Items Booklet Items Booklet

2014 Survey of Income and Program Participation (SIPP) Panel

A-2014 SIPP Items Booklet - Attachment A Part 1

SIPP 2014 Panel

OMB: 0607-0977

Document [pdf]
Download: pdf | pdf
CTRLNUM
**NON-DISPLAYED ITEM**

START
CENSUS CATI/CAPI SYSTEM

^VERDATE
^VERSION
SIPP

SURVEY OF INCOME AND PROGRAM PARTICIPATION
^I_PANEL

^WAVE

PSU: ^I_PSU
DATE IS: ^DATE
TIME IS: ^TIME

O.M.B Number: 0607-0957
Expiration Date: December 31, 2011

CASE STATUS IS: ^CSTATUS
INTERVIEW MODE: ^I_NXTINTFLG
APPOINTMENT: ^CALLBACK
ADDRESS:
HNO HNOSUF STRNAME
UNITDES
GQUNITINFO
NONCITYADD
PHYSDES
PO, ST ZIP5-ZIP4
BLDGNAME
1. Proceed - Personal interview
2. Proceed - Telephone interview
3. Set appointment for visit or call back
4. Quit - Do not attempt now
5. Ready to transmit, no more follow-up needed

FIX206
The current outcome code for this case is a 206 - At least one household member's interview is a
sufficient partial.
This outcome code is NOT transmittable.

Page 1 of 334

You can request the case be re-assigned to another FR for completion or you can close the case as a
207 - Completed partial interview with Type Z lines.
1. Reassign the case to another FR
2. Closeout the case with an outcome code of 207

CTRLNUM
**NON-DISPLAYED ITEM**

DIAL
Dial this number: (^I_AREA) ^I_PREFIX - ^I_SUFFIX ^I_EXTN
Secondary number: (^SAREA) ^SPREFIX - ^SSUFFIX ^SEXTN
Previous Wave Roster: Display the ROST_FNAME, ROST_MNAME, and ROST_LNAME of
all people who were listed on final household roster for the previous wave
1. Someone answers - BEGIN INTERVIEW
2. Someone answers - SET APPOINTMENT
3. No contact - answering machine/busy/no answer
4. New telephone number or telephone disconnected
5. Not attempted now

HHAPPT1
^INTRO_HHAPPT1
^HHRESP_FIL
STREET ADDRESS: ^I_HNO ^I_HNOSUF ^I_STRNAME
TELEPHONE NUMBER: (^I_AREA) ^I_PREFIX - ^I_SUFFIX ^I_EXTN
Is there a convenient time I can contact your household to complete this interview?
1. YES - Set appointment for interview
2. No - Cannot set up appointment
3. Need to contact Directory Assistance
4. All sample persons moved to a new address
5. Conduct interview NOW
Page 2 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

DASSIST_AREA
Call Directory Assistance in your area, if necessary, to obtain the correct telephone number for this
household.
CURRENT TELEPHONE NUMBER: (^I_AREA) ^I_PREFIX - ^I_SUFFIX ^I_EXTN
What is the new telephone number for the ^REFPER_DASSIST household?
Enter new area code.
Enter 000 if the household does not have a telephone.
Display the household address as follows:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
^I_BLDGNAME

DASSIST_PREFIX
Call Directory Assistance in your area, if necessary, to obtain the correct telephone number for this
household.
CURRENT TELEPHONE NUMBER: (^I_AREA) ^I_PREFIX - ^I_SUFFIX ^I_EXTN
(What is the new telephone number for the ^REFPER_DASSIST household?
Enter new prefix.
Display the household address as follows:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
^I_BLDGNAME

DASSIST_SUFFIX
Page 3 of 334

Call Directory Assistance in your area, if necessary, to obtain the correct telephone number for this
household.
CURRENT TELEPHONE NUMBER: (^I_AREA) ^I_PREFIX - ^I_SUFFIX ^I_EXTN
(What is the new telephone number for the ^REFPER_DASSIST household?
Enter new suffix.
Display the household address as follows:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
^I_BLDGNAME

DASSIST_EXTN
Call Directory Assistance in your area, if necessary, to obtain the correct telephone number for this
household.
CURRENT TELEPHONE NUMBER: ^I_AREA ^I_PREFIX - ^I_SUFFIX ^I_EXTN
(What is the new telephone number for the ^REFPER_DASSIST household?
Enter new extension (if applicable).
Display the household address as follows:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
^I_BLDGNAME

HHAPPT2
When would be a convenient time to conduct an interview with your household?

CTRLNUM
**NON-DISPLAYED ITEM**
Page 4 of 334

HHAPPT3
Before I go, let me verify some information. Is your address still

Read address:

ADDRESS:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5 - ^I_ZIP4
^I_BLDGNAME
If answer category 2 is selected, remember to move the household via the noninterview screen and
NOT the change of address screens.
1. Yes
2. No
3. Address correction -- household did not move
4. End interview

HHAPPT4_HNO
? [F1]
Enter the correct House Number or press ENTER for Same.

HHAPPT4_HNOSUF
? [F1]
Enter the correct House Number Suffix or press ENTER for Same.

HHAPPT4_STRNAME
? [F1]
Enter the correct Street Name or press ENTER for Same.

HHAPPT4_UNITDES
? [F1]
Enter the correct Apartment/Unit Number or press ENTER for Same.

Page 5 of 334

HHAPPT4_GQUNITINFO
? [F1]
Enter the correct GQ Unit Information or press ENTER for Same.

HHAPPT4_NONCITYADD
? [F1]
Enter the correct Non-City Style Address or press ENTER for Same.
Enter a P.O. Box here.

HHAPPT4_PHYSDES
? [F1]
Enter the correct Physical Description or press ENTER for Same.

HHAPPT4_PO
? [F1]
Enter the correct Locality or press ENTER for Same.

HHAPPT4_ST
? [F1]
Enter the correct State Abbreviation or press ENTER for Same.
AL. Alabama
AK. Alaska
AZ. Arizona
AR. Arkansas
CA. California
CO. Colorado
CT. Connecticut
DC. District of Columbia
DE. Delaware
FL. Florida
GA. Georgia
HI. Hawaii
ID. Idaho
Page 6 of 334

IL. Illinois
IN. Indiana
IA. Iowa
KS. Kansas
KY. Kentucky
LA. Louisiana
ME. Maine
MD. Maryland
MA. Massachusetts
MI. Michigan
MN. Minnesota
MS. Mississippi
MO. Missouri
MT. Montana
NE. Nebraska
NV. Nevada
NH. New Hampshire
NJ. New Jersey
NM. New Mexico
NY. New York
NC. North Carolina
ND. North Dakota
OH. Ohio
OK. Oklahoma
OR. Oregon
PA. Pennsylvania
RI. Rhode Island
SC. South Carolina
SD. South Dakota
TN. Tennessee
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
WA. Washington
WV. West Virginia
WI. Wisconsin
WY. Wyoming

Page 7 of 334

HHAPPT4_ZIP5
? [F1]
Enter the correct Zip Code or press ENTER for Same.

HHAPPT4_ZIP4
? [F1]
Enter the correct 4-Digit Zip Code or press ENTER for Same.

HHAPPT4_BLDGNAME
? [F1]
Enter the correct Building Name or press ENTER for Same.

HHAPPT5
I have listed

Read names as living in this household. Are all of these people still living here?

Display the ROST_FNAME, ROST_MNAME, and ROST_LNAME of all people who were
listed on final household roster for the previous wave
1. Yes
2. No

HHAPPT99
Thank you for your assistance. I will visit your household ^CALLBACK.
This household has persons who have moved since the last interview. You may wish to review
procedures for movers before this interview. Remember to deal with mover cases early in the month, so
that you have sufficient time to locate and interview the people who moved.
Enter 1 to continue.

1. Enter 1 to continue

INTRO_D
^NAMEFIL_INTROD
Some of the questions have already been answered. Let me see where we should begin.
Page 8 of 334

Press 1 to Continue
Then press END to go to the first unanswered question
1. Enter 1 to continue

INTRO
Hello. I'm ... from the United States Census Bureau. Here is my identification card Show ID card
. We are conducting a survey on the economic situation of people who live in the United States. I
have some questions to ask you.
^INCENTIVE_FIL
Ask the respondent if he/she received the advance letter. If no, give or read the letter to the
respondent (depending on the type of interview) before proceeding.
1. Proceed
2. Inconvenient time - try again later
3. Reluctant respondent - hold for refusal follow-up
4. Noninterview or ENTIRE household moved
5. Contacted incorrect household - END INTERVIEW

CARICON1
This interview may be recorded for quality control purposes. Is that O.K.?
1. Yes
2. No

NONINTERVIEW
^NONINTFILL

1. Type A noninterview
2. Type B noninterview
3. Type C noninterview or ENTIRE household moved
4. Type D noninterview

TYPE_A
Enter Type A noninterview code.
Page 9 of 334

1. No one home
2. Temporarily absent
3. Refused
4. Language problem
5. Unable to locate
6. Other Type A

TYPEA__SP
Specify the kind of 'other' Type A noninterview.

TYPE_B
Enter Type B noninterview code.
1. Vacant regular (REG)
2. Vacant - storage of household furniture
3. Unfit or to be demolished
4. Under construction, not ready
5. Converted to temporary business or storage
6. Unoccupied tent or trailer site
7. Permit granted, construction not started
8. Temporarily occupied by persons with URE
9. Occupied by persons under 15 years of age
10. ENTIRE household institutionalized
11. ENTIRE household on active duty in the Armed Forces
12. Other Type B

TYPEB__SP
Specify the kind of 'other' Type B noninterview.

TYPE_C
Enter code for Type C noninterview/ENTIRE household moved.
1. Demolished
2. House or trailer moved
3. Address outside segment
4. Converted to permanent business or storage
5. Merged
Page 10 of 334

6. Condemned
7. Unused Serial number/Listing sheet line
8. Removed during subsampling
10. ENTIRE household deceased
11. ENTIRE household moved out of the country
13. ENTIRE household moved together to known address OUTSIDE of FR's area
14. ENTIRE household moved together to known address WITHIN FR's area
15. ENTIRE household moved together to unknown address
16. ENTIRE household merged with another SIPP household
17. ENTIRE household moved and split into several new SIPP households

18. ENTIRE household moved - further work needed to obtain address (NOTE: the parent case will remain on your l
19. Other Type C
20. Spawned in error
21. Unlocatable sample address
22. Unit does not exist or unit is out of scope

TYPEC_SP
Specify the kind of 'other' Type C noninterview.

SPAWN_SP
Enter the reason why the household was spawned in error.

TYPE_D
Enter Type D noninterview code.
1. ENTIRE household moved, address unknown
2. ENTIRE household moved with US; RO determined case is outside SIPP limits

CTRLNUM
**NON-DISPLAYED ITEM**

NI_RACE
Enter your best guess as to the Race of the reference person.
Mark all that apply.
Page 11 of 334

1. White
2. Black/African American
3. American Indian or Alaska Native
4. Asian
5. Native Hawaiian or Other Pacific Islander
6. Other

NI_SEX
Enter your best guess as to the sex of the reference person.
^ENTERFIL

1. Male
2. Female

NI_SIZE
Ask or verify with some knowledgeable individual.
Enter your best guess as to the total number of people in the household. Count all children and
adults.
^ENTERFIL

NI_TENURE
Ask or verify with a knowledgeable individual, or enter your best guess.
Are the living quarters --

1. Owned or being bought by someone in the household
2. Rented
3. Occupied without payment of rent

TYPEAD_DISCUSS
You must discuss this case with your supervisor before transmitting it as a ^TYPEAD noninterview.
1. Enter 1 to continue
Page 12 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

BEGINT
We will begin the interview with questions about who lives here, their ages, how they're related to
each other, and other information. Then I will ask you questions about your jobs and any other
sources of income. After that, I'll have questions about anyone else who lives here.
Enter 1 to continue.

1. Enter 1 to continue

VERIFY_ADDRESS
? [F1]
I have your address listed as:
ADDRESS:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
^I_BLDGNAME
(Is this your exact address, or correct with only minor changes?)
Do not use the address change screen to indicate that an entire household has moved.

1. YES, address is EXACTLY CORRECT as listed
2. Address is MOSTLY CORRECT, but needs some minor changes
3. INCORRECT ADDRESS - terminate interview, find correct address

CTRLNUM
**NON-DISPLAYED ITEM**

NEW_HNO
Page 13 of 334

? [F1]
Enter the correct House Number or press ENTER for Same.

NEW_HNOSUF
? [F1]
Enter the correct House Number Suffix or press ENTER for Same.

NEW_STRNAME
? [F1]
Enter the correct Street Name or press ENTER for Same.

NEW_UNITDES
? [F1]
Enter the correct Apartment/Unit Number or press ENTER for Same.

NEW_GQUNITINFO
? [F1]
Enter the correct GQ Unit Information or press ENTER for Same.

NEW_NONCITYADD
? [F1]
Enter the correct Non-City Style Address or press ENTER for Same.
Enter a P.O. Box here.

NEW_PHYSDES
? [F1]
Enter the correct Physical Description or press ENTER for Same.

NEW_PO
? [F1]
Page 14 of 334

Enter the correct Locality or press ENTER for Same.

NEW_ST
? [F1]
Enter the correct State Abbreviation or press ENTER for Same.
AL. Alabama
AK. Alaska
AZ. Arizona
AR. Arkansas
CA. California
CO. Colorado
CT. Connecticut
DC. District of Columbia
DE. Delaware
FL. Florida
GA. Georgia
HI. Hawaii
ID. Idaho
IL. Illinois
IN. Indiana
IA. Iowa
KS. Kansas
KY. Kentucky
LA. Louisiana
ME. Maine
MD. Maryland
MA. Massachusetts
MI. Michigan
MN. Minnesota
MS. Mississippi
MO. Missouri
MT. Montana
NE. Nebraska
NV. Nevada
NH. New Hampshire
NJ. New Jersey
NM. New Mexico
Page 15 of 334

NY. New York
NC. North Carolina
ND. North Dakota
OH. Ohio
OK. Oklahoma
OR. Oregon
PA. Pennsylvania
RI. Rhode Island
SC. South Carolina
SD. South Dakota
TN. Tennessee
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
WA. Washington
WV. West Virginia
WI. Wisconsin
WY. Wyoming

NEW_ZIP5
? [F1]
Enter the correct Zip Code or press ENTER for Same.

NEW_ZIP4
? [F1]
Enter the correct 4-Digit Zip Code or press ENTER for Same.

NEW_BLDGNAME
? [F1]
Enter the correct Building Name or press ENTER for Same.

VERIFY_MAILADDR
? [F1]
Page 16 of 334

Is this also your mailing address?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

NEW_MHNO
? [F1]
Enter the correct House Number for the mailing address or press ENTER for Same.

NEW_MHNOSUF
? [F1]
Enter the correct House Number Suffix for the mailing address or press ENTER for Same.

NEW_MSTRNAME
? [F1]
Enter the correct Street Name for the mailing address or press ENTER for Same.

NEW_MUNITDES
? [F1]
Enter the correct Apartment/Unit Number of the mailing address or press ENTER for Same.

NEW_GQUNITINFO
? [F1]
Enter the correct GQ Unit Information of the mailing address or press ENTER for Same.

NEW_MNONCITYADD
? [F1]

Page 17 of 334

Enter the correct Non-City Style Mailing Address or press ENTER for Same.
Enter a P.O. Box here.

NEW_MPO
? [F1]
Enter the correct Locality of the mailing address or press ENTER for Same.

NEW_MST
? [F1]
Enter the correct State Abbreviation of the mailing address or press ENTER for Same.
AL. Alabama
AK. Alaska
AZ. Arizona
AR. Arkansas
CA. California
CO. Colorado
CT. Connecticut
DC. District of Columbia
DE. Delaware
FL. Florida
GA. Georgia
HI. Hawaii
ID. Idaho
IL. Illinois
IN. Indiana
IA. Iowa
KS. Kansas
KY. Kentucky
LA. Louisiana
ME. Maine
MD. Maryland
MA. Massachusetts
MI. Michigan
MN. Minnesota
MS. Mississippi
Page 18 of 334

MO. Missouri
MT. Montana
NE. Nebraska
NV. Nevada
NH. New Hampshire
NJ. New Jersey
NM. New Mexico
NY. New York
NC. North Carolina
ND. North Dakota
OH. Ohio
OK. Oklahoma
OR. Oregon
PA. Pennsylvania
RI. Rhode Island
SC. South Carolina
SD. South Dakota
TN. Tennessee
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
WA. Washington
WV. West Virginia
WI. Wisconsin
WY. Wyoming

NEW_MZIP5
? [F1]
Enter the correct Zip Code of the mailing address or press ENTER for Same.

NEW_MZIP4
? [F1]
Enter the correct 4-Digit Zip Code of the mailing address or press ENTER for Same.

Page 19 of 334

ACCESS
? [F1]
Ask if not apparent.
Do you have direct access to your home, either from the outside or through a common hall?
1. Yes
2. No

MERGE
This household must be merged with the household through which access is gained.
Refer to your Interviewer's manual to determine if the merged household is in or out of the SIPP
sample.

1. Merged - in SIPP sample
2. Merged - NOT in SIPP sample

LIVQTR
Enter type of living quarters.

1. House, apartment, flat
2. Unit in rooming house, hotel, motel, etc.
3. Mobile home or trailer
4. Other housing unit
5. Student quarters
6. Other group quarters unit
7. Unoccupied tent or trailer site

NUMBER_UNITS
Ask if not apparent.
How many housing units, both occupied and vacant, are there in this structure?

1. One, detached
2. One, attached
Page 20 of 334

3. Two
4. 3 - 4
5. 5 - 9
6. 10 - 19
7. 20 - 49
8. 50 or more

TENURE
Are your living quarters -Read answer categories.

1. Owned or being bought by someone in the household
2. Rented
3. Occupied without payment of rent

CTRLNUM
**NON-DISPLAYED ITEM**

RENTSUB
^RENTSUBQTEXT
Include respondents who live in a building owned by a Public Housing Authority (i.e. the housing
authority is the respondent's landlord) as receiving a rent subsidy.
1. Yes
2. No

VOUCHER
Does anyone in this household receive a housing voucher?
A housing voucher gives a renter the right to choose where to live AND it helps pay the rent.
1. Yes
2. No

Page 21 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

AGE
**NON-DISPLAYED ITEM**

AMOUNTSPELL
**NON-DISPLAYED ITEM**

ASTCODE
**NON-DISPLAYED ITEM**

ASTCODE2
**NON-DISPLAYED**

ASTCODE_RET
**NON-DISPLAYED ITEM**

BUSINESS_CODE
**NON-DISPLAYED ITEM**

CARICONFLAG
***NON-DISPLAYED ITEM****
1. Yes
2. No

CARNO
**NON-DISPLAYED ITEM**

CHILD_LNO
**NON-DISPLAYED ITEM**

Page 22 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

DISABLECODE
**NON-DISPLAYED ITEM**

ED_RETURNING
**NON-DISPLAYED ITEM**

EHC_PGM_SCRN
**NON-DISPLAYED ITEM**
1. Yes
2. No

FS_RETURNING
**NON-DISPLAYED ITEM**

GA_RETURNING
**NON-DISPLAYED ITEM**

HHSTAT
**NON-DISPLAYED ITEM**

INLIST
**NON-DISPLAYED ITEM**

INC_SCRN
**NON-DISPLAYED ITEM**
1. Yes
2. No

INVBUSINESS_CODE
Page 23 of 334

**NON-DISPLAYED ITEM**

LNBIODAD
**NON-DISPLAYED ITEM**

LNBIOMOM
**NON-DISPLAYED ITEM**

LNDCUPT
**NON-DISPLAYED ITEM**

LNGD
**NON-DISPLAYED ITEM**

LNGD_MEALS
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

LNPAR1
**NON-DISPLAYED ITEM**

LNPAR2
**NON-DISPLAYED ITEM**

LNOPRX
**NON-DISPLAYED ITEM**

LNSP
**NON-DISPLAYED ITEM**
Page 24 of 334

MARITAL_RETURNING
**NON-DISPLAYED ITEM**

MHLOAN_CODE
**NON-DISPLAYED ITEM**

MONTHCODE
**NON-DISPLAY ITEM**

MOVER_LNO
**NON-DISPLAY ITEM**

OSP_FLAG
***NON-DISPLAYED ITEM***

PCNTLT5T2
**NON-DISPLAYED ITEM**

PCNTFEGE15T2
**NON-DISPLAYED ITEM**

PCNTGE18T2
**NON-DISPLAYED ITEM**

PCNTLT18T2
**NON-DISPLAYED ITEM**

PLPCNTLE18T2
**NON-DISPLAYED ITEM**

PLPCNTLT5T2
**NON-DISPLAYED ITEM**

Page 25 of 334

PCNTLT22T2
**NON-DISPLAYED ITEM**

PLPCNT_TYPE2
**NON-DISPLAYED ITEM**

PELIG
**NON-DISPLAYED ITEM**

PLINTDATE
**NON-DISPLAYED ITEM**

PNUM
**NON-DISPLAYED ITEM**

PROCEEDMONTHNUM
**NON-DISPLAYED ITEM**

PROCEEDYEAR
**NON-DISPLAYED ITEM**

PROPLOAN_CODE
**NON-DISPLAYED ITEM**

PSTATUS
**NON-DISPLAYED ITEM**

RES_RETURNING
**NON-DISPLAYED ITEM**

RETIRECODE
**NON-DISPLAYED ITEM**

Page 26 of 334

SCREENER_CLUMP
**NON-DISPLAYED ITEM**
1. Yes
2. No

SLFPRX
**NON-DISPLAYED ITEM**

SSI_RETURNING
**NON-DISPLAYED ITEM**

SSCHLDFLAG
**NON-DISPLAYED ITEM**

SUPPORTPMTCODE
**NON-DISPLAYED ITEM**

SURVRCODE
**NON-DISPLAYED ITEM**

TANF_RETURNING
**NON-DISPLAYED ITEM**

TYPE_RECVEH_NUM
**NON-DISPLAYED ITEM**

UEMP_COMP_CODE
**NON-DISPLAYED ITEM**

URE_NUM
**NON-DISPLAYED ITEM**

VABENEFITCODE
Page 27 of 334

**NON-DISPLAYED ITEM**

WIC_RETURNING
**NON-DISPLAYED ITEM**

NBIOKIDHHROS
**NON-DISPLAYED ITEM**

NEWCHILD_FLAG
**NON-DISPLAYED ITEM**

NUMCLD27
**NON-DISPLAYED ITEM**

NUMCLD314
**NON-DISPLAYED ITEM**

NUMCLD014
**NON-DISPLAYED ITEM**

NUMCLD617
**NON-DISPLAYED ITEM**

NUMCLD05
**NON-DISPLAYED ITEM**

NALLKIDALLROS

NBIOKIDALLROS

Page 28 of 334

CHILDLIST05
CHILDLIST617
BIOCHILDLIST
PAR_BIOCHILDLIST
NCLD27_HH
**NON-DISPLAYED ITEM**

NCLD314_HH
**NON-DISPLAYED ITEM**

NCLD014_HH
**NON-DISPLAYED ITEM**

NCLD617_HH
**NON-DISPLAYED ITEM**

NCLD05_HH
**NON-DISPLAYED ITEM**

NCLD017_HH
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

PREROST
^QSTNTXT_PREROST
1. Enter 1 to continue

Page 29 of 334

PERSTAT
I have listed from a year ago

Read name(s).

Are ^BOTHALL of these people still living or staying here?
If 'NO,' use arrow keys to move to the correct person and enter the main reason for the membership
change.
If 'YES' or when done making corrections, press End to go to ROST_FNAME.
1. Deceased
2. Institutionalized or in other group quarters (e.g., nursing home, hospital, correctional facility)
3. On active duty in the Armed Forces
4. Moved outside of U.S.
5. Marital-status reasons (e.g., marriage, civil union, partnership, cohabitation, separation or divorce)
6. Job-related reasons
7. Attending college or boarding school, or other educational reason
8. Other family changes (e.g., change in custody, child moves out on his own)
9. Listed in error in prior wave
10. Other
11. Reinstate person

ROST_FNAME
^QSTNTXT_ROSTER
Enter first name.
Confirm the spelling of the person's first name. This information will be important for tracking movers in
future waves.
Enter 999 if no more/new people.
^MAX20

ROST_MNAME
^QSTNTXT_ROSTER
Enter middle name.

ROST_LNAME
Page 30 of 334

^QSTNTXT_ROSTER
Enter last name.
Confirm the spelling of the person's last name. This information will be important for tracking movers in
future waves.

ROST_ONAME
^QSTNTXT_ROSTER
Enter other/maiden name.

CM_PERSTAT
*** Non-Displayed Item ***
1. Active Household Member
3. Inactive, but may come back
4. Deceased

HHRESP2
Ask if necessary.
With whom am I speaking?
WARNING: This person must be 15 years of age or older. If in doubt inquire as to the person's age
and, if necessary, ask to speak with someone who is at least 15 years of age.
1. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
2. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
3. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
4. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
5. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
6. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
7. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
8. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
9. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
10. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
11. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
12. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
Page 31 of 334

13. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
14. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
15. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
16. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
17. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
18. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
19. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
20. Display the ^LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15

USUAL
? [F1]
^QSTNTXT_USUAL
1. Yes
2. No

NOTHERE
Who doesn't live or sleep here most of the time? Anyone else?
Mark all that apply.
If there is only one person in the household, do not read the question text, select that person and
proceed with the interview.

1. ^LNO ^ROST_FNAME ^ROST_LNAME
2. ^LNO ^ROST_FNAME ^ROST_LNAME
3. ^LNO ^ROST_FNAME ^ROST_LNAME
4. ^LNO ^ROST_FNAME ^ROST_LNAME
5. ^LNO ^ROST_FNAME ^ROST_LNAME
6. ^LNO ^ROST_FNAME ^ROST_LNAME
7. ^LNO ^ROST_FNAME ^ROST_LNAME
8. ^LNO ^ROST_FNAME ^ROST_LNAME
9. ^LNO ^ROST_FNAME ^ROST_LNAME
10. ^LNO ^ROST_FNAME ^ROST_LNAME
11. ^LNO ^ROST_FNAME ^ROST_LNAME
12. ^LNO ^ROST_FNAME ^ROST_LNAME
13. ^LNO ^ROST_FNAME ^ROST_LNAME
Page 32 of 334

14. ^LNO ^ROST_FNAME ^ROST_LNAME
15. ^LNO ^ROST_FNAME ^ROST_LNAME
16. ^LNO ^ROST_FNAME ^ROST_LNAME
17. ^^LNO ^ROST_FNAME ^ROST_LNAME
18. ^LNO ^ROST_FNAME ^ROST_LNAME
19. ^LNO ^ROST_FNAME ^ROST_LNAME
20. ^LNO ^ROST_FNAME ^ROST_LNAME
21. ^LNO ^ROST_FNAME ^ROST_LNAME
22. ^LNO ^ROST_FNAME ^ROST_LNAME
23. ^LNO ^ROST_FNAME ^ROST_LNAME
24. ^LNO ^ROST_FNAME ^ROST_LNAME
25. ^LNO ^ROST_FNAME ^ROST_LNAME

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

URE_NUM
**NON-DISPLAYED ITEM**

NITESTAY
During a typical week over the last month or so, how many nights did ^NAME_NOTHERE stay
here overnight, or was there no usual pattern?
11. Three or fewer
12. Four or more
13. No usual pattern
14. Other

NITESTAY_SP
What 'other' living arrangement?

Page 33 of 334

ASKURE
Is there another place where ^NAME_NOTHERE ^LIVES_ASKURE and ^SLEEPS_ASKURE most
of the time?
1. Yes
2. No

AWAYSCH
Ask if necessary.
AREIS ^NAME_NOTHERE...
... a student away attending school,
... non-married,
... whose permanent residence is here?

1. Yes to all 3
2. No

AWAYTRV
Ask if necessary.
^DODOES ^NAME_NOTHERE usually live here but AREIS away traveling for work, or on vacation,
or in the hospital?

1. Yes
2. No

MISSED_PER
? [F1]
Sometimes we miss people when it's not totally clear where they live or stay. Just to make sure,
^OTHERTHANFIL is there anyone else living or staying here now -- any babies, small children,
non-relatives, or anyone else?
1. Yes
2. No

ANYMOREPEOPLE
Page 34 of 334

We've listed 20 people living in this household, which is the maximum number that can be
collected on the household roster. How many additional people (not counting the 20 already listed
on the household roster) live here?

USUAL1
Is this the address where

Read name(s) lives and sleeps most of the time?

Display the names of the people added to the household roster via MISSED_PER.
1. Yes
2. No

NOTHEREONE
Ask or verify.
Who doesn't live or sleep here most of the time? Anyone else?
Mark all that apply.

