Passport Demand Forecasting Study

Passport Forecast Study Questionnaire – Introductions, Screeners, and
Core & Demographic Questions
INTRO
Hello. I am (FIRST NAME, LAST NAME) calling on behalf of the U.S.
Department of State, Passport Services.
We are conducting interviews with Americans ages 18 and older to help the
Department of State better serve the American public’s need for passport
services in the coming months and years. We mailed a letter about this
study to your household (a couple days ago/last week/at the beginning of
the month).Do you recall seeing that letter?
IF REQUESTED: Additional Information on the study can be found by in the
Federal Register under the OMB control # 1405-0177, expiration date
7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10
minutes. If you have comments regarding the interview length or content,
please email [email protected]
[IF NEEDED: I am calling from STR, a public opinion research firm located in
the greater Philadelphia area. We are conducting the research on behalf of
the U.S. Department of State, Passport Services.]
[IF NEEDED: Whether you/your household require passport services or not,
your participation in this study can help improve customer service, allocate
sufficient personnel; develop new products and plan for what citizens require .
]
[IF NEEDED: Your household was selected at random. It is important a person
who is knowledgeable about the travel habits of your household to complete
the interview.]
[IF NEEDED: We will not ask for your name. Your answers are anonymous and
confidential and will not be linked to any personally identifying information.
All answers from all participants are combined together to form statistical
summaries.]
a) YES
b) NO
c) DON’T KNOW

SKIP TO ADULT

OMB
Your participation, while voluntary, will be essential to the success of the
study. This interview is estimated to take less than 10 minutes to
1

complete. We will not ask your name. Your answers will be kept private to
the extent permitted by law and identifying information will not be released
outside of the Department of State. All answers from all participants are
combined together to form statistical summaries . If you want additional
information, I can provide that to you now or at the end of the interview.
IF REQUESTED: Additional Information on the study can be found by in the
Federal Register under the OMB control # 1405-0177, expiration date
7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10
minutes. If you have comments regarding the interview length or content,
please email [email protected].
[IF NEEDED: I am calling from STR, a public opinion research firm located in
the greater Philadelphia area. We are conducting the research on behalf of
the U.S. Department of State, Passport Services.]
[IF NEEDED: Whether you/your household require passport services or not,
your participation in this study can help improve customer service, allocate
sufficient personnel; develop new products and plan for what citizens require.]
[IF NEEDED: Your household was selected at random. It is important a person
who is knowledgeable about the travel habits of your household to complete
the interview.]
[IF NEEDED: We will not ask for your name. Your answers are anonymous and
confidential and will not be linked to any personally identifying information.
All answers from all participants are combined together to form statistical
summaries.]
ENTER A TO CONTINUE

ADULT
Before we continue, please confirm that you are an adult, that is, you are at
least 18 years old or older?
a)YES, ADULT ON PHONE
SKIP TO RESPONDENT
b)NO, ADULT COMING TO PHONE
c)NO, NO ADULT HOME NOW

SKIP TO CALLBACK SCHEDULING

d)NO ADULT LIVES IN THE HOUSEHOLD

INTRO1

2

CODE AS INELIGIBLE

Hello. I am (FIRST NAME, LAST NAME) calling on behalf of the U.S.
Department of State, Passport Services.
We are conducting interviews with Americans ages 18 and older to help the
Department of State better serve the American public’s need for passport
services in the coming months and years. We mailed a letter about this
study to your household (a couple days ago/last week/at the beginning of
the month). Do you recall seeing that letter?
IF REQUESTED: Additional Information on the study can be found by in the
Federal Register under the OMB control # 1405-0177, expiration date
7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10
minutes. If you have comments regarding the interview length or content,
please email [email protected].
[IF NEEDED: I am calling from STR, a public opinion research firm located in
the greater Philadelphia area. We are conducting the research on behalf of
the U.S. Department of State, Passport Services.
]
[IF NEEDED: Whether you/your household require passport services or not,
your participation in this study can help improve customer service, allocate
sufficient personnel; develop new products and plan for what citizens require.]
[IF NEEDED: Your household was selected at random. It is important a person
who is knowledgeable about the travel habits of your household to complete
the interview.]
[IF NEEDED: We will not ask for your name. Your answers are anonymous and
confidential and will not be linked to any personal ly identifying information.
All answers from all participants are combined together to form statistical
summaries.]
a)YES
b)NO
c)DON’T KNOW

