCCOMBX

2: Goto DIDYOU

18F

LOCCOMBX

LOCCOMBX

Only those things the respondent could not provide individual expenses
for should be combined and entered here.

1-99999999: IF entry lt 5 or gt 210 then goto ERR1_LOCCOMBX
ELSE goto FOODLCCM

DK,RF: Goto FOODLCCM

18F

FOODLCCM

FOODLCCM

Does this include anything for. . .

. . . Food and beverages?


1. Yes
2. No

Goto LODGLCCM

18F

LODGLCCM

LODGLCCM

Does this include anything for . .

. . . Lodging?


1. Yes
2. No

Goto ENTRLCCM

18F

ENTRLCCM

ENTRLCCM

Does this include anything for . .

. . . Entertainment?


1. Yes
2. No

Goto ELSELCCM

18F

ELSELCCM

ELSELCCM

Does this include any . . .

. . . Other expenses?


1. Yes
2. No

Goto DIDYOU

18F

DIDYOU

DIDYOU

Did (you/you or any members of your household) have any other stays at local hotels or motels?

1. Yes
2. No

1: Goto NUMLOC, next row

2,DK,RF: Exit block and goto S18F_END

18F


S18F_END

** Non Displayed **

Goto Section 19 - BSECT19

19A

S19A_INTRO

S19A_INTRO

42-43

Now I am going to ask about miscellaneous expenses which have not been collected anywhere
else in this survey. Please remember to include any payments you made online or had
automatically deducted. Also, please include any shipping and handling charges with the cost of any item that was shipped.


Description Amount Month
(MISCDESC) (MISCEXPX) (MISCMO)


1. Enter 1 to Continue

Goto BTableA.Brow.ITEM

19A

MIS_ITEM

ITEM

Screen 1 ------------------------------------------------------------

42 ? [F1]

Since the first of (reference month), have (you/you or any members of your household) had expenses for any of the
following, either for (you/your household) or for someone outside your household?

Read each item on list.


SCREEN 2 ------------------------------------------------------------------

43 ? [F1]

Have (you/you or any members of your household) had expenses for --

Read each item on list.
Do not include pet food. It is a Diary-only item.


1. Fresh flowers or potted plants?
2. Professional photography?
3. Services of lawyers or other legal professionals?
4. Accounting fees?
5. Occupational expenses, such as union dues or professional licenses?
6. Gardening or lawn care services?
7. Housekeeping services?
8. Home security system service fees?
9. Other home services or small repair jobs around the house, not previously reported?
10. Moving, storage, or freight?
11. Stamp or coin collecting?
12. Lotteries or games of chance?
13. Babysitting, nanny services, or other child care inside or outside of your home?
14. Toys or games?
15. Arts or crafts kits?
16. Sewing, knitting, or quilting materials and items?
17. Purchase of pets, pet supplies, or medicine for pets?
18. Pet services?
19. Veterinarian expenses for pets?
20. Catering?
21. Arrangement of live entertainment for special occasions?
22. Rental of party supplies?
23. Purchase or upkeep of cemetery lots or vaults?
24. Funerals, burials, or cremation?
95. Continue List
99. None/No more entries
888. Delete the line

1-24: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

95: Goto ITEM - next line of grid

99: Goto S19A_END

888: IF no more grid lines then goto S19A_END
ELSE goto ITEM - next line of grid

19A


PreFill

** SHOW ONLY **


19A

MISCDESC

DESCRIPTION

What was the expense for?

Description Amount Month
(MISCDESC) (MISCEXPX) (MISCMO)

Goto MONTH

19A

MISCMO

MONTH

In what month did you have this expense?

(* Enter 13 for same amount each month of the reference period)

Description Amount Month
(MISCDESC) (MISCEXPX) (MISCMO)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
13. ^S19_13Option

REF_MONTH - CUR_MONTH: IF month not in the reference period then goto ERR3_MONTH
ELSE goto WHO

13: IF ITEM = 2, 9, 11, 14-16, 20-22 then goto CK_MONTH
ELSE goto WHO

DK,RF: Goto WHO

19A

MISCGFTC

WHO

Was this expense for someone inside or outside your household?

Description Amount Month
(MISCDESC) (MISCEXPX) (MISCMO)



1. For household
2. For someone outside your household

Goto AMOUNT

19A

MISCEXPX

AMOUNT

(What was the total amount of this expense?/What is your monthly expense?)

(* Do not include legal fees related to real estate closing costs reported in Section 3./ )

Description Amount Month
(MISCDESC) (MISCEXPX) (MISCMO)

1-999999: IF (MISCCODE = 100 and MISCEXPX lt 5 or gt 7000) or (MISCCODE = 110 and MISCEXPX lt 10 or gt 3208) or (MISCCODE = 130 and MISCEXPX lt 14 or gt 6840) or (MISCCODE = 140 and MISCEXPX lt 5 or gt 300) or (MISCCODE = 150 and MISCEXPX lt 13 or gt 5000) or (MISCCODE = 160 and MISCEXPX lt 25 or gt 1000) or (MISCCODE = 170 and MISCEXPX lt 15 or gt 600) or (MISCCODE = 180 and MISCEXPX lt 20 or gt 1260) or (MISCCODE = 225 and MISCEXPX lt 10 or gt 10700) or (MISCCODE = 210 and MISCEXPX lt 5 or gt 557) or (MISCCODE = 230 and MISCEXPX lt 9 or gt 1800) or (MISCCODE = 240 and MISCEXPX lt 5 or gt 300) or (MISCCODE = 250 and MISCEXPX lt 8 or gt 500) or (MISCCODE = 260 and MISCEXPX lt 12 or gt 700) or (MISCCODE = 330 and MISCEXPX lt 5 or gt 550) or (MISCCODE = 340 and MISCEXPX lt 6 or gt 800) or (MISCCODE = 460 and MISCEXPX lt 5 or gt 214) or (MISCCODE = 360 and MISCEXPX lt 8 or gt 795) or (MISCCODE = 370 and MISCEXPX lt 19 or gt 300) or (MISCCODE = 380 and MISCEXPX lt 9 or gt 900) or (MISCCODE = 390 and MISCEXPX lt 5 or gt 520) or (MISCCODE = 400 and MISCEXPX gt 1300) or (MISCCODE = 410 and MISCEXPX lt 14 or gt 7000) or (MISCCODE = 420 and MISCEXPX lt 14 or gt 7000) then goto ERR1_AMOUNT
ELSEIF MISCCODE and the entry in AMOUNT for this record are equal to any records data on the prechart/input AND (that prechart records MISCMO does not equal 13) then goto ERR_DUP
ELSEIF ITEM = 14-24 then goto C
ELSE goto MORE

DK,RF: IF ITEM = 14-24 then goto C
ELSE goto MORE

19A

S19ACM_S

C

Enter a 'C' for a combined expense.

C: Goto CombCode

EMPTY: IF [(ITEM = 14 or 15) AND RT8100.POPGRP = 01] OR [ITEM = 17 AND RT8100.POPGRP = 11] then goto MISSTORE
ELSE goto MORE

IF anything other than a 'C' or the Enter key is entered then goto CK_C

19A

S19ACMB

CombCode

43 ? [F1]

What other expense is the (description) combined with?

Enter all that apply, separate with commas.

Description Amount Month
(MISCDESC) (MISCEXPX) (MISCMO)


14. Toys or games
15. Arts or craft kits
16. Sewing, knitting, or quilting materials and items
17. Purchase of pets, pet supplies, or medicine for pets
18. Pet services
19. Veterinary expenses for pets
20. Catering
21. Arrangement of live entertainment for special occasions
22. Rental of party supplies
23. Purchase or upkeep of cemetery lots or vaults
24. Funerals, burials, or cremations

IF [(ITEM = 14 or 15) AND RT8100.POPGRP = 01] OR [ITEM = 17 AND RT8100.POPGRP = 11] then goto MISSTORE

ELSE goto MORE

19A

MISSTORE

MISSTORE

Where ^WasWere_19A the (description) purchased?

Enter store, website, or company name

IF uppercase version of the entry = "GROUPON" or "GROUPON.COM" then goto ERR_GROUPON

ELSEIF ENTRY contains ".com", ".Com", ".cOm", ".coM", ".COm", ".CoM", ".cOM", or ".COM", then goto MORE

ELSEIF ENTRY = DK or RF then goto MORE

ELSE goto MISPURCH

19A

MISPURCH

MISPURCH

Ask if not apparent

Was this purchased online or in-person?


1. Online
2. In person
3. Other (phone, mail, catalog)

1,3,DK,RF: Goto MORE

2: Goto MISLOC

19A

MISLOC

MISLOC

Where is ^MISSTORE_fill located?

Enter city and state

Goto MORE

19A

MISCMORE

MORE

Did you have any other expenses for (description)?

Description Amount Month
(MISCDESC) (MISCEXPX) (MISCMO)


1. Yes
2. No

1: IF ROW number = 43 then goto ERR_MAX
ELSE goto ITEM, next line of grid

2,DK,RF: IF ROW number = 43 then goto S19A_END
ELSE goto ITEM, next line of grid

19A


S19A_END

** Non Displayed **

Goto section 19B - S19B_INTRO

19B

S19B_INTRO

S19B_INTRO

44

Now I am going to ask about payments and contributions to persons outside of your household.

Description Month Amount
(CONTDESC) (CONTMO) (CONTEXPX)



1. Enter 1 to Continue

Goto BSECT19.BTABLEB.BROW.ITEM

19B

CNT_ITEM

ITEM

44 ? [F1]


SCREEN 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Since the first of (reference month), have (you/you or any members of your household) given any money by cash, checks,
or given any gift cards to . . .

Read each item on list



SCREEN 2 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Since the first of (reference month), have (you/you or any members of your household) paid any of the following . . .

Read each item on list



SCREEN 3 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Since the first of (reference month), have (you/you or any members of your household) given any money by cash, checks,
money orders, or credit cards to benefit . . .

Read each item on list


SCREEN 4 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Since the first of (reference month), have (you/you or any members of your household) given any . . .

Read item on list


1. College students living away from home?
2. Any other people not in your household, such as friends, co-workers, or homeless persons?
3. Child support?
4. Alimony?
5. Educational institutions?
6. Political organizations?
7. Religious organizations, including churches, temples and mosques?
8. Charities or other organizations?
9. Stocks, bonds, or mutual funds to persons or organizations outside of your household?
95. Continue list
99. None/No more entries
888. Delete the line

1-9: IF ITEM ne Item2Shadow then goto CK_ITEM
ELSE goto DESCRIPTION

95: Goto next row

99: Goto S19B_END

888: IF no more grid lines then goto S19B_END
ELSE goto ITEM - next line of grid

19B


PreFill

** SHOW ONLY **


19B

CONTDESC

DESCRIPTION

What was the (payment/contribution) for?

Description Month Amount
(CONTDESC) (CONTMO) (CONTEXPX)

Goto MONTH

19B

CONTMO

MONTH

In what month did you make the (payment/contribution)?

Enter 13 for same (payment/contribution) each month of the reference period.


Description Month Amount
(CONTDESC) (CONTMO) (CONTEXPX)


1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
13. Same amount each month.

REF_MONTH-CUR_MONTH: IF entry is not within the reference period then goto ERR3_MONTH
ELSE goto AMOUNT

13,DK,RF: Goto AMOUNT

19B

CONTEXPX

AMOUNT

(What was the total amount of the (payment/contribution)./What is the monthly (payment/contribution).)

