Form Attachment A Attachment A Survey Protocol

Attachment A: Survey content

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Welcome! Thanks for your interest in this survey. We will be asking you about your experience with certain expenses, so before we can get started we need to ask you a few questions to determine if you are eligible to participate.

Screener for Group 1 (All responses must match *):
Do you have a mortgage for your home?
Yes*
No

Do you own a vehicle?
Yes*
No

Do you have any education expenses? Please include daycare expenses and payments on education loans.
Yes*
No

How familiar are you with your household’s home ownership, vehicle, and education expenses?
Very familiar*
Somewhat familiar*
Not at all familiar

Screener for Group 2 (All responses must match *):
Which category best describes the regularity of your income? (1/2 sample of each)
My income is regular - it stays pretty much the same from paycheck to paycheck
My income is irregular - the amount changes frequently

Do you have health insurance?
Yes*
No

Have you or anyone in your household had any medical expenses in the last three months?
Yes*
No

How familiar are you with your household’s income and expenses for health insurance and medical care?
Very familiar*
Somewhat familiar*
Not at all familiar

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If not eligible:

Thank you for your time, but you do not meet the qualifications for this study.

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If eligible:

Great! You have the experience we are looking for.

We need your help to improve instructions on a national survey on household spending.

On the following pages, you’ll be asked about how you organize and access your household’s financial records. We won’t ask about your expenses – we just want to know what information you have stored online and whether and how you would access it during an interview.

The survey should take no more than 20 minutes. Please do not use your browser’s back button.

This voluntary study is being collected by the Bureau of Labor Statistics under OMB No. 1220-0141. This survey will take no more than 20 minutes to complete. Your participation is voluntary, and you have the right to stop at any time. This survey is being administered by Qualtrics and resides on a server outside of the BLS domain. The BLS cannot guarantee the protection of survey responses and advises against the inclusion of sensitive personal information in any response. By proceeding, you give your consent to participate in this study.

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If you wanted to look up an expense from the last 12 months, where would you find it?
Mark all that apply.

Paper includes bills or statements you got in the mail, checkbooks, receipts, a ledger or any other record that you have a hard copy for.
Electronic includes e-mail receipts, bills or statements you access online, account history on an app or website.
If you had that expense but no longer have a record of it, select No Record.
Hover over the headers in the tables to see these definitions.

If you’ve never had that expense, select No Expense.

Group 1:

Housing	No Expense	Paper	Electronic	No Record
Mortgage total amount paid	[radio]	[check]	[check]	[check]
Mortgage, of total amount, interest paid
Mortgage, total amount owed before last payment
Regular payments to a homeowners or condo association
Special payments to management service
Special assessments to local government for construction, repair of roads, sidewalks or other things like that
Ground or land rent
Total monthly rental payments for all rented properties

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If you wanted to look up an expense from the last 12 months, where would you find it?
Mark all that apply.

Phone/Cable/Internet and Utilities	No Expense	Paper	Electronic	No Record
Residential telephone, including Voice over IP	[radio]	[check]	[check]	[check]
Cellular phone service
Pre-paid long distance telephone cards/minutes
Internet connection
Cable or satellite TV
Satellite radio services
Electricity
Natural gas
Fuel oil
Bottled or tanked gas
Other fuels (wood, coal, etc.)
Water and sewerage maintenance
Trash/Garbage collection
Septic tank cleaning
Water softening service

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If you wanted to look up an expense from the last 12 months, where would you find it?
Mark all that apply.

Education	No Expense	Paper	Electronic	No Record
Tuition (including daycare and college)	[radio]	[check]	[check]	[check]
Food or board while attending school
Test preparation or tutoring services
Purchase of any school books, reference books, supplies, or equipment
Support for college students
School bus

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If you wanted to look up an expense from the last 12 months, where would you find it?
Mark all that apply.

Vehicle purchase and maintenance	No Expense	Paper	Electronic	No Record
Purchase or lease of cars or trucks	[radio]	[check]	[check]	[check]
Purchase or lease of RVs and recreational vehicles
Sale of any vehicle
Rental of any vehicle
Vehicle maintenance or repair expenses
Vehicle insurance
Vehicle registration
Vehicle inspection
Driver’s license fees
Towing charges

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If you wanted to look up an expense from the last 12 months, where would you find it?
Mark all that apply.

Legal, financial, and other	No Expense	Paper	Electronic	No Record
Legal fees	[radio]	[check]	[check]	[check]
Bank account charges
Credit card memberships or annual fees
Child support and alimony
Contributions to charities and organizations

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Group 2:

Medical and health	No Expense	Paper	Electronic	No Record
Physician, dental, and eye care services	[radio]	[check]	[check]	[check]
Care of invalids and elderly
Hospital rooms and hospital services
Eyeglasses and hearing aids
Medical equipment – purchase, repair, rental

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If you wanted to look up an expense from the last 12 months, where would you find it?
Mark all that apply.

Insurance policies	No Expense	Paper	Electronic	No Record
Health insurance, amount spent on premiums, including payroll deductions	[radio]	[check]	[check]	[check]
Medicare Prescription Drug plan monthly premium
Life insurance (or other policies that provide benefits in case of death or disability) premium
Long term care insurance premium
Homeowner's or renter's insurance premium
Other (non-vehicle nor property) insurance premium

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If you wanted to look up an expense from the last 12 months, where would you find it?
Mark all that apply.