1. ^LNO ^ROST_FNAME ^ROST_LNAME
2. ^LNO ^ROST_FNAME ^ROST_LNAME
3. ^LNO ^ROST_FNAME ^ROST_LNAME
4. ^LNO ^ROST_FNAME ^ROST_LNAME
5. ^LNO ^ROST_FNAME ^ROST_LNAME
6. ^LNO ^ROST_FNAME ^ROST_LNAME
7. ^LNO ^ROST_FNAME ^ROST_LNAME
8. ^LNO ^ROST_FNAME ^ROST_LNAME
9. ^LNO ^ROST_FNAME ^ROST_LNAME
10. ^LNO ^ROST_FNAME ^ROST_LNAME
11. ^LNO ^ROST_FNAME ^ROST_LNAME
12. ^LNO ^ROST_FNAME ^ROST_LNAME
13. ^LNO ^ROST_FNAME ^ROST_LNAME
14. ^LNO ^ROST_FNAME ^ROST_LNAME
15. ^LNO ^ROST_FNAME ^ROST_LNAME
16. ^LNO ^ROST_FNAME ^ROST_LNAME
17. ^^LNO ^ROST_FNAME ^ROST_LNAME
18. ^LNO ^ROST_FNAME ^ROST_LNAME
19. ^LNO ^ROST_FNAME ^ROST_LNAME
20. ^LNO ^ROST_FNAME ^ROST_LNAME
Page 35 of 334

21. ^LNO ^ROST_FNAME ^ROST_LNAME
22. ^LNO ^ROST_FNAME ^ROST_LNAME
23. ^LNO ^ROST_FNAME ^ROST_LNAME
24. ^LNO ^ROST_FNAME ^ROST_LNAME
25. ^LNO ^ROST_FNAME ^ROST_LNAME

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

URE_NUM
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CHECKPT
According to the rules of this survey,

Read name(s) will be included in this interview.

Display the ROST_FNAME, and ROST_LNAME of all non-deleted people on the final
household roster. If everyone on the household is deleted, display the
following text 'No one in this household is eligible to be included in this
interview'
1. Enter 1 to continue

NOHHRESP
Since you do not stay or live here most of the time, who is available to answer the remaining
questions?
Page 36 of 334

Read name(s).

1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
3. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
4. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
5. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
6. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
7. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
8. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
9. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
10. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
11. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
12. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
13. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
14. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
15. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
16. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
17. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
18. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
19. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME

OTHRRP
All people listed have another residence where they usually live. They will not be included in this
interview. Take one of the following actions:
Enter 0 if the residence information is incorrect.
Enter a 1 if no other adult maintains this address as his/her usual place of residence. This designates
this address as a Type B noninterview.

0. The information about usual residence is incorrect
1. No other adult maintains this address as his/her usual residence

OTHRRP_WHO
Whose information is incorrect?
Page 37 of 334

1. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
2. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
3. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
4. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
5. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
6. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
7. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
8. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
9. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
10. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
11. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
12. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
13. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
14. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
15. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
16. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
17. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
18. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
19. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
20. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
21. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
22. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
23. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
24. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1
25. ^LNO ^ROST_FNAME, ROST_LNAME where UREFLAG = 1

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

OTHRRP_FIX
What information about ^HISHER residence needs to be corrected?
Read answer categories.

Page 38 of 334

Mark all that apply.

1. Is this the place where ^TEMPNAME ^LIVESLEEPFIL most of the time?
2. How many night ^DODOES ^TEMPNAME stay here overnight?
3. Is there another place where ^TEMPNAME ^LIVESLEEPFIL most of the time?
4. ^C_AREIS ^TEMPNAME a non-married student away attending school whose permanent residence is here?
5. ^C_DODOES ^TEMPNAME usually live here but is away traveling for work , or on vacation, or in a hospital?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

LEAVE_MO
^INTROLEAVE_FIL When did ^FNAME ^LNAME ^WHYLEFTFIL?
Enter the month.
0. Before ^MONTH1 ^CALENDAR_YRFIL
1. ^MONTH1 ^CALENDAR_YRFIL
2. ^MONTH2 ^CALENDAR_YRFIL
3. ^MONTH3 ^CALENDAR_YRFIL
4. ^MONTH4 ^CALENDAR_YRFIL
5. ^MONTH5 ^CALENDAR_YRFIL
6. ^MONTH6 ^CALENDAR_YRFIL
7. ^MONTH7 ^CALENDAR_YRFIL
8. ^MONTH8 ^CALENDAR_YRFIL
9. ^MONTH9 ^CALENDAR_YRFIL
10. ^MONTH10 ^CALENDAR_YRFIL
11. ^MONTH11 ^CALENDAR_YRFIL
12. ^MONTH12 ^CALENDAR_YRFIL
13. ^MONTH13 ^INTYEARFIL
14. ^MONTH14 ^INTYEARFIL
15. ^MONTH15^INTYEARFIL
16. ^MONTH16 ^INTYEARFIL
17. ^MONTH17 ^INTYEARFIL
Page 39 of 334

18. ^MONTH18 ^INTYEARFIL

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ENTER_MO
^INTROLEAVE_FIL When did this person start living here?
Enter the month.
0. Before ^MONTH1 ^CALENDAR_YRFIL
1. ^MONTH1 ^CALENDAR_YRFIL
2. ^MONTH2 ^CALENDAR_YRFIL
3. ^MONTH3 ^CALENDAR_YRFIL
4. ^MONTH4 ^CALENDAR_YRFIL
5. ^MONTH5 ^CALENDAR_YRFIL
6. ^MONTH6 ^CALENDAR_YRFIL
7. ^MONTH7 ^CALENDAR_YRFIL
8. ^MONTH8 ^CALENDAR_YRFIL
9. ^MONTH9 ^CALENDAR_YRFIL
10. ^MONTH10 ^CALENDAR_YRFIL
11. ^MONTH11 ^CALENDAR_YRFIL
12. ^MONTH12 ^CALENDAR_YRFIL
13. ^MONTH13 ^INTYEARFIL
14. ^MONTH14 ^INTYEARFIL
15. ^MONTH15^INTYEARFIL
16. ^MONTH16 ^INTYEARFIL
17. ^MONTH17 ^INTYEARFIL
18. ^MONTH18 ^INTYEARFIL

ENTER_REASON
^QSTNTXT_REASONENT
Mark all that apply.
Page 40 of 334

1. Birth
2. Marital-status reasons (e.g., marriage, civil union, partnership, cohabitation, separation or divorce)
3. Returned to household after missing one or more waves
4. Other family chages (e.g., change in custody, adoption or parent/child joins the household)
5. From an institution or other group quarters (e.g., nuring home, hospital, correctional facility)
6. From Armed Forces barracks
7. From outside the U.S.
8. Should have been listed as a member in Wave 1
9. Job-related reasons
10. Lived at this address before sample person(s) entered
11. Other

MAIN_REASON
What was the main reason ^FNAME ^LNAME ^JOINFIL the household?
1. Fill with 1st. reason selected in TRSNENT
2. Fill with 2nd. reason selected in TRSNENT
3. Fill with 3rd. reason selected in TRSNENT
4. Fill with 4th. reason selected in TRSNENT
5. Fill with 5th. reason selected in TRSNENT
6. Fill with 6th. reason selected in TRSNENT
7. Fill with 7th. reason selected in TRSNENT
8. Fill with 8th. reason selected in TRSNENT
9. Fill with 9th. reason selected in TRSNENT
10. Fill with 10th. reason selected in TRSNENT
11. Fill with 11th. reason selected in TRSNENT

RSNENT_SP
What is the 'other' reason FNAME LNAME joined this household?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

Page 41 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SEX
Ask if not apparent.
^C_AREISWAS ^TEMPNAME male or female?
1. Male
2. Female

REFPER2
Who ^OWNRENTFIL this home - that is, what names are on the ^DEEDLEASEFIL?
If the respondent can't identify an owner/renter, enter the line number of the head of household.
Mark all that apply.
1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
3. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
4. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
5. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
6. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
7. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
8. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
9. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
10. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
11. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
12. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
13. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
14. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
15. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
16. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
17. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
18. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
Page 42 of 334

19. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

RELRPEXP
A
^QSTNTXT_RELRP
Domestic partners should be classified as "Unmarried Partners"; we will ask a follow-up question later
that will capture this relationship.

1. Opposite sex husband/wife/spouse
2. Opposite sex unmarried partner
3. Same sex husband/wife/spouse
4. Same sex unmarried partner
5. Child
6. Grandchild
7. Parent
8. Sibling
9. Parent/Child In-law (mother/father, son/daughter in-law)
10. Brother/Sister in-law
11. Aunt/Uncle, Niece/Nephew
12. Other relative
13. Foster Child
14. Housemate/Roommate
15. Roomer/Boarder
16. Other non-relative
17. Current or former opposite sex husband/wife/spouse
18. Current or former opposite sex unmarried partner
19. Current or former same sex husband/wife/spouse
20. Current or former same sex unmarried partner
Page 43 of 334

RELRP
**NON-DISPLAYED ITEM**
1. Spouse (Husband/Wife)
2. Unmarried Partner
3. Child (Biological, Step, Adopted)
4. Grandchild
5. Parent (Mother/Father)
6. Brother/Sister
7. Other Relative (Uncle, cousin, mother-in-law, father-in-law, etc.)
8. Foster Child
9. Housemate/Roommate
10. Roomer/Boarder
11. Other non-relative
12. Current or Former Spouse (Husband/Wife)
13. Current or Former Unmarried Partner

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

DOB_BMONTH
^ASKORVERIFY
What ^ISWAS ^PTEMPNAME date of birth?
Enter month.
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
Page 44 of 334

9. September
10. October
11. November
12. December

DOB_BDAY
^ASKORVERIFY
(What ^ISWAS ^PTEMPNAME date of birth?)
Enter day.

DOB_BYEAR
^ASKORVERIFY
(What ^ISWAS ^PTEMPNAME date of birth?)
Enter year.

WHICH_AGE
^C_AREIS ^TEMPNAME now?
1. ^AGEX or
2. ^AGEX+1 years old?
3. Neither is correct

AGEGES
? [F1]
How old would you say ^TEMPNAME ^AREISWAS?
Enter best estimate of age.

FRGES
Page 45 of 334

Enter your best estimate of ^NAMEFIL age.

UNDERAGE
Both the household reference person and the household respondent must be 15 years of age or
older. You reported that the ^WHICHPERSONFIL is under 15. Since no one in the household is 15
years of age or older, the household is a Type B Noninterview.
Enter 1 to continue.

1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ORIGIN
^ASKORVERIFY
^C_AREISWAS ^TEMPNAME Spanish, Hispanic or Latino? (Such as Mexican, Mexican-American,
Chicano, Puerto Rican, Cuban or some other Spanish, Hispanic, or Latino group.)

1. Yes
2. No

HISPAN
B
^ASKORVERIFY
^C_AREISWAS ^TEMPNAME Mexican, Mexican American, Chicano, Puerto Rican, Cuban, Cuban
American, or other Spanish, Hispanic, or Latino group?
1. Mexican
Page 46 of 334

2. Mexican American
3. Chicano
4. Puerto Rican
5. Cuban
6. Cuban American
7. Other Spanish, Hispanic, or Latino group

OROTSP
What is the name of ^PTEMPNAME other Spanish, Hispanic, or Latino group?

OROTSS
What 'other' Spanish, Hispanic or Latino group?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

RACE
C, ? [F1]
^ASKORVERIFY
Please choose one or more races that ^NAME1FIL_RACE ^NAME2FIL_RACE to be.
Probe if response is 'Hispanic' or 'Latino', or a specific Hispanic Origin (e.g., 'Mexican', 'Cuban', etc.)
Mark all that apply.

1. White
2. Black or African American
3. American Indian or Alaska Native
4. Asian
5. Native Hawaiian or Other Pacific Islander
6. Other -- DO NOT READ
Page 47 of 334

RACEAS
^ASKORVERIFY
Which of the following Asian groups ^CONSIDERFIL_RACE?
Read answer categories.
Mark all that apply.
1. Asian Indian
2. Chinese
3. Filipino
4. Japanese
5. Korean
6. Vietnamese
7. Other Asian - DO NOT READ

RACEPI
^ASKORVERIFY
Which of the following Native Hawaiian or Other Pacific Islander groups ^CONSIDERFIL_RACE?
Read answer categories.
Mark all that apply.
1. Hawaiian
2. Guamanian or Chamorro
3. Samoan
4. Other Pacific Islander -- DO NOT READ

RACEOT
^ASKORVERIFY
Read only if necessary.
(What is ^PTEMPNAME other race?)
1. African American
2. Aleut
3. American
4. American Indian or Alaska Native
Page 48 of 334

5. American Nation, Ethnic Group or Tribe
6. Anglo-Saxon
7. Arab
8. Asian
9. Asian Indian
10. Black
11. Brazilian
12. Caucasian
13. Chicano
14. Chinese
15. Creole
16. Cuban or Cuban American
17. Eskimo
18. European
19. Filipino
20. German
21. Guamanian or Chamorro
22. Hispanic
23. Jamaican
24. Japanese
25. Korean
26. Latin American
27. Latino
28. Mexican or Mexican American
29. Native American
30. Native Hawaiian or Other Pacific Islander
31. Negro
32. No race given
33. Other - DO NOT READ
34. Puerto Rican
35. Samoan
36. Scotch-Irish
37. Spanish
38. Vietnamese
39. West Indian
40. White

RACEOS
What 'other' race?
Page 49 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

BORNUS
^ASKORVERIFY
^C_WASWERE ^TEMPNAME born in the United States?
1. Yes
2. No

BORNSTATE
^ASKORVERIFY
In what state ^WEREWAS ^TEMPNAME born?
1. Alabama
2. Alaska
3. American Samoa
4. Arizona
5. Arkansas
6. California
7. Colorado
8. Connecticut
9. Delaware
10. District of Columbia
11. Florida
12. Georgia
13. Guam
14. Hawaii
15. Idaho
16. Illinois
17. Indiana
18. Iowa
19. Kansas
20. Kentucky
Page 50 of 334

21. Louisiana
22. Maine
23. Maryland
24. Massachusetts
25. Michigan
26. Minnesota
27. Mississippi
28. Missouri
29. Montana
30. Nebraska
31. Nevada
32. New Hampshire
33. New Jersey
34. New Mexico
35. New York
36. North Carolina
37. North Dakota
38. Northern Marianas
39. Ohio
40. Oklahoma
41. Oregon
42. Other place
43. Pennsylvania
44. Puerto Rico
45. Rhode Island
46. South Carolina
47. South Dakota
48. Tennessee
49. Texas
50. U.S. Virgin Islands
51. Utah
52. Vermont
53. Virginia
54. Washington
55. West Virginia
56. Wisconsin
57. Wyoming

BORNST
Page 51 of 334

*** THIS IS A NON-DISPLAYED ITEM ***

BORNCNTRY
? [F1]
^ASKORVERIFY
In what country ^WEREWAS ^TEMPNAME born?
1. United States (US, USA)
2. Afghanistan
3. American Samoa
4. Argentina
5. Armenia
6. Australia
7. Austria
8. Azores
9. Bahamas
10. Bangladesh
11. Barbados
12. Belgium
13. Belize
14. Bermuda
15. Bolivia
16. Bosnia and Herzegovina
17. Brazil
18. Burma/Myanmar
19. Cambodia
20. Canada
21. Caribbean
22. Chile
23. China
24. Colombia
25. Costa Rica
26. Cuba
27. Czech Republic
28. Czechoslovakia
29. Denmark
30. Dominica
Page 52 of 334

31. Dominican Republic
32. Ecuador
33. Egypt
34. El Salvador
35. England
36. Ethiopia
37. Fiji
38. Finland
39. France
40. Germany
41. Ghana
42. Great Britain
43. Greece
44. Grenada
45. Guam
46. Guatemala
47. Guyana
48. Haiti
49. Honduras
50. Hong Kong
51. Hungary
52. India
53. Indonesia
54. Iran
55. Iraq
56. Ireland
57. Israel
58. Italy
59. Jamaica
60. Japan
61. Jordan
62. Kenya
63. Korea
64. Laos
65. Latvia
66. Lebanon
67. Lithuania
68. Malaysia
69. Mexico
Page 53 of 334

70. Morocco
71. Netherlands
72. New Zealand
73. Nicaragua
74. Nigeria
75. Northern Marianas
76. Norway
77. Pakistan
78. Palestine
79. Panama
80. Peru
81. Philippines
82. Poland
83. Portugal
84. Puerto Rico
85. Romania
86. Russia
87. Scotland
88. Slovakia
89. South Africa
90. South Korea
91. Spain
92. Sweden
93. Switzerland
94. Syria
95. Taiwan
96. Thailand
97. Trinidad and Tobago
98. Turkey
99. U.S. Virgin Islands
100. Ukraine
101. United Kingdom
102. United States (US, USA)
103. Uruguay
104. USSR
105. Venezuela
106. Vietnam
107. Yugoslavia
108. Other Africa
Page 54 of 334

109. Other Asia
110. Other Central America
111. Other Europe
112. Other Pacific Islands
113. Other South America
114. Other

BORNCOUNTRY
CITIZEN
^ASKORVERIFY
^C_AREISWAS ^TEMPNAME a citizen of the United States?
1. Yes
2. No

NATCIT
D, ? [F1]
^ASKORVERIFY
How did ^TEMPNAME become a U.S. citizen?

1. Naturalized
2. Through ^HISHER or spouse's military service in the Armed Forces
3. Adopted by U.S. citizen parent or parents
4. Born in a U.S. Island Area or born in the United States
5. Born abroad of U.S. citizen parent or parents

YRENTRY
^ASKORVERIFY
What year did ^TEMPNAME first come to live in the United States?

IMSTAT
E
Page 55 of 334

^ASKORVERIFY
When ^TEMPNAME first moved to the United States to live, what was ^HISHER immigration
status?
1. Relative or family sponsored
2. Employment-based
3. Other permanent
4. Refugee or asylum
5. Non-immigrant (e.g., student, tourist, etc.)
6. Other

HHSPEAK1
Do not read to the respondent.
So far, has any part of this interview been conducted in a language other than English?
Do not count American Sign Language as non-English Language.

1. Yes
2. No, all in English

HHSPEAK2
? [F1]
^INTROFIL_HHSPEAK2 speak a language other than English at home?
Do not count American Sign Language as non-English Language.

1. Yes
2. No, only English

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
Page 56 of 334

**NON-DISPLAYED ITEM**

HHSPEAK3
? [F1]
C_DODOES ^TEMPNAME speak a language other than English at home?
Do not count American Sign Language as non-English Language.

1. Yes
2. No

WHOSPEAK
? [F1]
Who ^OTHERTHANFIL_WHOSPEAK speaks a language other than English at home?
Anyone else?
Mark all that apply.

1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
3. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
4. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
5. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
6. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
7. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
8. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
9. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
10. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
11. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
12. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
13. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
14. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
15. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
16. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
17. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
Page 57 of 334

18. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
19. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5
20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 5

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

LANG1
? [F1]
What language ^DODOES ^TEMPNAME speak at home?
If more than one, mark the 'main' other language.

1. Spanish or Spanish Creole
2. Chinese
3. French (including Patois, Cajun)
4. French Creole
5. Tagalog, Filipino
6. Vietnamese
7. German
8. Korean
9. Russian
10. Italian
11. Hindi, Urdu
12. Arabic
13. Portuguese or Portuguese Creole
14. Polish
15. Persian
16. Gujarati
17. Other

HOWWELL
Page 58 of 334

^INTROFIL_HOWWELL
How well ^DODOES ^TEMPNAME speak English - would you say very well, well, not well, or not
at all?
1. Very well
2. Well
3. Not well
4. Not at all

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

MARITAL_STATUS
? [F1]
^C_AREIS ^TEMPNAME currently married, widowed, divorced, separated or ^HAVHAS ^HESHE
never married?

1. Married
2. Married, spouse absent -- DO NOT READ
3. Widowed
4. Divorced
5. Separated
6. Never Married

WHO_SPOUSE
Ask if necessary.
Who is ^PTEMPNAME spouse?

0. Person's spouse is not a member of the household
1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
Page 59 of 334

2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
3. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
4. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
5. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
6. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
7. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
8. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
9. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
10. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
11. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
12. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
13. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
14. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
15. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
16. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
17. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
18. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
19. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15
20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

PAR1HHLD
^DODOES ^NAMEFIL2 have a parent in the household?
Please include biological, step and adoptive parents.
1. Yes
2. No

PAR1_WHO
Page 60 of 334

Ask or verify:
Who is that? (Who is ^PNAMEFIL2 parent?)

1. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

2. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

3. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

4. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

5. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

6. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

7. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

8. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

9. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

10. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

11. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

12. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

13. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

14. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

15. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

16. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

17. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

18. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

19. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

20. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

PAR1TYPE
? [F1]
^C_AREISWAS ^NAMEFIL2 ^PPAR1NAME biological, step, or adopted child?
1. Biological child
2. Stepchild
3. Adopted child
4. Foster child

PAR2HHLD
Ask or verify:
^DODOES ^NAMEFIL2 have another parent in the household?
Page 61 of 334

Please include biological, step and adoptive parents.
1. Yes
2. No

PAR2_WHO
Ask or verify:
Who is that? (Who is ^PNAMEFIL2 other parent?)

1. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

2. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

3. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

4. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

5. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

6. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

7. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

8. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

9. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

10. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

11. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

12. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

13. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

14. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

15. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

16. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

17. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

18. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

19. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

20. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

PAR2TYPE
? [F1]
^C_AREISWAS ^NAMEFIL2 ^PPAR2NAME biological, step, or adopted child?
1. Biological child
2. Stepchild
Page 62 of 334

3. Adopted child
4. Foster child

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

EDUC
F, ? [F1]
What ^ISWAS_EDUC the highest level of school ^TEMPNAME had completed or the highest
degree ^HESHE had received by the end of December ^CALENDAR_YRFIL?

31. Less than 1st grade
32. 1st, 2nd, 3rd or 4th grade
33. 5th or 6th grade
34. 7th or 8th grade
35. 9th grade
36. 10th grade
37. 11th grade
38. 12th grade, no diploma
39. High School Graduate (diploma or GED or equivalent)
40. Some college credit, but less than 1 year (regular Jr.coll./coll./univ.)
41. 1 or more years of college, no degree (regular Jr.coll./coll./univ.)
42. Associate's degree (2-year college)
43. Bachelor's degree (for example: BA, AB, BS)
44. Master's degree (for example: MA, MS, MBA, MSW)
45. Professional School degree (for example: MD (doctor), DDS (dentist), JD (lawyer))
46. Doctorate degree (for example: Ph.D., Ed.D.)

GED_TEST
Had ^TEMPNAME completed high school by means of a GED or other equivalency test or
program?

Page 63 of 334

1. Yes
2. No

HSGRAD_GED
Ask or verify.
Did ^TEMPNAME get ^HISHER high school diploma by graduating from high school, or by
passing a GED exam (or other equivalent)?
1. Graduated from high school
2. GED or other test
3. No diploma or GED

AF_HHLD
Did ^YOUANYONE ever serve on active duty in the U.S. Armed Forces?
1. Yes
2. No

AF_WHO
Who?
Mark all that apply.
1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
3. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
4. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
5. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
6. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
7. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
8. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
9. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
10. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
11. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
12. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
13. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
14. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
Page 64 of 334

15. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
16. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
17. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
18. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
19. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

AFWHEN
When did ^TEMPNAME serve on active duty?
Any other times?
Mark all that apply.

1. September 2001 to present
2. August 1990 to August 2001 (including Persian Gulf War)
3. May 1975 to July 1990
4. Vietnam Era (August 1964 to April 1975)
5. Februrary 1955 to July 1964
6. Korean War (July 1950 to January 1955)
7. January 1947 to June 1950
8. World War II (December 1941 to December 1946)
9. November 1941 or earlier

AFNOW
^C_AREIS ^TEMPNAME now on active duty?
1. Yes
2. No
Page 65 of 334

FALLOUT
If AFCNT = PCNTGE17, then display the following text:
ALL HOUSEHOLD MEMBERS ELIGIBLE FOR INTERVIEW ARE CURRENTLY SERVING IN THE
ARMED FORCES. THIS HOUSEHOLD IS NOW CLASSIFIED AS A TYPE B NONINTERVIEW.
IF THIS INFORMATION IS INCORRECT, BACK UP TO CHANGE THE ARMED FORCES STATUS IN
THE AFNOW SCREEN; OTHERWISE, PRESS 1 TO CONTINUE.
If PCNTGE15 = 0 AND W1PERSON = 0, then display the following text:
ALL HOUSEHOLD MEMBERS ELIGIBLE FOR INTERVIEW ARE UNDER THE AGE OF 15. THIS
HOUSEHOLD IS NOW CLASSIFIED AS A TYPE C NONINTERVIEW.
IF THIS INFORMATION IS INCORRECT RESRTAT THE CASE IN CASE MANAGEMENT;
OTHERWISE, PRESS 1 TO CONTINUE.
1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CLUMPALL
This is a survey about people's economic situation since ^MONTH1 1st ^CALENDAR_YRFIL. The
picture would be incomplete if we didn't get a little information about people ^TEMPNAME used
to live with.
Did ^TEMPNAME and Read name(s) ^BOTHALL continuously live together
^DURATION_REFPERDFIL?
"Continuously" means separations not longer than one month. This question is used to cluster all
listed household members together.
Display the first and last name of all people on the final household roster
(excluding the HH respondent).

1. Yes
2. No
Page 66 of 334

CLUMPANY
^CLUMPANY_INTROFIL
Did ^TEMPNAME live together ^ENTIRE_TIMEFIL with ^EITHERANY of the people ^HESHE
currently ^LIVE_LIVESFIL with?
1. Yes
2. No

CLUMPWHO
Who was that? (Which of these people did ^TEMPNAME live with the entire time between ^MONTH1
1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?)
Mark all that apply.

1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
3. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
4. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
5. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
6. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
7. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
8. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
9. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
10. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
11. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
12. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
13. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
14. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
15. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
16. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
17. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
18. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
19. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME

CTRLNUM
**NON-DISPLAYED ITEM**
Page 67 of 334

LNO
**NON-DISPLAYED ITEM**

T2_YN
^OTHERWAS there anyone else who lived with ^TEMPNAME for one month or more, either here
or at any other previous address, at any time between ^MONTH1 1st and the end of
^LASTMONTH ^CALENDAR_YRFIL?
Prechart all partial period people (HHSTAT=5) and movers (HHSTAT=2 and not
URE) people here (If no one on the roster is HHSTAT=5 or a mover then
prechart should be blank).
(This is a survey about people's economic situation between ^MONTH1 1st and the end of
^LASTMONTH ^CALENDAR_YRFIL. The picture would be incomplete if we didn't get a little information
about people ^TEMPNAME used to live with.)
'One month or more' must be CONTINUOUS time, not a day or week here or there.

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

T2LNO
**NON-DISPLAYED ITEM**

T2SLOT
**NON-DISPLAY ITEM**

T2_ROST_NUM
T2 Who Question Text(That is, the people who lived with ^TEMPNAME^OTHERADD_COMMA at any
time between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL.)

Page 68 of 334

As each name is added, consider whether this is a duplicate name to one previously entered and
probe to make sure the responses are consistent.
Enter 0 to add a new person.
Enter 999 for none/no more.
Display the fist and last name of the people aready entered

T2_ROST_FNAME
^T2FNAMETEXT
Enter 999 for none/no more.

T2_ROST_LNAME
^T2LNAMETEXT
Enter 999 for none/no more.

T2_MORE
That's ten other people who lived with ^TEMPNAME between ^MONTH1 1st and the end of
^LASTMONTH ^CALENDAR_YRFIL, which is all this questionnaire has room for. How many
more were there?
Enter 0 for none.

T2SLOT
**NON-DISPLAY ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

Page 69 of 334

T2_RELEXP
BB
^T2_REL_RELATIONSHIPQFILL
Text to fill when limiting to only the first five type 2 people identified
If more than one relationship is applicable, enter the relationship that applied for most of the time spent
living together between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL.
If relationship is parent/child, probe for biological, step or adoptive.
If the exact relationship is unknown, mark 'Other Relatives' if the person is related or mark 'Other
Non-Relatives' if the person is not related.

1. Opposite sex husband/wife/spouse
2. Opposite sex unmarried partner
3. Same sex husband/wife/spouse
4. Same sex unmarried partner
5. Biological parent/child
6. Step parent/child
7. Adoptive parent/child
8. Grandparent/Grandchild
9. Brother/Sister
10. Parent/Child in-law
11. Brother/Sister in-law
12. Aunt/Uncle, Niece/Nephew
13. Other relative (cousin, etc.)
14. Foster parent/child
15. Other non-relative

T2_REL
**NON-DISPLAYED ITEM**
1. Spouse (Husband/Wife)
2. Unmarried Partners
3. Biological Parent/Child
4. Step-parent/child
5. Adoptive parent/child
6. Grandparent-grandchild
7. Siblings (e.g. brother/sister)
Page 70 of 334

8. Other Relatives (e.g., aunt/uncle, niece/nephew, cousins, parent/child-in-laws, etc.)
9. Foster Parent/Child
10. Friends, Roommates or Other Non-Relatives

T2SLOT
**NON-DISPLAY ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

T2_1_MONTHS
In which months, between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME and ^T2_ROSTNAMEFIL live together?
Mark all that apply.
Mark all months in which these people lived together for at least half of the month.

1. ^MONTH1 ^CALENDAR_YR
2. ^MONTH2 ^CALENDAR_YR
3. ^MONTH3 ^CALENDAR_YR
4. ^MONTH4 ^CALENDAR_YR
5. ^MONTH5 ^CALENDAR_YR
6. ^MONTH6 ^CALENDAR_YR
7. ^MONTH7 ^CALENDAR_YR
8. ^MONTH8 ^CALENDAR_YR
9. ^MONTH9 ^CALENDAR_YR
10. ^MONTH10 ^CALENDAR_YR
11. ^MONTH11 ^CALENDAR_YR
12. ^MONTH12 ^CALENDAR_YR

CTRLNUM
Page 71 of 334

**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

T2_SEX
Ask if necessary.
Is ^T2_ROSTNAMEFIL male or female?
1. Male
2. Female

T2_AGE
What was ^HISHER age as of the beginning of last year (^MONTH1 1st, ^CALENDAR_YEAR)?
(Your best guess is fine.)