SKIP TO ADULT1

OMB1
Your participation, while voluntary, will be essential to the success of the
study. This interview is estimated to take less than 10 minutes to
complete. We will not ask your name. Your answers will be kept private to
the extent permitted by law and identifying information will not be released
outside of the Department of State. All answers f rom all participants are
combined together to form statistical summaries. If you want additional
information, I can provide that to you now or at the end of the interview.
IF REQUESTED: : Additional Information on the study can be found by in
the Federal Register under the OMB control # 1405-0177, expiration date
7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10
3

minutes. If you have comments regarding the interview length or content,
please email [email protected].
[IF NEEDED: I am calling from STR, a public opinion research firm located in
the greater Philadelphia area. We are conducting the research on behalf of the
U.S. Department of State, Passport Services.]
[IF NEEDED: Whether you/your household require passport services or not,
your participation in this study can help improve customer service, allocate
sufficient personnel; develop new products and plan for what citizens require.]
[IF NEEDED: Your household was selected at random. It is important a person
who is knowledgeable about the travel habits of your household to complete
the interview.]
[IF NEEDED: This data collection consists of a voluntary interview. We will not
ask for your name. Your answers will be kept private to the extent permitt ed
by law and identifying information will not be released outside the Department
of State. All answers from all participants are combined together to form
statistical summaries.]
ENTER A TO CONTINUE TO ADULT 1

RESPONDENT
Are you able to answer a few basic questions about the general travel habits
of your household?
[IF NEEDED: It is just basic questions such as whether each person has a
passport or intends to get a passport.]
[IF NEEDED: This interview takes only about 10 minutes to complete. Let’s
get started.]
a)
b)
c)
d)

YES
NO
DON’T KNOW
REFUSED

SKIP TO CORE Q1
SKIP TO CORE Q1
CODE AS REFUSAL

KNOWR
May I please speak with the adult household member who would be more
knowledgeable about the general travel habits of your household?
a) YES, COMING TO PHONE
b) NO, NOT AVAILABLE NOW

SKIP TO CALLBACK SCHEDULING
4

c) REFUSED

CODE AS REFUSAL

INTRO2
Hello. I am (FIRST NAME, LAST NAME) calling on behalf of the U.S.
Department of State, Passport Services.
We are conducting interviews with Americans ages 18 and older to help the
Department of State better serve the American public’s need for passport
services in the coming months and years. We mailed a letter about this
study to your household (a couple days ago/last week/at the beginning of
the month). Do you recall seeing that letter?
IF REQUESTED: Additional Information on the study can be found by in the
Federal Register under the OMB control # 1405-0177, expiration date
7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10
minutes. If you have comments regarding the interview length or content,
please email [email protected].
[IF NEEDED: I am calling from STR, a public opinion research firm located in
the greater Philadelphia area. We are conducting the research on behalf of the
U.S. Department of State, Passport Services.]
[IF NEEDED: Whether you/your household require pass port services or not,
your participation in this study can help improve customer service, allocate
sufficient personnel; develop new products and plan for what citizens require.]
[IF NEEDED: Your household was selected at random. It is important a person
who is knowledgeable about the travel habits of your household to complete
the interview.]
[IF NEEDED: We will not ask for your name. Your answers are anonymous and
confidential and will not be linked to any personally identifying information.
All answers from all participants are combined together to form statistical
summaries.]
a) YES
b) NO
c) DON’T KNOW

SKIP TO ADULT2

OMB2
Your participation, while voluntary, will be essential to the success of the
study. This interview [use “questionnaire” for web version?] is estimated to
take less than 10 minutes to complete. If you want additional information, I
can provide that to you now or at the end of the interview.

5

IF REQUESTED: : Additional Information on the study can be found by in
the Federal Register under the OMB control # 1405-0177, expiration date
7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10
minutes. If you have comments regarding the interview length or content ,
please email [email protected].
[IF NEEDED: I am calling from STR, a public opinion research firm located in
the greater Philadelphia area. We are conducting the research on behalf of
the U.S. Department of State, Passport Services.]
[IF NEEDED: Whether you/your household require passport services or not,
your participation in this study can help the Department of State to improve
customer service, allocate sufficient personnel; develop new products and plan
for what citizens require. ]
[IF NEEDED: Your household was selected at random. It is important a
person who is knowledgeable about the travel habits of your household
complete the interview.]
[IF NEEDED: We will not ask for your name. Your answers are anonymous and
confidential and will not be linked to any personally identifying information.
All answers from all participants are combined together to form statistical
summaries.]
ENTER A TO CONTINUE TO ADULT2
ADULT2
Before we continue, please confirm that you are an adult, that is, you are
at least 18 years old or older?