Description Month Amount
(CONTDESC) (CONTMO) (CONTEXPX)

1-999999: IF (CONTCODE = 100 and AMOUNT lt 20 or gt 3000) OR (CONTCODE = 110 and AMOUNT lt 55 or gt 3600) OR (CONTCODE = 120 and AMOUNT lt 40 or gt 8000) OR (CONTCODE = 130 and AMOUNT lt 5 or gt 1500) OR (CONTCODE = 140 and AMOUNT lt 5 or gt 1000) OR (CONTCODE = 150 and AMOUNT lt 10 or gt 1600) OR (CONTCODE = 160 and AMOUNT lt 5 or gt 650) OR (CONTCODE = 170 and AMOUNT lt 5 or gt 2300) OR (CONTCODE = 180 and AMOUNT lt 5 or gt 10000) then goto ERR1_AMOUNT
ELSEIF CONTCODE and the entry in AMOUNT for this record are equal to any records data on the pre-chart/input AND (that prechart records CONTMO does not equal 13)then goto ERR_DUP
ELSE goto MORE

DK,RF: Goto MORE

19B

CONTMORE

MORE

Did you make any other (payment/contribution).

Description Month Amount
(CONTDESC) (CONTMO) (CONTEXPX)


1. Yes
2. No

1: IF Row number = 43 then goto ERR_MAX
ELSE goto ITEM, next line in grid

2,DK,RF: IF Row number = 43 then goto S19B_END
ELSE goto ITEM, next line in grid

19B


S19B_END

** Non Displayed **

Goto section 20A - BSECT20

20A

GROCWEKX

GROCWEKX

45

Now I am going to ask about expenses for food, beverages and other items (you/your household) (have/has) purchased since the first of (reference month).

What has been (you/your household) usual WEEKLY expense for grocery shopping?

Include grocery home delivery service fees and drinking water delivery fees.

0,DK,RF: Goto OTHSTOR

1-9999: IF Entry gt 300 then goto ERR1_GROCWEKX
ELSE OTHSTUFX

20A

OTHSTUFX

OTHSTUFX

About how much of this amount was for nonfood items, such as paper
products, detergents, home cleaning supplies, pet foods, and alcoholic
beverages?

0-9999: IF Entry gt 50 then goto ERR1_OTHSTUFX
ELSEIF Entry gt GROCWEKX then goto CK_OTHSTUFX
ELSE goto OTHSTOR

DK,RF: Goto OTHSTOR

20A

OTHSTOR

OTHSTOR

45

Other than your regular grocery shopping already reported, have (you/you or any members of your household) purchased any food or nonalcoholic beverages from places such as grocery stores, convenience stores, specialty stores, home delivery, or farmer's markets?


1. Yes
2. No

1: Goto OSTORWKX

2,DK,RF: Goto DINE_WKX

20A

OSTORWKX

OSTORWKX

What was your usual WEEKLY expense at these places?

0-9999: IF entry lt 5 or gt 90 then goto ERR1_OSTORWKX
ELSE goto DINE_WKX

DK,RF: Goto DINE_WKX

20A

DINE_WKX

DINE_WKX

45

What has been (you/your household) usual WEEKLY expense for meals or snacks from restaurants, fast food places, cafeterias, carryouts or other such places? (Do not include meals purchased at school./ )

1-9999: IF ENTRY lt 10 or gt 120 then goto ERR1_DINEWKX
ELSE goto CIGARETT

0,DK,RF: Goto CIGARETT

20A

CIGARETT

CIGARETT

45

Since the first of (reference month), have (you/you or any members of your household) purchased cigarettes?
Do not include e-cigarettes.


1. Yes
2. No

1: Goto CIGARETX

2,DK,RF: Goto OTHTOBAC

20A

CIGARETX

CIGARETX

What is the usual WEEKLY expense for cigarettes?

0-9999: IF entry lt 5 or gt 80 then goto ERR1_CIGARETX
ELSE goto OTHTOBAC

DK,RF: Goto OTHTOBAC

20A

OTHTOBAC

OTHTOBAC

45 ? [F1]

Have (you/you or any members of your household) purchased other tobacco products such as cigars, pipe tobacco, chewing tobacco, or vaping products?


1. Yes
2. No

1: Goto OTHTBACX

2,DK,RF: Goto ALC_HOMX

20A

OTHTBACX

OTHTBACX

? [F1]

What is the usual WEEKLY expense?

0-999: IF entry lt 5 or gt 80 then goto ERR1_OTHTBACX
ELSE goto ALC_HOMX

DK,RF: Goto ALC_HOMX

20A

ALC_HOMX

ALC_HOMX

45

What has been (you/your household) usual MONTHLY expense for alcohol, including beer and wine to be served at home?

0-9999: IF Entry gt 210 then goto ERR1_ALCHOMX
ELSE goto ALC_OUTX

DK,RF: Goto ALC_OUTX

20A

ALC_OUTX

ALC_OUTX

45

What has been your usual MONTHLY expense for alcohol, including beer and wine at restaurants, bars and recreational events?

0-9999: IF Entry gt 240 then goto ERR1_ALCOUTX
ELSEIF any "active" CU member has AGE lt 22 then goto ANYMEALS
ELSE goto S20A_END

DK,RF: IF any "active"CU member has AGE lt 22 then goto ANYMEALS
ELSE goto S20A_END

20A

ANYMEALS

ANYMEALS

44

Since the first of (reference month), not including (current month), have (you/you or any members of your household) purchased any meals at school for preschool through high school age children?


1. Yes
2. No

1: Goto FBPERSN

2,DK,RF: Goto 20A_END

20A

FBPERSON

FBPERSON

What are the names of all household members who purchased meals at school?

Enter line numbers for all that apply, separate with commas.

1. Person 1
2. Person 2
3. Person 3
4. Person 4
5. Person 5
6. Person 6
7. Person 7
8. Person 8
9. Person 9
10. Person 10
11. Person 11
12. Person 12
13. Person 13
14. Person 14
15. Person 15
16. Person 16
17. Person 17
18. Person 18
19. Person 19
20. Person 20
21. Person 21
22. Person 22
23. Person 23
24. Person 24
25. Person 25
26. Person 26
27. Person 27
28. Person 28
29. Person 29
30. Person 30

1-30: Goto TblSCHMEAL

DK,RF: Goto 20A_END

20A


MEM_NAME

** SHOW ONLY **


20A

SCHLMLX

SCHLMLX

Since the first of (reference month), not including (current month), what has been the usual expense for the meals (Name) purchased at school?

Select time period on the next screen.

Goto SCHMLPD

20A

SCHLMLPD

SCHLMLPD

Specify time period

1. Day
2. Week
3. Two Weeks
4. Month
5. Other, specify

1: IF SCHLMLX gt 10 goto ERR1_SCHLMLPD
ELSE goto SCHMLWKQ

2: IF SCHLMLX lt 5 or gt 30 goto ERR1_SCHLMLPD
ELSE goto SCHMLWKQ

3: IF SCHLMLX lt 5 or gt 60 go to ERR1_SCHLMLPD
ELSE goto SCHMLWKQ

4: IF SCHLMLX lt 5 or gt 120 goto ERR1_SCHLMLPD
ELSE goto SCHMLWKQ

5: Goto SCHLMLSP

DK,RF: Goto SCHMLWKQ

20A

SCHLMSP

SCHLMSP

Specify:

Goto SCHMLWKQ

20A

SCHMLWKQ

SCHMLWKQ

How many WEEKS did ^NAME purchase meals?

IF no more persons then goto S20_END
ELSE goto SCHLMLX for next person

20B

LNDROMAT

LNDROMAT

45 ? [F1]

Since the first of (reference month), not including (current month) have (you/you or any members of your household) had any expenses for self-service laundry machines?


1. Yes
2. No

1: Goto LNDRYX

2,DK,RF: Goto DRYCLEAN

20B

LNDRYX

LNDRYX

? [F1]

What was the total cost?

0-9999: IF Entry lt 5 or gt 260 then goto ERR1_LNDRYX
ELSE goto OTHLNDRY

DK,RF: Goto OTHLNDRY

20B

OTHLNDRY

OTHLNDRY

45 ? [F1]

Was any of this amount for items other than clothes, such as linens or drapes?


1. Yes
2. No

1: Goto OTHLNDRX

2,DK,RF: Goto DRYCLEAN

20B

OTHLNDRX

OTHLNDRX

? [F1]

How much?

0-9999: IF entry lt 5 or gt 100 then goto ERR1_OTHLNDRX
ELSEIF entry gt LNDRYX then goto CK_OTHLNDRX
ELSE goto DRYCLEAN

DK,RF: Goto DRYCLEAN

20B

DRYCLEAN

DRYCLEAN

45 ? [F1]

Have (you/you or any members of your household) had any expenses for dry cleaning or laundry service?


1. Yes
2. No

1: Goto DRYCLNX

2,DK,RF: Goto SALONS

20B

DRYCLNX

DRYCLNX

? [F1]

What was the total cost?

0-9999: IF Entry lt 6 or gt 390 then goto ERR1_DRYCLNX
ELSE goto OTHDRCLN

DK,RF: Goto OTHDRCLN

20B

OTHDRCLN

OTHDRCLN

45 ? [F1]

Was any of this amount for items other than clothes, such as linens, drapes, or rugs?


1. Yes
2. No

1: Goto OTHDCLNX

2,DK,RF: Goto SALONS

20B

OTHDCLNX

OTHDCLNX

? [F1]

How much?

0-9999: IF entry lt 5 or gt 200 then goto ERR1_OTHDRCLNX
ELSEIF entry gt DRYCLNX then goto CK_OTHDCLNX
ELSE goto SALONS

DK,RF: Goto SALONS

20B

SALONS

SALONS

45 ? [F1]

Since the first of (reference month), not including (current month) have (you/you or any members of your household) had any expenses for haircutting, styling, attached hair pieces, manicures, massages or other salon services?


1. Yes
2. No

1: Goto SALONX

2,DK,RF: Goto WIGS

20B

SALONX

SALONX

? [F1]

What was the total expense for these services since the first of (reference month), not including (current month)?

0-9999: IF entry = 1-5 or gt 300 then goto ERR1_SALONX
ELSEIF RT8100.POPGRP = 14 then goto SALNNAME
ELSE goto WIGS

DK,RF: IF RT8100.POPGRP = 14 then goto SALNNAME
ELSE goto WIGS

20B

SALNNAME

SALNNAME

Where did (you/you or any members of your household) last receive any salon services?

Enter name of establishment, not name of salon technician

RESPONSE: IF uppercase version of the entry = "GROUPON" or "GROUPON.COM" then goto ERR_GROUPON
ELSE goto SALNLOC

DK,RF: Goto WIGS

20B

SALNLOC

SALNLOC

Where is ^SALNNAME_fill located?

Enter city and state

Goto WIGS

20B

WIGS

WIGS

45 ? [F1]

Since the first of (reference month), not including (current month) have (you/you or any members of your household) had any expenses for removable hairpieces, wigs or toupees?


1. Yes
2. No

1: Goto WIGSX

2,DK,RF: Goto SAFEDPST

20B

WIGSX

WIGSX

? [F1]

What was the total expense for these items since the first of (reference month), not including (current month)?

0-9999: IF entry = 1-5 or gt 300 then goto ERR1_WIGSX
ELSE goto SAFEDPST

DK,RF: Goto SAFEDPST

20B

SAFEDPST

SAFEDPST

Have (you/you or any members of your household) had any expenses for the rental of a safe deposit box located in a bank or similar financial institution?


1. Yes
2. No

1: Goto SAFDPSTX

2,DK,RF: Goto BANKSRVC

20B

SAFDPSTX

SAFDPSTX

What was the total rental expense for the safe deposit box since the first of (reference month), not including (current month)?