T2_AGERANGE
Was ^HESHE...
1. Under 5 years old?
2. 5 - 14 years old?
3. 15 - 19 years old?
4. 20 - 29 years old?
5. 30 - 49 years old?
6. 50 - 69 years old?
7. 70 years old or over?

T2_HIED
What is the highest level of school that ^T2_ROSTNAMEFIL has completed, or the highest degree
^T2HESHE has received?
1. Did NOT graduate from high school
2. Graduated from high school (Diploma or GED)
3. College graduate (Bachelor's degree or higher)

Page 72 of 334

T2_WORK
Did ^T2_ROSTNAMEFIL work for pay at any time when ^TEMPNAME and ^T2_ROSTNAMEFIL
lived together?
PRECHART MONTHS LISTED IN T2_1_MONTHS

1. Yes
2. No

T2_INC
Including all income sources, what would you guess was ^T2HISHER annual income?
(We don't expect an exact amount. Your best guess is fine.)
If a specific time is asked for, use ^MONTH1 1st, ^CALENDAR_YEAR.
If the person's income is $1 million or more, enter 999,999.
Round the amount to the nearest dollar.

T2_INCDK1
Was it more than $25,000?
If a specific time is asked for, use ^MONTH1 1st, ^CALENDAR_YEAR.
1. Yes, more than $25,000
2. No

T2_INCDK2A
Was it more than $50,000?
If a specific time is asked for, use ^MONTH1 1st, ^CALENDAR_YEAR.
1. Yes, more than $50,000
2. No

T2_INCDK2B
Was it more than $10,000?

Page 73 of 334

If a specific time is asked for, use ^MONTH1 1st, ^CALENDAR_YEAR.
1. Yes, more than $10,000
2. No

TYPE2_COMP
The Type 2 section is complete. Enter 1 to continue.
1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

PARFLAG
*********** NON-DISPLAYED ITEM ****************
1. Yes
2. No

PROCERT
Now I have some preliminary questions about ^TEMPNAME that will help streamline the
interview.
^C_DODOESDID ^TEMPNAME have a professional certification or a state or industry license?
A professional certification or license shows you are qualified to perform a specific job and includes
things like Licensed Realtor, Certified Medical Assistant, Certified Construction Manager, a Project
Management Professional, or PMP certification, or an IT Certification.

1. Yes
2. No

Page 74 of 334

WHOCERT
Who issued this certification or license?
Mark all that apply.
1. Federal, state, or local government

2. Professional or trade association (for example, Pediatric Nursing Certification Board, National Exercise and Spor
3. Business or company (for example, Microsoft, 3M Company, Xerox)
4. Other group or organization

CERT
Some people decide to enroll at a college, university, community college, or trade school to earn
a certificate rather than a degree. ^C_HAVHASDID ^TEMPNAME ever ^EARN_FIL this type of
certificate?
An educational certificate is typically earned by completing a program of study offered by a college or
university, a community college, or a trade school, but it does not lead to an associate's, bachelor's or
graduate degree. Sometimes these are also called vocational diplomas, for example, a cosmetology or
mechanics diploma, which differs from a high school diploma.

1. Yes
2. No

YR_CURR_MARR
yet another possible intro in person-level demo block
In what year did ^TEMPNAME enter ^HISHER current marriage?

TIMES_MARRIED
How many times ^HAVEHAS ^TEMPNAME been married?

1. Once
2. Twice
3. Three times
4 or more. Four or more times
0. Never Married

Page 75 of 334

YR_FIRST_MARR
In what year did ^TEMPNAME get married ^FIRSTIMEFIL?

EVRWID
^C_HAVHAS ^TEMPNAME ever been widowed?
1. Yes
2. No

EVRDIV
? [F1]
^C_HAVHAS ^TEMPNAME ever been divorced?

1. Yes
2. No

PARENT_SCRN
^DEMO_Q_INTRO2
C_DODOES ^TEMPNAME have any children?
Please include biological, step or adopted children, both living and deceased.
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

HHINCSCR_YR
I also have a couple of preliminary questions about income. In ^CALENDAR_YEAR
was ^PINCPER_FILL total annual income below $^INCYR_FILL?
Page 76 of 334

1. Yes
2. No

HHINCSCR_MTH
During any month in ^CALENDAR_YEAR, was ^PINCPER_FILL total monthly income ever below
$^INCMTH_FILL?
1. Yes
2. No

HHPGMSCR
Just to be sure nothing is missed, at any time since ^MONTH1 ^CALENDAR_YRFIL,
did ^PPROGRAM_FILL receive any assistance from any federal, state, or local agency, such as
from Food Stamps/SNAP or WIC, Medicaid, TANF FIL1, TANF FILL, TANF FILL (PACASH1,
PATANF), or General Assistance?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

STATE_EXC
**NON-DISPLAYED ITEM**

STATE_PRE
*Non-displayed item*

NOESI
**NON-DISPLAYED ITEM**

Page 77 of 334

NOPRIVCOV
**NON-DISPLAYED ITEM**

NOHICOV
**NON-DISPLAYED ITEM**

HIFU_INTRO
? [F1]
The next section of the interview includes a few follow-up questions based on the health
insurance information you have already provided.
1. Enter 1 to continue

EXCHANGE
Did ^TEMPNAME get any of ^HISHER health coverage through the Health Insurance Exchange
during ^CALENDAR_YEAR? State Specific Exchange Portal Name, " STATENAME Health
Exchange".
1. Yes
2. No

PREMYN
Was there a monthly premium for ^HISHER health coverage during ^CALENDAR_YEAR?
A monthly premium is a fixed amount of money people pay each month to have health coverage. It
does not include copays or other expenses such as prescription costs.
If a respondent had more than one plan during this time, and at least one plan had a premium, then
answer Yes.

1. Yes
2. No

PREMSUBS
Was the cost of the premium subsidized based on Fill to determine if Health Exchange premium
Page 78 of 334

was subsidized. income?
A monthly premium is a fixed amount of money people pay each month to have heatlh coverage. It
does not include copays or other expenses such as prescription costs.
If a respondent had more than one plan, and the premium was subsidized for at least one of these
plans, then answer Yes.
1. Yes
2. No

EMPNOESI
During ^CALENDAR_YEAR, there was a period of at least one month when ^TEMPNAME
^WEREWAS employed, but did not have health coverage through ^HISHER job. During this time,
did ^HISHER employer offer health insurance to any of its employees?
If a respondent had more than one employer during this time, and at least one employer offered health
insurance to any of its employees, then answer Yes.
1. Yes
2. No

WHYNOESI
X, ? [F1]
(Fill used in post EHC Health Insurance section for the WHYNOESI question. ) Why didn't
^TEMPNAME sign up for the health insurance offered through this employer?
Mark all that apply
If a respondent had more than one employer that offered health insurance to its employees during this
time, then mark all reasons the respondent did not sign up for health insurance through both/all of these
employers.
1. ^EXPENSIVE
2. Haven't worked for this employer long enough
3. Part-Time, Temporary, or Contract employee
4. ^ELIGIBLE
5. Healthy (haven't needed health insurance)
6. Able to get care elsewhere (such as a health clinic)
7. ^OTHERPLN
8. Dissatisfied or don't believe in insurance
9. ^WAITING
Page 79 of 334

10. ^CONFUSE
11. Other

NOESIOTH
You said ^TEMPNAME had some other reason for not accepting employer-sponsored health
insurance. What was that reason?

WHYNOPRI
Y, ? [F1]
Fill for WHYNOPRI based on coverage
Fill for WHYNOPRI based on coverage18
Mark all that apply.
1. ^EXPENSIVE
2. Haven't worked for this employer long enough
3. Part-Time, Temporary, or Contract employee
4. ^ELIGIBLE
5. Healthy (haven't needed health insurance)
6. Able to get care elsewhere (such as a health clinic)
7. ^OTHERPLN
8. Dissatisfied or don't believe in insurance
9. ^WAITING
10. ^CONFUSE
11. Other

NOPRIOTH
You said ^TEMPNAME had some other reason for not being covered by private health insurance.
What was that reason?

WHYNOPUB
Z, ? [F1]
Why didn't ^TEMPNAME get Medicaid or Medical Assistance then?
Mark all that apply.
Page 80 of 334

1. ^EXPENSIVE
2. Haven't worked for this employer long enough
3. Part-Time, Temporary, or Contract employee
4. ^ELIGIBLE
5. Healthy (haven't needed health insurance)
6. Able to get care elsewhere (such as a health clinic)
7. ^OTHERPLN
8. Dissatisfied or don't believe in insurance
9. ^WAITING
10. ^CONFUSE
11. Other

NOPUBOTH
You said ^TEMPNAME had some other reason for not being covered by public health insurance.
What was that reason?

PROGINCOME_INTRO
? [F1]
Next I'll ask some questions about additional ways money may enter or leave your household.
(This includes income from other sources such as Social Security, Unemployment Compensation,
Worker's Compensation, disability payments, and survivor's benefits.) I'll also ask you about This is
the fill if the respondent has children or has ever divorced any payments ^TEMPNAME might
have made for the support or care of non-household members.
1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CAREPAY_ANYONE
Now I have a few questions about the care of dependents.
Page 81 of 334

In December ^CALENDAR_YEAR, did anyone here pay for the care of a child or a disabled
person so that a household member could work, attend training, or look for a job?
1. Yes
2. No

DEPENDENT_EXP
What was the total cost of these care arrangements in December, ^CALENDAR_YEAR?

EXPENSE_RANGE
Is the amount (for December, ^CALENDAR_YEAR) less than $200, between $200 and $400,
between $400 and $600, or more than $600?
1. Less than $200
2. $200 to $399
3. $400 to $599
4. $600 or more

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

VA_ANY
Earlier you indicated ^TEMPNAME served in the military.

Page 82 of 334

Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any payments from the VA that is, the Department of Veterans Affairs?
1. Yes
2. No

VA_TYPE
N
^QSTNTXT_VATYPE What type of VA payments did ^TEMPNAME receive since ^MONTH1
^CALENDAR_YRFIL?
If necessary, read response choices 1, 2, and 3. Do not read response choice 4, 5, or 6.
Mark all that apply.
1. Service-connected disability compensation
2. Veterans' pension
3. Other VA payments
4. G.I. Bill benefits
5. Insurance proceeds
6. Did not receive any VA benefits

VADISRATE
^QSTNTXT_VADISRATE. What was ^PTEMPNAME total service-connected disability rating since
^MONTH1 ^CALENDAR_YRFIL?
1. 0 percent
2. 10 - 20 percent
3. 30 - 40 percent
4. 50 - 60 percent
5. 70+ percent

VATYPE_SP
What was that other type of VA payment?

VAQUES
^C_WASWERE ^TEMPNAME required to fill out an Eligibility Verification Report, or EVR, since
^MONTH1 ^CALENDAR_YRFIL in order to receive VA benefits?
Page 83 of 334

1. Yes
2. No

VABENEFITCODE
***NON-DISPLAYED ITEM***

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

VA_NOW
C_DODOES ^TEMPNAME receive ^TYPEVAPMTFIL now?
1. Yes
2. No

VA_LAST_REC
When did ^TEMPNAME last receive ^TYPEVAPMTFIL?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
Page 84 of 334

15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

VA_START_REC
When did ^TEMPNAME start receiving ^TYPEVAPMTFIL?
Enter 0 if the person started receiving ^TYPEVAPMTFIL prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

VA_1STAMT
How much ^DIDDO ^TEMPNAME receive in ^TYPEVAPMTFIL ^VACURAMT_FIL?

VA_GUESS
What would you estimate the monthly amount to be?

VA_1STSTART
Page 85 of 334

When did ^TEMPNAME start receiving ^VAAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

VA_2NDAMT
How much did ^TEMPNAME receive in ^TYPEVAPMTFIL ^VASTART1_FIL?

VA_2NDSTART
When did ^TEMPNAME start receiving ^VAAMT2_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
Page 86 of 334

10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

VA _3RDAMT
How much did ^TEMPNAME receive in ^TYPEVAPMTFIL ^VASTART2_FIL?

VA_3RDSTART
When did ^TEMPNAME start receiving ^VAAMT3_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

VA_4THAMT
Page 87 of 334

How much did ^TEMPNAME receive in ^TYPEVAPMTFIL ^VASTART3_FIL?

VA_4THSTART
When did ^TEMPNAME start receiving ^VAAMT4_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

VA_STARTAMT
How much did ^TEMPNAME receive in ^TYPEVAPMTFIL in ^VASTARTAMT_FIL?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CTRLNUM
Page 88 of 334

**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SSS_ANY
? [F1]
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any Social Security income
for ^HIMHERSELF?
1. Yes
2. No

REASON_SELF
^QSTNTXT_REASONSELF What is the reason ^HESHE received Social Security since ^MONTH1
^CALENDAR_YRFIL?
Mark all that apply.
1. Retired
2. Disabled
3. Widowed
4. Spouse
5. Other reason
6. Did not receive Social Security

REASON_SP
What was the other reason ^TEMPNAME received Social Security?

AGESS
At what age did ^TEMPNAME begin receiving Social Security (for ^HIMHERSELF) because of
^HISHER disability?
Report age in years.

Page 89 of 334

JOINT_SS
(Since ^MONTH1 1st ^CALENDAR_YRFIL,) Did ^TEMPNAME receive Social Security jointly with
^HISHER spouse?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SSS_NOW
C_DODOES ^TEMPNAME receive Social Security for ^HIMHERSELF now?
1. Yes
2. No

SSS_LAST_REC
When did ^TEMPNAME last receive Social Security (for ^HIMHERSELF)?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
Page 90 of 334

16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SSS_START_REC
When did ^TEMPNAME start receiving Social Security (for ^HIMHERSELF)?
Enter 0 if the person started receiving Social Security prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SSS_1STAMT
How much ^DIDDO ^TEMPNAME receive in Social Security before any deductions were taken
out ^SSSCURAMT_FIL?

SSS_GUESS
What would you estimate the monthly amount to be?
Ask respondent to please report the gross amount, that is before any deductions are taken out.
Page 91 of 334

SSS_1STSTART
When did ^TEMPNAME start receiving ^SSSAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SSS_2NDAMT
How much did ^TEMPNAME receive in Social Security before any deductions were taken
out ^SSSSTART1_FIL?

SSS_2NDSTART
When did ^TEMPNAME start receiving ^SSSAMT2_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
Page 92 of 334

8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SSS_3RDAMT
How much ^DIDDO ^TEMPNAME receive in Social Security before any deductions were taken
out ^SSSSTART2_FIL?

SSS_3RDSTART
When did ^TEMPNAME start receiving ^SSSAMT3_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
Page 93 of 334

18. ^INTV_MONTH6, ^INTV_YEAR

SSS_4THAMT
How much did ^TEMPNAME receive in Social Security before any deductions were taken
out ^SSSSTART3_FIL?

SSS_4THSTART
When did ^TEMPNAME start receiving ^SSSAMT4_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SSS_STARTAMT
How much did ^TEMPNAME receive in Social Security before any deductions were taken out in
^SSSSTARTAMT_FIL?

CTRLNUM
**NON-DISPLAYED ITEM**
Page 94 of 334

LNO
**NON-DISPLAYED ITEM**

SSPARTB
? [F1]
Earlier ^TEMPNAME stated ^HESHE ^HAVHAS Medicare medical insurance, also called Part B.
C_DODOES ^TEMPNAME have the premium taken out of ^HISHER Social Security benefit before
it reaches HIMHER?
1. Yes
2. No

SSPARTBAMT
How much is deducted from ^PTEMPNAME monthly Social Security benefits?

SSPARTC
? [F1]
Earlier ^TEMPNAME stated ^HESHE ^HAVHAS a Medicare Advantage Plan, also called Part C.
C_DODOES ^TEMPNAME have the premium taken out of ^HISHER Social Security benefit before
it reaches HIMHER?
1. Yes
2. No

SSPARTCAMT
How much is deducted from ^PTEMPNAME monthly Social Security benefits?

SSPARTCAMT_PD
How much did ^TEMPNAME pay per month for Medicare Part C?

SSPARTD
? [F1]
Earlier ^TEMPNAME stated ^HESHE ^HAVHAS prescription drug coverage through Medicare,
Page 95 of 334

also called Medicare Part D.
C_DODOES ^TEMPNAME have the premium taken out of ^HISHER Social Security benefit before
it reaches HIMHER?
1. Yes
2. No

SSPARTDAMT
How much is deducted from ^PTEMPNAME monthly Social Security benefits?

SSPARTDAMT_PD
How much did ^TEMPNAME pay per month for Medicare Part D?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SSC_ANY
Since ^MONTH1 ^CALENDAR_YRFIL, did ^TEMPNAME receive any Social Security on behalf of a
child?
1. Yes
2. No

SSKIDCOV
^QSTNTXT_SSKIDCOV Who was covered by the Social Security income you received since
^MONTH1 ^CALENDAR_YRFIL?
Mark all that apply.

1. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

2. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
Page 96 of 334

3. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

4. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

5. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

6. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

7. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

8. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

9. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

10. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

11. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

12. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

13. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

14. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

15. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

16. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

17. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

18. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

19. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

20. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

21. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

22. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

23. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

24. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE

25. Display the ^LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
26. Someone not listed
27. Did not receive Social Security on behalf of a child

REASON_CHILD
What are the reasons ^TEMPNAME AREIS receiving Social Security on behalf of

Read Names ?

Display the first and last name of all children selected in SSKIDCOV under
the heading Children. If SSKIDCOV=26, display "this child" instead of
nothing.
Mark all that apply.
1. Surviving child
2. Dependent child

CTRLNUM
Page 97 of 334

**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SSC_NOW
C_DODOES ^TEMPNAME receive Social Security on behalf of

Read Names now?

Display the first and last name of the children identified in SSKIDCOV under
the heading "Child(ren)". Display "this child" if SSKIDCOV=26.
1. Yes
2. No

SSC_LAST_REC
When did ^TEMPNAME last receive Social Security on behalf of ^THISTHESECHILDREN?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SSC_START_REC
Page 98 of 334

When did ^TEMPNAME start receiving Social Security on behalf of ^THISTHESECHILDREN?
Enter 0 if the person starting receiving Social Security on behalf of ^THISTHESECHILDREN prior to
the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SSC_1STAMT
How much ^DIDDO ^TEMPNAME receive in Social Security before any deductions were taken
out on behalf of ^THISTHESECHILDREN before any deductions were taken
out ^SSCCURAMT_FIL?

SSC_GUESS
What would you estimate the monthly amount to be?
Ask respondent to please report the gross amount, that is before any deductions are taken out.

SSC_1STSTART
When did ^TEMPNAME start receiving ^SSCAMT1_FIL?

Page 99 of 334

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SSC_2NDAMT
How much did ^TEMPNAME receive in Social Security before any deductions were taken out on
behalf of ^THISTHESECHILDREN ^SSCSTART1_FIL?

SSC_2NDSTART
When did ^TEMPNAME start receiving ^SSCAMT2_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
Page 100 of 334

10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SSC_3RDAMT
How much did ^TEMPNAME receive in Social Security before any deductions were taken out on
behalf of ^THISTHESECHILDREN ^SSCSTART2_FIL?

SSC_3RDSTART
When did ^TEMPNAME start receiving ^SSCAMT3_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

Page 101 of 334

SSC_4THAMT
How much did ^TEMPNAME receive in Social Security before any deductions were taken out on
behalf of ^THISTHESECHILDREN ^SSCSTART3_FIL?

SSC_4THSTART
When did ^TEMPNAME start receiving ^SSCAMT4_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SSC_STARTAMT
How much did ^TEMPNAME receive in Social Security before any deductions were taken out on
behalf of ^THISTHESECHILDREN ^SSCSTARTAMT_FIL?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
Page 102 of 334

**NON-DISPLAYED ITEM**

WC_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any money from Workers'
Compensation as a result of any kind of job-related injury or illness?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

WC_NOW
C_DODOES ^TEMPNAME receive any money from Workers' Compensation (as a result of any kind
of job-related injury or illness) now?
1. Yes
2. No

WC_LAST_REC
When did ^TEMPNAME last receive money from Workers' Compensation (as a result of any kind of
job-related injury or illness)?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
Page 103 of 334

11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
19. ^FEEDBACKWRONG

WC_START_REC
When did ^TEMPNAME start receiving money from Workers' Compensation (as a result of any kind
of job-related injury or illness)?
Enter 0 if the person started receiving money from Workers' Compensation prior to the start of the
reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

WC_1STAMT
How much ^DIDDO ^TEMPNAME receive in Workers' Compensation ^WCCURAMT_FIL?
Page 104 of 334

WC_GUESS
What would you estimate the monthly amount to be?

WC_1STSTART
When did ^TEMPNAME start receiving ^WCAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

WC_2NDAMT
How much did ^TEMPNAME receive in Workers' Compensation ^WCSTART1_FIL?

WC_2NDSTART
When did ^TEMPNAME start receiving ^WCAMT2_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
Page 105 of 334

6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

WC_3RDAMT
How much did ^TEMPNAME receive ^WCSTART2_FIL?

WC_3RDSTART
When did ^TEMPNAME start receiving ^WCAMT3_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
Page 106 of 334

18. ^INTV_MONTH6, ^INTV_YEAR

WC_4THAMT
How much did ^TEMPNAME receive ^WCSTART3_FIL?

WC_4THSTART
When did ^TEMPNAME start receiving ^WCAMT4_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

WC_STARTAMT
How much did ^TEMPNAME receive ^WCSTARTAMT_FIL?

UC_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any money from
Unemployment Compensation?
1. Yes
2. No
Page 107 of 334

UC_TYPE
^QSTNTXT_UCTYPE What type of Unemployment Compensation payments did ^TEMPNAME
receive since ^MONTH1 ^CALENDAR_YRFIL?
Mark all that apply.
1. Regular, government-provided
2. Supplemental, employer-provided
3. Other, including union benefits
4. Did not receive Unemployment Compensation

UEMP_COMP_CODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

UC_LAST_REC
When did ^TEMPNAME last receive ^TYPEUCFIL?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
Page 108 of 334

15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

UC_START_REC
When did ^TEMPNAME start receiving ^TYPEUCFIL?
Enter 0 if the person started receiving ^TYPEUCFIL prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

UC_OTH_REC
In which months from UC_START_REC to UC_LAST_REC did ^TEMPNAME receive
^TYPEUCFIL?
Enter 0 if the respondent received unemployment compensation in all months OR Mark all that apply.
0. All Months
1. MONTH1, CALENDAR_YEAR
2. MONTH2, CALENDAR_YEAR
Page 109 of 334

3. MONTH3, CALENDAR_YEAR
4. MONTH4, CALENDAR_YEAR
5. MONTH5, CALENDAR_YEAR
6. MONTH6, CALENDAR_YEAR
7. MONTH7,CALENDAR_YEAR
8. MONTH8, CALENDAR_YEAR
9. MONTH9, CALENDAR_YEAR
10. MONTH10, CALENDAR_YEAR
11. MONTH11, CALENDAR_YEAR
12. MONTH12, CALENDAR_YEAR
13. INTV_MONTH1, INTV_YEAR
14. INTV_MONTH2, INTV_YEAR
15. INTV_MONTH3, INTV_YEAR
16. INTV_MONTH4, INTV_YEAR
17. INTV_MONTH5, INTV_YEAR
18. INTV_MONTH6, INTV_YEAR

UC_LAST_AMT
How much ^DIDDOLAST_AMT ^TEMPNAME receive in ^TYPEUCFIL ^LASTMONTH_UCCS?

UC_GUESS
What would you estimate the monthly amount to be?

UC_WHEN_AMT
Did ^TEMPNAME get ^UC_LAST_AMT in ^UC_MONTHS?

1. Yes
2. No

UEMP_COMP_CODE
**NON-DISPLAYED ITEM**

MONTHCODE
**NON-DISPLAY ITEM**
Page 110 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

UC_OTH_AMT
Intro fill to make FR aware of temporal switch much ^TYPEUCFIL did ^TEMPNAME receive in
^OTH_MONTHFIL?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

UTILITIES
^DIDFIL_UTILYN pay ^SEPARATE_UTILYN for water, electricity, gas, or oil?
1. Yes
2. No

ENERGY_ASST
? [F1]
^HAVEYOUFIL_EGYASSYN received any energy assistance from the Federal, State, or Local
government at any time between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL?

1. Yes
2. No

ENERGY_PMT1
? [F1]

Page 111 of 334

Was this assistance received in the form of...
...checks sent to the household?
(...coupons or vouchers sent to the household?)
(...payments sent directly to the utility company, fuel dealer, or landlord?)

1. Yes
2. No

ENERGY_PMT2
? [F1]
(Was this assistance received in the form of...)
(...checks sent to the household?)
...coupons or vouchers sent to the household?
(...payments sent directly to the utility company, fuel dealer, or landlord?)

1. Yes
2. No

ENERGY_PMT3
? [F1]
(Was this assistance received in the form of...)
(...checks sent to the household?)
(...coupons or vouchers sent to the household?)
...payments sent directly to the utility company, fuel dealer, or landlord?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
Page 112 of 334

**NON-DISPLAYED ITEM**

SCHOOL_LUNCH
? [F1]
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,
^DIDFIL_SCHOOLMEALS usually get the lunch that ^THEIRFIL_SCHOOLMEALS school
provides?
Display the first and last name(s) of all children where LNGD_MEALS=LNO.
1. Yes
2. No

WHO_LUNCH
? [F1]
Which children usually got the school lunch?
Mark all that apply.

1. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

2. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

3. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

4. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

5. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

6. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

7. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

8. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

9. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

10. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

11. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

12. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

13. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

14. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

15. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

16. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

17. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

18. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO
Page 113 of 334

19. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

20. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

21. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

22. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

23. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

24. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

25. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO
26. Child not listed

FREE_LUNCH
? [F1]
Were these lunches Read answer categories?

1. Free
2. Reduced-price
3. Full Price (did not qualify)

SCHOOL_BREAKFAST
? [F1]
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,
^DIDFIL_SCHOOLMEALS usually get the breakfast that ^THEIRFIL_SCHOOLMEALS school
provides?
Display the first and last name(s) of all children where LNGD_MEALS=LNO.
1. Yes
2. No

WHO_BREAKFAST
? [F1]
Which children usually got the school breakfast?
Mark all that apply.

1. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO
Page 114 of 334

2. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

3. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

4. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

5. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

6. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

7. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

8. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

9. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

10. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

11. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

12. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

13. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

14. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

15. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

16. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

17. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

18. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

19. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

20. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

21. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

22. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

23. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

24. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

25. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO
26. Child not listed

FREE_BREAKFAST
? [F1]
Were these breakfasts Read answer categories?

1. Free
2. Reduced-price
3. Full price (Did not qualify)

CTRLNUM
**NON-DISPLAYED ITEM**
Page 115 of 334

LNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

LMPNOW
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME
receive any severance pay or lump sum payments from a pension or retirement plan?
1. Yes
2. No

LUMPTYP
What type of payment was that?
Anything else?
Mark all that apply.
1. Lump sum from a pension/retirement plan
2. Severance pay
3. Deferred payment/final paycheck
4. Something else

LUMPTYP_SP
What was the other type?

LUMPAMT
What was the total amount of lump sum payments ^TEMPNAME received between ^MONTH1 1st
and the end of ^LASTMONTH ^CALENDAR_YRFIL?
Round the amount to the nearest dollar.

Page 116 of 334

ROLLOVR1
Earlier you said that ^TEMPNAME received a lump sum payment from
^LUMPFIL_ROLLOVR1. Did ^HESHE re-invest or roll-over any of the money into an IRA or some
other kind of retirement plan?
1. Yes
2. No

ROLLOVR2
C_DODOES ^HESHE plan to re-invest or roll-over any of the money?
1. Yes
2. No

ROLLAMT
How much ^PLANFIL_ROLLAMT roll-over into another retirement account?
Round the amount to the nearest dollar.

DEFERAMT
What was the amount of the deferred payment or final paycheck ^TEMPNAME received between
^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?
Round the amount to the nearest dollar.

DISABL
C_DODOES ^TEMPNAME have a physical, mental or other health condition that limits the kind or
amount of work he/she can do at a job or business?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**
Page 117 of 334

LNO
**NON-DISPLAYED ITEM**

DIS_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any income
^OTHERTHAN_DISANY because of ^HISHER health condition?
1. Yes
2. No

DIS_TYPE
N, ? [F1]
^QSTNTXT_DISTYPE What type of disability income did ^TEMPNAME receive since ^MONTH1
^CALENDAR_YRFIL?
Mark all that apply.
1. Payments from a sickness, accident, or disability insurance policy
2. Employer disability payments
3. Pension from a company or union including income from a profit-sharing plan
4. Federal Civil Service or other Federal civilian employee pension
5. State government pension
6. Local government pension
7. U.S. Military retirement pay
8. U.S. Government Railroad Retirement
9. Black Lung benefits
10. Other disability income
11. Did not receive disability payments

DIS_TYPETWO
Did ^TEMPNAME purchase that policy on ^HISHER own?
1. Yes
2. No

DISTYPE_SP
What was that other type of disability income?
Page 118 of 334

DISABLECODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

DIS_NOW
C_DODOES ^TEMPNAME receive ^DISABILITY_TYPE now?

1. Yes
2. No

DIS_LAST_REC
When did ^TEMPNAME last receive ^DISABILITY_TYPE?