a) YES, ADULT ON PHONE
b) NO, ADULT COMING TO PHONE
c) NO, NO ADULT HOME NOW

SKIP TO INTRO2…
SKIP TO CALLBACK

SCHEDULING
d) NO ADULT LIVES IN THE HOUSEHOLD

CODE AS INELIGIBLE

RESPONDENT1
Are you able to answer a few basic questions about the general travel habits
of your household?
[IF NEEDED: It is just basic questions such as whether each person has a
passport or intends to get a passport.]
[IF NEEDED: This interview takes only about 10 minutes to complete. Let’s
get started.]
6

a)
b)
c)
d)

YES
NO
DON’T KNOW
REFUSED

SKIP TO CORE Q1
SKIP TO KNOWR1…
SKIP TO CORE Q1
CODE AS REFUSAL

7

Web Intro:
We are conducting interviews with Americans ages 18 and older to help the
Department of State better serve the American public’s need for passport services
in the coming months and years. Your household was selected at random. It is
important for a person who is knowledgeable about the travel habits of your
household to complete this interview. Your participation, while voluntary, will be
essential to the success of the study. Your responses are confidential and
individual responses will not be used to identify respondents for any
purposes.
Thank you for participating in this important research!

CORE - PASSPORT FORECAST SECTION
1. Do you currently have a valid:
a) U.S. passport BOOK (valid for international air, land, or sea travel),
b) U.S. passport CARD (sized like a driver’s license and vali d for land and
sea travel only),
c) Both a U.S. passport book and card,
d) Or do you not currently have any valid U.S. passport?

Which of the following do you currently have?
Valid U.S. passport BOOK(valid for international air, land, or sea travel)

Valid U.S. passport CARD(sized like a driver's license and valid for land and sea
travel only)
Both a valid U.S. passport book and valid passport card
None of the above

8

2. When did you last get a new or renewed passport? Was it:
a) Within the last 12 months,
b) 1 year to less than 2 years ago,
c) 2 years to less than 3 years ago,
d) 3 years to less than 4 years ago,
e) 4 years to less than 10 years ago,
f) 10 or more years ago,
g) Or have you never had a U.S. passport?Skip to PASSPORT FORECAST
Q4
h) DON’T KNOW
i) REFUSED

When did you last get a new or renewed passport? Was it:
Within the last 12 months
1 year to less than 2 years ago
2 years to less than 3 years ago
3 years to less than 4 years ago
4 years to less than 10 years ago
I have never had a U.S. passport.
Don't know

3. Which of the following best describes how you applied for your most recent
U.S. passport (new or renewed, book or card):
a) Filled out the forms in person at a U.S. Passport Agency location ,
b) Filled out the forms in person at a Post Office,
c) Filled out the forms in person at a city hall, court house, or other
government office (not a U.S. Passport Agency location or Post Office),
d) Filled out the forms myself and then mailed them in, or
e) Some other way?
f) DON’T KNOW
g) REFUSED

9

Which of the following best describes how you applied for your most recent U.S.
passport (new or renewed, book or card)?
Filled out the forms in person at a U.S. Passport Agency location
Filled out the forms in person at the Post Office
Filled out the forms in person at a city hall, court house, or other government
office (not a U.S. Passport Agency location or Post Office)
Filled out the forms myself and then mailed them in
I applied in some other way.
Don't know

4. Do you plan to apply for either a new, renewed or replacement U.S.
passport at some point in the next three years?
a) YES
b) NO Skip to PASSPORT FORECAST Q8
c) DON’T KNOWSkip to PASSPORT FORECAST Q8
d) REFUSEDSkip to PASSPORT FORECAST Q8

Do you plan to apply for either a new, renewed or replacement U.S. passport at some
point in the next three years?
Yes
No
Don't know

4a.

Will that be a:
a) Passport book,
b) Passport card, or
 Skip to PASSPORT FORECAST 5b
c) both a passport book and card?
d) DON’T KNOW
e) REFUSED

10

When you apply for a renewal, for which of the following will you apply?