0-999: IF entry gt 100 then goto ERR1_SAFEDPSTX
ELSE goto BANKSRVC

DK,RF: Goto BANKSRVC

20B

BANKSRVC

BANKSRVC

45 ? [F1]

Have (you/you or any members of your household) paid any charges or fees for bank services such as ATM or overdraft fees or account service charges from a bank or similar financial institution?


1. Yes
2. No

1: Goto BANKMOX

2,DK,RF: Goto TXLIMSRV

20B

BANKMOX

BANKMOX

? [F1]

What is the usual MONTHLY charge?

0-99999: IF entry lt 5 or gt 50 then goto ERR1_BANKMOX
ELSE goto TXLIMSRV

DK,RF: Goto TXLIMSRV

20B

TXLIMSRV

TXLIMSRV

45 ? [F1]

Since the first of (reference month) not including (current month), have (you/you or any members of your household) had expenses for taxis, limousine service, or car rides booked through an app? Do not include expenses entirely reimbursed for business purposes or expenses incurred on a trip.


1. Yes
2. No

1: Goto TXLIMX

2,DK,RF: Goto MASSTRAN

20B

TXLIMX

TXLIMX

? [F1]

What was the total expense?

0-9999: IF entry lt 5 or gt 520 then goto ERR1_TXLIMX
ELSEIF RT8100.POPGRP = 11 then goto LIMO
ELSE goto MASSTRAN

DK,RF: Goto MASSTRAN

20B

LIMO

LIMO

Was the $^TXLIMX_fill solely for limousine service?


1. Yes
2. No

1: Goto MASSTRAN

2,DK,RF: Goto TAXINAME

20B

TAXINAME

TAXINAME

What is the name of the last taxi or ride service app that (you/you or any members of your household) used?

IF uppercase version of the entry = "GROUPON" or "GROUPON.COM" then goto ERR_GROUPON

ELSE goto MASSTRAN

20B

MASSTRAN

MASSTRAN

45 ? [F1]

Do (you/you or any members of your household) pay out-of-pocket for public transportation services such as bus, subway, train, or passenger ferry?

Include all forms of public transportation

1. Yes
2. No

1: IF RT8100.POPGRP = 11 then goto MASSNAME
ELSEIF NUMHOUSE = 1 then goto TBLMSTRAN
ELSE goto TRANSIT

2,DK,RF: Goto S20B_END

20B

MASSNAME

MASSNAME

What is the name of the public transportation system (you/your household) ^use_uses_fill?

IF NUMHOUSE = 1 then goto TBLMSTRAN

ELSE goto TRANSIT

20B

TRANSIT

TRANSIT

What are the names of all household members who use mass transit?

Enter line numbers for all that apply, separate with commas

1. Person1
2. Person2
3. Person3
4. Person4
5. Person5
6. Person6
7. Person7
8. Person8
9. Person9
10. Person10
11. Person11
12. Person12
13. Person13
14. Person14
15. Person15
16. Person16
17. Person17
18. Person18
19. Person19
20. Person20
21. Person21
22. Person22
23. Person23
24. Person24
25. Person25
26. Person26
27. Person27
28. Person28
29. Person29
30. Person30

1-30: Goto TBLMSTRAN

DK,RF: Goto S20B_END

20B


MEMBNO

** Non-Displayed**


20B


MEM_NAME

** SHOW ONLY **


20B

TRANAMTX

TRANAMTX

What is (your/NAME's) usual out-of-pocket cost?

Select time period (per day, week, or month) on next screen

1-9999: Goto TRANPD

0,DK,RF: Goto TRANSUB

20B

TRANPD

TRANPD

Select time period

1. Day
2. Week
3. Month

1: IF TRANAMTX = ??? then goto ERR1_ TRANAMTX
ELSE goto TRANDAYX

2: IF TRANAMTX = ??? then goto ERR1_ TRANAMTX
ELSE goto AMTRAK

3: IF TRANAMTX = ??? then goto ERR1_ TRANAMTX
ELSE goto AMTRAK

DK,RF: Goto AMTRAK

20B

TRANDAYX

TRANDAYX

How many days per week usually?

Goto AMTRAK

20B

AMTRAK

AMTRAK

Is any of the ^TRANAMTX_Fill^TRANPD_Fill Amtrak?

1. Yes
2. No

1: Goto AMTRAKX

2,DK,RF: Goto TRANSUB

20B

AMTRAKX

AMTRAKX

How much?

Enter dollar amount ^TRANPD_Fill2

Goto TRANSUB

20B

TRANSUB

TRANSUB

Did (you/NAME) receive a transit subsidy?

1. Yes
2. No

1: Goto TRANSUBX

2,DK,RF: IF no more persons, exit block and goto S20_END
ELSE goto TRANAMTX for the next person

20B

TRANSUBX

TRANSUBX

What is the usual monthly amount?

0-9999: IF entry lt 5 or gt 200 then goto ERR1_TRANSUBX
ELSEIF no more persons, exit block and goto S20_END
ELSE goto TRANAMTX for the next person

DK,RF: IF no more persons, exit block and goto S20_END
ELSE goto TRANAMTX for the next person

20B


S20B_END

** NOT DISPLAYED **

Goto Section 21 - BSECT21

21A

ANYWORK

ANYWORK

Since the first of (reference month), did (you/NAME) earn any income from wages or salary?


1. Yes
2. No

1: Goto 21A_INTRO

2,DK,RF: Goto S21A_CHECK

21A

S21A_INTRO

S21A_INTRO

The next few questions are about income. We know people aren't used to discussing their income, but please be assured that, like all other information you have provided, these answers will be kept strictly confidential.

1. Enter 1 to Continue

Goto INCWEEKQ

21A

INCWEEKQ

INCWEEKQ

(Now I am going to ask about (Your/Name's) work experience and income/ )

In the past 12 months, including paid vacation and sick leave, how many weeks did (you/NAME) work?

If household member did not work, enter zero.

0: Goto INCNONWK

1-52,DK,RF: Goto INC_HRSQ

21A

INC_HRSQ

INC_HRSQ

In the weeks that (you/NAME) worked, how many hours did (you/he/she) usually work per week?

Goto OCCUCODE

21A

OCCUCODE

OCCUCODE

46 ? [F1]

Which of the following categories best describes the job in which (you/NAME) received the most earnings during the past 12 months?


1. Administrator, manager
2. Teacher
3. Professional
4. Administrative support, including clerical
5. Sales, retail
6. Sales, business goods and services
7. Technician
8. Protective service
9. Private household service
10. Other service
11. Machine or transportation operator, laborer
12. Construction workers, mechanics
13. Farming
14. Forestry, fishing, groundskeeping
15. Armed Forces

Goto INCOMEY

21A

INCOMEY

INCOMEY

^WereWas (you/NAME):


1. An employee of a PRIVATE company, business, or individual working for wages or salary?
2. A Federal government employee?
3. A State government employee?
4. A local government employee?
5. Self-employed ^YourHisHer OWN business, partnership, professional practice, or farm?
6. Working WITHOUT PAY in a family business or farm?

Goto SALARYST

21A

INCNONWK

INCNONWK

What was the main reason (you/NAME) did not work during the past 12 months?

^WereWas (you/he/she) -


1. Retired?
2. Taking care of home/family?
3. Going to school?
4. Ill, disabled, unable to work?
5. Unable to find work?
6. Doing something else?

Goto SALARYST

21A

SALARYST

SALARYST

? [F1]

The next few questions are about income DURING THE PAST 12 MONTHS, that is from ^DATE1 to ^DATE2...

Did (you/NAME) receive any wages, salary, tips, bonuses, or commissions?


1. Yes
2. No

1: Goto SALARYX

2,DK,RF: Goto SEMPFRM

21A

SALARYX

SALARYX

? [F1]

How much did (you/NAME) receive before taxes?

1-99999999: IF SALARYX lt 500 or gt 116249 goto ERR1_SALARYX
ELSE goto GROSPAYX

DK,RF: Goto SALARYB

21A

SALARYB

SALARYB

47 ? [F1]

Could you tell me which range on CARD A best reflects (your/NAME's) total wages and salaries for ALL JOBS during the PAST 12 MONTHS?


1. $1-$4,999
2. $5,000-$9,999
3. $10,000-$14,999
4. $15,000-$19,999
5. $20,000-$29,999
6. $30,000-$39,999
7. $40,000-$49,999
8. $50,000-$69,999
9. $70,000-$89,999
10. $90,000-$119,999
11. $120,000 and over

Goto GROSPAYX

21A

GROSPAYX

GROSPAYX

What was the amount of (your/NAME's) last pay before any deductions?

Goto PAYPERD

21A

PAYPERD

PAYPERD

What period of time did this cover?


1. One week
2. Two weeks
3. Month
4. Quarter
5. Year
6. Twice a month
7. Other

1: IF GROSPAYX lt 50 or gt 1635 goto ERR1_PAYPERD
ELSE goto PAYSTUB

2: IF GROSPAYX lt 120 or gt 4800 goto ERR1_PAYPERD
ELSE goto PAYSTUB

3: IF GROSPAYX lt 100 or gt 12000 goto ERR1_PAYPERD
ELSE goto PAYSTUB

4: IF GROSPAYX lt 51 or gt 14583 goto ERR1_PAYPERD
ELSE goto PAYSTUB

5: IF GROSPAYX lt 250 or gt 155000 goto ERR1_PAYPERD
ELSE goto PAYSTUB

6: IF GROSPAYX lt 15 or gt 12838 goto ERR1_PAYPERD
ELSE goto PAYSTUB

7: IF GROSPAYX lt 200 or gt 10000 goto ERR1_PAYPERD
ELSE goto PAYPRDOT

DK,RF: IF GROSPAYX lt 8 or gt 200000 goto ERR1_PAYPERD
ELSE goto PAYSTUB

21A

PAYPRDOT

PAYPRDOT

Specify:

Goto PAYSTUB

21A

PAYSTUB

PAYSTUB

Does the respondent have a paper or electronic pay check record present for (his / her / his/her) last paycheck?

1. Yes
2. No

Goto PRIVPENS

21A

PRIVPENS

PRIVPENS

Was there any money deducted from (your/NAME's) pay for -

Private pension fund?


1. Yes
2. No

1: Goto PRIVPENX

2,DK,RF: Goto GOVRET

21A

PRIVPENX

PRIVPENX

How much?

1-99999999: IF PAYPERD = DK or RF and (PRIVPENX lt 5 or gt 147000) OR PAYPERD = 1 and (PRIVPENX lt 5 or gt 275) OR PAYPERD = 2 and (PRIVPENX lt 8 or gt 644) OR PAYPERD = 3 and (PRIVPENX lt 32 or gt 6000) OR PAYPERD = 4 and (PRIVPENX lt 5 or gt 4500) OR PAYPERD = 5 and (PRIVPENX lt 7 or gt 20000) OR PAYPERD = 6 and (PRIVPENX lt 30 or gt 1000) OR PAYPERD = 7 and (PRIVPENX lt 12 or gt 3000) THEN goto ERR1_PRIVPENX
ELSE goto GOVRET

DK,RF: Goto GOVRET

21A

GOVRET

GOVRET

Was there any money deducted from (your/NAME's) pay for -

Government retirement?


1. Yes
2. No

1: Goto GOVRETX

2,DK,RF: Goto RRRDED

21A

GOVRETX

GOVRETX

How much?

1-99999999: IF GOVRETX lt 5 or gt 590 then goto ERR1_GOVRETX
ELSE goto RRRDED

DK,RF: Goto RRRDED

21A

RRRDED

RRRDED

Was there any money deducted from (your/NAME's) pay for -

Railroad retirement?


1. Yes
2. No

1: Goto RRRDEDX

2,DK,RF: Goto SSDED

21A

RRRDEDX

RRRDEDX

How much?