1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
Page 119 of 334

DIS_START_REC
When did ^TEMPNAME start receiving ^DISABILITY_TYPE?
Enter 0 if the person started receiving ^DISABILITY_TYPE prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

DIS_1STAMT
How much ^DIDDO ^TEMPNAME receive in ^DISABILITY_TYPE ^DISCURAMT?

DIS_GUESS
What would you estimate the monthly amount to be?

DIS_1STSTART
When did ^TEMPNAME start receiving ^DISAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
Page 120 of 334

5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

DIS_2NDAMT
How much did ^TEMPNAME receive in ^DISABILITY_TYPE ^DISSTART1_FIL?

DIS_2NDSTART
When did ^TEMPNAME start receiving ^DISAMT2_FIL?

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
Page 121 of 334

16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

DIS_3RDAMT
How much did ^TEMPNAME receive in ^DISABILITY_TYPE ^DISSTART2_FIL?

DIS_3RDSTART
When did ^TEMPNAME start receiving ^DISAMT3_FIL?

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

DIS_4THAMT
How much did ^TEMPNAME receive in ^DISABILITY_TYPE ^DISSTART3_FIL?

DIS_4THSTART
When did ^TEMPNAME start receiving ^DISAMT4_FIL?

Page 122 of 334

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

DIS_STARTAMT
How much did ^TEMPNAME receive in ^DISABILITY_TYPE in ^DISSTARTAMT_FIL?

EVERET
^C_HAVHAS ^TEMPNAME ever retired, for any reason, from a job or business?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

RET_ANY
Page 123 of 334

^RETINTRO_FIL
^OTHERTHANFIL_RETANY ^SSHLTHFIL_RETANY ^DIDFIL_RETANY ^TEMPNAME receive any
^OTHERFIL_RETANY retirement income?

1. Yes
2. No

RET_TYPE
N
^QSTNTXT_RETTYPE What type of retirement income did ^TEMPNAME receive since ^MONTH1
^CALENDAR_YRFIL?
Mark all that apply.
1. Pension from a company or union including income from a profit-sharing plan
2. Federal Civil Service or other Federal Civilian employee pension
3. State government pension
4. Local government pension
5. Military retirement pay
6. U.S. Government Railroad Retirement
7. National Guard or Reserve Forces retirement
8. Other retirement income
9. Did not receive retirement income

RETTYPE_SP
What was that other type of retirement income?

RETIRECODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
Page 124 of 334

**NON-DISPLAYED ITEM**

RET_NOW
C_DODOES ^TEMPNAME receive ^RETIREMENT_TYPE now?

1. Yes
2. No

RET_LAST_REC
Whe did ^TEMPNAME last receive ^RETIREMENT_TYPE?

1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

RET_START_REC
When did ^TEMPNAME start receiving ^RETIREMENT_TYPE?
Enter 0 if the person started receiving ^RETIREMENT_TYPE prior to the start of the reference period.

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
Page 125 of 334

1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

RET_1STAMT
How much ^DIDDO ^TEMPNAME receive in ^RETIREMENT_TYPE ^RETCURAMT_FIL?

RET_GUESS
What would you estimate the montly amount to be?

RET_1STSTART
When did ^TEMPNAME start receiving ^RETAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
Page 126 of 334

9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

RET_2NDAMT
How much did ^TEMPNAME receive in ^RETIREMENT_TYPE ^RETSTART1_FIL?

RET_2NDSTART
When did ^TEMPNAME start receiving ^RETAMT2_FIL?

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

Page 127 of 334

RET_3RDAMT
How much did ^TEMPNAME receive in ^RETIREMENT_TYPE ^RETSTART2_FIL?

RET_3RDSTART
When did ^TEMPNAME start receiving ^RETAMT3_FIL?

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

RET_4THAMT
How much did ^TEMPNAME receive in ^RETIREMENT_TYPE ^RETSTART3_FIL?

RET_4THSTART
When did ^TEMPNAME start receiving ^RETAMT4_FIL?

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
Page 128 of 334

5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

RET_STARTAMT
How much did ^TEMPNAME receive in ^RETIREMENT_TYPE ^RETSTARTAMT_FIL?

LIFEYN
? [F1]
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME
receive any retirement income from a paid-up life insurance policy or annuity?

1. Yes
2. No

LIFEREG
Did that come as a single lump-sum?
1. Yes
2. No

LIFEWHEN
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, during which months
did ^TEMPNAME receive retirement income from a paid-up life insurance policy or annuity?
Page 129 of 334

Mark all that apply.
1. ^MONTH1 ^CALENDAR_YEAR
2. ^MONTH1 ^CALENDAR_YEAR
3. ^MONTH1 ^CALENDAR_YEAR
4. ^MONTH1 ^CALENDAR_YEAR
5. ^MONTH1 ^CALENDAR_YEAR
6. ^MONTH1 ^CALENDAR_YEAR
7. ^MONTH1 ^CALENDAR_YEAR
8. ^MONTH1 ^CALENDAR_YEAR
9. ^MONTH1 ^CALENDAR_YEAR
10. ^MONTH1 ^CALENDAR_YEAR
11. ^MONTH1 ^CALENDAR_YEAR
12. ^MONTH1 ^CALENDAR_YEAR
13. All months

LIFEAMT
What was the total amount of life insurance payments ^TEMPNAME received between ^MONTH1
1st to the end of ^LASTMONTH ^CALENDAR_YRFIL?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SUR_ANY
^OTHERTHANFIL_SURANY ^SSHLTHRETFIL_SURANY ^DIDFIL_SURANY ^TEMPNAME receive
any ^OTHERFIL_SURANY income as a result of being a ^WIDOWFIL_SURANY?
1. Yes
2. No

SUR_TYPE
N
Page 130 of 334

^QSTNTXT_SURTYPE What type of survivor income did ^TEMPNAME receive since ^MONTH1
^CALENDAR_YRFIL?
Mark all that apply.
1. Pension from a company or union including income from a profit-sharing plan
2. Veterans' compensation or pension
3. Federal Civil Service or other Federal civilian employee pension
4. U.S. Government Railroad Retirement
5. State government pension
6. Local government pension
7. Income from a paid-up life insurance policy or annuity
8. Military retirement pay
9. Black Lung benefits
10. Workers' Compensation
11. Payments from an estate or trust
12. National Guard or Reserve Forces retirement
13. Other survivor income
14. Did not receive survivor income

SURTYPE_SP
What was that other type of survivor income?

SURVRCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SUR_NOW
C_DODOES ^TEMPNAME receive ^SURVIVOR_TYPE now?

Page 131 of 334

1. Yes
2. No

SUR_LAST_REC
When did ^TEMPNAME last receive ^SURVIVOR_TYPE?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SUR_START_REC
When did ^TEMPNAME start receiving ^SURVIVOR_TYPE?
Enter 0 if the person starting receiving ^SURVIVOR_TYPE prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
Page 132 of 334

8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SUR_1STAMT
How much ^DIDDO ^TEMPNAME receive in ^SURVIVOR_TYPE ^SURCURAMT_FIL?

SUR_GUESS
What would you estimate the monthly amount to be?

SUR_1STSTART
When did ^TEMPNAME start receiving ^SURAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
Page 133 of 334

16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SUR_2NDAMT
How much did ^TEMPNAME receive in ^SURVIVOR_TYPE ^SURSTART1_FIL?

SUR_2NDSTART
When did ^TEMPNAME start receiving ^SURAMT2_FIL?

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SUR_3RDAMT
How much did ^TEMPNAME receive in ^SURVIVOR_TYPE ^SURSTART2_FIL?

SUR_3RDSTART
When did ^TEMPNAME start receiving ^SURAMT3_FIL?

Page 134 of 334

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SUR_4THAMT
How much did ^TEMPNAME receive in ^SURVIVOR_TYPE ^SURSTART3_FIL?

SUR_4THSTART
When did ^TEMPNAME start receiving ^SURAMT4_FIL?

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
Page 135 of 334

11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SUR_STARTAMT
How much did ^TEMPNAME receive in ^SURVIVOR_TYPE ^SURSTARTAMT_FIL?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

FCC_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any foster child care
payments?
1. Yes
2. No

ALI_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any payments from
^FORMERFIL_ALI_ANY spouse, such as alimony or spousal support?
1. Yes
2. No

CSAGREE
Have child support payments ever been court-ordered, or informally agreed to, for
name(s)?
Page 136 of 334

Read

Display the first and last name of children under the age of 21 from both the
HH and T2 rosters where either one or both parents are not household members
and the child(ren) are NOT foster child(ren) and the respondent is the
'guardian' as specified by the question universe (NOTE: because of the age
range, this does not necessarily conform to usual guardianship flag; see
question universe)

1. Yes
2. No

CS_ANY
? [F1]
fill to acknowledge what we know about pass-through child support ^MONTH1 1st
^CALENDAR_YRFIL, did ^TEMPNAME receive any child support payments or other financial help
from the ^PARFIL_CSANY of Read name(s)?
Do not include alimony.
Display the first and last name of children under the age of 21 on both the
HH and T2 rosters where either one or both parents are not household members
and the child(ren) are NOT foster child(ren) and for whom the Respondent is
the guardian as specified in question universe for CSAGREE.

1. Yes
2. No
3. No - absent parent deceased (volunteered)

SUPPORTPMTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**
Page 137 of 334

SUP_LAST_REC
When did ^TEMPNAME last receive ^FMLY_SUP_TYPE?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
19. ^FEEDBACKWRONG

SUP_START_REC
When did ^TEMPNAME start receiving ^FMLY_SUP_TYPE?
Enter 0 if the person starting receiving ^FMLY_SUP_TYPE prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
Page 138 of 334

12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

SUP_OTH_REC
In which months from ^SUP_START_REC to ^SUP_LAST_REC did ^TEMPNAME
receive^FMLY_SUP_TYPE?
Enter 0 if the respondent received ^FMLY_SUP_TYPE in all months OR Mark all that apply.

0. All Months
1. MONTH1, CALENDAR_YEAR
2. MONTH2, CALENDAR_YEAR
3. MONTH3, CALENDAR_YEAR
4. MONTH4, CALENDAR_YEAR
5. MONTH5, CALENDAR_YEAR
6. MONTH6, CALENDAR_YEAR
7. MONTH7,CALENDAR_YEAR
8. MONTH8, CALENDAR_YEAR
9. MONTH9, CALENDAR_YEAR
10. MONTH10, CALENDAR_YEAR
11. MONTH11, CALENDAR_YEAR
12. MONTH12, CALENDAR_YEAR
13. INTV_MONTH1, INTV_YEAR
14. INTV_MONTH2, INTV_YEAR
15. INTV_MONTH3, INTV_YEAR
16. INTV_MONTH4, INTV_YEAR
17. INTV_MONTH5, INTV_YEAR
18. INTV_MONTH6, INTV_YEAR

SUP_LAST_AMT
How much ^DIDDOLAST_AMT ^TEMPNAME receive in ^FMLY_SUP_TYPE ^LASTMONTH_UCCS?

Page 139 of 334

SUP_GUESS
What would you estimate the monthly amount to be?

SUP_WHEN_AMT
Did ^TEMPNAME get ^SUP_LAST_AMT ^SUP_OTH_REC?

1. Yes
2. No

SUPPORTPMTCODE
**NON-DISPLAYED ITEM**

MONTHCODE
**NON-DISPLAY ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SUP_OTH_AMT
Intro fill to make FR aware of temporal switch much ^FMLY_SUP_TYPE did
^TEMPNAME receive in ^OTH_MONTHFIL?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ANYKID
Page 140 of 334

Did ^TEMPNAME have any children under 21 years of age who lived elsewhere with their other
parent or guardian at any time between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL?
Do not include children who were away at school and were considered part of this household. On the
other hand, if a child is away at school and was considered part of the other parent or guardian's
household, then they should be included.

1. Yes
2. No

NUMKIDS
How many children?

SUPPORTPAY
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME
make any payments for the support of ^CHILDCHILDREN_CS_SUPPORTPAY (who lived
elsewhere)?
Include any payments:
... made directly to the other parent/guardian,
... made through a court or agency, or
... withheld from this person's paycheck.
1. Yes
2. No

AMOUNTPAID
What was the total amount of support payments ^TEMPNAME made for
^CHILDCHILDREN_CS_AMTPAY between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL?
Count all forms of child support payments, including:
... payments made directly to the other parent/guardian,
... payments made through a court or agency, or
... payments withheld from this person's paycheck.

TIMESPENT
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, about how often did
^TEMPNAME see ^CS_THISCHILDYOUNGESTCHILD (who lived elsewhere)?
Page 141 of 334

0. Not at all
1. About once a year
2. Several times a year
3. One to three times a month
4. About once a week
5. Several times a week

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

OTHERSUPPORT
The following questions are about regular or lump sum support payments ^TEMPNAME might
have made between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL to people
living outside ^HISHER household.
To which of the following people who lived outside ^HISHER household did ^TEMPNAME make
support payments: READ ANSWER LIST?
Mark all that apply
Payments can be either mandatory or voluntary
Do not include people who were away at school and who were considered part of this household.
Supported parents who are not the respondent's own (i.e., in-laws) should be classified as "Someone
else not related to ^TEMPNAME"
Supported children who are not the respondent's own should be classified as either "Someone else
related to ^TEMPNAME" or "Someone else not related to ^TEMPNAME"

1. ^C_PTEMPNAME parent or parents
2. ^C_PTEMPNAME child 21 years old or older who lived elsewhere
Page 142 of 334

3. Someone else related to ^TEMPNAME (OPTIONAL TEXT: excluding ^PTEMPNAME children under 21 living els
4. ^C_PTEMPNAME ex-spouse or ex-partner (OPTIONAL TEXT: Or current spouse or partner living elsewhere)
5. Someone else not related to ^TEMPNAME
6. Did not make support payments

NUMPARSUP
How many parents did ^TEMPNAME make support payments for (between ^MONTH1 1st and the
end of ^LASTMONTH ^CALENDAR_YRFIL)?

PARTOTAMT
What was the total amount ^TEMPNAME paid in support for ^HISHER parent(s) between
^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?

NUMKIDSUP
How many of ^PTEMPNAME children 21 years old and older who lived elsewhere did
^TEMPNAME make support payments for (between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL)?

KIDTOTAMT
What was the total amount ^TEMPNAME paid in support for ^HISHER children 21 years old or
older who lived elsewhere between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL?

NUMORSUP
How many relatives (other than parents and children) did ^TEMPNAME make support payments for
(between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)?

ORTOTAMT
What was the total amount ^TEMPNAME paid in support for ^THISTHESE_ORSUP between
^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?

NUMEXSUP
How many current or ex-spouses (or partners) who lived elsewhere did ^TEMPNAME make
Page 143 of 334

support payments for (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)?
This support includes payments such as alimony or spousal support.

EXTOTAMT
What was the total amount ^TEMPNAME paid in support for ^HISHER current or ex-spouse(s) (or
partner(s)) between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?

NUMNRSUP
How many non-relatives did ^TEMPNAME make support payments for (between ^MONTH1 1st and
the end of ^LASTMONTH ^CALENDAR_YRFIL)?

NRTOTAMT
What was the total amount ^TEMPNAME paid in support for ^THISTHESE_NRSUP between
^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

FILING
Did ^TEMPNAME file a federal income tax return during ^CALENDAR_YEAR for tax
year ^CALENDAR_YEAR-1 ?
Respondents should report their filing status for their ^CALENDAR_YEAR-1 tax return.
To file as a head of household, you must be unmarried and have dependents.
1. Yes
2. No

WILLFILE
Page 144 of 334

C_DODOES ^TEMPNAME plan to file a federal income tax return for tax
year ^CALENDAR_YEAR-1?
1. Yes
2. No

FSTATUS
What ^WASWILL ^PTEMPNAME filing status on ^HISHER tax year ^CALENDAR_YEAR-1 federal
income tax return?
Read answer categories.

1. Single
2. Married filing jointly
3. Married filing separately
4. Head of household

DEPCLM
^C_FILED_WASWERE claimed as a dependent on ^PTEMPNAME parent's or someone else's
income tax return for tax year ^CALENDAR_YEAR-1?
1. Yes
2. No

EITC
^C_DIDWILL ^TEMPNAME claim an Earned Income Tax Credit (EITC) on ^HISHER tax year
^CALENDAR_YEAR-1 federal income tax return?
The EITC is a benefit for people who work and have low to moderate wage earnings. The EITC
reduces the amount of taxes you may owe and often results in an income benefit to the eligible federal
tax filer.
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**
Page 145 of 334

LNO
**NON-DISPLAYED ITEM**

INCOME_TYPE
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME
receive any money or income from any of the following sources?
Read answer categories.
Mark all that apply.

1. A community or religious charity
2. Family or friends
3. Roomers or boarders
4. Estates
5. Incidental or casual earnings
6. Miscellaneous cash income (such as lottery winnings)
7. National Guard or Reserve Pay
8. Did not receive money from any of these sources

AMOUNT_TOTAL
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL), how much did you
receive from ^THISTHESE_MISC Read List Below?

Display all selections from INCOME_TYPE.

AMOUNT_GUESS
L
What would you estimate the annual amount to be- less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more

Page 146 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

TRANS_TYPE1
Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the
following types of transportation assistance...
... gas vouchers?
(... bus or subway tokens or passes?)
(... help registering, repairing, or insuring a car?)
(... rides to a doctor's office or medical appointment?)
(... some other kind of transportation assistance?)
Do not include any assistance previously reported (such as commuting expenses paid by an
employer).
1. Yes
2. No

TRANS_TYPE2
(Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the following
types of transportation assistance...)
(... gas vouchers?)
... bus or subway tokens or passes?
(... help registering, repairing, or insuring a car?)
(... rides to a doctor's office or medical appointment?)
(... some other kind of transportation assistance?)
Do not include any assistance previously reported (such as commuting expenses paid by an
employer.)
1. Yes
2. No

TRANS_TYPE3
(Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the following
types of transportation assistance...)
Page 147 of 334

(... gas vouchers?)
(... bus or subway token or passes?)
... help registering, repairing, or insuring a car?
(... rides to a doctor's office or medical appointment?)
(... some other kind of transportation assistance?)
Do not include any assistance previously reported (such as commuting expenses paid by an
employer).
1. Yes
2. No

TRANS_TYPE4
(Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the following
types of transportation assistance...)
(... gas vouchers?)
(... bus or subway tokens or passes?)
(... help registering, repairing, or insuring a car?)
... rides to a doctor's office or medical appointment?
(... some other kind of transportation assistance?)
Do not include any assistance previously reported (such as commuting expenses paid by an
employer).
1. Yes
2. No

TRANS_OTH
(Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the following
types of transportation assistance...)
(... gas vouchers?)
(... bus or subway tokens or passes?)
(... help registering, repairing, or insuring a car?)
(... rides to a doctor's office or medical appointment?)
... some other kind of transportation assistance?
1. Yes
2. No

Page 148 of 334

TRANSOTH_SP
What was the other kind of transportation assistance ^TEMPNAME received?

GAS_SOURCE
Did ^TEMPNAME receive the gas vouchers through a government social service agency?

1. Yes
2. No

GAS_SOURCE_SP
What was the source of the gas voucher?

TOKEN_SOURCE
Did ^TEMPNAME receive the bus or subway tokens or passes through a government agency?

1. Yes
2. No

TOKEN_SOURCE_SP
What was the source of the bus or subway tokens or passes?

TRANS_WHEN
During which months did ^TEMPNAME receive transportation assistance?
Mark all that apply.
1. ^MONTH1 ^CALENDAR_YEAR
2. ^MONTH1 ^CALENDAR_YEAR
3. ^MONTH1 ^CALENDAR_YEAR
4. ^MONTH1 ^CALENDAR_YEAR
5. ^MONTH1 ^CALENDAR_YEAR
6. ^MONTH1 ^CALENDAR_YEAR
7. ^MONTH1 ^CALENDAR_YEAR
8. ^MONTH1 ^CALENDAR_YEAR
9. ^MONTH1 ^CALENDAR_YEAR
10. ^MONTH1 ^CALENDAR_YEAR
Page 149 of 334

11. ^MONTH1 ^CALENDAR_YEAR
12. ^MONTH1 ^CALENDAR_YEAR
13. All months

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

FOOD_TYPE1
Do not include any assistance previously reported (such as ^FOODFIL).
Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the
following types of food assistance...
... Money, vouchers, or certificates to buy groceries or food (Other than Food Stamps) ?
(... Bags of groceries or packaged foods?)
(... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?)
(... Any other food assistance?)

1. Yes
2. No

FOOD_TYPE2
Do not include any assistance previously reported (such as ^FOODFIL).
(Between ^MONTH1 and December ^CALENDAR_YEAR, did ^TEMPNAME receive any of the following
types of food assistance...)
(... Money, vouchers, or certificates to buy groceries or food (Other than Food Stamps)?)
... Bags of groceries or packaged foods?
(... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?)
(... Any other food assistance?)

1. Yes
2. No
Page 150 of 334

FOOD_TYPE3
Do not include any assistance previously reported (such as ^FOODFIL).
(Between ^MONTH1 and December ^CALENDAR_YEAR, did ^TEMPNAME receive any of the following
types of food assistance...)
(... Money, vouchers, or certificates to buy groceries or food (Other than Food Stamps)?)
(... Bags of groceries or packaged foods?)
... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?
(... Any other food assistance?)

1. Yes
2. No

FOOD_OTH
Do not include any assistance previously reported (such as ^FOODFIL).
(Between ^MONTH1 and December ^CALENDAR_YEAR, did ^TEMPNAME receive any of the following
types of food assistance...)
(... Money, vouchers, or certificates to buy groceries or food (Other than Food Stamps)?)
(... Bags of groceries or packaged foods?)
(... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?)
... Any other food assistance?

1. Yes
2. No

FOODOTH_SP
What was the other type of food assistance ^TEMPNAME received?

FOOD_SOURCE
Was this food assistance provided by

Read answer categories?

Mark all that apply.
1. Government agency
2. Community or religious charity
3. Family or friends
4. Someplace else
Page 151 of 334

FOOD_SOURCE_SP
What was the other source of food assistance?

FOOD_WHEN
During which months did ^TEMPNAME receive food assistance?
Mark all that apply.

1. ^MONTH1 ^CALENDAR_YEAR
2. ^MONTH1 ^CALENDAR_YEAR
3. ^MONTH1 ^CALENDAR_YEAR
4. ^MONTH1 ^CALENDAR_YEAR
5. ^MONTH1 ^CALENDAR_YEAR
6. ^MONTH1 ^CALENDAR_YEAR
7. ^MONTH1 ^CALENDAR_YEAR
8. ^MONTH1 ^CALENDAR_YEAR
9. ^MONTH1 ^CALENDAR_YEAR
10. ^MONTH1 ^CALENDAR_YEAR
11. ^MONTH1 ^CALENDAR_YEAR
12. ^MONTH1 ^CALENDAR_YEAR
13. All months

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CLTH_TYPE
Between ^MONTH1 and December ^CALENDAR_YRFIL, Did ^TEMPNAME receive any of the
following types of clothing assistance...
Read answer categories?
1. Free or reduced price clothes
2. Money or vouchers
3. Both free or reduced price clothes and money or vouchers
4. Did not receive clothing assistance
Page 152 of 334

CLTH_SOURCE
Was this clothing assistance provided by

Read answer categories?

Mark all that apply.
1. Government agency
2. Community or religious charity
3. Family or friends
4. Employer
5. Someplace else

CLTH_SOURCE_SP
What was the other source of clothing assistance?

HOUSE_ANY
(Since ^MONTH1 ^CALENDAR_YRFIL,) Did ^TEMPNAME receive any assistance to help pay for
housing^ENERGYFIL?
1. Yes
2. No

OTHASST_WHEN
During which months did ^TEMPNAME receive ^OTHASSTFIL assistance?
Mark all that apply.
1. ^MONTH1 ^CALENDAR_YEAR
2. ^MONTH1 ^CALENDAR_YEAR
3. ^MONTH1 ^CALENDAR_YEAR
4. ^MONTH1 ^CALENDAR_YEAR
5. ^MONTH1 ^CALENDAR_YEAR
6. ^MONTH1 ^CALENDAR_YEAR
7. ^MONTH1 ^CALENDAR_YEAR
8. ^MONTH1 ^CALENDAR_YEAR
9. ^MONTH1 ^CALENDAR_YEAR
10. ^MONTH1 ^CALENDAR_YEAR
11. ^MONTH1 ^CALENDAR_YEAR
12. ^MONTH1 ^CALENDAR_YEAR
13. All months
Page 153 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

WELACTV1
Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME attend any of the
following types of training...
...classes to improve basic reading or math skills?
(...job readiness training to learn about resume writing, job interviewing, or building self-esteem?)
(...job search programs or job clubs, or use any job resource centers to find out about jobs, to schedule
interviews, or to fill out applications?)
(...training to learn a specific job skill, such as computers, car repair, nursing, day care work, or some
other job skill?)
1. Yes
2. No

WELACTV2_1
Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME attend any of the following
types of training...
(...classes to improve basic reading or math skills?)
...job readiness training to learn about resume writing, job interviewing, or building self-esteem?
(...job search programs or job clubs, or use any job resource centers to find out about jobs, to schedule
interviews, or to fill out applications?)
(...training to learn a specific job skill, such as computers, car repair, nursing, day care work, or some
other job skill?)

1. Yes
2. No

WELACTV2_2
Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME attend any of the following
types of training...
(...classes to improve basic reading or math skills?)
(...job readiness training to learn about resume writing, job interviewing, or building self-esteem?)
Page 154 of 334

...job search programs or job clubs, or use any job resource centers to find out about jobs, to
schedule interviews, or to fill out applications?
(...training to learn a specific job skill, such as computers, car repair, nursing, day care work, or some
other job skill?)
1. Yes
2. No

WELACTV2_3
Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME attend any of the following
types of training...
(...classes to improve basic reading or math skills?)
(...job readiness training to learn about resume writing, job interviewing, or building self-esteem?)
(...job search programs or job clubs, or use any job resource centers to find out about jobs, to schedule
interviews, or to fill out applications?)
...training to learn a specific job skill, such as computers, car repair, nursing, day care work, or
some other job skill?
1. Yes
2. No

WELACTV3
Did ^TEMPNAME ^TRAINJOB_FIL because the state or local welfare office required it, or because
^HESHE chose to do it, or for both reasons?
1. Required to ^TRAINJOB_FIL
2. Chose to ^TRAINJOB_FIL2
3. Both required and chose

WELACTV4
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME participate in any work experience
programs, such as a community service job, in exchange for ^PTEMPNAME ^TANF_FIL?

1. Yes
2. No

WORKEXP1
Page 155 of 334

Did ^TEMPNAME already tell me about this work when ^HESHE reported
^PTEMPNAME ^JOBS_FIL1 with Read employer name(s)?
Display the name(s) of the respondents employer(s).
1. Yes
2. No

WHICHEXP1
Which job(s)? (Which job(s) did ^HESHE have as part of a work experience program?)
Mark all that apply.
Display list of names of the respondents employers
0. None of the employers
1. Employer name from Jobline1
2. Employer name from Jobline2
3. Employer name from Jobline3
4. Employer name from Jobline4
5. Employer name from Jobline5
6. Employer name from Jobline 6
7. Employer name from Jobline 7

WORKEXP2
Earlier ^TEMPNAME told me that ^HESHE worked for Read employer name(s). Was this also a
work experience program where ^TEMPNAME worked at Read employer name(s) in exchange for
^PTEMPNAME ^TANF_FIL?
Display list of name(s) of all of the respondents employers
1. Yes
2. No

WHICHEXP2
Which job(s)? (Which job(s) did ^HESHE have as part of a work experience program?)
Mark all that apply.

Page 156 of 334

0. None of the employers
1. Employer name from Jobline1
2. Employer name from Jobline2
3. Employer name from Jobline3
4. Employer name from Jobline4
5. Employer name from Jobline5
6. Employer name from Jobline 6
7. Employer name from Jobline 7

WORKEXP3
Did ^TEMPNAME participate in a work experience program because the state or local welfare
office required it, or because ^HESHE chose to do it, or for BOTH reasons?
1. Required to do work experience program
2. Chose to do work experience program
3. Both required and chose

TRAIN_WHEN
During which months did ^TEMPNAME attend training?
Mark all that apply.
1. ^MONTH1 ^CALENDAR_YEAR
2. ^MONTH1 ^CALENDAR_YEAR
3. ^MONTH1 ^CALENDAR_YEAR
4. ^MONTH1 ^CALENDAR_YEAR
5. ^MONTH1 ^CALENDAR_YEAR
6. ^MONTH1 ^CALENDAR_YEAR
7. ^MONTH1 ^CALENDAR_YEAR
8. ^MONTH1 ^CALENDAR_YEAR
9. ^MONTH1 ^CALENDAR_YEAR
10. ^MONTH1 ^CALENDAR_YEAR
11. ^MONTH1 ^CALENDAR_YEAR
12. ^MONTH1 ^CALENDAR_YEAR
13. All months

CTRLNUM
Page 157 of 334

**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ASSET_INTRO
? [F1]
Next I'll ask some questions about the value of assets ^TEMPNAME ^OWNOWNSFIL_PR, income
received from those assets, and any debts ^TEMPNAME may have. This is the additional
sentence in the Assets intro to be included when someone has a spouse.
(The Census Bureau uses the data collected to create national estimates of wealth.) We know that
people aren't used to talking about their assets, but we ask these questions to get an overall
picture of your community and the nation -- NOT to find out about ^YOUANYONEFIL personally.
The types of assets I will be asking you about include checking and savings accounts,
retirement accounts, stocks, cars, motorcycles, and real estate.
1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

AST1B
? [F1]
Next are a couple of questions about retirement accounts. At any time between ^MONTH1 1st
and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME have an Individual
Retirement Account (IRA) or a Keogh account?