Passport book
Passport card
Both a passport book AND card
Don't know

5a.
When might you apply for a new, renewed, or replacement U.S. passport
book? Would you say:
a) I’ve already applied for and am waiting to receive it , IF 4a = a, Skip to
PASSPORT FORECAST Q8
b) In the next 6 months, IF 4a = a, Skip to PASSPORT FORECAST Q6a
c) In the next 7-12 months, IF 4a = a, Skip to PASSPORT FORECAST Q6a
d) In more than 1 year to less than 2 years, orIF 4a = a, Skip to
PASSPORT FORECAST Q6a
e) In 2 or more years? IF 4a = a, Skip to PASSPORT FORECAST Q6a
f) DON’T KNOWIF 4a = a, Skip to PASSPORT FORECAST Q8
g) REFUSEDIF 4a = a, Skip to PASSPORT FORECAST Q8

When might you apply for a new, renewed, or replacement U.S. passport book:
I've already applied for one and am waiting to receive
it
In the next 6 months
In the next 7 - 12 months
In more than 1 year but less than 2 years
In 2 or more years
Don't know

11

5b.
When might you apply for a new, renewed, or replacement U.S. passport
card:
a) I’ve already applied for one and am waiting to receive it,  Skip to
PASSPORT FORECAST Q8
b) In the next 6 months,  IF 4a = b, Skip to PASSPORT FORECAST Q6b
c) In the next 7-12 months, IF 4a = b, Skip to PASSPORT FORECAST Q6b
d) In more than 1 year but less than 2 years, or  IF 4a = b, Skip to
PASSPORT FORECAST Q6b
e) In 2 or more years?  IF 4a = b, Skip to PASSPORT FORECAST Q6b
f) DON’T KNOW  Skip to PASSPORT FORECAST Q8
g) REFUSED Skip to PASSPORT FORECAST Q8

When might you apply for a new, renewed, or replacement U.S. passport card:
I've already applied for one and am waiting to receive it
In the next 6 months
In the next 7 - 12 months
In more than 1 year but less than 2 years
In 2 or more years
Don't know

6a.
How likely is it that you will apply for a U.S. passport book [INSERT
ANSWER TO 5a]:
a) Not at all likely,
b) A little likely,
c) Somewhat likely,
d) Likely, or
e) Extremely likely?
f) DON’T KNOW
g) REFUSED

12

How likely is it that you will apply for a U.S. passport book in the next 7 - 12
months?
Not at all likely
A little likely
Somewhat likely
Likely
Extremely likely
Don't know

6b.

IF 4a = a, Skip to PASSPORT FORECAST Q7a
How likely is it that you will apply for a U.S. passport card [INSERT
ANSWER TO 5b]:
a) Not at all likely,
b) A little likely,
c) Somewhat likely,
d) Likely, or
e) Extremely likely?
f) DON’T KNOW
g) REFUSED

How likely is it that you will apply for a U.S. passport card in the next 7 - 12
months?
Not at all likely
A little likely
Somewhat likely
Likely
Extremely likely
Don't know

13

7a.Passport Services would like to get more information about when you
might apply for a U.S. passport book. Please indicate during which month
and year you are most likely to apply for a U.S. passport book. If you are
unsure of the exact month, indicate the earliest month and year during
which you are likely to apply.
7am.
7ay.

ENTER MONTH
DON’T KNOW
REFUSED
ENTER YEAR
DON’T KNOW
REFUSED

Passport Services would like to get more information about when you might apply for
a U.S. passport book. Please indicate during which month and year you are most
likely to apply for a U.S. passport book.
If you are unsure of the exact month, indicate the earliest month and year during
which you are likely to apply.

ENTER MONTH AND YEAR

IF 4a = a, Skip to PASSPORT FORECAST Q8
7b.Passport Services would like to get more information about when you
might apply for a U.S. passport card. Please indicate during which month
and year you are most likely to apply for a U.S. passport card. If you are
unsure of the exact month, indicate the earliest month and year during
which you are likely to apply.
7bm.
7by.

ENTER MONTH
DON’T KNOW
REFUSED
ENTER YEAR
DON’T KNOW
REFUSED

14

Passport Services would like to get more information about when you might
apply for a U.S. passport card. Please indicate during which month and year
you are most likely to apply for a U.S. passport card.
If you are unsure of the exact month, indicate the earliest month and year
during which you are likely to apply.