1-99999999: IF RRRDEDX lt 5 or gt 444 then goto ERR1_RRRDEDX
ELSE goto SSDED

DK,RF: Goto SSDED

21A

SSDED

SSDED

Was there any money deducted from (your/NAME's) pay for -

Social Security including Medicare?


1. Yes
2. No

1: Goto MEDICOV

2,DK,RF: Goto SSNORM

21A

SSNORM

SSNORM

Are Social Security payments NORMALLY deducted from (your/NAME's) pay?


1. Yes
2. No

1: Goto MEDICOV

2,DK,RF: Goto EMPLCONT

21A

MEDICOV

MEDICOV

Does the money deducted for Social Security cover only the Medicare portion of Social Security?


1. Yes
2. No

Goto EMPLCONT

21A

EMPLCONT

EMPLCONT

Other than Social Security, did any employer or union contribute to (your/NAME's) pension or retirement plan in the past 12 months?


1. Yes
2. No

Goto SEMPFRM

21A

SEMPFRM

SEMPFRM

? [F1]
DURING THE PAST 12 MONTHS -

Did (you/NAME) receive any self-employment income or have a loss?

(Report income from own businesses (farm or non-farm) including proprietorships and partnerships)

1. Yes
2. No

1: Goto SEMPFRMX

2,DK,RF: Goto SOCSRRET

21A

SEMPFRMX

SEMPFRMX

? [F1]

What was the amount?

(Report net income after operating expenses. Include earning as a tenant farmer or sharecropper.)

If net income was a loss, precede amount with a '-'
Breakeven = 1

-999999999-999999999: IF SEMPFRMX = 0 then goto CK_SEMPFRMX
ELSEIF SEMPFRMX lt 1 or gt 200000 then goto ERR1_SEMPFRMX
ELSE goto SOCSRRET

DK,RF: Goto SEMPFRMB

21A

SEMPFRMB

SEMPFRMB

47 ? [F1]

Could you tell me which range on CARD A best reflects (your/NAME's) income or loss from self-employment during the PAST 12 MONTHS?


0. Loss
1. $1-$4,999
2. $5,000-$9,999
3. $10,000-$14,999
4. $15,000-$19,999
5. $20,000-$29,999
6. $30,000-$39,999
7. $40,000-$49,999
8. $50,000-$69,999
9. $70,000-$89,999
10. $90,000-$119,999
11. $120,000 and over

Goto SOCSRRET

21A

SOCSRRET

SOCSRRET

? [F1]

DURING THE PAST 12 MONTHS -

Did (you/NAME) receive any Social Security or Railroad Retirement benefits?


1. Yes
2. No

1: Goto RRRETIRX

2,DK,RF: Goto SUPPLINC

21A

RRRETIRX

RRRETIRX

? [F1]

What was the amount of the last Social Security or Railroad Retirement payment received?

1-99999999: IF RRRETIRX lt 139 or gt 6000 then goto ERR1_RRRETIRX
ELSE goto INCMEDCR

DK,RF: Goto RRRETIRB

21A

RRRETIRB

RRRETIRB

48 ? [F1]

Could you tell me which range on CARD B best reflects the amount of (your/NAME's) last Social Security or Railroad Retirement payment during the PAST 12 MONTHS?


1. Less than $500
2. $500-$699
3. $700-$999
4. $1,000-$1,299
5. $1,300-$1,699
6. $1,700 and over

Goto INCMEDCR

21A

INCMEDCR

INCMEDCR

Is this amount AFTER the deduction for a Medicare premium?


1. Yes
2. No

Goto SS_RRQ

21A

SS_RRQ

SS_RRQ

During the past 12 months, how many Social Security or Railroad Retirement payments did (you/NAME) receive?

IF SS_RRQ gt 12 then goto ERR1_SSRRQ

ELSE goto SUPPLINC

21A

SUPPLINC

SUPPLINC

? [F1]

DURING THE PAST 12 MONTHS -

Did (you/NAME) receive any -

Supplemental Security Income (SSI) payments?


1. Yes
2. No

1: Goto SSIX

2,DK,RF: Goto INDRETAC

21A

SSIX

SSIX

? [F1]

What was the amount?

1-99999999: IF SSIX lt 5 or gt 15180 then goto ERR1_SSIX
ELSE goto INDRETAC

DK,RF: Goto SSIB

21A

SSIB

SSIB

49 ? [F1]

Could you tell me which range on CARD C best reflects the amount (you/NAME) received in Supplemental Security income during the past 12 months?


1. $1-$999
2. $1,000-$1,999
3. $2,000-$2,999
4. $3,000-$3,999
5. $4,000-$4,999
6. $5,000-$9,999
7. $10,000-$14,999
8. $15,000-$19,999
9. $20,000-$29,999
10. $30,000-$39,999
11. $40,000-$49,999
12. $50,000 and over

Goto INDRETAC

21A

INDRETAC

INDRETAC

DURING THE PAST 12 MONTHS -

Did (you/NAME) place any money in a retirement plan such as an Individual Retirement Account (IRA) or Keogh? Do not include rollovers.


1. Yes
2. No

1: Goto INDRETX

2,DK,RF: Goto S21A_CHECK

21A

INDRETX

INDRETX

How much?

IF INDRETX lt 75 or gt 18000 AND (ne DK or RF) then goto ERR1_INDRETX

ELSE goto S21A_CHECK

21A


S21A_CHECK

** Non Displayed **

IF no more persons with 8500.INCWEEKQ = 0 or 8500.ANYWORK = 2,DK or RF then goto S21A_END

ELSE goto ANYWORK for the next person

21A


S21A_END

** Non Displayed **

Goto Section 21B

21B

INTERDIV

INTERDIV

? [F1]

^UpUntil_fill

DURING THE PAST 12 MONTHS -

Did (you/you or any members of your household) receive any interest or dividends? Report even small amounts credited to an account.


1. Yes
2. No

1: Goto INTRDVX

2,DK,RF: Goto NETRENT

21B

INTRDVX

INTRDVX

? [F1]

What was the amount?

1-99999999: IF INTRDVX gt 18000 then goto ERR1_INTRDVX
ELSE goto NETRENT

DK,RF: Goto INTRDVB

21B

INTRDVB

INTRDVB

49 ? [F1]

Could you tell me which range on CARD C best reflects the amount (you/you or any members of your household) received in interest or dividends during the PAST 12 MONTHS?


1. $1-$999
2. $1,000-$1,999
3. $2,000-$2,999
4. $3,000-$3,999
5. $4,000-$4,999
6. $5,000-$9,999
7. $10,000-$14,999
8. $15,000-$19,999
9. $20,000-$29,999
10. $30,000-$39,999
11. $40,000-$49,999
12. $50,000 and over

Goto NETRENT

21B

NETRENT

NETRENT

? [F1]

DURING THE PAST 12 MONTHS -

Did (you/you or any members of your household) receive any net rental income or loss?

Net rental income is the total amount after expenses.

1. Yes
2. No

1: Goto NETRENTX

2,DK,RF: Goto ROYEST

21B

NETRENTX

NETRENTX

? [F1]

What was the amount?

The net amount is the total amount after expenses.

If income was a loss, precede amount with a '-'.
Breakeven = 1.

-999999999-999999999: IF NETRENTX = 0 then goto CK_NETRENTX
ELSEIF (NETRENTX lt -150,000 or gt 48,000) then goto ERR1_NETRENTX
ELSE goto ROYEST

DK,RF: Goto NETRENTB

21B

NETRENTB

NETRENTB

49 ? [F1]

Could you tell me which range on CARD C best reflects the total net rental income or loss during the PAST 12 MONTHS?


0. Loss
1. $1-$999
2. $1,000-$1,999
3. $2,000-$2,999
4. $3,000-$3,999
5. $4,000-$4,999
6. $5,000-$9,999
7. $10,000-$14,999
8. $15,999-$19,999
9. $20,000-$29,999
10. $30,000-$39,999
11. $40,000-$49,999
12. $50,000 and over

Goto ROYEST

21B

ROYEST

ROYEST

? [F1]

DURING THE PAST 12 MONTHS -

Did (you/you or any members of your household) receive any royalty income or income from estates and trusts?


1. Yes
2. No

1: Goto ROYESTX

2,DK,RF: Goto RETSURV

21B

ROYESTX

ROYESTX

? [F1]

What was the amount?

1-99999999: IF ROYESTX lt 11 or gt 57926 then goto ERR1_ROYESTX
ELSE goto RETSURV

DK,RF: Goto ROYESTB

21B

ROYESTB

ROYESTB

49 ? [F1]

Could you tell me which range on CARD C best reflects the total amount received in royalty income or income from estates and trusts during the PAST 12 MONTHS?


1. $1-$999
2. $1,000-$1,999
3. $2,000-$2,999
4. $3,000-$3,999
5. $4,000-$4,999
6. $5,000-$9,999
7. $10,000-$14,999
8. $15,000-$19,999
9. $20,000-$29,999
10. $30,000-$39,999
11. $40,000-$49,999
12. $50,000 and over

Goto RETSURV

21B

RETSURV

RETSURV

? [F1]

DURING THE PAST 12 MONTHS -

Did (you/you or any members of your household) receive any retirement, survivor, or disability pensions?


1. Yes
2. No

1: Goto RETSURVX

2,DK,RF: Goto OTHREG

21B

RETSURVX

RETSURVX

? [F1]

What was the amount?

(Do not include Social Security.)

1-99999999: IF RETSURVX lt 125 or gt 10530 then goto ERR1_RETSURVX
ELSE goto OTHREG

DK,RF: Goto RETSURVB

21B

RETSURVB

RETSURVB

49 ? [F1]

Could you tell me which range on CARD C best reflects the total amount received in retirement, survivor, or disability pensions during the PAST 12 MONTHS?


1. $1-$999
2. $1,000-$1,999
3. $2,000-$2,999
4. $3,000-$3,999
5. $4,000-$4,999
6. $5,000-$9,999
7. $10,000-$14,999
8. $15,000-$19,999
9. $20,000-$29,999
10. $30,000-$39,999
11. $40,000-$49,999
12. $50,000 and over

Goto OTHREG

21B

OTHREG

OTHREG

? [F1]

DURING THE PAST 12 MONTHS -

Did (you/you or any members of your household) receive income on a REGULAR basis from any other source such as Veteran's Administration (VA) payments, unemployment compensation, child support, or alimony?


1. Yes
2. No

1: Goto OTHREGX

2,DK,RF: Goto LUMPSUM

21B

OTHREGX

OTHREGX

? [F1]

What was the amount from all sources?

(Do not include lump sum payments such as money from an inheritance or sale of a home.)

1-99999999: IF OTHREGX lt 58 or gt 29812 then goto ERR1_OTHREGX
ELSE goto LUMPSUM

DK,RF: Goto OTHREGB

21B

OTHREGB

OTHREGB

49 ? [F1]

Could you tell me which range on CARD C best reflects the total amount received in Veteran's Administration (VA) payments, unemployment compensation, child support, or alimony during the PAST 12 MONTHS?


1. $1-$999
2. $1,000-$1,999
3. $2,000-$2,999
4. $3,000-$3,999
5. $4,000-$4,999
6. $5,000-$9,999
7. $10,000-$14,999
8. $15,000-$19,999
9. $20,000-$29,999
10. $30,000-$39,999
11. $40,000-$49,999
12. $50,000 and over

Goto LUMPSUM

21B

LUMPSUM

LUMPSUM

? [F1]

DURING THE PAST 12 MONTHS -

Did (you/you or any members of your household) receive any lump sum payments from insurance, estates, trusts, royalties, child support, alimony, prizes or games of chance, or from persons outside your household?