1. Yes
2. No

AST1C
Page 158 of 334

? [F1]
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did
^TEMPNAME ^ALSOFIL own a retirement plan, such as a 401k, 403b, 503b, or thrift plan?

1. Yes
2. No

AST1D
? [F1]
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did ^TEMPNAME
participate in a defined-benefit pension or cash balance plan?

1. Yes
2. No

ASSETDRAW
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME
receive any lump sum or regular distribution payments from ^ANYOFFIL ^HISHER ^IRA401FIL?
1. Yes, lump sum
2. Yes, regular distribution
3. Yes, both
4. No, no payments received

AST1A
O, ? [F1]
Please only include U.S. Government savings bonds or U.S. Government securities that were owned
separately from any mutual funds.
The next few questions are about assets and other investments, either individually or jointly
owned INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL, did ^TEMPNAME own, either individually or jointly...
...any U.S. Government savings bonds or U.S. Government securities?
(...an interest-earning checking account?)
(...a non-interest (regular) checking account?)
Page 159 of 334

(...a savings account?)
(^RETIRE_FIL)
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...mutual funds?)
(...stocks?)
1. Yes
2. No

AST2A
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
...an interest-earning checking account?
(...a non-interest (regular) checking account?)
(...a savings account?)
(^RETIRE_FIL)
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...mutual funds?)
(...stocks?)

1. Yes
2. No

AST2E
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
(...an interest-earning checking account?)
...a non-interest (regular) checking account?
Page 160 of 334

(...a savings account?)
(^RETIRE_FIL)
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...mutual funds?)
(...stocks?)
1. Yes
2. No

AST2B
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
(...an interest-earning checking account?)
(...a non-interest (regular) checking account?)
...a savings account?
(^RETIRE_FIL)
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...mutual funds?)
(...stocks?)

1. Yes
2. No

AST2C
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
(...an interest-earning checking account?)
(...a non-interest (regular) checking account?)
Page 161 of 334

(...a savings account?)
^RETIRE_FIL
...a money market deposit account or fund?
(...any certificates of deposit (that is, CDs)?)
(...mutual funds?)
(...stocks?)

1. Yes
2. No

AST2D
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
(...an interest-earning checking account?)
(...a non-interest (regular) checking account?)
(...a savings account?)
^RETIRE_FIL
(...a money market deposit account or fund?)
...any certificates of deposit (that is, CDs)?
(...mutual funds?)
(...stocks?)

1. Yes
2. No

AST3A
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
(...an interest-earning checking account?)
Page 162 of 334

(...a non-interest (regular) checking account?)
(...a savings account?)
^RETIRE_FIL
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
...mutual funds?
(...stocks?)

1. Yes
2. No

AST3B
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
(...an interest-earning checking account?)
(...a non-interest (regular) checking account?)
(...a savings account?)
^RETIRE_FIL
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...mutual funds?)
...stocks?

1. Yes
2. No

AST3C
P, ? [F1]
Read (or verify) all response options.
^ASSET2_QSTNTXT
...any municipal or corporate bonds?
Page 163 of 334

(...any life insurance policies?)
(...rental property?)
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)
1. Yes
2. No

MUNCOR
Were these municipal/corporate bonds separate from the mutual funds you just told me about?
Select 'Yes' if some municipal and corporate bonds are included in mutual funds, and some are not.
1. Yes
2. No

AST5A
P, ? [F1]
Read (or verify) all response options.
^ASSET2_QSTNTXT
(...any municipal or corporate bonds?)
...any life insurance policies?
(...rental property?)
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)

1. Yes
2. No

AST4A
P, ? [F1]
Page 164 of 334

Read (or verify) all response options.
^ASSET2_QSTNTXT
(...any municipal or corporate bonds?)
(...any life insurance policies?)
...rental property?
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)

1. Yes
2. No

AST5B
P, ? [F1]
Read (or verify) all response options.
Do not include right-to-use timeshares as 'other' real estate.
^ASSET2_QSTNTXT
(...any municipal or corporate bonds?)
(...any life insurance policies?)
(...rental property?)
...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)
1. Yes
2. No

AST5E
P, ? [F1]
Read (or verify) all response options.
Page 165 of 334

^ASSET2_QSTNTXT
(...any municipal or corporate bonds?)
(...any life insurance policies?)
(...rental property?)
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
...annuities and trusts?
(...businesses as an investment only?)
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)

1. Yes
2. No

AST5F
P, ? [F1]
Read (or verify) all response options.
^ASSET2_QSTNTXT
(...any municipal or corporate bonds?)
(...any life insurance policies?)
(...rental property?)
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
(...annuities and trusts?)
...businesses as an investment only?
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)
1. Yes
2. No

AST4C
P, ? [F1]
Read (or verify) all response options.
^ASSET2_QSTNTXT
(...any municipal or corporate bonds?)
Page 166 of 334

(...any life insurance policies?)
(...rental property?)
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid
to HIMHER, other loans owed to HIMHER, or royalties.
1. Yes
2. No

AST4C_SP
? [F1]
What 'other' type of financial investment(s)?
Please separate individual 'other' financial investments by the use of a comma.

VERIFY_ASSETS
^QSTNTXT_VERIFYASSETS
Read list.
Display all of the assets reported by the respondent as defined in the
special instructions
1. Yes
2. No

FIX_ASSETS
Which assets should not be included on the list?
1. IRA or Keogh account
2. 401k, 403b, or thrift plan
3. Defined benefit pension or cash balance plan
4. U.S. Govt. savings bonds/securities
5. Interest-earning checking account
6. Regular (non-interest earning) checking account
7. Savings account
Page 167 of 334

8. Money market deposit account
9. Certificates of deposit
10. Educational or college savings account
11. Mutual funds
12. Stocks
13. Municipal or corporate bonds
14. Life insurance
15. Rental property
16. Real estate
17. Annuities and trusts
18. Businesses as an investment only
19. ^Fill with response to item AST4C_SP

ASTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JT
^JT_QSTNTXT
1. Yes
2. No

JTWHO1
With whom?
Mark all that apply.
Enter 50 if the person owns the asset(s) with a non-household member.

Page 168 of 334

1. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
2. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
3. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
4. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
5. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
6. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
7. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
8. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
9. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
10. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
11. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
12. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
13. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
14. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
15. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
16. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
17. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
18. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
19. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
20. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
21. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
22. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
23. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
24. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
25. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
50. Non-household member(s)

OAST1
^INADDITIONFIL_OAST1 ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME ^ALSOFIL_OAST1 own any in ^HISHER name only?

1. Yes
2. No

ASTCODE2
**NON-DISPLAYED**
Page 169 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ANYJNT
^ANYJNT_QSTNTXT

1. Yes
2. No

JTWHO2
With whom?
Mark all that apply.
Enter 50 if the respondent owns the mutual funds and/or stocks with a non-household member.
1. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
2. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
3. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
4. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
5. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
6. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
7. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
8. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
9. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
10. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
11. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
12. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
13. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
14. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
15. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
16. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
17. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
18. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
19. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
Page 170 of 334

20. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
21. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
22. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
23. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
24. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
25. Display the ^LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
50. Non-household member(s)

OAST2
^INADDITIONFIL_OAST2 ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,
did ^TEMPNAME ^ALSOFIL_OAST2 ^FNDSTCK2FIL in ^HISHER name only?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

TYPE_LIFEINSUR
? [F1]
(You said that between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,
^TEMPNAME owned life insurance.) Was that policy Read answer categories or did ^HESHE own
both of these types (term and whole life/universal life)?
1. Term insurance
2. Whole life/Universal life insurance
3. Both term and whole life/universal life insurance

CTRLNUM
**NON-DISPLAYED ITEM**

Page 171 of 334

AST2F
? [F1]
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL was anyone in
^PTEMPNAME household the owner or the beneficiary of an educational or college savings
account (such as a 529 account)?
1. Yes
2. No

NUM_EDSAV
^NUMEDSAV_QSTNTXT
Enter 0 if the household was no longer the owner or the beneficiary of the educational or college
savings account as of the last day of ^LASTMONTH, ^CALENDAR_YEAR.
If the person/household was the owner or the beneficiary of three or more educational or college
savings accounts, the person should report the accounts with the largest balance.

EDSAVNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

EDSAV_OWNER
Who was the owner of the (educational or college savings) account ^123_EDSAVFIL?
1. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
2. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
3. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
4. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
5. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
6. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
7. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
8. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
9. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
10. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
11. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
Page 172 of 334

12. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
13. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
14. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
15. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
16. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
17. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
18. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
19. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
20. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
50. A non-household member

EDSAV_BENEFICIARY
Who was the beneficiary of the (educational or college savings) account?
1. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
2. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
3. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
4. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
5. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
6. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
7. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
8. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
9. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
10. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
11. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
12. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
13. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
14. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
15. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
16. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
17. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
18. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
19. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
20. Display the ^LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
21. Display the ^FNAME and ^LNAME of a Type 2 Person
22. Display the ^FNAME and ^LNAME of a Type 2 Person
23. Display the ^FNAME and ^LNAME of a Type 2 Person
24. Display the ^FNAME and ^LNAME of a Type 2 Person
25. Display the ^FNAME and ^LNAME of a Type 2 Person
Page 173 of 334

50. A non-household member

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ANYJTRNT
^ANYJTRNT_QSTNTXT
1. Yes
2. No

JTWHO4
With whom?
Mark all that apply.
Enter 50 if the respondent owns the rental property with a non-household member.

1. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

2. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

3. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

4. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

5. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

6. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

7. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

8. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

9. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

10. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

11. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

12. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

13. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

14. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

15. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H
Page 174 of 334

16. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

17. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

18. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

19. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

20. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

21. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

22. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

23. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

24. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

25. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H
50. Non-household member(s)

OWNRNT
^INADDITIONFIL_OWNRNT ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME ^ALSOFIL_OWNRNT own any rental property in ^HISHER name only?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ANYJTPROP
^ANYJTPROP_QSTNTXT
1. Yes
2. No

JTWHO5
With whom?

Page 175 of 334

Mark all that apply.
Enter 50 if the respondent owns the non-retirement/non-rental property, such as a second home with a
non-household member.

1. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

2. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

3. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

4. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

5. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

6. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

7. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

8. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

9. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

10. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

11. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

12. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

13. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

14. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

15. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

16. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

17. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

18. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

19. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

20. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

21. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

22. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

23. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

24. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

25. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H
50. Non-household member(s)

OWNPROP
^INADDITIONFIL_OWNPROP ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,
did ^TEMPNAME ^ALSOFIL_OWNPROP own any real estate (such as a vacation home, a deeded
timeshare, or an undeveloped lot) in ^HISHER name only?
1. Yes
2. No
Page 176 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

AST5C
^VEHICLE_QSTNTXT
1. Yes
2. No

NUM_VEHICLE
^NUMVEHICLE_QSTNTXT
Enter 0 if the household no longer owned the vehicle as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

CARNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

MODEL_YRX
VEHICLE ^X
What is the model year of ^WHICH_VEHICLE?
^FR_VEHICLE

MAKEX
Page 177 of 334

VEHICLE ^X
What is the make of this vehicle?
Make of vehicle is its brand name (for example: Honda or Chevrolet).
Enter trucks, SUVs, vans and minivans in the make specific truck line from the list (e.g. record a
4Runner under Toyota Truck, not Toyota).

MAKEX_SP
VEHICLE ^X
What is the make of this vehicle?

MODELX
VEHICLE ^X
Read if necessary.
What is the model of this vehicle?
1. ^CAR_MODEL1
2. ^CAR_MODEL2
3. ^CAR_MODEL3
4. ^CAR_MODEL4
5. ^CAR_MODEL5
6. ^CAR_MODEL6
7. ^CAR_MODEL7
8. ^CAR_MODEL8
9. ^CAR_MODEL9
10. ^CAR_MODEL10
11. ^CAR_MODEL11
12. ^CAR_MODEL12
13. ^CAR_MODEL13
14. ^CAR_MODEL14
15. ^CAR_MODEL15
16. ^CAR_MODEL16
17. ^CAR_MODEL17
18. ^CAR_MODEL18
19. ^CAR_MODEL19
Page 178 of 334

20. ^CAR_MODEL20
21. ^CAR_MODEL21
22. ^CAR_MODEL22
23. ^CAR_MODEL23
24. ^CAR_MODEL24
25. ^CAR_MODEL25
26. ^CAR_MODEL26
27. ^CAR_MODEL27
28. ^CAR_MODEL28
29. ^CAR_MODEL29
30. ^CAR_MODEL30
31. ^CAR_MODEL31
32. ^CAR_MODEL32
33. ^CAR_MODEL33
34. ^CAR_MODEL34
35. ^CAR_MODEL35
36. ^CAR_MODEL36
37. ^CAR_MODEL37
38. ^CAR_MODEL38
39. ^CAR_MODEL39
40. ^CAR_MODEL40

MODELX_SP
VEHICLE ^X
What is the model of this vehicle?

WHO_VEHICLE
Who owns this vehicle as of the last day of ^LASTMONTH, ^CALENDAR_YEAR?
Mark all that apply.
1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
3. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
4. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
5. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
6. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
7. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
Page 179 of 334

8. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
9. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
10. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
11. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
12. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
13. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
14. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
15. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
16. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
17. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
18. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
19. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1

CTRLNUM
**NON-DISPLAYED ITEM**

AST5D
^RV_QSTNTXT
1. Yes
2. No

TYPE_RECVEH
^TYPERV_QSTNTXT
Mark all that apply.
1. Motorcycle
2. Boat
3. Recreational vehicle (RV)
4. Another type of vehicle

RECVEH_SP
What 'other' type of recreational vehicle?

Page 180 of 334

ADINCSRCE2
The next part of the interview is about ^PTEMPNAME income and the value of ^PTEMPNAME
assets between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL. We want to be
both as accurate and efficient as we can, so it would be very helpful if you could refer to any
records you might have. (Also -- we know that people aren't used to talking about their income and the
value of their assets, but we ask these questions to get an overall picture of your community and the
nation -- NOT to find out about ^YOUANYONEFIL personally.)
At appropriate moments, encourage respondent to get records.
1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ASTCODE_RET
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

RETIRE_VALUE
? [F1]
(Earlier I recorded that ^TEMPNAME ^OWNPARTICIPATEFIL ^TYPERETACCT.) As of the last day of
^LASTMONTH, ^CALENDAR_YEAR, what was the total balance or market value of the
^RETIREACCTFIL ^TEMPNAME ^OWNPARTICIPATEFIL?
Enter 0 if the person no longer ^OWNSPARTICIPATESFIL ^TYPERETACCT as of the last day of
^LASTMONTH, ^CALENDAR_YEAR.

Page 181 of 334

RETIRE_RANGE
ASSET TYPE: ^C_RETIREMENT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $50,000, or more than $50,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $49,999
4. $50,000 or more

ASTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ASTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JINTSP_PD
? [F1]
^JINTSPPD_QSTNTXT
^AST3CINT_FIL
Page 182 of 334

JCATSP1Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $25, between $25 and $75, between $75 and $150, or more than $150?
1. Less than $25
2. $25 to $74.99
3. $75 to $149.99
4. $150 or more

JCATSP1VALUE
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^REG_CHKFIL ^JCATSP_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

JCATSP1RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $500, between
$500 and $1,000, between $1,000 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $999
3. $1,000 to $4,999
4. $5,000 or more

JCATSP2Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,500, or more than $1,500?
1. Less than $100
Page 183 of 334

2. $100 to $499.99
3. $500 to $1,499.99
4. $1,500 or more

JCATSP2VALUE
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^JCATSP_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

JCATSP2RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) ^RANGEAMTFIL?
1. Less than $1,000
2. $1,000 to $4,999
3. $5,000 to $9,999
4. $10,000 or more
5. Less than $5,000
6. $5,000 to $9,999
7. $10,000 to $19,999
8. $20,000 or more

JCATSP3Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $1,500, between $1,500 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
4. $5,000 or more
Page 184 of 334

JCATSP3VALUE
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^JCATSP_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
^AST3CMV_FIL

JCATSP3RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $100,000, or more than $100,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $99,999
4. $100,000 or more

ASTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JINTCH_PD
? [F1]
Earlier I recorded that ^TEMPNAME owned ^ASNAME_BANKACCT jointly with Read name(s).
How much INTEREST INCOME was produced (by those joint ^ASNAME_BANKACCT)
between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL?
Page 185 of 334

^AST3CINT_FIL
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO1

JCATCH1Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $25, between $25 and $75, between $75 and $150, or more than $150?
1. Less than $25
2. $25 to $74.99
3. $75 to $149.99
4. $150 or more

JCATCH1VALUE
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^REG_CHKFIL As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL
BALANCE or MARKET VALUE (including interest earned) of the
^ASNAME_BANKACCT ^TEMPNAME owned jointly with Read name(s)?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO1

JCATCH1RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $500, between
$500 and $1,000, between $1,000 and $5,000, or more than $5,000?
1. Less than $500
Page 186 of 334

2. $500 to $999
3. $1,000 to $4,999
4. $5,000 or more

JCATCH2Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,500, or more than $1,500?
1. Less than $100
2. $100 to $499.99
3. $500 to $1,499.99
4. $1,500 or more

JCATCH2VALUE
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
As of the last day of ^LASTMONTH ^CALENDAR_YEAR, what was the TOTAL BALANCE or
MARKET VALUE (including interest earned) of the ^ASNAME_BANKACCT ^TEMPNAME owned
jointly with Read name(s)?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO1

JCATCH2RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) ^RANGEAMTFIL?
1. Less than $1,000
2. $1,000 to $4,999
3. $5,000 to $9,999
4. $10,000 or more
5. Less than $5,000
Page 187 of 334

6. $5,000 to $9,999
7. $10,000 to $19,999
8. $20,000 or more

JCATCH3Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $1,500, between $1,500 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
4. $5,000 or more

JCATCH3VALUE
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL BALANCE or
MARKET VALUE (including interest earned) of the ^ASNAME_BANKACCT ^TEMPNAME owned
jointly with Read name(s)?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
^AST3CMV_FIL
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO1.

JCATCH3RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $100,000, or more than $100,000?
1. Less than $5,000
2. $5,000 to $24,999
Page 188 of 334

3. $25,000 to $99,999
4. $100,000 or more

ASTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTOTHINT_PD
? [F1]
^JTOTHINTPD_QSTNTXT
'Share' refers to share in dollars and not to percentage share.
^AST3CINT_FIL
Display the first and last name(s) of the person(s) selected in JTWHO1 (with
the exception of the person's spouse or registered domestic/civil union
partner if one exists). Star the name(s) of the child(ren) under the age of
15 who are living in the household. Display 'a Non-household member' when
JTWHO1 = 50

JCATOT1Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $25, between $25 and $75, between $75 and $150, or more than $150?
1. Less than $25
2. $25 to $74.99
3. $75 to $149.99
4. $150 or more
Page 189 of 334

JCATOTH1VALUE
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^REG_CHKOTHFIL ^JCATOTH_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO1 (with
the exception of the person's spouse or registered domestic/civil union
partner if one exists). Star the name(s) of the child(ren) under the age of
15 who are living in the household. Display 'a Non-household member' when
JTWHO1 = 50

JCATOTH1RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $500, between
$500 and $1,000, between $1,000 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $999
3. $1,000 to $4,999
4. $5,000 or more

JCATOT2Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,500, or more than $1,500?
1. Less than $100
2. $100 to $499.99
3. $500 to $1,499.99
4. $1,500 or more

JCATOTH2VALUE
Page 190 of 334

? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^JCATOTH_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO1 (with
the exception of the person's spouse or registered domestic/civil union
partner if one exists). Star the name(s) of the child(ren) under the age of
15 who are living in the household. Display 'a Non-household member' when
JTWHO1 = 50

JCATOTH2RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) ^RANGEAMTFIL?
1. Less than $1,000
2. $1,000 to $4,999
3. $5,000 to $9,999
4. $10,000 or more
5. Less than $5,000
6. $5,000 to $9,999
7. $10,000 to $19,999
8. $20,000 or more

JCATOT3Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $1,500, between $1,500 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
4. $5,000 or more
Page 191 of 334

JCATOTH3VALUE
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^JCATOTH_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
^AST3CMV_FIL
Display the first and last name(s) of the person(s) selected in JTWHO1 (with
the exception of the person's spouse or registered domestic/civil union
partner if one exists). Star the name(s) of the child(ren) under the age of
15 who are living in the household. Display 'a Non-household member' when
JTWHO1 = 50

JCATOTH3RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $100,000, or more than $100,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $99,999
4. $100,000 or more

ASTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**
Page 192 of 334

EXCL_CD
Earlier I recorded that ^TEMPNAME ^ALSOFIL_ASSETS owned CDs ^OWNNAMEFIL_EXCL Were
those CDs included in ^PTEMPNAME ^IRA401FIL_EXCL, or did ^HESHE own them separately
from any retirement account(s) -- or both?
1. All CDs are included in IRA, Keogh, 401k,403b, or thrift accounts
2. All CDs are owned separately from retirement accounts
3. Both -- some are included in retirement accounts and some are owned separately

OINT_PD
? [F1]
^INCOMENOWFIL_OINT
^EARLIERFIL_OINT How much INTEREST INCOME did ^TEMPNAME earn ^OWNNAME_FIL (from
those ASNAME_BANKACCT) between ^MONTH1 1st. and the end of ^LASTMONTH
^CALENDAR_YRFIL?
^FRAST1A_FIL
^AST3CINT_FIL

OCAT1Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $25, between $25 and $75, between $75 and $150, or more than $150?
1. Less than $25
2. $25 to $74.99
3. $75 to $149.99
4. $150 or more

OCAT1VALUE
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^REG_CHKFIL As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL
BALANCE or MARKET VALUE (including interest earned) of the ^ASNAME_BANKACCT
^OWNNAME_FIL?
Page 193 of 334

Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

OCAT1RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $500, between
$500 and $1,000, between $1,000 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $999
3. $1,000 to $4,999
4. $5,000 or more

OCAT2Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,500, or more than $1,500?
1. Less than $100
2. $100 to $499.99
3. $500 to $1,499.99
4. $1,500 or more

OCAT2VALUE
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL
BALANCE or MARKET VALUE (including interest earned) of the ^ASNAME_BANKACCT
^OWNNAME_FIL?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

OCAT2RANGE
Page 194 of 334

ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) ^RANGEAMTFIL?
1. Less than $1,000
2. $1,000 to $4,999
3. $5,000 to $9,999
4. $10,000 or more
5. Less than $5,000
6. $5,000 to $9,999
7. $10,000 to $19,999
8. $20,000 or more

OCAT3Y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $1,500, between $1,500 and $5,000, or more than $5,000?
^FRAST1A_FIL
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
4. $5,000 or more

OCAT3VALUE
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL
BALANCE or MARKET VALUE (including interest earned) of the ^ASNAME_BANKACCT
^OWNNAME_FIL?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
^AST3CMV_FIL

Page 195 of 334

OCAT3RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $100,000, or more than $100,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $99,999
4. $100,000 or more

DKINT
^ASIDEFRMFIL_DKINT was the total amount of INTEREST INCOME ^TEMPNAME ^HAVHAS
earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL on all
^OTHERFIL_DKINT ^ASNAME_BANKACCT ^HESHE owned?

DKINT1RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL) less
than $25, between $25 and $75, between $75 and $150, or more than $150?
1. Less than $25
2. $25 to $74.99
3. $75 to $149.99
4. $150 or more

DKINT2RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL) less
than $100, between $100 and $500, between $500 and $1,500, or more than $1,500?
1. Less than $100
2. $100 to $499.99
3. $500 to $1,499.99
4. $1,500 or more

DKINT3RANGE
Page 196 of 334

ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL) less
than $500, between $500 and $1,500, between $1,500 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
4. $5,000 or more

DKMRKTVAL
^ASIDEFRMFIL_DKMRKTVAL was the TOTAL BALANCE or MARKET VALUE (including interest
earned) of the ^OTHERFIL_DKMRKTVAL ^ASNAME_BANKACCT ^HESHE owned as of the last
day of ^LASTMONTH, ^CALENDAR_YEAR?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

DKMRKTVAL1RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $500, between
$500 and $1,000, between $1,000 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $999
3. $1,000 to $4,999
4. $5,000 or more

DKMRKTVAL2RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) ^RANGEAMTFIL?
1. Less than $1,000
2. $1,000 to $4,999
3. $5,000 to $9,999
4. $10,000 or more
Page 197 of 334

5. Less than $5,000
6. $5,000 to $9,999
7. $10,000 to $19,999
8. $20,000 or more

DKMRKTVAL3RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $100,000, or more than $100,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $99,999
4. $100,000 or more

ASTCODE2
**NON-DISPLAYED**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ASTCODE2
**NON-DISPLAYED**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**
Page 198 of 334

JTANYWSP
^EARLIERFIL_JTANYWSP What kind of dividends
did ^YOUTHEYFIL_JTANYW ^BOTHALLFIL_JTANYWSP get from those joint ^ASNAME_MFS?
Were the dividends credited against a margin account or automatically reinvested or did
^YOUTHEYFIL_JTANYW get dividend checks?

1. Dividend CHECKS
2. CREDITED or AUTOMATICALLY REINVESTED dividends
3. Both
4. Neither; no dividends received

JTDIVSP_PD
? [F1]
^INCLUDEFIL_JTDIVSP ^CREDITEDFIL_JTDIVSP DIVIDEND INCOME was produced by those
joint ^ASNAME_MFS (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)?

JDIVSP1Y
ASSET TYPE: MUTUAL FUNDS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $250, between $250 and $1,000, between $1,000 and $2,500, or more than $2,500?
1. Less than $250
2. $250 to $999.99
3. $1,000 to $2,499.99
4. $2,500 or more

JDIVSP1VALUE
? [F1]
ASSET TYPE: MUTUAL FUNDS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL BALANCE
or MARKET VALUE (including dividends and less any debt or margin account held against those mutual
funds) of the mutual funds ^WHO_JDIVSPVALUE?
Enter 0 if the person no longer owns the mutual funds as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Page 199 of 334

Please remind the person to only report the value of mutual funds held outside of any retirement
account.
Display the first and last name(s) of the children under the age of 15 living
in the household who were selected in JTWHO2

JDIVSP1RANGE
ASSET TYPE: MUTUAL FUNDS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

JDIVSP2Y
ASSET TYPE: STOCKS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,000, or more than $1,000?
1. Less than $100
2. $100 to $499.99
3. $500 to $999.99
4. $1,000 or more

JDIVSP2VALUE
? [F1]
ASSET TYPE: STOCKS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL
BALANCE or MARKET VALUE (including dividends and less any debt or margin account held against
those stocks) of the stocks ^WHO_JDIVSPVALUE?
Enter 0 if the person no longer owns the stocks as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

Page 200 of 334

Please remind the person to only report the value of stocks held outside of any retirement account.
Display the first and last name(s) of the children under the age of 15 living
in the household who were selected in JTWHO2

JDIVSP2RANGE
ASSET TYPE: STOCKS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

ASTCODE2
**NON-DISPLAYED**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTANYWCH
^EARLIERFIL_JTANYWCH What kind of dividends did ^YOUTHEYFIL_JTANYW
^BOTHALLFIL_JTANYWCH get from those joint ^ASNAME_MFS? Were the dividends credited
against a margin account or automatically reinvested or did ^YOUTHEYFIL_JTANYW get
dividend checks?
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO2
1. Dividend CHECKS
2. CREDITED or AUTOMATICALLY REINVESTED dividends
3. Both
Page 201 of 334

4. Neither; no dividends received

JTDIVCH_PD
? [F1]
^INCLUDEFIL_JTDIVCH ^CREDITEDFIL_JTDIVCH DIVIDEND INCOME was produced by
those joint ^ASNAME_MFS (between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL)?