Income for the last 12 months	No Expense	Paper	Electronic	No Record
Wages, salary, tips, bonuses, or commissions	[radio]	[check]	[check]	[check]
Self-employment income or loss
Supplemental Security Income (SSI) payments
Social Security or Railroad Retirement benefits
Retirement plan such as an Individual Retirement Account (IRA) or Keogh
Amount of last pay before any deductions
Deductions from pay
Employer or union contributions to a pension or retirement plan
Welfare payments or cash assistance from state or local welfare office
Cash value of food stamps or Electronic Benefit Transfers (EBT) received
Regular income from other sources, such as veterans’ (VA) payments, unemployment compensation, child support, or alimony
Lump-sum payments from insurance, estates, trusts, royalties, child support, alimony, prize or games of chance, or from people outside of the household
Other money income, including from cash scholar-ships and fellowships, stipends not based on working and the care of foster children

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If you wanted to look up an expense from the last 12 months, where would you find it?
Mark all that apply.

Assets and liabilities for the last 12 months	No Expense	Paper	Electronic	No Record
Retirement accounts such as 401(k)s, IRAs, and Thrift Savings Plans	[radio]	[check]	[check]	[check]
Directly-held stocks, bonds, and mutual funds not in retirement accounts
Checking, savings, money market accounts, and certificates of deposit or CDs
Whole life insurance or other life insurance policies that can be surrendered for cash or borrowed against prior to the death of the person insured
Other financial assets, such as annuities, trusts, and royalties
Balance on any major credit cards including store cards and gas cards
Student loans
Other debt such as medical loans or personal loans

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All participants:

We are particularly interested in the kinds of electronic records that people keep and how people access them. Below are the expenses that you said you had electronic records for. Please tell us how you would typically find your statements and records.
Mark all that apply.

[Repeat the same blocks shown previously, all on one screen with no page breaks. Include only expenses (rows) for which the participant said they have electronic records.]

[Name of expenditure category]	Financial software (not online)	E-mail	Online account that you can access	Online account that someone else in the household can access	App on your phone	Other
[Name of expenditure]	[check]	[check]	[check]	[check]	[check]	[text entry]

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Thanks for that information. Now we’d like to learn about how you would use electronic records in an interview.

We will be using your feedback to decide what is reasonable to ask of our respondents. Please consider the questions carefully and give your honest feedback. Focus on what you would actually do - not a friend or anyone else.

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Think about an interview that:

• Takes place in your home.

• Is conducted by a U.S. Census Bureau interviewer.

• Is completely confidentially- no one would be able to identify you or your expenses.

• Is not mandatory.

• Is private; if you choose to use records during the interview, you would not have to share them with anyone else.

During an interview like that, which electronic records would you use to answer questions about your expenses?

[Repeat the same blocks shown previously, all on one screen with no page breaks. Include only expenses (rows) for which the participant said they have electronic records.]

[Name of expenditure category]	Would Use	Would Not Use	Reason (optional)
[Name of expenditure]	[check]	[check]	[text entry]

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[Display only if said would use at least one expense, above]

And how would you use these electronic records during the interview?

Mark all that apply.

-Print them before the interview

-Take screenshots before the interview

-Email them to myself before the interview

-Log in to the accounts as needed during the interview

-[open text entry]

-[open text entry]

-[open text entry]

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Would you store and share your electronic records with us in an online, secure data storage bank? This cloud storage would be maintained by the U.S. Census Bureau.
Yes
No

Consider the cloud storage features listed below. Please mark all the features that you would want or expect to be provided.
Mark all that apply.

• No one would know that I was using the cloud or know which files were mine

• No one would be able to steal my information

• No one, not even my interviewer, could look at my files without my permission

• My interviewer would be able to look at my files before my interview

• I would have to create a username and password

• I would be able to access the cloud on my smartphone through a mobile-friendly website to upload and view files

• I would be able to e-mail my files to a secure e-mail address and have them show up in my account

• I would be able to download a smartphone app to upload and view files

• I would be able to link information from my other apps, like Mint or my bank account

• I would be able to black-out or redact any private information that I didn’t want to share

• I would be instructed on how to label the files so that it was easy to use them during the interview

• My interviewer would be able to look at my files on her computer during my interview

• [open text entry]

• [open text entry]

• [open text entry]

In the future, we may be able to automatically read the information we need from records that you upload to an online data storage bank. Instead of meeting us in-person for an interview, you could just upload your files instead. Would you be willing to do that?

Yes
No

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And now just a few questions about yourself.

1. In what year were you born?

[open text box; numeric]

2. What is your sex?

Male
Female

3. Are you Hispanic or Latino?

Yes
No

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

American Indian or Alaska native

Asian

Black or African American

Native Hawaiian or Pacific Islander

White

5. What is the highest degree you have received?

No schooling completed
Elementary school diploma
High school diploma or the equivalent (GED)

Associate degree

Bachelor’s degree

Master’s degree

Professional or doctorate degree

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Thanks very much for your responses. Your feedback will help us to improve our surveys.

Your HIT verification code is:

[random numeric code]

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