1. Yes
2. No

1: Goto LUMPSUMX

2,DK,RF: Goto OTHERINC

21B

LUMPSUMX

LUMPSUMX

? [F1]

What was the total amount received ^ByMem?

1-99999999: IF LUMPSUMX lt 5 or gt 106000 then goto ERR1_LUMPSUMX
ELSE goto OTHERINC

DK,RF: Goto LUMPSUMB

21B

LUMPSUMB

LUMPSUMB

49 ? [F1]

Could you tell me which range on CARD C best reflects the total lump sum payments during the PAST 12 MONTHS?


1. $1-$999
2. $1,000-$1,999
3. $2,000-$2,999
4. $3,000-$3,999
5. $4,000-$4,999
6. $5,000-$9,999
7. $10,000-$14,999
8. $15,000-$19,999
9. $20,000-$29,999
10. $30,000-$39,999
11. $40,000-$49,999
12. $50,000 and over

Goto OTHERINC

21B

OTHERINC

OTHERINC

? [F1]

DURING THE PAST 12 MONTHS -

Did (you/you or any members of your household) receive any other money income, including money received from cash scholarship and fellowships, stipends not based on working, or from the care of foster children, not already reported?


1. Yes
2. No

1: Goto OTHRINCX

2,DK,RF: Goto MISCTAX

21B

OTHRINCX

OTHRINCX

? [F1]

What was the total amount received (by all household members/ )?

1-99999999: IF OTHRINCX lt 100 or gt 23404 then goto ERR1_OTHRINCX
ELSE goto MISCTAX

DK,RF: Goto OTHRINCB

21B

OTHRINCB

OTHRINCB

49 ? [F1]

Could you tell me which range on CARD C best reflects the total amount of other money income received during the PAST 12 MONTHS?


1. $1-$999
2. $1,000-$1,999
3. $2,000-$2,999
4. $3,000-$3,999
5. $4,000-$4,999
6. $5,000-$9,999
7. $10,000-$14,999
8. $15,000-$19,999
9. $20,000-$29,999
10. $30,000-$39,999
11. $40,000-$49,999
12. $50,000 and over

Goto MISCTAX

21B

MISCTAX

MISCTAX

DURING THE PAST 12 MONTHS -

Did (you/you or any members of your household) PAY any inheritance or estate tax?


1. Yes
2. No

1: Goto MISCTAXX

2,DK,RF: Goto FOODSMP

21B

MISCTAXX

MISCTAXX

What was the total amount PAID (by all household members/ )?

IF MISCTAXX lt 35 or gt 6500 and (ne DK or RF) then goto ERR1_MISCTAXX

ELSE goto FOODSMP

21B

FOODSMP

FOODSMP

DURING THE PAST 12 MONTHS -

Did anyone in this household receive Food Stamps or a Food Stamp benefit card? Include government benefits from the Supplemental Nutritional Assistance Program (SNAP). Do NOT include WIC or the National School Lunch Program.


1. Yes
2. No

1: Goto FS_MTHI

2,DK,RF: Goto WELFARE

21B

FS_MTHI

FS_MTHI

In how many of the past 12 months were food stamps or EBTs received?

Goto FS_AMT

21B

FS_AMT

FS_AMT

What was the dollar value of the last food stamps or EBT received?

1-99999999: IF FS_AMT lt 10 or gt 540 then goto ERR1_FS_AMT
ELSE goto WELFARE

DK,RF: Goto WELFARE

21B

WELFARE

WELFARE

? [F1]

DURING THE PAST 12 MONTHS -

Did (you/you or any members of this household, including children,) receive any welfare payments or cash assistance from the state or local welfare office?

Please include even if only for one month. Do NOT include benefits from food, energy, or rental assistance programs.


1. Yes
2. No

1: Goto WELFAREX

2,DK,RF: Goto MEALSPAY

21B

WELFAREX

WELFAREX

? [F1]

What was the amount for the PAST 12 MONTHS?

1-99999999: IF WELFAREX lt 120 or gt 11064 then goto ERR1_WELFAREX
ELSE goto MEALSPAY

DK,RF: Goto WELFAREB

21B

WELFAREB

WELFAREB

49 ? [F1]

Could you tell me which range on CARD C best reflects the total amount of income from cash assistance from state or local government welfare programs during the PAST 12 MONTHS?


1. $1-$999
2. $1,000-$1,999
3. $2,000-$2,999
4. $3,000-$3,999
5. $4,000-$4,999
6. $5,000-$9,999
7. $10,000-$14,999
8. $15,000-$19,999
9. $20,000-$29,999
10. $30,000-$39,999
11. $40,000-$49,999
12. $50,000 and over

Goto MEALSPAY

21B

MEALSPAY

MEALSPAY

DURING THE PAST 12 MONTHS -

Have (you/you or any members of your household) received any free meals at work as part of your pay?


1. Yes
2. No

1: Goto MLPAYWKX

2,DK,RF: Goto S21B_END

21B

MLPAYWKX

MLPAYWKX

About what was the WEEKLY dollar value of these meals?

IF MLPAYWKX lt 18 or gt 3213 and (ne DK or RF) then goto ERR1_MLPAYWKX

ELSE goto MLPYQWKS

21B

MLPYQWKS

MLPYQWKS

How many weeks did (you/you or any members of your household) receive such meals during the past 12 months?

Goto S21B_END

21B


S21B_END

** Non Displayed **

IF INTNMBR = 4 then goto Section 22

ELSE goto the BBACK block

22

LIAINTRO

LIAINTRO

The next few questions are about financial assets, credit, and loans. We know people aren't used to discussing their debt and financial assets, but we use this information to get a picture of how spending relates to changes in debt and savings. Be assured that, like all other information you have provided, these answers will be kept strictly confidential.

1. Enter 1 to Continue

Goto IRA

22

IRA

IRA

Do (you/you or any members of your household) have any retirement accounts such as 401(k)s, IRAs, Thrift Savings Plans?

1. Yes
2. No

1: Goto IRAX

2,DK,RF: Goto DEFBENRP

22

IRAX

IRAX

? [F1]

As of TODAY --

What is the total value of all retirement accounts such as 401(k)s, IRAs, Thrift Savings Plans that (you/your household) (own/owns)?

1-999999999999: IF IRAX gt 600000 then goto ERR1_IRAX
ELSE Goto IRAYRX

DK,RF: Goto IRAB

22

IRAB

IRAB

50 ? [F1]

Could you tell me which range on CARD D best reflects the total value of all retirement accounts such as 401(k)s, IRAs, and Thrift Savings Plans?


1. $1-$1,999
2. $2,000-$9,999
3. $10,000-$49,999
4. $50,000-$199,999
5. $200,000-$449,999
6. $450,000 and over

1-6: Goto IRAYRX

DK,RF: Goto DEFBENRP

22

IRAYRX

IRAYRX

? [F1]

What was the total value of all retirement accounts ONE YEAR AGO TODAY?

0: Goto IRAYR

1-999999999999: IF IRAYRX gt 600000 then goto ERR1_IRAYRX
ELSE Goto DEFBENRP

DK,RF: Goto IRAYRB

22

IRAYRB

IRAYRB

50 ? [F1]

Could you tell me which range on CARD D best reflects the total value of all retirement accounts ONE YEAR AGO TODAY?


1. $1-$1,999
2. $2,000-$9,999
3. $10,000-$49,999
4. $50,000-$199,999
5. $200,000-$449,999
6. $450,000 and over

Goto DEFBENRP

22

IRAYR

IRAYR

Did (you/you or any members of your household) have any retirement accounts such as 401(k)s, IRAs, Thrift Savings Plans ONE YEAR AGO TODAY?

1. Yes
2. No

Goto DEFBENRP

22

DEFBENRP

DEFBENRP

? [F1]

Do (you/you or any members of your household) have a defined benefit retirement plan, such as a pension from an employer?


1. Yes
2. No

Goto STOCK

22

STOCK

STOCK

? [F1]

Do (you/you or any members of your household) have any directly-held stocks, bonds, or mutual funds (Not in Retirement accounts/ )?

Include U.S. savings bonds

1. Yes
2. No

1: Goto STOCKX

2,DK,RF: Goto LIQUID

22

STOCKX

STOCKX

? [F1]

As of TODAY --

What is the total value of all directly-held stocks, bonds, and mutual funds (Not in Retirement accounts/ ) that (you/your household) (own/owns)?

Include US savings bonds

1-999999999999: IF STOCKX lt 5 or gt 600000 then goto ERR1_STOCKX
ELSE goto STOCKYRX

DK,RF: Goto STOCKB

22

STOCKB

STOCKB

50 ? [F1]

Could you tell me which range on CARD D best reflects the total value of all directly-held stocks, bonds, and mutual funds (Not in Retirement accounts/ )?

Include US savings bonds

1. $1-$1,999
2. $2,000-$9,999
3. $10,000-$49,999
4. $50,000-$199,999
5. $200,000-$449,999
6. $450,000 and over

1-6: Goto STOCKYRX

DK,RF: Goto LIQUID

22

STOCKYRX

STOCKYRX

? [F1]

What was the total value of all directly-held stocks, bonds, and mutual funds (Not in Retirement accounts/ ) ONE YEAR AGO TODAY?

Include US savings bonds

0: Goto STOCKYR

1-999999999999: IF STOCKYRX = 1-5 or gt 600000 then goto ERR1_STOCKYRX
ELSE goto LIQUID

DK,RF: Goto STOCKYRB

22

STOCKYRB

STOCKYRB

50 ? [F1]

Could you tell me which range on CARD D best reflects the total value of all directly-held stocks, bonds, and mutual funds (Not in Retirement accounts/ ) ONE YEAR AGO TODAY?

Include US savings bonds

1. $1-$1,999
2. $2,000-$9,999
3. $10,000-$49,999
4. $50,000-$199,999
5. $200,000-$449,999
6. $450,000 and over

Goto LIQUID

22

STOCKYR

STOCKYR

Did (you/you or any members of your household) have any directly-held stocks, bonds, or mutual funds (Not in Retirement accounts/ ) ONE YEAR AGO TODAY?

Include U.S. savings bonds

1. Yes
2. No

Goto LIQUID

22

LIQUID

LIQUID

Do (you/you or any members of your household) have any checking, savings, money market accounts, or certificates of deposit or CDs?

1. Yes
2. No

1: Goto LIQUIDX

2,DK,RF: Goto WHOLIF

22

LIQUIDX

LIQUIDX

? [F1]

As of TODAY --

What is the total value of all checking, savings, money market accounts, and certificates of deposit or CDs (you/your household) (have/has)?

1-999999999999: IF LIQUIDX gt 200000 then goto ERR1_LIQUIDX
ELSE goto LIQUDYRX

DK, RF: Goto LIQUIDB

22

LIQUIDB

LIQUIDB

51 ? [F1]

Could you tell me which range on CARD E best reflects the total value of checking, savings, money market accounts, and certificates of deposit or CDs?


1. $1-$499
2. $500-$999
3. $1,000-$2,499
4. $2,500-$9,999
5. $10,000-$34,999
6. $35,000 and over

1-6: Goto LIQUDYRX

DK, RF: Goto WHOLIF

22

LIQUDYRX

LIQUDYRX

? [F1]

What was the total value of all checking, savings, money market accounts, and certificates of deposit or CDs ONE YEAR AGO TODAY?

0: Goto LIQUDYR

1-999999999999: IF LIQUDYRX gt 200000 then goto ERR1_LIQUDYRX
ELSE goto WHOLIF

DK,RF: Goto LIQUDYRB

22

LIQUDYRB

LIQUDYRB

51 ? [F1]

Could you tell me which range on CARD E best reflects the total value of all checking, savings, money market accounts, and certificates of deposit or CDs ONE YEAR AGO TODAY?