JDIVCH1Y
ASSET TYPE: MUTUAL FUNDS
Wass the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $250, between $250 and $1,000, between $1,000 and $2,500, or more than $2,500?
1. Less than $250
2. $250 to $999.99
3. $1,000 to $2,499.99
4. $2,500 or more

JDIVCH1VALUE
? [F1]
ASSET TYPE: MUTUAL FUNDS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL
BALANCE or MARKET VALUE (including dividends and less any debt or margin account held against
those mutual funds) of the mutual funds ^TEMPNAME owned jointly with Read name(s)?
Enter 0 if the person no longer owns the mutual funds as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of mutual funds held outside of any retirement
account.
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO2

JDIVCH1RANGE
Page 202 of 334

ASSET TYPE: MUTUAL FUNDS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

JDIVCH2Y
ASSET TYPE: STOCKS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,000, or more than $1,000?
1. Less than $100
2. $100 to $499.99
3. $500 to $999.99
4. $1,000 or more

JDIVCH2VALUE
? [F1]
ASSET TYPE: STOCKS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL
BALANCE or MARKET VALUE (including dividends and less any debt or margin account held against
those stocks) of the stocks ^TEMPNAME owned jointly with Read name(s)?
Enter 0 if the person no longer owns the stocks as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of stocks held outside of any retirement account.
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO2

JDIVCH2RANGE
ASSET TYPE: STOCKS
Page 203 of 334

Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

ASTCODE2
**NON-DISPLAYED**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTOTHANY
^EARLIERFIL_JTOTHANY What kind of dividends did those joint ^MUTFNDSTOCKOTFIL
produce? Were the dividends credited against a margin account or automatically reinvested or
did ^YOUTHEYFIL_JTANYW get dividend checks?
Display the first and last name(s) of the person(s) selected in JTWHO2 (with
the exception of the person's spouse or registered domestic/civil union
parter if one exists). Star the name(s) of the child(ren) under the age of 15
who are living in the household. Display 'a non-household member(s)' when
JTWHO1 = 50
1. Dividend CHECKS
2. CREDITED or AUTOMATICALLY REINVESTED dividends
3. Both
4. Neither; no dividends received

JTOTHDIV_PD
? [F1]
^INCLUDEFIL_JTOTHDIV was ^PTEMPNAME^ANDWHO_JTOTHDIV share, in dollars, of the
Page 204 of 334

^CREDITEDFIL_JTOTHDIV DIVIDEND INCOME that was produced by those
joint ^MUTFNDSTOCKOTFIL (between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL)?
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO2 (with
the exception of the person's spouse or registered domestic/civil union
parter if one exists). Star the name(s) of the child(ren) under the age of 15
who are living in the household. Display 'a non-household member(s)' when
JTWHO1 = 50

JDIVOT1Y
ASSET TYPE: MUTUAL FUNDS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $250, between $250 and $1,000, between $1,000 and $2,500, or more than $2,500?
1. Less than $250
2. $250 to $999.99
3. $1,000 to $2,499.99
4. $2,500 or more

JDIVOT1VALUE
? [F1]
ASSET TYPE: MUTUAL FUNDS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was
^PTEMPNAME^ANDWHO_JTOTHDIV share, in dollars, of the TOTAL BALANCE
or MARKET VALUE (including dividends and less any debt or margin account held against those mutual
funds) of the mutual funds ^TEMPNAME owned jointly?
Enter 0 if the person no longer owns the mutual funds as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of mutual funds held outside of any retirement
account.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO2 (with
the exception of the person's spouse or registered domestic/civil union
Page 205 of 334

parter if one exists). Star the name(s) of the child(ren) under the age of 15
who are living in the household. Display 'a non-household member(s)' when
JTWHO1 = 50

JDIVOT1RANGE
ASSET TYPE: MUTUAL FUNDS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

JDIVOT2Y
ASSET TYPE: STOCKS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1000, or more than $1,000?
1. Less than $100
2. $100 to $499.99
3. $500 to $999.99
4. $1,000 or more

JDIVOT2VALUE
? [F1]
ASSET TYPE: STOCKS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was
^PTEMPNAME^ANDWHO_JTOTHDIV share, in dollars, of the TOTAL BALANCE or MARKET
VALUE (including dividends and less any debt or margin account held against those stocks) of the
stocks ^TEMPNAME owned jointly?
Enter 0 if the person no longer owns the stocks as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of stocks held outside of any retirement account.
Page 206 of 334

'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO2 (with
the exception of the person's spouse or registered domestic/civil union
parter if one exists). Star the name(s) of the child(ren) under the age of 15
who are living in the household. Display 'a non-household member(s)' when
JTWHO1 = 50

JDIVOT2RANGE
ASSET TYPE: STOCKS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

ASTCODE2
**NON-DISPLAYED**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

EXCLUDE
Earlier I recorded that ^TEMPNAME ^ALSOFIL_EXCLUDE owned ^SOMEFIL ^MUTFNDSTOCKFIL
^OWNNAMEFIL_EXCLUDE Were those ^MUTFNDSTOCKFIL included in ^PTEMPNAME
^IRA401FIL_EXCL, or did ^HESHE own them separately from any retirement account(s) -- or
both?
1. All shares are included in IRA/Keogh/401k/403b/thrift accounts
2. All shares are owned separately from retirement accounts
Page 207 of 334

3. Both -- some are included in retirement accounts and some are owned separately

OWNTYPE
^INCOMENOWFIL_OWNTYPE
^EARLIERFIL_OWNTYPE What kind of dividends did ^TEMPNAME get from those
^MUTFNDSTOCKFIL? Were the dividends credited against a margin account or automatically
reinvested or did ^HESHE get dividend checks?
1. Dividend CHECKS
2. CREDITED or AUTOMATICALLY REINVESTED dividends
3. Both
4. Neither; no dividends received

OWNDIV_PD
? [F1]
^INCOMENOWFIL_OWNDIV
^INCLUDEFIL_OWNDIV ^CREDITEDFIL_OWNDIV DIVIDEND INCOME did ^TEMPNAME receive
^OWNNAME_FIL from those ^ASNAME_MFS (between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL)?

ODIV1Y
ASSET TYPE: MUTUAL FUNDS
Was the annual amount (earned between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL) less than $250, between $250 and $1,000, between $1,000 and $2,500, or
more than $2,500?
1. Less than $250
2. $250 to $999.99
3. $1,000 to $2,499.99
4. $2,500 or more

ODIV1VALUE
? [F1]
ASSET TYPE: MUTUAL FUNDS
Page 208 of 334

As of the last day of ^LASTMONTH, ^CALENDAR_YEAR , what was the TOTAL BALANCE or
MARKET VALUE (including dividends and less any debt or margin account held against those mutual
funds) of the mutual funds ^OWNNAME_FIL?
Enter 0 if the person no longer owns the mutual funds as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of mutual funds held outside of any retirement
account.

ODIV1RANGE
ASSET TYPE: MUTUAL FUNDS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

ODIV2Y
ASSET TYPE: STOCKS
Was the annual amount (earned between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL) less than $100, between $100 and $500, between $500 and $1000, or more
than $1,000 dollars?
1. Less than $100
2. $100 to $499.99
3. $500 to $999.99
4. $1,000 or more

ODIV2VALUE
? [F1]
ASSET TYPE: STOCKS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR , what was the TOTAL
Page 209 of 334

BALANCE or MARKET VALUE (including dividends and less any debt or margin account held against
those stocks) of the stocks ^OWNNAME_FIL?
Enter 0 if the person no longer owns the stocks as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of stocks held outside of any retirement account.

ODIV2RANGE
ASSET TYPE: STOCKS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

DKANYW
Earlier I recorded that ^TEMPNAME owned some ^ASNAME_MFS.
^ASIDEFRMFIL_DKANYW kind of dividends did ^HESHE get from those ^ASNAME_MFS? Were
the dividends credited against a margin account or automatically reinvested or did ^HESHE get
dividend checks?
1. Dividend CHECKS
2. CREDITED or AUTOMATICALLY REINVESTED dividends
3. Both
4. Neither; no dividends received

DKDIV
^ASIDEFRMFIL_DKDIV was the total amount of dividend income ^TEMPNAME ^HAVHAS earned
between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL on
all ^OTHERFIL_DKDIV ^ASNAME_MFS ^HESHE owned?

DKDIV1RANGE
ASSET TYPE: MUTUAL FUNDS

Page 210 of 334

Was the amount (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL) less
than $250, between $250 and $1,000, between $1,000 and $2,500, or more than $2,500?
1. Less than $250
2. $250 to $999.99
3. $1,000 to $2,499.99
4. $2,500 or more

DKDIV2RANGE
ASSET TYPE: STOCKS
Was the amount (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL) less
than $100, between $100 and $500, between $500 and $1,000, or more than $1,000?
1. Less than $100
2. $100 to $499.99
3. $500 to $999.99
4. $1,000 or more

DKDIVVALUE
^ASIDEFRMFIL_DKDIVVALUE was the TOTAL BALANCE or MARKET VALUE (including
dividends and less any debt or margin account held against those assets) of
the ^OTHERFIL_DKDIVVALUE ^ASNAME_MFS ^HESHE owned as of the last day of
^LASTMONTH, ^CALENDAR_YEAR?
Enter 0 if the person no longer owns the ^ASNAME_MFS as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

DKDIVVALUE1RANGE
ASSET TYPE: MUTUAL FUNDS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

Page 211 of 334

DKDIVVALUE2RANGE
ASSET TYPE: STOCKS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

CTRLNUM
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

MOBILE_VALUE
(Earlier I recorded that ^TEMPNAME ^OWNOWNSFIL_PR or AREIS in the process of buying
^PTEMPNAME primary residence.) As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what
was the value of this mobile home; that is, how much ^DODOES ^TEMPNAME think it would have
sold for if it were for sale?

MOBILE_DEBT
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, was there a mortgage, installment loan,
contract to purchase, or other debt on this mobile home or site?
Reverse mortgages are included as debts against this home.

1. Yes
2. No

MOBILE_LOANS
Page 212 of 334

Altogether, how many mortgages, contracts, or other types of loans were there on this mobile
home as of the last day of ^LASTMONTH, ^CALENDAR_YEAR?

MHLOAN_CODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

MOBILE_AMT
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much principal was owed on
^PTEMPNAME ^123_FILL mortgage and/or loan on this mobile home?

MHSITE_DEBT
Is this mortgage, contract, or other debt for just the site, just the mobile home, or does it apply to
both the mobile home and the site?
1. Just the site
2. Just the mobile home
3. Both the mobile home and the site

CTRLNUM
**NON-DISPLAYED ITEM**

PROPERTY_VALUE
(Earlier I recorded that ^TEMPNAME ^OWNOWNSFIL_PR, or AREIS in the process of buying,
^PTEMPNAME primary residence.) As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what
was the value of this property; that is, how much ^DODOES ^TEMPNAME think it would have
sold for if it were for sale?

PROPERTY_DEBT
? [F1]
Page 213 of 334

As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, were there any mortgages, home equity
loans, or other debt on this home?
Reverse mortgages are included as debts against this home.
1. Yes
2. No

PROPERTY_LOANS
Altogether, how many mortgages or other types of loans were there on this home as of the last
day of ^LASTMONTH, ^CALENDAR_YEAR?

PROPLOAN_CODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

PROPERTY_AMT
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much principal was owed on
^PTEMPNAME ^123_FILL mortgage/loan on this home?

YRS_DEBT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total number of years over
which ^PTEMPNAME ^123_FILL mortgage or loan payments were to be made?
The respondent should provide the full span of the mortgages, not the years remaining at the time of
interview.

PROPERTY_RATE
What was the annual interest rate on this ^123_FILL mortgage or loan as of the last day of
^LASTMONTH, ^CALENDAR_YEAR?
Page 214 of 334

Enter both a whole number and a decimal.
Respondents' usually report mortgage interest rates as whole numbers followed by fractions. For
example: '5 and 3/8ths %'.
Here is a 'Fraction to Decimal Converstion Chart' to help convert the second part, the fraction,
of the respondent's answer:
1/8 = .125
1/4 = .25
3/8 = .375

1/2 = .5
5/8 = .625
3/4 = .75

7/8 = .875

Examples of complete mortgage interest rates, that is whole numbers followed by a fraction, converted
to decimal form are listed below. Remember, respondents may give any whole number or a whole
number and a fraction response, not just the below examples:
If rate is 3 and 1/8%, then enter 3.125%
If rate is 4 and 1/4%, then enter 4.25%
If rate is 5 and 3/8%, then enter 5.375%
If rate is 6 and 1/2%, then enter 6.5%
If rate is 7 and 5/8%, then enter 7.625%
If rate is 8 and 3/4%, then enter 8.75%
If rate is 7 and 7/8%, then enter 7.875%
If rate is 7%, then enter 7.0%
If rate is 11%, then enter 11.0%

RATETYPE_DEBT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, was the interest rate ^TEMPNAME
^PAY_FIL on this ^123_FILL mortgage or loan fixed, variable, or a combination of the two?
1. Fixed
2. Variable
3. Combination of fixed and variable

TYPE_DEBT
? [F1]
Did ^TEMPNAME obtain this ^123_FILL mortgage or loan through an FHA, VA, or other mortgage
program?
Read answer categories.
Page 215 of 334

1. FHA
2. VA
3. Other mortgage program
4. None of these

RENTMORT_PAY
How much was this household's ^RENTMORT payment in December ^CALENDAR_YEAR,
including any condominium or association fees?

RENTMORT_RANGE
Was the amount (as of December, ^CALENDAR_YEAR) less than $400, between $400 and $750,
between $750 and $1,200, or more than $1,200?
1. Less than $400
2. $400 to $749
3. $750 to $1,199
4. $1,200 or more

CTRLNUM
**NON-DISPLAYED ITEM**

UTILITIES_EXPENSE
How much did this household pay for electricity, gas, basic telephone service, and other utilities
in December ^CALENDAR_YEAR?
Other common examples of utilities include water, heating oil and wood, trash/recycling, and mobile
telephone service (excluding data plans, applications, games, and ringtones. Do not include cable TV or
internet.

UTILITIES_RANGE
Was the amount (as of December, ^CALENDAR_YEAR) less than $100, between $100 and $200,
between $200 and $300, or more than $300?
1. Less than $100
2. $100 to $199
3. $200 to $299
Page 216 of 334

4. $300 or more

WHOPAY
Starting with the person who paid the most, who paid for ^MOTRNTUTL_FILL in ^LASTMONTH
^CALENDAR_YEAR?
Mark all that apply.

1. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

2. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

3. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

4. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

5. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

6. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

7. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

8. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

9. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

10. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

11. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

12. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

13. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

14. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

15. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

16. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

17. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

18. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

19. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

20. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

21. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

22. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

23. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

24. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl

25. Display the LNO, ROST_FNAME, ROST_LNAME, where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peopl
50. A non-household member

UTILITIES_AMT
How much did ^NAME_WHOPAY pay in December ^CALENDAR_YEAR?

Page 217 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

FACELIFE
? [F1]
(Earlier ^TEMPNAME said ^HESHE owned life insurance policies.) As of the last day of
^LASTMONTH, ^CALENDAR_YEAR, what was the FACE VALUE of all life insurance policies that
^TEMPNAME ^HAVHAS? By face value, we mean the amount stated on an insurance policy, to
be paid upon death or maturity.
Enter 0 if the person no longer owns the life insurance policies as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

CASHLIFE
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the CASH VALUE of all life
insurance policies that ^TEMPNAME ^HAVHAS? The cash value is NOT the same as the face
value. By cash value, we mean the amount an insurance company will pay to the policyholder in
the event his or her policy is voluntarily terminated before its maturity; the cash value is the
savings component of most whole life and universal life insurance policies.
Enter 0 if the person no longer owns the life insurance policies as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

EDUC_VALUE
? [F1]
^EDSAV_QSTNTXTFIL
Page 218 of 334

Enter 0 if the person no longer owns the educational or college savings account as of the last day of
^LASTMONTH, ^CALENDAR_YEAR.
If the person/household owned three or more educational or college savings accounts, the person
should report the accounts with the largest balance.

EDUC_RANGE
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $10,000,
between $10,000 and $75,000, between $75,000 and $150,000, or more than $150,000?
1. Less than $10,000
2. $10,000 to $74,999
3. $75,000 to $149,999
4. $150,000 or more

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTRNTSP_PD
? [F1]
^JTRNTSPPD_QSTNTXT

JTNETSP_PD
Page 219 of 334

? [F1]
^JTNETSPPD_QSTNTXT
Enter a net loss as a negative amount.

SPNET1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $2,500, between $2,500 and $5,000, or more than $5,000?
Enter a net loss in the first response category.
1. Less than $500
2. $500 to $2,499.99
3. $2,500 to $4,999.99
4. $5,000 or more

JTSPMRKVALUE
? [F1]
^JTSPMRKVALUE_QSTNTXT
Enter 0 if the person no longer owns the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

SPMRKVALUE1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

JTSPDEBT
Page 220 of 334

? [F1]
^JTSPDEBT_QSTNTXT

SPDEBT1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YRFIL) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTOTHRNT_PD
? [F1]
^JTOTHRNTPD_QSTNTXT
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO4 (with
the exception of the person's spouse or registered domestic/civil union
partner if one exists). Display 'a Non-household member' when JTWHO4 = 50

JTOTHNET_PD
? [F1]
^JTOTHNETPD_QSTNTXT

Page 221 of 334

Enter a net loss as a negative amount.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO4 (with
the exception of the person's spouse or registered domestic/civil union
partner if one exists). Display 'a Non-household member' when JTWHO4 = 50

OTHNET1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $2,500, between $2,500 and $5,000, or more than $5,000?
Enter a net loss in the first response category.
1. Less than $500
2. $500 to $2,499.99
3. $2,500 to $4,999.99
4. $5,000 or more

JTOTHMRKVALUE
? [F1]
^JTOTHMRKVALUE_QSTNTXT
Enter 0 if the person no longer owns the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO4 (with
the exception of the person's spouse or registered domestic/civil union
partner if one exists). Display 'a Non-household member' when JTWHO4 = 50

OTHMRKVALUE1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
Page 222 of 334

1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

JTOTHDEBT
? [F1]
^JTOTHDEBT_QSTNTXT
Enter 0 if the person no longer owns the rental property.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO4 (with
the exception of the person's spouse or registered domestic/civil union
partner if one exists). Display 'a Non-household member' when JTWHO4 = 50

OTHDEBT1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YRFIL) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

OWNRENT_PD
? [F1]
Page 223 of 334

Earlier I recorded that ^TEMPNAME ^ALSOFIL_OWNRENT owned rental
property ^OWNNAMEFIL_OWNRENT. How much GROSS rent did ^TEMPNAME receive from all
rental property owned ^OWNNAME_FIL between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL?

OWNNET_PD
? [F1]
What was the NET income or NET loss after expenses (from all of those rental properies
^TEMPNAME owned ^OWNNAME_FIL between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL) ?
Enter a net loss as a negative amount.

OWNNET1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $2,500, between $2,500 and $5,000, or more than $5,000?
Enter a net loss in the first response category.
1. Less than $500
2. $500 to $2,499.99
3. $2,500 to $4,999.99
4. $5,000 or more

OWNMRKVALUE
? [F1]
Excluding properties attached to or located on ^PTEMPNAME own residence, and as of the last
day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total market value of all of those rental
properties ^OWNNAME_FIL?
Enter 0 if the person no longer owns the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

Page 224 of 334

OWNMRKVALUE1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

OWNDEBT
? [F1]
Excluding properties attached to or located on ^PTEMPNAME own residence, and as of the last
day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total value of any debt (such as
mortgages, deeds of trust, or other debt) owed on all of those rental properties (^TEMPNAME owned
^OWNNAME_FIL)?

OWNDEBT1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YRFIL) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

DKRNT
^ASIDEFRMFIL_DKRNT was the total amount of GROSS rent ^TEMPNAME received
between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL from
all ^OTHERFIL_DKRNT rental property ^HESHE owned?

DKNET
(^ASIDEFRMFIL_DKRNT) was the NET income or NET loss after expenses (from all of those rental
properties between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL) ?
Page 225 of 334

Enter a net loss as a negative amount.

DKNETRANGE
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $2,500, between $2,500 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
4. $5,000 or more

DKVALUE
^ASIDEFRMFIL_DKVALUE was the TOTAL MARKET VALUE from all ^OTHERFIL_DKVALUE
rental property ^HESHE owned as of the last day of ^LASTMONTH, ^CALENDAR_YEAR?
Enter 0 if the person no longer owns the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

DKRNTRANGE
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

DKDEBT
? [F1]
^ASIDEFRMFIL_DKDEBT properties attached to or located on ^PTEMPNAME own residence and
as of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total value of any debt
(such as mortgages, deeds of trust, or other debt) owed on all ^OTHERFIL_DKDEBT rental
properties?
Page 226 of 334

DKDEBTRANGE
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YRFIL) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTSPOUSE_MRKVALUE
? [F1]
^SPMRKVALUE_QSTNTXT
Enter 0 if the person no longer owns the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

SPMRKVALUE2Y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
Page 227 of 334

1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

JTSPREDEBT
^JTSPREDEBT_QSTNTXT

SPDEBT2Y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTOTHER_MRKVALUE
? [F1]
^OTMRKVALUE_QSTNTXT
Enter 0 if the person no longer owns the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO5 (with
the exception of the person's spouse or registered domestic/civil union
Page 228 of 334

partner if one exists).

Display 'a Non-household member' when JTWHO5 = 50

OTMRKVALUE2Y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

JTOTREDEBT
^JTOTREDEBT_QSTNTXT
Enter 0 if the person no longer owns the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO5 (with
the exception of the person's spouse or registered domestic/civil union
partner if one exists). Display 'a Non-household member' when JTWHO5 = 50

OTDEBT2Y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

CTRLNUM
Page 229 of 334

**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SELF_MRKVALUE
? [F1]
Earlier I recorded that ^TEMPNAME ^ALSOFIL_OWNREAL owned real estate (such as a vacation
home, a deeded timeshare, or an undeveloped lot) ^OWNNAME_FIL. As of the last day of
^LASTMONTH, ^CALENDAR_YEAR, what was the total market value of all of those properties?
Enter 0 if the person no longer owns the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

SELFMRKVALUE2Y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

SELFDEBT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total value of any debt
(such as mortgages, deeds of trust, or other debt) owed on all of those properties (^TEMPNAME
owned in ^HISHER own name)?
Enter 0 if the person no longer owns the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

SELFDEBT2Y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
Page 230 of 334

between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

DKREVALUE
^ASIDEFRMFIL_DKREVALUE was the TOTAL MARKET VALUE from all ^OTHERFIL_DKREVALUE
real estate (such as a vacation home, a deeded timeshare, or an undeveloped lot) ^HESHE owned as
of the last day of ^LASTMONTH, ^CALENDAR_YEAR?
Enter 0 if the person no longer owns the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

DKREVALUERANGE
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

DKREDEBT
? [F1]
^ASIDEFRMFIL_DKREDEBT of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the
total value of any debt (such as mortgages, deeds of trust, or other debt) owed on all of those
^OTHERFIL_DKREDEBT properties?

DKREDEBTRANGE
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
Page 231 of 334

1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more

CARNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

CARFREE
^QSTN_TYPECARFIL
Enter 0 if the household no longer owns the vehicle as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
0. Person no longer owns the vehicle
1. Free and clear
2. Money owed

CAROWED
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much was owed on that vehicle?

PRIMARY_USE
Was this vehicle used primarily either for business purposes or for the transportation of a
disabled person?
Please do not consider a vehicle to be used primarily for business purposes if that vehicle was used
primarily for transportation to/from work.
1. Yes
2. No

TYPE_RECVEH_NUM
Page 232 of 334

**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

WHO_RECVEH
Who owns the ^TYPE_RECVEH as of the last day of ^LASTMONTH, ^CALENDAR_YEAR?
Mark all that apply.
1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
3. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
4. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
5. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
6. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
7. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
8. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
9. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
10. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
11. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
12. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
13. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
14. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
15. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
16. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
17. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
18. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
19. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1

REC_VEHICLE
^RECVEH_QSTNTXT
Enter 0 if the household no longer owns the vehicle as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

RECVEHICFREE
Page 233 of 334

As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, was that ^TYPE_RECVEH owned free
and clear, or was there still money owed on it?
0. Person no longer owns the vehicle
1. Free and clear
2. Money owed

RECVEHICOWED
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much was owed on that
^TYPE_RECVEH?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ANNUITY_TRUST
? [F1]
(Earlier I recorded that ^TEMPNAME owned an annuity or trust/managed investment account.) As of
the last day of ^LASTMONTH, CALENDARY_YEAR, did ^HESHE have just an annuity, just a
trust/managed investment account, both, or no longer own either?
1. Annuities
2. Trusts
3. Both
4. No longer owns either an annuity or trust/managed investment account

ANNUITY_INC
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how much annuity
income did ^TEMPNAME receive?
If annuity income is shared, count only ^HISHER share.

ANNUITY_INC_RANGE
Page 234 of 334

ASSET TYPE: ANNUITIES
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $2,500, between $2,500 and $5,000, between $5,000 and $10,000 or more than $10,000?
1. Less than $2,500
2. $2,500 to $4,999
3. $5,000 to $9,999
4. More than $10,000

ANNUITY_SELF
? [F1]
Did ^TEMPNAME have annuities in which some or all of the equity belong to HIMHER?
1. Yes
2. No

ANNUITY_VALUE
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was ^PTEMPNAME share, in
dollars, of the total value of those annuities (in which ^TEMPNAME
^OWNOWNSFIL_ANNUITYTRUST some or all of the equity)?
Round the amount to the nearest dollar.

ANNUITY_RANGE
ASSET TYPE: ANNUITIES
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $25,000,
between $25,000 and $50,000, between 50,000 and 100,000, or more than $100,000?
1. Less than $25,000
2. $25,000 to $49,999
3. $50,000 to $99,999
4. $100,000 or more

TRUST_INC
Page 235 of 334

Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how much trust or
managed investment account income did ^TEMPNAME receive?
If trust or managed investment account income in shared, count only ^HISHER share.

TRUST_INC_RANGE
ASSET TYPE: TRUSTS/MANAGED INVESTMENT ACCOUNTS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $2,500, between $2,500 and $5,000, between $5,000 and $10,000 or more than $10,000?
1. Less than $2,500
2. $2,500 to $4,999
3. $5,000 to $9,999
4. More than $10,000

TRUST_SELF
? [F1]
Did ^TEMPNAME have trusts/managed investment accounts in which some or all of the equity
belong to HIMHER?
1. Yes
2. No

TRUST_VALUE
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was ^PTEMPNAME share, in
dollars, of the total value of those trusts/managed investment accounts (in which ^TEMPNAME
^OWNOWNSFIL_ANNUITYTRUST some or all of the equity)?
Round the amount to the nearest dollar.

TRUST_RANGE
ASSET TYPE: TRUSTS/MANAGED INVESTMENT ACCOUNTS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $25,000,
between $25,000 and $50,000, between $50,000 and $100,000, or more than $100,000?

Page 236 of 334

1. Less than $25,000
2. $25,000 to $49,999
3. $50,000 to $99,999
4. $100,000 or more

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

BUSINESS_INV_NUM
(Earlier I recorded that ^TEMPNAME owned a business(es) as an investment only.) As of the last day
of ^LASTMONTH, ^CALENDAR_YEAR, how many businesses as an investment only did ^HESHE
own?
Enter 0 for none.

INVBUSINESS_CODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

BUSINESS_INV_NAME
What was the name ^NAME_BUSFIL
While respondents are allowed to report that they own up to 10 businesses as an investment only, we
are only asking the detailed questions for up to 3 businesses as an investment only.

Page 237 of 334

INVBUSINESS_CODE
**NON-DISPLAYED ITEM**

BUSINESS_CODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

PERCENT_OWNED
^SELF_EMPFIL As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what percent of
^BUSINESS_NAMES did ^TEMPNAME own?
Enter 0 if the person no longer owns the business as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please enter all ownership percentages as WHOLE numbers. For any NON-WHOLE number
ownership percentages, please round up or down accordingly. For example, for 50 percent, please enter
'50'; for 9.7 percent, please enter '10'; for 25.2 percent, please enter '25'.

BUSINESS_VALUE
? [F1]
(As of the last day of ^LASTMONTH, ^CALENDAR_YEAR) What was the total value of
^BUSINESS_NAMES before figuring in any debts that might be owed against it?

BUSINESS_RANGE
ASSET TYPE: BUSINESS(ES) OWNED
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $10,000,
between $10,000 and $50,000, between $50,000 and $150,000, or more than $150,000?
1. Less than $10,000
2. $10,000 to $49,999
3. $50,000 to $149,999
4. $150,000 or more
Page 238 of 334

BUSINESS_DEBT
? [F1]
(As of the last day of ^LASTMONTH, ^CALENDAR_YEAR) What was the total debt owed against
^BUSINESS_NAMES?
Enter 0 for none.

BUSINESS_DEBT_RANGE
ASSET TYPE: BUSINESS(ES) OWNED
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $10,000,
between $10,000 and $50,000, between $50,000 and $150,000, or more than $150,000?
1. Less than $10,000
2. $10,000 to $49,999
3. $50,000 to $149,999
4. $150,000 or more

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

RNDUP2_INCOME
? [F1]
(Earlier I recorded that ^TEMPNAME had Read investments.) Between ^MONTH1 1st and the end
of ^LASTMONTH ^CALENDAR_YRFIL, what was ^HISHER share of income from Read
investments ^INTOTAL_FIL? (If the income is shared, count only ^HISHER ^CHILDFIL)
Enter a net loss as a negative amount.
Display the 'other' investments reported in AST4C_SP:
Financial Investments

RNDUP2_INC_RANGE
Page 239 of 334

Heading:

Other

ASSET TYPE: OTHER INVESTMENTS
Was the amount less than $25, between $25 and $100, between $100 and $500, or more than
$500?
1. Less than $25
2. $25 to $99.99
3. $100 to $499.99
4. $500 or more

RNDUP2_VALUE
? [F1]
ASSET TYPE: OTHER INVESTMENTS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total balance or market
value of the Read investments ^TEMPNAME owned ^ALLTOG_FIL?
Enter 0 if the person no longer owns the 'other' investments as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Display the list of 'other financial investment' reported in AST4C_SP
Heading: Other Financial Investments

RNDUP2_VAL_RANGE
ASSET TYPE: OTHER INVESTMENTS
Was the amount less than $1,000, between $1,000 and $10,000, between $10,000 and $25,000, or
more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
Page 240 of 334

**NON-DISPLAYED ITEM**

CREDIT_CARDS
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME owe
any money for
...store bills or credit card bills?
(...educational or education-related expenses?)
(...any other debt we have not yet mentioned, including medical bills not covered by insurance, loans
obtained through a bank or credit union, money owed to private individuals, or any other debt not
covered?)
Please exclude store bills or credit card debt for business expenses that will be paid or reimbursed by
an employer or business.
1. Yes
2. No

EDUC_LOANS
? [F1]
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME owe any
money for)
(...store bills or credit card bills?)
...educational or education-related expenses?
(...any other debt we have not yet mentioned, including medical bills not covered by insurance, loans
obtained through a bank or credit union, money owed to private individuals, or any other debt not
covered?)
Examples include loans to students (such as Stafford Loans and Perkins loans), loans to parents (such
as PLUS loans), as well as other loans obtained for the purpose of financing education.
Please exclude any home equity loans taken out to pay for education.
1. Yes
2. No

OTHER_DEBT
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME owe any
money for)

Page 241 of 334

(...store bills or credit card bills?)
(...educational or education-related expenses?)
...any other debt we have not yet mentioned, including medical bills not covered by insurance,
loans obtained through a bank or credit union, money owed to private individuals, or any other
debt not covered?
Please exclude any debt that the respondent has already reported.
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTCC_DEBT
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did ^TEMPNAME owe
money for store bills or credit card bills jointly with ^HISHER ^SPOUSEPARTNER_FIL?
Please exclude store bills or credit card debt for business expenses that will be paid or reimbursed by
an employer or business.
1. Yes
2. No

JTCC_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME and
^HISHER ^SPOUSEPARTNER_FIL jointly owe for store bills or credit card bills?
Please exclude store bills or credit card debt for business expenses that will be paid or reimbursed by
an employer or business.
Enter '0' if the store bills or credit card debt has been paid in full.