1. $1-$499
2. $500-$999
3. $1,000-$2,499
4. $2,500-$9,999
5. $10,000-$34,999
6. $35,000 and over

Goto WHOLIF

22

LIQUDYR

LIQUDYR

Did (you/you or any members of your household) have any checking, savings, money market accounts, or certificates of deposit or CDs ONE YEAR AGO TODAY?

1. Yes
2. No

Goto WHOLIF

22

WHOLIF

WHOLIF

? [F1]
(Do/Does) (you/your household) own any whole life insurance or other life insurance policies that can be surrendered for cash or borrowed against prior to the death of the person insured?

Also include universal life and variable life insurance
Do NOT include term life insurance or other policies that only have a benefit upon death or disability

1. Yes
2. No

1: Goto WHOLIFX

2,DK,RF: Goto OTHAST

22

WHOLIFX

WHOLIFX

? [F1]

As of TODAY --

What is the total surrender value of these policies?

Surrender value is also known as the cash value

Enter the amount that can be borrowed or withdrawn prior to death, NOT the benefit upon
death of the insured

1-999999999999: IF WHOLIFX gt 70000 then goto ERR1_WHOLIFX
ELSE goto WHLFYRX

DK,RF: Goto WHOLIFB

22

WHOLIFB

WHOLIFB

51 ? [F1]
Could you tell me which range on CARD E best reflects the total surrender value of these policies?

Surrender value is also known as the cash value
Enter the amount that can be borrowed or withdrawn prior to death, NOT the benefit upon
death of the insured


1. $1-$499
2. $500-$999
3. $1,000-$2,499
4. $2,500-$9,999
5. $10,000-$34,999
6. $35,000 and over

1-6: Goto WHLFYRX

DK,RF: Goto OTHAST

22

WHLFYRX

WHLFYRX

? [F1]

What was the total surrender value of these policies ONE YEAR AGO TODAY?

Surrender value is also known as the cash value

Enter the amount that can be borrowed or withdrawn prior to death, NOT the benefit upon
death of the insured

0: Goto WHLFYR

1-999999999999: IF WHLFYRX gt 70000 then goto ERR1_WHLFYRX
ELSE goto OTHAST

DK,RF: Goto WHLFYRB

22

WHLFYRB

WHLFYRB

51 ? [F1]
Could you tell me which range on CARD E best reflects the total surrender value of these policies ONE YEAR AGO TODAY?

Surrender value is also known as the cash value
Enter the amount that can be borrowed or withdrawn prior to death, NOT the benefit upon
death of the insured


1. $1-$499
2. $500-$999
3. $1,000-$2,499
4. $2,500-$9,999
5. $10,000-$34,999
6. $35,000 and over

Goto OTHAST

22

WHLFYR

WHLFYR

Did (you/your household) own any whole life insurance or other life insurance policies that can be surrendered for cash or borrowed against prior to the death of the person insured ONE YEAR AGO TODAY?

Also include universal life and variable life insurance

Do NOT include term life insurance or other policies that only have a benefit upon death or disability

1. Yes
2. No

Goto OTHAST

22

OTHAST

OTHAST

(Do/Does) (you/your household) have any other financial assets, such as annuities, trusts, and royalties?

1. Yes
2. No

1: Goto OTHASTX

2,DK,RF: Goto CREDIT

22

OTHASTX

OTHASTX

As of TODAY --

What is the total value of these other financial assets?

1-999999999999: IF OTHASTX lt 5 or gt 600000 then goto ERR1_OTHASTX
ELSE goto OTHSTYRX

DK, RF: Goto OTHASTB

22

OTHASTB

OTHASTB

50

Could you tell me which range on CARD D best reflects the total value of these other financial assets?


1. $1-$1,999
2. $2,000-$9,999
3. $10,000-$49,999
4. $50,000-$199,999
5. $200,000-$449,999
6. $450,000 and over

1-6: Goto OTHSTYRX

DK, RF: Goto CREDIT

22

OTHSTYRX

OTHSTYRX

What was the total value of these other financial assets ONE YEAR AGO TODAY?

0: Goto OTHSTYR

1-999999999999: IF OTHSTYRX =1-5 or gt 600000 then goto ERR1_OTHSTYRX
ELSE goto CREDIT

DK,RF: Goto OTHSTYRB

22

OTHSTYRB

OTHSTYRB

50

Could you tell me which range on CARD D best reflects the total value of these other financial assets ONE YEAR AGO TODAY?


1. $1-$1,999
2. $2,000-$9,999
3. $10,000-$49,999
4. $50,000-$199,999
5. $200,000-$449,999
6. $450,000 and over

Goto CREDIT

22

OTHSTYR

OTHSTYR

Did (you/your household) have any other financial assets, such as annuities, trusts, and royalties ONE YEAR AGO TODAY?

1. Yes
2. No

Goto CREDIT

22

CREDIT

CREDIT

? [F1]

(Do/Does) (you/your household) have any credit cards including store cards and gas cards?


1. Yes
2. No

1: Goto CREDITX

2,DK,RF: Goto STUDNT

22

CREDITX

CREDITX

? [F1]

What is the total amount owed on all cards as of TODAY?

0-999999999999: IF CREDITX = 1-9 or gt 30000 then goto ERR1_CREDITX
ELSE goto CREDTYRX

DK, RF: Goto CREDITB

22

CREDITB

CREDITB

51 ? [F1]

Could you tell me which range on CARD E best reflects the total amount owed on all major credit cards including store cards and gas cards?


1. $1-$499
2. $500-$999
3. $1,000-$2,499
4. $2,500-$9,999
5. $10,000-$34,999
6. $35,000 and over

1-6: Goto CREDTYRX

DK,RF: Goto CREDFINX

22

CREDTYRX

CREDTYRX

? [F1]

What was the total amount owed on all cards ONE YEAR AGO TODAY?

0: Goto CREDYR

1-999999999999: IF CREDTYRX = 1-9 or gt 30000 then goto ERR1_CREDTYRX
ELSE goto CREDFINX

DK, RF: Goto CREDYRB

22

CREDYRB

CREDYRB

51 ? [F1]

Could you tell me which range on CARD E best reflects the total amount owed on all major credit cards including store cards and gas cards ONE YEAR AGO TODAY?


1. $1-$499
2. $500-$999
3. $1,000-$2,499
4. $2,500-$9,999
5. $10,000-$34,999
6. $35,000 and over

Goto CREDFINX

22

CREDYR

CREDYR

Did (you/your household) have any credit cards including store cards and gas cards ONE YEAR AGO TODAY?

1. Yes
2. No

Goto CREDFINX

22

CREDFINX

CREDFINX

What was the total amount paid in finance, late charges, and interest for all cards in (last month)?

0-999999999999: IF CREDFINX gt 700 then goto ERR1_CREDFINX
ELSE Goto STUDNT

DK, RF: Goto STUDNT

22

STUDNT

STUDNT

? [F1]

As of TODAY --

(Do/Does) (you/your household) have any student loans?


1. Yes
2. No

1: Goto STUDNTX

2, DK, RF: Goto OTHLOAN

22

STUDNTX

STUDNTX

? [F1]

What is the total amount owed on all student loans?

1-999999999999: IF STUDNTX lt 50 or gt 72000 then goto ERR1_STUDNTX
ELSE goto STDNTYRX

DK, RF: Goto STUDNTB

22

STUDNTB

STUDNTB

51 ? [F1]

Could you tell me which range on CARD E best reflects the total amount owed on all student loans?


1. $1-$499
2. $500-$999
3. $1,000-$2,499
4. $2,500-$9,999
5. $10,000-$34,999
6. $35,000 and over

1-6: Goto STDNTYRX

DK, RF: Goto STUDFINX

22

STDNTYRX

STDNTYRX

? [F1]

What was the total amount owed on all student loans ONE YEAR AGO TODAY?

0: Goto STDNTYR

1-999999999999: IF STDNTYRX = 1-49 or gt 72000 then goto ERR1_STDNTYRX
ELSE goto STUDFINX

DK, RF: Goto STDNTYRB

22

STDNTYRB

STDNTYRB

51 ? [F1]

Could you tell me which range on CARD E best reflects the total amount owed on all student loans ONE YEAR AGO TODAY?


1. $1-$499
2. $500-$999
3. $1,000-$2,499
4. $2,500-$9,999
5. $10,000-$34,999
6. $35,000 and over

Goto STUDFINX

22

STDNTYR

STDNTYR

Did (you/your household) have any student loans ONE YEAR AGO TODAY?

1. Yes
2. No

Goto STUDFINX

22

STUDFINX

STUDFINX

What was the total amount paid in finance, late charges, and interest for all student loans in (last month)?

0-999999999999: IF STUDFINX gt 375 then goto ERR1_STUDFINX
ELSE goto OTHLOAN

DK, RF: Goto OTHLOAN

22

OTHLOAN

OTHLOAN

? [F1]
As of TODAY --

(Do/Does) (you/your household) have any other debt such as medical loans or personal loans?

Do not include mortgages, home equity loans, or vehicle loans

1. Yes
2. No

1: Goto OTHLONX

2,DK,RF: Goto S22_END

22

OTHLONX

OTHLONX

? [F1]

What is the total amount owed on all other loans?

Do not include mortgages, home equity loans, or vehicle loans

1-999999999999: IF OTHLONX lt 50 or gt 72000 then goto ERR1_OTHLONX
ELSE goto OTHLNYRX

DK,RF: Goto OTHLONB

22

OTHLONB

OTHLONB

51 ? [F1]

Could you tell me which range on CARD E best reflects the total amount owed on all other loans?

Do not include mortgages, home equity loans, or vehicle loans

1. $1-$499
2. $500-$999
3. $1,000-$2,499
4. $2,500-$9,999
5. $10,000-$34,999
6. $35,000 and over

1-6: Goto OTHLNYRX

DK,RF: Goto OTHFINX

22

OTHLNYRX

OTHLNYRX

? [F1]

What was the total amount owed on all other loans ONE YEAR AGO TODAY?

Do not include mortgages, home equity loans, or vehicle loans

0: Goto OTHLNYR

1-999999999999: IF OTHLNYRX = 1-49 or gt 72000 then goto ERR1_OTHLNYRX
ELSE goto OTHFINX

DK,RF: Goto OTHLNYRB

22

OTHLNYRB

OTHLNYRB

51 ? [F1]

Could you tell me which range on CARD E best reflects the total amount owed on all other loans ONE YEAR AGO TODAY?

Do not include mortgages, home equity loans, or vehicle loans

1. $1-$499
2. $500-$999
3. $1,000-$2,499
4. $2,500-$9,999
5. $10,000-$34,999
6. $35,000 and over

Goto OTHFINX

22

OTHLNYR

OTHLNYR

Did (you/your household) have any other debt such as medical loans or personal loans ONE YEAR AGO TODAY?

Do not include mortgages, home equity loans, or vehicle loans

1. Yes
2. No

Goto OTHFINX

22

OTHFINX

OTHFINX

What was the total amount paid in finance, late charges, and interest for all other loans in (last month)?