Page 242 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SELFCC_DEBT
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did ^TEMPNAME owe
money for store bills or credit card bills in ^HISHER own name only?
Please exclude store bills or credit card debt for business expenses that will be paid or reimbursed by
an employer or business.
1. Yes
2. No

SELFCC_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME owe for
store bills or credit card bills (in ^HISHER name only)?
Please exclude store bills or credit card debt for business expenses that will be paid or reimbursed by
an employer or business.
Enter '0' if the store bills or credit card debt has been paid in full.

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTEDUC_DEBT
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did ^TEMPNAME have
the loans for educational or education-related expenses jointly with ^HISHER
^SPOUSEPARTNER_FIL?
Please exclude any home equity loans taken out to pay for education.
Page 243 of 334

1. Yes
2. No

JTEDUC_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME and
^HISHER ^SPOUSEPARTNER_fIL jointly owe in loans for educational or education-related
expenses?
Enter '0' if the loans have been paid in full.

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SELFEDUC_DEBT
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did ^TEMPNAME have
any loans for educational or education-related expenses in ^HISHER own name only?
Please exclude any home equity loans taken out to pay for education.
1. Yes
2. No

SELFEDUC_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME owe in
loans for educational or education-related expenses (in ^HISHER name only)?
Enter '0' if the loans have been paid in full.

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
Page 244 of 334

**NON-DISPLAYED ITEM**

JTOTH_DEBT
Did ^TEMPNAME have other debt (including medical bills not covered by insurance, money owed to
private individuals, debts or margin accounts held against stocks or mutual funds, or any other debt not
covered) jointly with ^HISHER ^SPOUSEPARTNER_FIL (between ^MONTH1 1st and the end of
^LASTMONTH ^CALENDAR_YRFIL)?
Please exclude any debt that the respondent has already reported.
1. Yes
2. No

JTOTH_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME and
^HISHER ^SPOUSEPARTNER_FIL jointly owe in other debt (including medical bills not covered by
insurance, money owed to private individuals, debts or margin accounts held against stocks or mutual
funds, or any other debt not covered)?
Please exclude any debt that the respondent has already reported.
Enter '0' if the 'other' debt has been paid in full.

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SELFOTH_DEBT
Did ^TEMPNAME have other debt (including medical bills not covered by insurance, money owed to
private individuals, debts or margin accounts held against stocks or mutual funds, or any other debt not
covered) in ^HISHER own name only (between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL)?
Please exclude any debt that the respondent has already reported.
1. Yes
Page 245 of 334

2. No

SELFOTH_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME owe in
other debt (including medical bills not covered by insurance, money owed to private individuals, debts or
margin accounts held against stocks or mutual funds, or any other debt not covered)?
Please exclude any debt that the respondent has already reported.
Enter '0' if the 'other' debt has been paid in full.

ASTRECUSE
Did the respondent use any records to answer any asset questions?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

UTILZ_INTRO
? [F1]
Next I'll ask some questions about doctor visits, (such as how often ^TEMPNAME visited a doctor or
dentist,) as well as ^PTEMPNAME medical expenses during the year. These questions apply to
both physical as well as mental health care visits and expenses.
1. Enter 1 to continue

HLTHSTS
Would you say ^HISHER health in general is-Page 246 of 334

(These questions apply to both physical and mental health.)
Read answer categories

1. Excellent
2. Very good
3. Good
4. Fair
5. Poor

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

HOSPNGHT
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, ^WEREWAS
^TEMPNAME a patient in a hospital overnight or longer?
1. Yes
2. No

HOSPNMNGT
? [F1]
How many nights in total did ^HESHE spend in a hospital of any type (between ^MONTH1 1st and
the end of ^LASTMONTH ^CALENDAR_YRFIL)?

HOSPRSNNGT
Which of the following describes why ^HESHE entered the hospital ^RECENT_STAYFIL
Read answer categories.
Mark all that apply.
Page 247 of 334

1. for diagnostic test to determine what was wrong.
2. for a birth (either to be born, or to give birth, including C-section).
3. to have an operation or surgery.
4. for some other treatment or therapy not including surgery.
5. for any other reason.

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

PRESCRIPYR
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME take
any prescription medications?
1. Yes
2. No

PRESCRIP
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL did ^HESHE take
prescription medicines on a daily basis for a month or more?
^BIRTHCONTROL_FIL
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

Page 248 of 334

DENTALVIS
Q
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how many visits did
^TEMPNAME make to a dentist or other dental professional?
Enter 0 for none.

DENTTHLS
^C_HAVHAS ^TEMPNAME lost any of ^HISHER permanent adult teeth?
Exclude the removal of wisdom teeth.

1. Yes
2. No

DENTALTH
^C_HAVHAS ^HESHE lost ALL of ^HISHER permanent adult teeth?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

HLTHPRVD
R
^HLTHPROV_QSTNTXTFIL
Enter 0 for none.
Exclude email contacts.
Page 249 of 334

HLTHDR
Did that visit or call include contact with a physician?
1. Yes
2. No

HLTHDR_NO
How many of the ^NUM_VISITFIL visits or calls included contact with a physician?

DAYSICK
^DAYSICK_QSTNTXTFIL
Enter 0 for none.
If the person can't provide the exact number of days, ask for an estimate.

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

MEDCRPAY
Next I will ask about out-of-pocket medical expenses between ^MONTH1 1st and the end of
^LASTMONTH ^CALENDAR_YRFIL.
^MOOP_INTRO
^MOOP_QSTNTXT
^MOOP_NOTE
^MOOP_FRNOTE

MEDCRPAY_RANGE
Page 250 of 334

Was it ...
Enter 0 for none.
Read answer categories.

0. $0
1. $1 to $300
2. $301 to $500
3. $501 to $1,000
4. $1,001 to $2,000
5. $2,001 to $3,000
6. $3,001 to $4,000
7. $4,001 to $7,000
8. $7,001 to $11,000
9. $11,001 or more

MDPAY
? [F1]
^MDPAY_QSTNTXT

MDPAY_RANGE
Was it ...
Enter 0 for none.
Read answer categories.

0. $0
1. $1 to $50
2. $50 to 100
3. $101 to $300
4. $301 to $500
5. $501 to $800
6. $801 to $1,000
7. $1,001 to $3,000
8. $3,001 to $6,000
Page 251 of 334

9. $6,001 or more

OTCMDPAY
^OTCMDPAY_QSTNTXT

OTCMDPAY_RANGE
Was it ...
Enter 0 for none.
Read answer categories.

0. $0
1. $1 to $10
2. $11 to $50
3. $51 to $100
4. $101 to $200
5. $201 to $300
6. $301 to $500
7. $501 to $1,000
8. $1,001 to $5,000
9. $5,001 or more

FLEXSPND
? [F1]
^INTRO_HSA, did ^TEMPNAME have a Flexible Spending Account for health expenses?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

Page 252 of 334

LNO
**NON-DISPLAYED ITEM**

NOINDNT
Earlier ^TEMPNAME said that ^HESHE ^WEREWAS not covered by any health insurance in
Read month(s). During ^THATTHOSE_MOFIL did ^TEMPNAME go to a dentist or other dental
professional?
Display the name of the months of no health insurance coverage as reported in
the EHC (include ONLY reference months)
1. Yes
2. No

NOINDOC
(Earlier ^TEMPNAME said that ^HESHE ^WEREWAS not covered by any health insurance in
Read month(s).) During ^THATTHOSE_MOFIL did ^TEMPNAME go to a doctor, nurse, or other
medical provider?
Display the name of the months of no health insurance coverage as reported in
the EHC (include ONLY reference months)
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

NOINCLN
Where did ^TEMPNAME go to get those health care services?
Read answer categories.
Mark all that apply.

Page 253 of 334

1. Clinic or Public Health Department
2. Emergency room
3. Hospital, excluding emergency room
4. VA Hospital
5. Doctor's office
6. Dentist's office
7. Someplace else

NOININC
Did anyone ask what ^PTEMPNAME income was before they set a price for the services?
1. Yes
2. No

NOINTRT
Did ^TEMPNAME receive treatment for an illness or injury?
1. Yes
2. No

NOINCHK
Did ^TEMPNAME receive any routine or preventative care, ^TYPECAREFIL?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

HEARING
^C_AREIS ^TEMPNAME deaf or ^DODOES ^HESHE have serious difficulty hearing?
Page 254 of 334

1. Yes
2. No

SEEING
^C_AREIS ^TEMPNAME blind or ^DODOES ^HESHE have serious difficulty seeing even when
wearing glasses or contacts?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

COGNIT_AD
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME experience any of
the following:
...serious difficulty concentrating, remembering, or making decisions?
...serious difficulty walking or climbing stairs?
...difficulty dressing or bathing?
...difficulty doing errands alone such as visiting a doctor's office or shopping?
...difficulty finding a job or remaining employed?
...prevented from working?

1. Yes
2. No

AMBULAT_AD
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME experience any of the
following:
...serious difficulty concentrating, remembering, or making decisions?
...serious difficulty walking or climbing stairs?
...difficulty dressing or bathing?
Page 255 of 334

...difficulty doing errands alone such as visiting a doctor's office or shopping?
...difficulty finding a job or remaining employed?
...prevented from working?

1. Yes
2. No

SELFCARE_AD
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME experience any of the
following:
...serious difficulty concentrating, remembering, or making decisions?
...serious difficulty walking or climbing stairs?
...difficulty dressing or bathing?
...difficulty doing errands alone such as visiting a doctor's office or shopping?
...difficulty finding a job or remaining employed?
...prevented from working?

1. Yes
2. No

ERRANDS
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME experience any of the
following:
...serious difficulty concentrating, remembering, or making decisions?
...serious difficulty walking or climbing stairs?
...difficulty dressing or bathing?
...difficulty doing errands alone such as visiting a doctor's office or shopping?
...difficulty finding a job or remaining employed?
...prevented from working?

1. Yes
2. No

FINDJOB
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME experience any of the
following:
Page 256 of 334

...serious difficulty concentrating, remembering, or making decisions?
...serious difficulty walking or climbing stairs?
...difficulty dressing or bathing?
...difficulty doing errands alone such as visiting a doctor's office or shopping?
...difficulty finding a job or remaining employed?
...prevented from working?

1. Yes
2. No

JOBCANT
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME experience any of the
following:
...serious difficulty concentrating, remembering, or making decisions?
...serious difficulty walking or climbing stairs?
...difficulty dressing or bathing?
...difficulty doing errands alone such as visiting a doctor's office or shopping?
...difficulty finding a job or remaining employed?
...prevented from working?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

COGNIT
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME...
...experience serious difficulty concentrating, remembering, or making decisions?
...experience serious difficulty walking or climbing stairs?
...experience difficulty dressing or bathing?
...have limited ability to play with other children of the same age?
Page 257 of 334

...have limitations in ^HISHER ability to do regular school work?

1. Yes
2. No

AMBULAT
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME...
...experience serious difficulty concentrating, remembering, or making decisions?
...experience serious difficulty walking or climbing stairs?
...experience difficulty dressing or bathing?
...have limited ability to play with other children of the same age?
...have limitations in ^HISHER ability to do regular school work?

1. Yes
2. No

SELFCARE
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME...
...experience serious difficulty concentrating, remembering, or making decisions?
...experience serious difficulty walking or climbign stairs?
...experience difficulty dressing or bathing?
...have limited ability to play with other children of the same age?
...have limitations in ^HISHER ability to do regular school work?

1. Yes
2. No

PLAYDIF
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME...
...experience serious difficulty concentrating, remembering, or making decisions?
...experience serious difficulty walking or climbign stairs?
...experience difficulty dressing or bathing?
...have limited ability to play with other children of the same age?
...have limitations in ^HISHER ability to do regular school work?

Page 258 of 334

1. Yes
2. No

SKOOLWK
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME...
...experience serious difficulty concentrating, remembering, or making decisions?
...experience serious difficulty walking or climbign stairs?
...experience difficulty dressing or bathing?
...have limited ability to play with other children of the same age?
...have limitations in ^HISHER ability to do regular school work?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

DDELAY
C_DODOES ^TEMPNAME have a developmental condition or delay that limits ordinary activity?
1. Yes
2. No

FERT_INTRO
? [F1]
Next I'll ask some questions about Text to appear on introductory screen of Fertility/Parent
mortality/natality depending on subsequent content.
1. Enter 1 to continue

Page 259 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

I_PWCEB
**NON-DISPLAYED ITEM**

PARCHL
^ALTOGETHERFIL many children ^HAVHAS ^HESHE ever ^BIRTHFATHERFIL?
Count all biological children of this person, regardless of whether they were born within or outside of
any marriage. Include those who don't live with this person now, or if they died or were adopted by
someone else.
Do not count children adopted by this person, foster children, or stepchildren. Do not count stillbirths
and do not count children not yet born.
Enter 0 for none.

KIDLISTCHK
I am showing that ^PTEMPNAME biological ^CHILDFERTFIL ^FERT_AREIS Read Name(s). Is
that correct?
Display the first names and ages of the children in ^BIOCHILDLIST.

1. Yes
2. No

KIDLIST_REV
question text fill for PARCHK

Mark all that apply.
Enter 95 if all of the children are biological children.

Page 260 of 334

Enter 96 if none of these children are biological children.

1. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
2. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
3. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
4. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
5. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
6. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
7. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
8. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
9. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
10. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
11. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
12. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
13. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
14. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
15. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
16. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
17. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
18. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
19. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
20. Fill with ^LNO, ^FNAME, ^LNAME from BIOCHILDLIST
95. All of the children are her biological children
96. None of the children are her biological children

FERT_CONF
You have keyed:
NUMBER OF CHILDREN: (fill with answer to PARCHL_COUNT)
LIST OF KNOWN CHILDREN: ^FERT_BIOCHILDLIST
WARNING: Once you enter 1 to continue, you cannot make changes to the information above.

Enter 1 to Continue
1. Enter 1 to continue

Page 261 of 334

PARCHL_COUNT
**NON-DISPLAYED ITEM**

CEB_FLAG
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

KIDLNO

HVARKID_F
**NON-DISPLAY ITEM**

CHLNAME
Child roster name intro
^CHLNAMEFIL
Enter 999 if no more children.

CHL_BMON
What is this child's date of birth?
Enter month.
1. January
2. February
3. March
4. April
5. May
Page 262 of 334

6. June
7. July
8. August
9. September
10. October
11. November
12. December

CHL_BYR
(What is this child's date of birth?)
Enter year.

CHL_AGEGS
? [F1]
How old would you say this child is?
Enter best estimate of age.

SAMEPAR
? [F1]
Ask or verify:
Do ^ALLBOTH of ^PTEMPNAME biological children have the same biological Mother/Father fill
for fertility section?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

Page 263 of 334

LNO
**NON-DISPLAYED ITEM**

HVAR_CLST
**NON-DISPLAY ITEM**

CLUSTER
? [F1]
CLUSTERFIL
Mark all that apply.

1. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
2. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
3. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
4. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
5. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
6. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
7. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
8. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
9. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
10. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
11. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
12. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
13. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
14. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
15. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
16. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
17. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
18. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
19. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
20. Display the ^LNO ^CHL_NAME, ^CHL_AGE of each child from BKIDS
95. All of these children have the same biological ^MOTHFATH

OP_LIVHH
Does READ NAME's biological Mother/Father fill for fertility section live here?

Page 264 of 334

List names, ages of children from ^CHL_CLUSTERFIL.
1. Yes
2. No

WHOBIOP
Ask or verify:
Who is READ NAMES's biological Mother/Father fill for fertility section?
List names and ages from ^CHL_CLUSTERFIL
1. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
2. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
3. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
4. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
5. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
6. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
7. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
8. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
9. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
10. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
11. Someone not listed.

GRNDPR_FLG
**NON-DISPLAYED ITEM**

GRNDPR
Ask or verify.
^C_AREIS ^TEMPNAME a grandparent - that is, ^ANYCHILDFIL have any biological or adopted
children of their own who are currently living?

1. Yes
2. No

CTRLNUM
Page 265 of 334

**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

BIOMOM
The intent of these questions is to collect information about the respondent's biological parents, even if
the respondent is adopted or has a step-parent.
Is ^PTEMPNAME biological mother (still) alive?
1. Yes
2. No

BIOMOMDOD_M
In what month and year did ^PTEMPNAME biological mother die?
Enter month
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

BIOMOMDOD_Y
(In what month and year did ^PTEMPNAME biological mother die?)
Enter year

Page 266 of 334

BIOMOMDOD_DKR3
How old was ^PTEMPNAME mother when she passed away?

BIOMOMDOD_DKR1
How old ^WEREWAS ^TEMPNAME when ^HISHER biological mother passed away?

BIOMOMDOD_DKR2
^C_WASWERE ^TEMPNAME younger than 19 years old when ^HISHER biological mother passed
away?
1. Yes
2. No

BIOMOMDOB_M
In what month and year was ^PTEMPNAME biological mother born?
Enter month
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December

BIOMOMDOB_Y
(In what month and year was ^PTEMPNAME biological mother born?)
Enter year

Page 267 of 334

BIOMOMUS
? [F1]
Was ^PTEMPNAME (biological) mother born in the United States?
1. Yes
2. No

BIOMOMNAT
? [F1]
In what country was ^PTEMPNAME (biological) mother born?
1. United States (US, USA)
2. Afghanistan
3. American Samoa
4. Argentina
5. Armenia
6. Australia
7. Austria
8. Azores
9. Bahamas
10. Bangladesh
11. Barbados
12. Belgium
13. Belize
14. Bermuda
15. Bolivia
16. Bosnia and Herzegovina
17. Brazil
18. Burma/Myanmar
19. Cambodia
20. Canada
21. Caribbean
22. Chile
23. China
24. Colombia
25. Costa Rica
26. Cuba
27. Czech Republic
Page 268 of 334

28. Czechoslovakia
29. Denmark
30. Dominica
31. Dominican Republic
32. Ecuador
33. Egypt
34. El Salvador
35. England
36. Ethiopia
37. Fiji
38. Finland
39. France
40. Germany
41. Ghana
42. Great Britain
43. Greece
44. Grenada
45. Guam
46. Guatemala
47. Guyana
48. Haiti
49. Honduras
50. Hong Kong
51. Hungary
52. India
53. Indonesia
54. Iran
55. Iraq
56. Ireland
57. Israel
58. Italy
59. Jamaica
60. Japan
61. Jordan
62. Kenya
63. Korea
64. Laos
65. Latvia
66. Lebanon
Page 269 of 334

67. Lithuania
68. Malaysia
69. Mexico
70. Morocco
71. Netherlands
72. New Zealand
73. Nicaragua
74. Nigeria
75. Northern Marianas
76. Norway
77. Pakistan
78. Palestine
79. Panama
80. Peru
81. Philippines
82. Poland
83. Portugal
84. Puerto Rico
85. Romania
86. Russia
87. Scotland
88. Slovakia
89. South Africa
90. South Korea
91. Spain
92. Sweden
93. Switzerland
94. Syria
95. Taiwan
96. Thailand
97. Trinidad and Tobago
98. Turkey
99. U.S. Virgin Islands
100. Ukraine
101. United Kingdom
102. United States (US, USA)
103. Uruguay
104. USSR
105. Venezuela
Page 270 of 334

106. Vietnam
107. Yugoslavia
108. Other Africa
109. Other Asia
110. Other Central America
111. Other Europe
112. Other Pacific Islands
113. Other South America
114. Other

BIOMOMCOUNTRY
*** NON-DISPLAYED ITEM ***

BIODAD
The intent of these questions is to collect information about the respondent's biological parents, even if
the respondent is adopted or has a step-parent.
Is ^PTEMPNAME biological father (still) alive?
1. Yes
2. No

BIODADDOD_M
In what month and year did ^PTEMPNAME biological father die?
Enter month
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
Page 271 of 334

12. December

BIODADDOD_Y
(In what month and year did ^PTEMPNAME biological father die?)
Enter year

BIODADDOD_DKR3
How old was ^PTEMPNAME father when he passed away?

BIODADDOD_DKR1
How old ^WEREWAS ^TEMPNAME when ^HISHER biological father passed away?

BIODADDOD_DKR2
^C_WASWERE ^TEMPNAME younger than 19 years old when ^HISHER biological father passed
away?
1. Yes
2. No

BIODADDOB_M
In what month and year was ^PTEMPNAME biological father born?
Enter month
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
Page 272 of 334

12. December

BIODADDOB_Y
(In what month and year was ^PTEMPNAME biological father born?)
Enter year

BIODADUS
? [F1]
Was ^PTEMPNAME (biological) father born in the United States?
1. Yes
2. No

BIODADNAT
? [F1]
In what country was ^PTEMPNAME (biological) father born?
1. United States (US, USA)
2. Afghanistan
3. American Samoa
4. Argentina
5. Armenia
6. Australia
7. Austria
8. Azores
9. Bahamas
10. Bangladesh
11. Barbados
12. Belgium
13. Belize
14. Bermuda
15. Bolivia
16. Bosnia and Herzegovina
17. Brazil
18. Burma/Myanmar
Page 273 of 334

19. Cambodia
20. Canada
21. Caribbean
22. Chile
23. China
24. Colombia
25. Costa Rica
26. Cuba
27. Czech Republic
28. Czechoslovakia
29. Denmark
30. Dominica
31. Dominican Republic
32. Ecuador
33. Egypt
34. El Salvador
35. England
36. Ethiopia
37. Fiji
38. Finland
39. France
40. Germany
41. Ghana
42. Great Britain
43. Greece
44. Grenada
45. Guam
46. Guatemala
47. Guyana
48. Haiti
49. Honduras
50. Hong Kong
51. Hungary
52. India
53. Indonesia
54. Iran
55. Iraq
56. Ireland
57. Israel
Page 274 of 334

58. Italy
59. Jamaica
60. Japan
61. Jordan
62. Kenya
63. Korea
64. Laos
65. Latvia
66. Lebanon
67. Lithuania
68. Malaysia
69. Mexico
70. Morocco
71. Netherlands
72. New Zealand
73. Nicaragua
74. Nigeria
75. Northern Marianas
76. Norway
77. Pakistan
78. Palestine
79. Panama
80. Peru
81. Philippines
82. Poland
83. Portugal
84. Puerto Rico
85. Romania
86. Russia
87. Scotland
88. Slovakia
89. South Africa
90. South Korea
91. Spain
92. Sweden
93. Switzerland
94. Syria
95. Taiwan
96. Thailand
Page 275 of 334

97. Trinidad and Tobago
98. Turkey
99. U.S. Virgin Islands
100. Ukraine
101. United Kingdom
102. United States (US, USA)
103. Uruguay
104. USSR
105. Venezuela
106. Vietnam
107. Yugoslavia
108. Other Africa
109. Other Asia
110. Other Central America
111. Other Europe
112. Other Pacific Islands
113. Other South America
114. Other

BIODADCOUNTRY
*** NON-DISPLAYED ITEM ***

CHILD_INTRO
? [F1]
Next I'll ask some questions about children in the household. I will ask aboutChild care fill
children's attitude towards school and homework, children's interaction with both parents or
caregivers, and about activities children participate in both inside and outside of school.

1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
Page 276 of 334

**NON-DISPLAYED ITEM**

PAR
During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any
of the following arrangements to look afterChild/children for Child Care READ NAMES while
^TEMPNAME ^WEREWAS working (or in school).
Child's other parent or stepparent?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD

1. Yes
2. No

PARWHCH
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.
Child's other parent or stepparent?)
Which child or children?
Mark all that apply.
1. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
Page 277 of 334

12. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.

SELF
During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES while ^TEMPNAME
^WEREWAS working (or in school).
Did ^TEMPNAME care forChild/children for Child Care READ NAMES while ^TEMPNAME
^WEREWAS working (or in school)?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD

1. Yes
2. No

SELFWHCH
(During a typical week in September ^CALENDAR_YRFIL, please tell me if you used any of the following
arrangements to look afterChild/children for Child Care READ NAMES while you were working.
Did ^TEMPNAME care forChild/children for Child Care READ NAMES while ^TEMPNAME
^WEREWAS working (or in school))
Page 278 of 334

Which child or children?
Mark all that apply.
1. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.

GRAN
^CC_NONWORKINTROFIL
Grandparent?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
If the respondent is the grandparent of the children in question, then ask about "other grandparents."
Page 279 of 334

CHILDREN:
List names of all children under 15 for whom respondent is LNGD
1. Yes
2. No

GRANWHCH
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.
Grandparent?)
Which child or children?
Mark all that apply.
1. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
Page 280 of 334

25. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.

SIB15
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.)
Brother or sister age 15 or older?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD

1. Yes
2. No

SIB15WHCH
(During a typical week in September ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES Designated
parent working/not working suffix fill.
Brother or sister age 15 or older?)
Which child or children?
Mark all that apply.
1. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
Page 281 of 334

11. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.

OTHR
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.)
Any other relative?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD

1. Yes
2. No

OTHRWHCH
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.
Any other relative?)
Page 282 of 334

Which child or children?
Mark all that apply.
1. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.

NREL
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.)
A non-relative such as a friend, neighbor, sitter, nanny, or au pair?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
Page 283 of 334

CHILDREN:
List names of all children under 15 for whom respondent is LNGD

1. Yes
2. No

NRELWHCH
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.
A non-relative such as a friend, neighbor, sitter, nanny, or au pair?)
Which child or children?
Mark all that apply.
1. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
Page 284 of 334

23. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.

DAYCARE
(During a typical week in December ^CALENDAR_YRFIL, please tell me if you used any of the following
arrangements to look afterChild/children for Child Care READ NAMES Designated parent working/not
working suffix fill.)
A child care or day care center?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD

1. Yes
2. No

DAYWHCH
(During a typical week in December ^CALENDAR_YRFIL, please tell me if you used any of the following
arrangements to look afterChild/children for Child Care READ NAMES Designated parent working/not
working suffix fill.
A child care or day care center?)
Which child or children?
Mark all that apply.
1. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
Page 285 of 334

8. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.

DAYHS
ISTHISCC child care or day care CENTER a Head Start program?
Head Start is a federally sponsored preschool program primarily for children from low-income families.

1. Yes
2. No

DAYHSWHCH
(ISTHISCC child care or day care CENTER a Head Start program?)
Which child or children are in a Head Start program?
Mark all that apply.

1. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

2. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

3. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
Page 286 of 334

4. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

5. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

6. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

7. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

8. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

9. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

10. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

11. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

12. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

13. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

14. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

15. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

16. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

17. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

18. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

19. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

20. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

21. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

22. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

23. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

24. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

25. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
26. Someone not listed.

NUR
(During a typical WEEK in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.)
A nursery or preschool?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List the names of all children ages 2-7 for whom the respondent is LNGD

1. Yes
2. No

Page 287 of 334

NURWHCH
(During a typical WEEK in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.
A nursery or preschool?)
Which child or children?
Mark all that apply.
CHILDREN:
List the names of all children 2-7 for whom the respondent is LNGD

1. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

2. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

3. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

4. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

5. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

6. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

7. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

8. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

9. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

10. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

11. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

12. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

13. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

14. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

15. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

16. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

17. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

18. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

19. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

20. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

21. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

22. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

23. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

24. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

25. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
26. Someone not listed.

NURHS
Page 288 of 334

ISTHISCC nursery School/Schools for Child Care or preSchool/Schools for Child Care a Head
Start program?
Head Start is a federally sponsored preschool program primarily for children from low-income families.

1. Yes
2. No

NURHSWHCH
(ISTHISCC nursery or preSchool/Schools for Child Care a Head Start program?)
Which child or children are in a Head Start program?
Mark all that apply.

1. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

2. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

3. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

4. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

5. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

6. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

7. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

8. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

9. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

10. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

11. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

12. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

13. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

14. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

15. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

16. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

17. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

18. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

19. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

20. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

21. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

22. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

23. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

24. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
Page 289 of 334

25. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
26. Someone not listed.

HEADSTART
(During a typical WEEK in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.)
A Head Start program?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
Head Start is a federally sponsored preschool program primarily for children from low-income families.
CHILDREN:
List the names of all children ages 2-7 for whom the respondent is LNGD
1. Yes
2. No

HEADSTWHCH
(During a typical WEEK in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.
A Head Start program?)
Which child or children?
Mark all that apply.

1. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

2. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

3. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

4. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

5. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

6. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

7. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

8. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

9. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
Page 290 of 334

10. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

11. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

12. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

13. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

14. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

15. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

16. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

17. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

18. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

19. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

20. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

21. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

22. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

23. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

24. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

25. ^LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
26. Someone not listed.

FAM
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.)
Family day care provider caring for two or more children outside of ^PTEMPNAME home?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD

1. Yes
2. No

FAMWHCH
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
Page 291 of 334

working/not working suffix fill.
Family day care provider caring for two or more children outside of ^PTEMPNAME home?)
Which child or children?
Mark all that apply.
1. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.

PROG
(During a typical WEEK in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.)
Before or after school care programs?
Page 292 of 334

If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children ages 3-14 for whom the respondent is LNGD
1. Yes
2. No

PROGWHCH
(During a typical WEEK in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.
Before or after school care programs?)
Which child or children?
Mark all that apply.

1. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

2. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

3. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

4. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

5. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

6. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

7. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

8. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

9. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

10. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

11. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

12. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

13. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

14. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

15. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

16. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

17. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

18. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

19. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

20. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
Page 293 of 334

21. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

22. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

23. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

24. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER

25. ^LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
26. Someone not listed.

KIDSELF
Sometimes it is difficult to make arrangements to look after children all of the time. During a
typical week in December ^CALENDAR_YRFIL, did Child/children for Child Care READ NAMES
care for ^HIMHERSELFFIL_CC for even a small amount of time when ^TEMPNAME ^WEREWAS
not there?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
1. Yes
2. No

KSELFWHCH
(Sometimes it is difficult to make arrangements to look after children all of the time. During a typical
week in December ^CALENDAR_YRFIL, did Child/children for Child Care READ NAMES care for
^HIMHERSELFFIL_CC for even a small amount of time?)
Which child or children?
Mark all that apply.
1. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
Page 294 of 334

13. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.

PAYREFYR
Did ^TEMPNAME or ^HISHER family pay for child care at any time while ^TEMPNAME
^WEREWAS working during ^REFYEAR?
Include cost of preschool and nursery school, but do not include tuition costs for kindergarten or grade
school.
1. Yes
2. No

PAYWKREFYR
In a typical week in ^REFYEAR when ^TEMPNAME ^WEREWAS working, how much did
^TEMPNAME or ^HISHER family pay for child care?
Include cost of preschool and nursery school, but do not include tuition costs for kindergarten or grade
school.
If the respondent has trouble reporting the amount for a typical week, then ask: (How much did
^TEMPNAME or ^PTEMPNAME family pay for child care in the last week where child care was used?)

PAY
I'd like you to think about all the child care arrangements used for READ NAMES in December
^CALENDAR_YRFIL.
Did ^TEMPNAME or ^HISHER family usually pay for any of these arrangements for
Page 295 of 334

READ

NAMES?
Include cost of preschool and nursery school, but do not include tuition costs for kindergarten or grade
school.
Child/children for Child Care:
(List the names of all children on TCHILD_CC014 answer list, excluding 'someone not listed')

1. Yes
2. No
3. Did not use any arrrangements

PAYWK
Intro CAREPAY text if speaking to ref person a typical WEEK in December ^CALENDAR_YRFIL,
how much did ^TEMPNAME or ^HISHER family pay for all of these arrangements for READ
NAMES?
Include cost of preschool and nursery school, but do not include tuition costs for kindergarten or grade
school.
Do not include money paid to household members for care arrangements such as babysitting.
If the respondent has trouble reporting the amount for a typical week, then ask: (How much did
^TEMPNAME or ^PTEMPNAME family pay any of these arrangements in the the first week of December
^CALENDAR_YRFIL?)
Child/children for Child Care:
List the names of all of the children on the TCHILD_CC answer list (exclude answer category of
"someone not listed")

PAYHELP
Sometimes a parent may pay less than the total cost of a child care arrangement because some
other person or agency pays part of the cost. By this I mean a government agency,
^PTEMPNAME employer, or someone else outside of ^HISHER household.
Did any person or agency help pay for ^PAYFILL care in December ^CALENDAR_YRFIL?
Remind the respondent to include all children under 15: (Please include all of ^PTEMPNAME children
under 15 who were living with ^TEMPNAME in December ^CALENDAR_YRFIL.)

Page 296 of 334

1. Yes
2. No

WHOPAID
What persons or agencies helped to pay for part or all of ^PTEMPNAME ^PCHILD care in
December ^CALENDAR_YRFIL?
Mark all that apply.
Remind the respondent to include all children under 15: (Please include all of ^PTEMPNAME children
under 15 who were living with ^TEMPNAME in December ^CALENDAR_YRFIL.)

1. Welfare or Social Services
2. Employer
3. Non-resident parent
4. Relative or friend
5. Other

LIST
^C_WASWERE ^TEMPNAME on a waiting list for a child care arrangement in December
^CALENDAR_YRFIL?
Remind the respondent to include all children under 15: (Please include all of ^PTEMPNAME children
under 15 who were living with ^TEMPNAME in December ^CALENDAR_YRFIL.)

1. Yes
2. No

WORKMORE
Did ^TEMPNAME have any problems in obtaining child care that prevented ^TEMPNAME from
^WRK_WRKM in December ^CALENDAR_YRFIL?
Remind the respondent to include all children under 15: (Please include all of ^PTEMPNAME children
under 15 who were living with ^TEMPNAME in December ^CALENDAR_YRFIL.)

1. Yes
2. No
Page 297 of 334

TIMELOST
^TIMELOSTINTRO much time, if any, did ^TEMPNAME lose in December ^CALENDAR_YRFIL
from work or school either because of failures in child care arrangements or because
^TEMPNAME could not find a child care provider?
Enter number. The next screen captures whether this is reported as hours, days, or weeks.

TIMELOST_TYPE
^TIMELOSTINTRO much time, if any, was lost in December ^CALENDAR_YRFIL from work or school
either because of failures in child care arrangements or because ^TEMPNAME could not find a child
care provider?
Read if necessary: Is that hours, days, or weeks?
1. Hours
2. Days
3. Weeks

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CHLD_ANY
(People in need don't always receive unrestricted cash payments from the government - they may
receive money for specific activities or other kinds of help.)
Thinking now about all months since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME ever
receive any child care services or assistance so ^HESHE could go to work or school or training?
1. Yes
2. No

CHLD_OTH_REC
question text fill
Page 298 of 334

Mark all that apply.
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

DINLNGD
Now I would like to ask you some questions about

READ NAMES.

In a typical week, how many days ^DODOES ^TEMPNAME eat dinner with
CHILDREN:
List the names of all children for whom respondent is the LNGD

0. None
Page 299 of 334

READ NAMES?

1. One day
2. Two days
3. Three days
4. Four days
5. Five days
6. Six days
7. Seven days

DINOP
In a typical week, how many days does question text for DINOP eat dinner with READ NAMES?
FR Help screen for single parents
0. None
1. One day
2. Two days
3. Three days
4. Four days
5. Five days
6. Six days
7. Seven days

READCWB
In a typical week , about how many days ^DODOES ^TEMPNAME or any family member read
stories to: READ NAMES?
Children:
Please list all children under 6 for whom the respondent is the LNGD

0. None
1. One day
2. Two days
3. Three days
4. Four days
5. Five days
6. Six days
7. Seven days
Page 300 of 334

OUTINGLNGD
In a typical week, about how many days ^DODOES ^TEMPNAME take READ NAMES on any
kind of outing, such as to the park, library, zoo, a store, church, a restaurant, or a family
gathering?
Children:
Please list all children under 6 for whom the respondent is the LNGD

0. None
1. One day
2. Two days
3. Three days
4. Four days
5. Five days
6. Six days
7. Seven days

OUTINGSOP
In a typical week, about how many days does question text for DINOP take READ NAMES on
any kind of outing, such as to the park, library, zoo, a store, church, a restaurant, or a family
gathering?
FR Help screen for single parents

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

KIDLNO
HVARKID
**NON-DISPLAY ITEM**

CARES
Page 301 of 334

^SCHCARE

1. All of the time
2. Most of the time
3. Some of the time
4. None of the time
6. Not Enrolled

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

KIDLNO
HVARKID
**NON-DISPLAY ITEM**

WORKS
^SCHWORK

1. All of the time
2. Most of the time
3. Some of the time
4. None of the time
6. Not Enrolled

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**
Page 302 of 334

KIDLNO
HVARKID
**NON-DISPLAY ITEM**

GETBY
^SCHGETBY

1. All of the time
2. Most of the time
3. Some of the time
4. None of the time
6. Not Enrolled

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

KIDLNO
HVARKID
**NON-DISPLAY ITEM**

HMWRK
^SCHHMWK

1. All of the time
2. Most of the time
3. Some of the time
4. None of the time
6. Not Enrolled

REPGRD
Page 303 of 334

C_HAVEHASCWB this/these for 6-17
any reason?

READ NAMES ever repeated a grade, or been held back for

Children:
Please list all children ages 6-17 for whom the respondent is the LNGD

1. Yes
2. No

REPGRDWHCH
(C_HAVEHASCWB this/these for 6-17
any reason?)

READ NAMES ever repeated a grade, or been held back for

Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed

Page 304 of 334

EXPSCH
C_HAVEHASCWB this/these for 6-17
from school?

READ NAMES ever been suspended, excluded, or expelled

Children:
Please list all children ages 6-17 for whom the respondent is the LNGD

1. Yes
2. No

EXPSCHWHCH
(C_HAVEHASCWB this/these for 6-17
from school?)

READ NAMES ever been suspended, excluded, or expelled

Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed

Page 305 of 334

GIFTED
C_HAVEHASCWB this/these for 6-17 READ NAMES ever gone to any special classes for gifted
students, or done advanced work in any subject?
Children:
Please list all children ages 6-17 for whom the respondent is the LNGD

1. Yes
2. No

GIFTDWHCH
(C_HAVEHASCWB this/these for 6-17 READ NAMES ever gone to any special classes for gifted
students, or done advanced work in any subject?)
Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed

Page 306 of 334

SPORT
In ^CALENDAR_YEAR, did this/these for 6-17
Either in or out of school

READ NAMES play on a sports team?

Children:
Please list all children ages 6-17 for whom the respondent is the LNGD

1. Yes
2. No

SPORTWHCH
(In ^CALENDAR_YEAR, did this/these for 6-17
school?)

READ NAMES play on a sports team, either in or out of

Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed

Page 307 of 334

LESSON
In ^CALENDAR_YEAR, did this/these for 6-17 READ NAMES take lessons after school or on
weekends in subjects like music, dance, language, computers, or religion?
Children:
Please list all children ages 6-17 for whom the respondent is the LNGD

1. Yes
2. No

LESSONWHCH
(In ^CALENDAR_YEAR, did this/these for 6-17 READ NAMES take lessons after school or on
weekends in subjects like music, dance, language, computers, or religion?)
Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed
Page 308 of 334

CLUB
In ^CALENDAR_YEAR, did this/these for 6-17 READ NAMES participate in any clubs or
organizations after school or on weekends, such as Scouts, a religious group, or a Girls' or Boys'
club?
Children:
Please list all children ages 6-17 for whom the respondent is the LNGD

1. Yes
2. No

CLUBWHCH
(In ^CALENDAR_YEAR, did this/these for 6-17 READ NAMES participate in any clubs or
organizations after school or on weekends, such as Scouts, a religious group, or a Girls' or Boys' club?)
Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed
Page 309 of 334

RELIG
In the past year, how often did READ NAMES go to a religious service, a religious social event,
or to religious education such as Sunday school?

If designated parent has more than one child and has trouble determining how often, then ask, "In the
past year, how often did ^HISHER OLDEST child go to a religious service, a religious social event, or to
a religious education such as Sunday school?"
CHILDREN
List all children ages 6-17 for whom the respondent is LNGD
1. Never
2. Several times a year
3. About once a month
4. About once a week
5. Every day or almost every day

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

AWB_INTRO
? [F1]
Next I'll ask some questions about conditions in your home, the safety of your neighborhood,
and questions about whether or not ^TEMPNAME had problems obtaining the kinds or amount of
food ^TEMPNAME needed.
1. Enter 1 to continue

AWBCRACK
I have some questions about the place where ^TEMPNAME ^WEREWAS living in ^YEAR. Were
the following conditions present:
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.
Page 310 of 334

...holes in the walls or ceiling, or cracks wider than the edge of a dime?
...holes in the floor big enough to catch your foot on?
...problems with pests such as rats, mice, roaches, or other insects?
...a toilet, hot water heater, or other plumbing that didn't work?
1. Yes
2. No

AWBHOLES
I have some questions about the place where ^TEMPNAME ^WEREWAS living in ^YEAR. Were the
following conditions present:
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.
...holes in the walls or ceiling, or cracks wider than the edge of a dime?
...holes in the floor big enough to catch your foot on?
...problems with pests such as rats, mice, roaches, or other insects?
...a toilet, hot water heater, or other plumbing that didn't work?
1. Yes
2. No

AWBPESTS
I have some questions about the place where ^TEMPNAME ^WEREWAS living in ^YEAR. Were the
following conditions present:
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.
...holes in the walls or ceiling, or cracks wider than the edge of a dime?
...holes in the floor big enough to catch your foot on?
...problems with pests such as rats, mice, roaches, or other insects?
...a toilet, hot water heater, or other plumbing that didn't work?
1. Yes
2. No

AWBPLUMB
Page 311 of 334

I have some questions about the place where ^TEMPNAME ^WEREWAS living in ^YEAR. Were the
following conditions present:
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.
...holes in the walls or ceiling, or cracks wider than the edge of a dime?
...holes in the floor big enough to catch your foot on?
...problems with pests such as rats, mice, roaches, or other insects?
...a toilet, hot water heater, or other plumbing that didn't work?
1. Yes
2. No

AWBTRAFF
Do you think any of the following conditions were problems in the neighborhood
where ^TEMPNAME lived in ^YEAR:
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.

...street noise or heavy street traffic?
...trash, litter, or garbage in the streets or lots?
1. Yes
2. No

AWBTRASH
Do you think any of the following conditions were problems in the neighborhood where ^TEMPNAME
lived in ^YEAR:
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.
...street noise or heavy street traffic?
...trash, litter, or garbage in the streets or lots?
1. Yes
2. No
Page 312 of 334

AWBSTAY
Did ^TEMPNAME stay in ^PTEMPNAME home at certain times during ^YEAR because ^HESHE
thought ^HESHE might be unsafe?
If the respondent lived in more than one place, ask for the place where they lived the longest or spent
the most time. Record persistent conditions, or conditions that were present for the majority of the time.

1. Yes
2. No

AWBSAFE
Was ^PTEMPNAME neighborhood in ^YEAR

Read answer categories?

1. Very safe
2. Somewhat safe
3. Somewhat unsafe
4. Very unsafe

AWBMORT
Next are questions about difficulties people sometimes have in meeting their essential household
expenses.
During ^YEAR, was there ANY time when ^YOUYOURHOUSEHOLD_ADULT_WB :
....did not pay the full amount of the rent or mortgage?
....did not pay the full amount of the gas, oil, or electricity bill?
If respondent owns the residence free and clear, enter '2' and continue.
1. Yes
2. No

AWBGAS
Next are questions about difficulties people sometimes have in meeting their essential household
expenses.
During ^YEAR, was there ANY time when ^YOUYOURHOUSEHOLD_ADULT_WB :
....did not pay the full amount of the rent or mortgage?
Page 313 of 334

....did not pay the full amount of the gas, oil, or electricity bill?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

FOODF1
These next questions are about whether ^TEMPNAME could afford the food ^HESHE needed
during ^CALENDAR_YEAR. I'm going to read you some statements that people have made about
their food situations.
The first statement is, "The food that ^IWE_FOOD bought just didn't last, and ^IWE_FOOD didn't
have money to get more." Was that often, sometimes, or never true for
^YOUYOURHOUSEHOLD_ADULT_WB in ^CALENDAR_YRFIL?

1. Often true
2. Sometimes true
3. Never true

FOODF2
^C_IWE_FOOD couldn't afford to eat balanced meals." Was that often, sometimes, or never true
for ^YOUYOURHOUSEHOLD_ADULT_WB in ^YEAR?
1. Often true
2. Sometimes true
3. Never true

FOODF3
In ^YEAR, did ^YOUOTHERADULTS_FOOD ever cut the size of meals or skip meals because
there wasn't enough money for food?
Page 314 of 334

1. Yes
2. No

FOODF4
How often did this happen

Read answer categories?

1. Almost every month
2. Some months but not every month
3. Only 1 or 2 months

FOODF5
In ^YEAR, did ^TEMPNAME ever eat less than ^HESHE felt you should because there wasn't
enough money for food?
1. Yes
2. No

FOODF6
In ^YEAR, ^WEREWAS ^TEMPNAME ever hungry but didn't eat because there wasn't enough
money for food?
1. Yes
2. No

RIP
? [F1]
^RIPINTRO_W2_FIL

We will recontact this household in the future to update information. We would like to
^RIPYES_FIL use some of the information you have provided today to make that interview
shorter and more efficient. When we come back next time, whether we speak to you or someone
else you are living with, is it OK if we use some of your answers as a starting point?
(Only a limited amount of information (such as whether you attended school and whether you are
married) is passed forward into the next interview.)
To see a comprehensive list of content that would be passed forward, see the Help Screen.
Page 315 of 334

1. Yes
2. No

NEXT_ADULT_INT
^QSTNTXT_NEXTADLTINT
1. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
2. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
3. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
4. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
5. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
6. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
7. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
8. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
9. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
10. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
11. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
12. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
13. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
14. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
15. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
16. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
17. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
18. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
19. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
20. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
99. No more people with an incomplete interview

INT_TYPE
^QSTNTXT_INTTYPE
1. Self
2. Proxy - Other household member is able to conduct interview
3. TYPE Z - Not available during the entire interview period

PROXY_INT
Ask if necessary.
Page 316 of 334

Who will be answering for ^PROXY_INT_NAMEFIL?

1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
3. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
4. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
5. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
6. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
7. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
8. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
9. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
10. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
11. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
12. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
13. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
14. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
15. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
16. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
17. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
18. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
19. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1

CARICON2
This interview may be recorded for quality control purposes. Is that O.K.?
1. Yes
2. No

EHC_INTRO
In this section of the interview, we are interested in ^YOURHISHER residence, income, and other
circumstances since ^MONTH1 1st ^CALENDAR_YRFIL.
Enter 1 to continue.

1. Enter 1 to continue
Page 317 of 334

WHY_TYPEZ
Why is ^INT_PERSON_NAMEFIL not available to be interviewed? Is ^HESHE ill or in the hospital,
temporarily away from home, or is there some other reason?
1. Person was ill or in the hospital
2. Person was temporarily away from home
3. Other

TYPEZ_SPECIFY
What is the other reason?

CTRLNUM
**NON-DISPLAYED ITEM**

FIN
This case is not completed.
Enter 1 to continue.
1. Enter 1 to continue

WHO_SPEAK_WITH
Do not read to the respondent.
Select the person (based on his/her line number) with whom you are speaking right now.

1. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
2. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
3. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
4. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
5. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
6. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
7. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
8. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
9. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
10. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
Page 318 of 334

11. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
12. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
13. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
14. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
15. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
16. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
17. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
18. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
19. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
20. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

TELEPHONE_NO
Ask or verify.
What is the telephone number where ^TEMPNAME would like to be called?

TELEPHONE_TYPE
What type of telephone is it?

1. Home
2. Work
3. Cellular or digital
Page 319 of 334

4. Beeper/Pager/Answering service
5. Public (pay phone)
6. Toll free
7. Phone outside the household (relative, friend, etc.)
8. Other

SEC_TELEPHONE_NO
Ask or verify.
What is the second telephone number where ^TEMPNAME would like to be called?

SEC_TELEPHONE_TYPE
What type of telephone is it?

1. Home
2. Work
3. Cellular or digital
4. Beeper/Pager/Answering service
5. Public (pay phone)
6. Toll free
7. Phone outside the household (relative, friend, etc.)
8. Other

BEST_TIME_CONTACT
Ask or verify.
When is the best time to contact ^TEMPNAME?
Do not read answer categories.

1. Morning (9am - 12 noon)
2. Noon/lunchtime (11:00am - 1pm)
3. Afternoon (12 noon - 4pm)
4. Suppertime/early evening/dinner time (4pm - 7pm)
5. Evening (6pm - 9pm)
6. Anytime (9am - 9pm)
7. Late evening/night (7pm - 9pm)
Page 320 of 334

8. Daytime (9am - 4pm)
9. After 5pm
10. Other

CONT_PSN1_FNAME
Ask or verify.
What is the first name of a close relative or friend, not currently living at this address, who would
know how to reach ^TEMPNAME if we are unable to do so?

CONT_PSN1_LNAME
Ask or verify.
What is this person's last name?

CONT_PSN1_REL
Ask or verify.
What is this person's relationship to ^TEMPNAME?

CONT_PSN1_TELENO
What is this person's telephone number?
Include the area code, prefix, suffix, and the extension (if one exists).

CONT_PSN1_PO
Ask or verify.
In what city does this person live?

CONT_PSN1_ST
Ask or verify.
In what state does this person live?

1. Alabama
Page 321 of 334

2. Alaska
3. American Samoa
4. Arizona
5. Arkansas
6. California
7. Colorado
8. Connecticut
9. Delaware
10. District of Columbia
11. Florida
12. Georgia
13. Guam
14. Hawaii
15. Idaho
16. Illinois
17. Indiana
18. Iowa
19. Kansas
20. Kentucky
21. Louisiana
22. Maine
23. Maryland
24. Massachusetts
25. Michigan
26. Minnesota
27. Mississippi
28. Missouri
29. Montana
30. Nebraska
31. Nevada
32. New Hampshire
33. New Jersey
34. New Mexico
35. New York
36. North Carolina
37. North Dakota
38. Northern Marianas
39. Ohio
40. Oklahoma
Page 322 of 334

41. Oregon
42. Other place
43. Pennsylvania
44. Puerto Rico
45. Rhode Island
46. South Carolina
47. South Dakota
48. Tennessee
49. Texas
50. U.S. Virgin Islands
51. Utah
52. Vermont
53. Virginia
54. Washington
55. West Virginia
56. Wisconsin
57. Wyoming

MOVING_INTENT
^DODOES ^TEMPNAME have any plans to move in the next year?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**
Page 323 of 334

MOVING_ST
What is the new state going to be?
1. Alabama
2. Alaska
3. American Samoa
4. Arizona
5. Arkansas
6. California
7. Colorado
8. Connecticut
9. Delaware
10. District of Columbia
11. Florida
12. Georgia
13. Guam
14. Hawaii
15. Idaho
16. Illinois
17. Indiana
18. Iowa
19. Kansas
20. Kentucky
21. Louisiana
22. Maine
23. Maryland
24. Massachusetts
25. Michigan
26. Minnesota
27. Mississippi
28. Missouri
29. Montana
30. Nebraska
31. Nevada
32. New Hampshire
33. New Jersey
34. New Mexico
35. New York
36. North Carolina
37. North Dakota
Page 324 of 334

38. Northern Marianas
39. Ohio
40. Oklahoma
41. Oregon
42. Other place
43. Pennsylvania
44. Puerto Rico
45. Rhode Island
46. South Carolina
47. South Dakota
48. Tennessee
49. Texas
50. U.S. Virgin Islands
51. Utah
52. Vermont
53. Virginia
54. Washington
55. West Virginia
56. Wisconsin
57. Wyoming

MOVING_PO
What is the new city going to be?

MOVING_REASON
Does the respondent plan to move:
Read answer list
1. Outside the U.S.
2. Inside the U.S., to an unknown state
3. Inside the U.S., to an institution

LTRADDR
To whom should future correspondence be addressed?
You may only select original sample people to receive future correspondence.

Page 325 of 334

Read names if necessary.

1. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
2. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
3. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
4. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
5. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
6. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
7. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
8. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
9. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
10. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
11. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
12. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
13. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
14. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
15. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
16. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
17. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
18. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
19. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
20. Display the ^LNO, ^FNAME, ^LNAME, where AGE >= 15
99. No one

PHONE_INT
Is a telephone interview acceptable?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

CALLBACK_TODAY
I'd like to schedule a return visit to finish conducting the interview. When should I come back to
complete the interview?
Page 326 of 334

Enter 1 if the respondent gives you a time for later today.
Enter 2 if the respondent give you a day in the future.

1. Enter a time (for later today)
2. Enter a date (for a later date)

TODAY_TIME
What time today?

CALLBACK_DATE
What DATE and TIME would be best to visit again to conduct the interview?
Enter the date (MM/DD/YYYY).

CALLBACK_TIME
(What DATE and TIME would be best to visit again to conduct the inteview?)
Enter the time (hour, minutes, and am/pm).

THANKYOU_CALLBACK
Thank you for your help. I will come back at the time suggested.
^CALLBACKAPPTFIL
Enter 1 to continue.

1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

BCINFO
Page 327 of 334

Was the noninterview status determined by observation only or did someone provide you with
information about the housing unit?

1. By observation only
2. Information provided by someone else

BCINFO2_MONTH
Enter the month in which the household left the sample.
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

BCINFO2_DAY
Enter the day in which the household left the sample.

BCINFO2_FN
Enter the first name of the person providing the noninterview status.

BCINFO2_LN
Page 328 of 334

Enter the last name of the person providing the noninterview status.

BCINFO2_CPREL
Enter the title of the contact person (relative, neighbor, etc.).

BCINFO2_STRNUM
Enter the street number (including any unit designation) of the contact person's address.

BCINFO2_STRNME
Enter the street name of the contact person's address.

BCINFO2_PO
Enter the city of the contact person's address.

BCINFO2_ST
Enter the state of the contact person's address.
AL. Alabama
AK. Alaska
AZ. Arizona
AR. Arkansas
CA. California
CO. Colorado
CT. Connecticut
DC. District of Columbia
DE. Delaware
FL. Florida
GA. Georgia
HI. Hawaii
ID. Idaho
IL. Illinois
IN. Indiana
IA. Iowa
KS. Kansas
KY. Kentucky
LA. Louisiana
Page 329 of 334

ME. Maine
MD. Maryland
MA. Massachusetts
MI. Michigan
MN. Minnesota
MS. Mississippi
MO. Missouri
MT. Montana
NE. Nebraska
NV. Nevada
NH. New Hampshire
NJ. New Jersey
NM. New Mexico
NY. New York
NC. North Carolina
ND. North Dakota
OH. Ohio
OK. Oklahoma
OR. Oregon
PA. Pennsylvania
RI. Rhode Island
SC. South Carolina
SD. South Dakota
TN. Tennessee
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
WA. Washington
WV. West Virginia
WI. Wisconsin
WY. Wyoming

BCINFO2_ZIP
Enter the zip code of the contact person's address.

BCINFO2_ZIP4
Enter the 4-digit zip code of the contact person's address.
Page 330 of 334

BCINFO2_AR
Enter the area code of the contact person's telephone number.

BCINFO2_NO
Enter the contact person's telephone number.

BCINFO2_EXT
Enter any extension to the contact person's telephone number (if applicable).

CTRLNUM
**NON-DISPLAYED ITEM**

TRANSMIT
Do not read to the respondent.
Are you ready to transmit the case?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

WHY_TYPEZ_HHLD
^TYPEZHHLDQSTNTXTFIL

1. Person was ill or in the hospital
2. Person was temporarily away from home
3. Other

TYPEZ_SPECIFY
What is the other reason?

Page 331 of 334

CTRLNUM
**NON-DISPLAYED ITEM**

OTHER_NAME
Do not read to the respondent.
Identify the person who responded to the majority of this interview.

1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
3. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
4. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
5. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
6. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
7. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
8. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
9. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
10. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
11. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
12. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
13. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
14. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
15. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
16. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
17. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
18. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
19. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME

THANKYOU
Thank you for your participation. Since this is a survey that measures economic change over
time, we recontact respondents annually to update their information. However, this fall, another
U.S. Census Bureau interviewer may also contact you on behalf of the Social Security
Administration. The Social Security Administration needs information from households like
yours to manage and improve their programs. Also, as part of our quality assurance program,
my office may contact you in the next several weeks to verify the quality of my work. Thank you
again.
Enter 1 to continue.
Page 332 of 334

1. Enter 1 to continue

CHECKOUT
**NON-DISPLAYED ITEM**

VISIT_COUNT
How many times have you attempted personal contact (actually visited the address)?

INT_MODE
Was ^MAJORITY_FIL this interview done by telephone interview or by personal interview?

1. Telephone interview
2. Personal interview

SPANISH_INT
Did you conduct any of this household's interview in Spanish?

1. Yes
2. No

LANGUAGE
What language is spoken in this household that prevented you from conducting the interview?
1. Spanish or Spanish Creole
2. Chinese
3. French (including Patois, Cajun)
4. French Creole
5. Tagalog, Filipino
6. Vietnamese
7. German
8. Korean
9. Russian
10. Italian
Page 333 of 334

11. Hindi, Urdu
12. Arabic
13. Portuguese or Portuguese Creole
14. Polish
15. Persian
16. Gujarati
17. Other

SHOWFINAL
MODE: ^INT_MODEFIL
OUTCOME: ^OUTCOMEFIL
MARK: ^MARKFIL
MARKTWO: ^MARKTWOFIL
Enter 1 to continue.
1. Enter 1 to continue

Page 334 of 334
File Type	application/pdf
File Modified	0000-00-00
File Created	2013-07-25