Do not include mortgages, home equity loans, or vehicle loans

0-999999999999: IF OTHFINX gt 375 then goto ERR1_OTHFINX
ELSE goto S22_END

DK, RF: Goto S22_END

22


S22_END

** Non Displayed **


BACK


AFTERMID

** Non Displayed **

IF COMPLETE_FLAG = 1 and NOCONTACT = 0 and INTNMBR = 4 then goto BlkAPPT.BResearch

IF COMPLETE_FLAG = 1 then goto DK_THANK

IF INTROB = 6 then goto APPTOTH

IF START = 4 OR INTROB = 2 or 4 then goto VERIFY_INFO

IF START = 3 then goto TRANS

IF INTROB = 5 OR REPLACE_VER2 = 1 OR ONE_CU = 1 OR MULTI_CU = 1 then goto DONE

IF (TYPEC = 3, 7, 10-12) then goto DONE

IF NONTYP = 1-3 then goto THANK2

ELSE goto SKIP_CHECK

BACK

SKIP_CHECK

SKIP_CHECK

Some Sections have been skipped.
Is there anyone in the household now that would be able to provide information on:

Press Shift-F5 to view the status table


1. Yes
2. No
3. Battery problem

1: Goto SK_RESP

2: Goto APPTOTH

3: Goto DONE

BACK

SK_RESP

SK_RESP

Ask if necessary:

With whom am I speaking?

ENTER LINE NUMBER or 95. For proxy respondent

1. ^NAME[1]
2. ^NAME[2]
3. ^NAME[3]
4. ^NAME[4]
5. ^NAME[5]
6. ^NAME[6]
7. ^NAME[7]
8. ^NAME[8]
9. ^NAME[9]
10. ^NAME[10]
11. ^NAME[11]
12. ^NAME[12]
13. ^NAME[13]
14. ^NAME[14]
15. ^NAME[15]
16. ^NAME[16]
17. ^NAME[17]
18. ^NAME[18]
19. ^NAME[19]
20. ^NAME[20]
21. ^NAME[21]
22. ^NAME[22]
23. ^NAME[23]
24. ^NAME[24]
25. ^NAME[25]
26. ^NAME[26]
27. ^NAME[27]
28. ^NAME[28]
29. ^NAME[29]
30. ^NAME[30]
95. Proxy Respondent

1-30: IF (SKIPFLAG[SK_RESP] = 1) OR (SK_RESP gt NROSIZ) OR (AGERNG[SK_RESP] lt 2) OR (HHMEM[SK_RESP] = 2) then goto CK_SK_RESP

ELSE goto SK_RESP2

95: Goto SK_RESP2

BACK

RES_INTRO

RES_INTRO

We would like to improve the survey taking experience for others and your feedback can help us do that. Please think of your involovement in this survey as a whole when answering these next few questions.

1. Enter 1 to Continue

Goto RES01

Back

RES01

RES01

How burdensome was this survey to you? Would you say:

1. Not at all burdensome?
2. A little burdensome?
3. Somewhat burdensome?
4. Very burdensome?
5. Very burdensome?

Goto RES02

Back

RES02

RES02

How difficult was it for you to answer the questions in this survey?

1. Not at all difficult
2. A little difficult
3. Somewhat difficult
4. Very difficult
5. Extremely difficult

Goto RES03

Back

RES03

RES03

How sensitive did you feel the questions I asked today were?

1. Not at all sensitive
2. A little sensitive
3. Somewhat sensitive
4. Very sensitive
5. Extremely sensitive

Goto RES04

Back

RES04

RES04

In thinking about the length of today's survey, would you say that it was...

1. Very short?
2. Somewhat short?
3. Neither short nor long?
4. Somewhat long?
5. Very long?

Exit BResearch block and goto DK_CHECK

BACK

APPTOTH

APPTOTH

I'd like to schedule a DATE to (conduct/complete) the interview.
What DATE AND TIME would be best to visit again?

Today is: (current date) B. Battery problem

Missing Sections: Press shift-F5 to view the status table

25 characters: Goto THANKCB

B: Goto DONE

RF: IF outcome = 202 then goto CBREF
ELSE goto VERIFY_INFO

BACK

CBREF

CBREF

Exit this case now.
Call the case up again and make it a TYPE A non-interview before transmitting.


1. Enter 1 to Continue

Goto VERIFY_INFO

BACK

THANKCB

THANKCB

Thank you.

I will come back at the time suggested

Revisit (Appointment information)

1. Enter 1 to Continue

Goto VERIFY_INFO

BACK

DK_CHECK

DK_CHECK

Are there any Don't Know items that you need to callback for?

Press Ctrl-M to review all Don't Knows


1. Yes
2. No

1: Goto DK_APPT

2: Goto THANKYOU

BACK

DK_APPT

DK_APPT

I'd like to schedule a DATE to complete the missing items.
What DATE AND TIME would be best to visit you again?

Today is (current date)

DK Items: Press Ctrl-M to review all Don't Knows

Goto DK_THANK

BACK

DK_THANK

DK_THANK

Thank you.

I will come back at the time suggested.

Revisit: (Appointment information)

1. Enter 1 to Continue

Goto VERIFY_INFO

BACK

THANKYOU

THANKYOU

This concludes the interview. Thank you for your patience, and for taking the time to answer our questions.

Let me remind you that the information you provide is very valuable because it is used to update the Consumer Price Index, which is one of our nation's leading economic indicators.

That is why we sincerely appreciate your participation in this survey(and look forward to your continued support when we contact you again in 3 months.).

Interview number: (1/2/3/4/5)
NOTE: Inform the respondent that a supervisor may call them to conduct re-interview.
Explain re-interview as needed.


1. Enter 1 to Continue

IF INTNMBR = 1-3 then goto QTRAPPT
ELSE goto HOW_INTV

BACK

QTRAPPT

QTRAPPT

Today is (current date). I would like to return during the first week of (month) to conduct your next interview. What day and time works best with your schedule?

Enter date and time of the next quarter appointment.

Give respondent an appointment card with the filled-in date and time with Regional Office or Field Representative contact information.

NOTE : If you are not making an appointment for the next interview, press Enter.

Goto HOW_INTV

BACK

THANK2

THANK2

Thank you for your time. You've been very helpful.

NOTE: Inform the respondent that a supervisor
may call them to conduct re-interview.
Explain re-interview as needed.

Interview number: (1/2/3/4/5)


1. Enter 1 to Continue

IF BCNAME ne blank then goto VERIFY_INFO

ELSEIF NONTYP = 1-3 then goto TELPV

ELSE goto DONE

BACK

TRANS

TRANS


Are you ready to transmit this case?


1. Yes
2. No

1: Goto MISS_SEC

2: Goto VERIFY_INFO

BACK

MISS_SEC

MISS_SEC

No survey data were collected for a required section(s).

Press F5 to view status table

Enter the reason that best describes why survey data was not collected.

Goto TELPV

BACK

HOW_INTV

HOW_INTV

How did you collect the data for this (first/second/third/fourth) interview for this household?

1. Personal visit for all sections
2. Personal visit for all sections, but telephone followup for some questions
3. Personal visit for more than half of the sections, the rest by telephone
4. Equally split between personal visit and telephone
5. Telephone for more than half of the sections, the rest by personal visit
6. Telephone for all sections

1,6: Goto SNGL_INT

2: Goto TEL_RESN

3,4,5: Goto TEL_SECT

BACK

SNGL_INT

SNGL_INT

Were you able to conduct the interview in a single (visit/call)?


1. Yes
2. No

IF HOW_INTV = 6 then goto TEL_RESN
ELSE goto CONVREF

BACK

TEL_SECT

TEL_SECT

Which of these sections did you collect entirely by telephone?

Enter all that apply, separate with commas.

Do not select 6 or 7 if any part of the section was collected in person.


1. Sections 2 and 3 Housing - rent, mortgage, home equity loans.
2. Section 4 Utilities/Communications (electricity, heating, telephone, cable, internet).
3. Section 6 Appliances
4. Section 8 Home Furnishings
5. Section 9 Clothing
6. Sections 10, 11, and 12 Vehicle Expenses
7. Sections 13 and 15 Insurance
8. Section 14 Medical/Health Expenses
9. Section 18 Trips and Vacations
10. Section 21 Work Experience and Income

Goto TEL_RESN

BACK

TEL_RESN

TEL_RESN

What was the main reason for collecting data by telephone?


1. Barriers to reaching the sample unit (i.e., doorman, security, dog).
2. Collecting data from additional respondent(s) in household
3. Excessive distance or travel time to sample unit.
4. Respondent called FR to do interview.
5. Respondent only available by telephone (scheduling issues).
6. Respondent refused personal visit.
7. Respondent requested telephone interview.
8. Other (Specify).

1-7: Goto CONVREF

8: Goto OTHTLRSN

BACK

OTHTLRSN

OTHTLRSN

Specify

Goto CONVREF

BACK

TELPV

TELPV

How did you collect MOST of the data for this case?
(Include follow-ups)



1. By personal visit
2. By phone

IF Bcoverage.NONTYP = 1 AND SECTCOMP[2 or 3] = 1 AND NOCONTACT = 0 then goto RESPON

ELSE goto DONE

BACK

CONVREF

CONVREF

? [F1]

Was this a converted refusal?


1. Yes
2. No

Goto RESPON

BACK

RESPON

RESPON

Enter the line number of the MAIN respondent.

1. ^NAME[1]
2. ^NAME[2]
3. ^NAME[3]
4. ^NAME[4]
5. ^NAME[5]
6. ^NAME[6]
7. ^NAME[7]
8. ^NAME[8]
9. ^NAME[9]
10. ^NAME[10]
11. ^NAME[11]
12. ^NAME[12]
13. ^NAME[13]
14. ^NAME[14]
15. ^NAME[15]
16. ^NAME[16]
17. ^NAME[17]
18. ^NAME[18]
19. ^NAME[19]
20. ^NAME[20]
21. ^NAME[21]
22. ^NAME[22]
23. ^NAME[23]
24. ^NAME[24]
25. ^NAME[25]
26. ^NAME[26]
27. ^NAME[27]
28. ^NAME[28]
29. ^NAME[29]
30. ^NAME[30]
95. Proxy Respondent

If (BControlcard.TUnit1.Person.HH_MEM[RESPON] = 2) OR (BControlcard.TUnit2.Person.AGERNG[RESPON] = 1) OR (BControlcard.TUnit1.Person.PERSTAT[RESPON] = 7, 8 or 99) OR (BControlcard.TUnit1.Person.MEMBSTAT[RESPON] = 1, 3 or 5) then goto CK_RESPON

ELSE goto OTHRSP

BACK

OTHRSP

OTHRSP

Enter the line number of ALL OTHER respondents.

Enter 0 For None


(Display Names of persons in the household)

0. None
1. ^NAMEonly(1)
2. ^NAMEonly(2)
3. ^NAMEonly(3)
4. ^NAMEonly(4)
5. ^NAMEonly(5)
6. ^NAMEonly(6)
7. ^NAMEonly(7)
8. ^NAMEonly(8)
9. ^NAMEonly(9)
10. ^NAMEonly(10)
11. ^NAMEonly(11)
12. ^NAMEonly(12)
13. ^NAMEonly(13)
14. ^NAMEonly(14)
15. ^NAMEonly(15)
16. ^NAMEonly(16)
17. ^NAMEonly(17)
18. ^NAMEonly(18)
19. ^NAMEonly(19)
20. ^NAMEonly(20)
21. ^NAMEonly(21)
22. ^NAMEonly(22)
23. ^NAMEonly(23)
24. ^NAMEonly(24)
25. ^NAMEonly(25)
26. ^NAMEonly(26)
27. ^NAMEonly(27)
28. ^NAMEonly(28)
29. ^NAMEonly(29)
30. ^NAMEonly(30)
95. Proxy respondent

IF OTHRSP = RESPON then goto CK_OTHRSP
ELSEIF (BControlcard.Tunit1.Person.FNAME[Othrsp] = 999 or EMPTY) or (BControlcard.Tunit1.Person.HH_MEM[othrsp] = 2) OR (BControlcard.Tunit1.Person.MEMBSTAT[othrsp] = 1, 3 or 5) OR (BControlcard.Tunit1.Person.PERSTAT[othrsp] = 7, 8 or 99) then goto CK2_OTHRSP
ELSEIF 0 is selected with other answer list options then goto CK3_OTHRSP
ELSE goto USERECS

BACK

USERECS

USERECS

In this interview, how often did the respondent consult records?


1. Always or almost always
2. Most of the time
3. Occasionally or used at least one record
4. Never, no records used

1-3: Goto TYPERECS

4: Goto HOMEFILE

BACK

TYPERECS

TYPERECS

What types of bills, receipts, or records did the respondent(s) use to answer expenditure questions?

Enter all that apply, separate with commas.



1. Bills
2. Checkbook ledger or check stubs
3. Personal finance or budgeting software records
4. Receipts or e-mail receipts
5. Home file (provided by Census Bureau)
6. Contracts or agreements
7. Credit card, bank, or online bill-paying statements
8. Pay stub
9. Other- specify

1-8: Goto RSECTN

9: Goto SPECRECS

BACK

SPECRECS

SPECRECS

Specify

Goto RSECTN

BACK

RSECTN

RSECTN

Which of these sections did the respondent(s) use bills, receipts, or other resources to answer
expenditure questions?


Enter all that apply, separate with commas.

1. Section 1 - General Housing Characteristics
2. Section 2 - Rental Living Quarters
3. Sections 3 - Owned Living Quarters & Other Owned Real Estate
4. Section 4 - Utilities and Fuels
5. Section 5 - Construction, Repairs, Alterations, and Maintenance of Property
6. Section 6 - Appliances, Household Equipment, and Other Selected Items
7. Section 7 - Household Item Repairs, Service Contracts, and Extended Warranties
8. Section 8 - Home Furnishings and Related Household Items
9. Section 9 - Clothing and Clothing Services
10. Section 10 - Rented and Leased Vehicles
11. Section 11 - Owned vehicles
12. Section 12 - Vehicle Operating Expenses
13. Section 13 - Health Insurance
14. Section 14 - Medical and Health Expenses
15. Section 15 - Insurance Other than Health
16. Section 16 - Educational Expenses
17. Section 17 - Subscriptions, Memberships, Books, and Entertainment Expenses
18. Section 18 - Trips and Vacations
19. Section 19 - Miscellaneous Expenses
20. Section 20 - Expense Patterns for Selected Goods and Services
21. Section 21 - Work Experience and Income
22. Section 22 - Assets and Liabilities

Goto HOMEFILE

BACK

HOMEFILE

HOMEFILE


Did you give the respondent a Home File this quarter?


1. Yes
2. No

Goto INFOBOOK

BACK

INFOBOOK

INFOBOOK


In the interview, how often did the respondent consult the information booklet?

If reading the book to the respondent, enter 5.


1. Almost always (90% of the time or more)
2. Most of the time (50% to 89% of the time)
3. Occasionally (10% to 49% of the time)
4. Never or almost never (less than 10% of the time)
5. The respondent did not have access to the information booklet.

Goto LANGUAGE

BACK

LANGUAGE

LANGUAGE


In what language was the interview conducted?


1. English
2. Spanish
3. Other - specify

1,2: Goto VERIFY_INFO

3: Goto LANG_SP

BACK

LANG_SP

LANG_SP

Specify

Goto VERIFY_INFO

BACK

VERIFY_INFO

VERIFY_INFO


Verify/change any of the information listed below

Telephone number: ((area)) (phone number) (Extension)
Second phone: (2nd phone number) (2nd phone extension)
Best time to call : (Bestime code description)
Specific best time: (best time specify)

No Sunday: ((No Sunday Interview/Sunday interview okay))



1. Enter 1 to Continue
2. Change something

1: Goto DONE

2: Goto V_PHONE

BACK

V_PHONE

V_PHONE

What is your telephone number?

Enter 0 for none.

IF entry lt 10 digits and ne 0 then goto CK_VPHONE
ELSE goto V_BSTTI

BACK

V_BSTTI

V_BSTTI

Best time to contact


1. Morning (9am-12noon)
2. Noon/lunchtime (11am-1pm)
3. Afternoon (12noon-4pm)
4. Suppertime/early evening/dinnertime(4pm-7pm)
5. Evening (6pm-9pm)
6. Anytime (9am-9pm)
7. Late evening/night (7pm-9pm)
8. Daytime (9am-4pm)
9. After 5pm
10. Battery problem

1-9, Empty: Goto V_BSTTI2

10: Goto DONE

BACK

V_BSTTI2

V_BSTTI2

Enter specific best time to contact

Goto V_NOSUN

BACK

V_NOSUN

V_NOSUN

Would a Sunday interview be acceptable?


1. Yes
2. No
3. battery problem

Goto DONE

BACK


DONE

** Non Displayed **

Goto SET_REINT

BACK


SET_REINT

** Non Displayed **

Exit Instrument

CHI

CTATEMPT

CTATEMPT

CONTACT HISTORY INSTRUMENT

Describe this contact attempt.

1. Personal visit
2. Telephone (outgoing)
3. Telephone (incoming)
4. Not attempting contact

1-3: Goto TIMEOFCT

4: Goto NOATTEMPT

CHI

TIMEOFCT

TIMEOFCT

TIME OF CONTACT

Are you entering the Contact History Instrument at the time of a contact attempt?


1. Yes
2. No

1: Goto CASECONTACT

2: Goto FR_DATE

CHI

FR_DATE

FR_DATE

DATE OF CONTACT
Enter the date of the contact attempt in MM/DD/YYYY format

Goto FRTIME

CHI

FRTIME

FRTIME

TIME OF CONTACT
Enter the time of the contact attempt in HH:MM am/pm format

Goto CASECONTACT

CHI

NOATTEMPT

NOATTEMPT

NOT ATTEMPTING CONTACT

What were you doing?
Enter all that apply, separate with commas.

1. Reviewing or changing case information
2. Readying case for transmission
3. Doing ACS geocode verification
4. Locating activities (canvassing, management or government office, FastData, ALMI, etc.)
5. Verification of Type B/C
6. Opened case/ CHI by mistake
99. Other - specify

1-6: Exit CHI
99: Goto SPECNOATTEMPT

CHI

SPECNOATTEMPT

SPECNOATTEMPT

OTHER NOT ATTEMPTING CONTACT

Specify other activites you were doing

Exit CHI

CHI

CASECONTACT

CASECONTACT

CONTACT OR NONCONTACT

Select the category that best describes this attempt.


1. Contact with sample unit member
2. Contact with NON-SAMPLE unit member
3. Noncontact

1: Goto CTTYPE

2,3: IF CTATEMPT = 1 then goto NCTPER
ELSE goto NCTTEL

CHI

CTTYPE

CTTYPE

CONTACT

Select the category that best describes this contact attempt.


1. Completed case - ready to transmit
2. Partial interview - follow-up required
3. Unable to conduct interview

1: Goto RSPNDENT

2,3: Goto NONINTER

CHI

NONINTER

NONINTER

PARTIAL INTERVIEW OR UNABLE TO CONDUCT INTERVIEW

Select the categories that describe why you were not able to conduct or complete the interview during this contact attempt.
Enter all that apply, separate with commas.


1. Eligible person not available
2. Inconvenient time
3. Respondent is reluctant
4. Language problem - specify
5. Health problem
6. Successful paper questionnaire placement / pick-up
99. Other - specify

1-3,5,6: Goto RSPNDENT

4: Goto cLANGUAGE

99: Goto CTOTHER

CHI

CTOTHER

CTOTHER

OTHER Contact Category
Specify the reason for not completing the interview during this contact attempt.

Goto RSPNDENT

CHI

cLANGUAGE

cLANGUAGE

LANGUAGE

Select the categories that descrige this language situation.
Enter all that apply, separate with commas.


1. Specify language or dialect
2. No household member able to translate
3. Contact RO about language problem
4. Unable to find translator
5. No time left to find translator

IF 1 selected then goto LANGLIST

ELSE goto RSPNDENT

CHI

LANGLIST

LANGLIST

LANGUAGE LIST

Specify language or dialect


11. Spanish
12. Arabic
13. Chinese
14. French
15. German
16. Greek
17. Italian
18. Japanese
19. Korean
20. Polish
21. Portuguese
22. Russian
23. Tagalog
24. Urdu
25. Vietnamese
97. Other problem - hard of hearing
98. Unknown language
99. Other

11-25, 97, 98: Goto RSPNDENT

99: Goto SPECLANG

CHI

SPECLANG

SPECLANG

SPECIFY LANGUAGE OR DIALECT.

Goto RSPNDENT

CHI

RSPNDENT

RSPNDENT

CONCERN / BEHAVIOR / RELUCTANCE

Select the categories that describe respondent concerns, behaviors, or reluctance during this contact
attempt.
Enter all that apply, separate with commas.

1. Not interested
2. Too busy
3. Interview takes too much time
4. Scheduling difficulties
5. Survey is voluntary
6. Privacy concerns
7. Local / State / Federal government concerns
8. Asks questions about the survey
9. Hang-up / slams door on Fr
10. Hostile or threatens FR
11. Family issues (death, illness, block participation in survey)
12. Gave that information last time
13. Asked too many personal questions last time
14. Too many interviews
15. Intends to quit survey
98. No concerns
99. Other - specify

IF 99 selected then goto RSPNDOTH
ELSE goto STRATEGS

CHI

RSPNDOTH

RSPNDOTH

OTHER CONCERNS/BEHAVIORS/RELUCTANCE

Specify other concerns/behaviors/reluctance during this contact attempt.

Goto STRATEGS

CHI

NCTTEL

NCTTEL

CONTACT-NONCONTACT / TELEPHONE

Select the categories that describe this telephone contact/noncontact.
Enter all that apply, separate with commas.


1. Got answering machine
2. Ring, no answer
3. Busy Signal
4. Disconnected
5. Wrong number
6. Spoke with ineligible person
7. Respondent left message
99. Other - specify

IF 99 selected then goto NCTTELOT

ELSE goto STRATEGS

CHI

NCTTELOT

NCTTELOT

OTHER Noncontact Telephone Attempt Category

Specify the details about this telephone noncontact.

Goto STRATEGS

CHI

NCTPER

NCTPER

CONTACT-NONCONTACT / PERSONAL VISIT

Select the categories that describe this personal visit contact/noncontact.
Enter all that apply, separate with commas.

1. No one home / No eligible person home
2. No one home - pervious note / letter taken
3. Household does not answer door - - evidence someone is home
4. Observe HH from vehicle
5. Unable to reach / locked gate / buzzer entry
6. Address does not exist / unable to locate
7. On vacation, away from home / at second home
8. Spoke with neighbor
9. Building management / doorman contact
10. Completed case (Type B or C)
99. Other - specify

IF 99 selected then goto NCTPEROT

ELSE goto STRATEGS

CHI

NCTPEROT

NCTPEROT

OTHER Noncontact Personal Visit Category

Specify the details about this personal visit noncontact.

Goto STRATEGS

CHI

STRATEGS

STRATEGS

CONTACT STRATEGIES ATTEMPTED

Select the categories that describe the strategies used on this contact attempt.
Enter all that apply, separate with commas.


1. Advance letter given
2. Scheduled appointment
3. Left note / appointment card
4. Left promotional packet / informational brochure
5. Called household
6. Left message on answering machine
7. Waited for respondent
8. Checked with neighbors
9. Contacted other family members
10. Contacted property manager doorman
11. Offered incentive
12. CED Double placement
98. No Strategies
99. Other - specify

IF 99 selected then goto STRATOTH
ELSE exit CHI

CHI

STRATOTH

STRATOTH

OTHER STRATEGY

Specify the strategy used on this contact attempt.

Exit CHI



Page 30 of 30


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorBrattland, Janel - BLS
File Modified0000-00-00
File Created2021-01-23

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