ENTER MONTH AND YEAR

8. Did you have prior plans to get a passport (book or card) in the past 12
months, but then decided not to apply for a passport (book or card)?
a) YES
b) NO
 Skip to PASSPORT FORECAST Q10
c) DON’T KNOW
 Skip to PASSPORT FORECAST Q10
d) REFUSED
 Skip to PASSPORT FORECAST Q10

Did you have prior plans to get a passport (book or card) in the past 12 months, but
then decided not to apply for a passport (book or card)?
Yes
No
Don't know

9. What was the primary reason you changed your plans to obtain a passport
(book or card):
a) Your personal travel needs changed,
b) Your business travel needs changed,
c) Your personal financial situation changed,
d) The overall economic downturn,
e) Concerns about the spread of disease while traveling,
f) Unsafe conditions in your planned international travel location,
g) The costs for planned travel were too high, or
h) Something else?
i) DON’T KNOW
j) REFUSED

15

What was the primary reason you changed your plans to obtain a passport (book or
card)?
My personal travel needs changed
My business travel needs changed
My personal financial situation changed
The overall economic downturn
Concerns about the spread of disease while traveling
Unsafe conditions in my planned international travel
location
The costs for planned travel were too high
Some other reason
Don't know

10.

How many children under the age of 18 currently live in your household?
ZERO
 Skip to PASSPORT FORECAST Q11
ENTER NUMBER IN VALID RANGE OF ONE-TWENTY
DON’T KNOW
REFUSED

 Skip to PASSPORT FORECAST Q11
 Skip to PASSPORT FORECAST Q11

How many children under the age of 18 currently live in your household?
Enter 0 if there are no children under 18 in your household

Refused

0:20:0

16

10A.To help predict the future demand for U.S. passports, Passport Services
would like to know about the passport plans for the [one
child/children]under the age of 18 currently living in your household.
[Let’s start with the (younger/youngest child).]
10Aa. How old is this child?
ENTER YEARS [VALID RANGE 0-17]
IF ZERO YEARS, ENTER MONTHS
[VALID RANGE 0-11]
IF ZERO MONTHS, ENTER WEEKS
[VALID RANGE 0-4]
IF ZERO WEEKS, ENTERS DAYS
[VALID RANGE 1-6]
 IF AGE PROVIDED SKIP TO PASSPORT FORECAST 10Ab
DON’T KNOW
REFUSED

GO TO 10Aage
 GO TO 10Aage

To help predict the future demand for U.S. passports, Passport Services would like to
know about the passport plans for the children under the age of 18 currently living in
your household.
Let's start with the younger child.
How old is this child?
Enter 0 for under 1 year old.
Refused
10Aage. Age is an important factor in understanding passport service needs.
Please estimate in which of the following general categories is this
child’s age as of today:
a) Newborn through 5 years old,
b) 6 through10 years old,
c) 11 through13 years old
d) 14 through 15 years old, or
e) 16 through18 years old?
f) DON’T KNOW
g) REFUSED

17

Age is an important factor in understanding passport service needs. Please
estimate in which of the following general categories is this child’s age as of
today:
o
o
o
o
o
o
o

Newborn through 5 years old
6 through 10 years old
11through 13 years old
14 through 15 years old
16 through 18 years old
Don't Know
Refused

10Ab. Is this child:
a) Male or
b) Female?
c) DON’T KNOW
d) REFUSED
Is this child male or female?
o
o
o

Male
Female
Refused

10Ac.Does [he/she/this child] currently have a valid U.S. passport?
a) YES
b) NO
c) DON’T KNOW
d) REFUSED

Does he/she currently have a valid U.S. passport?
o
o
o

Yes
No
Don't know

10Ad. Will this child be applying for a new, renewed, or
replacement U.S. passport in the next 12 months?
a) YES

18

b) NO
IF Q10=1, Skip to PASSPORT FORECAST Q11,
OTHERWISE SKIP TO 10B
c) DON’T KNOW
 IF Q10=1, Skip to PASSPORT FORECAST Q11,
OTHERWISE SKIP TO 10B
d) REFUSED
 IF Q10=1, Skip to PASSPORT FORECAST Q11,
OTHERWISE SKIP TO 10B
Will this child be applying for a new, renewed, or replacement U.S. passport in
the next 12 months?
o
o
o

Yes
No
Don't know

10Ae. In what month and year will [he/she] be applying for a new,
renewed, or replacement U.S. passport?
10Aea. ENTER MONTH
DON’T KNOW
REFUSED
10Aeb. ENTER YEAR
DON’T KNOW
REFUSED
ALL
 IF Q10=1, Skip to PASSPORT FORECAST Q11,
OTHERWISE SKIP TO 10B

In what month and year will he be applying for a new, renewed, or
replacement U.S. passport?
If unsure, mark the earliest month likely to apply.
ENTER MONTH AND YEAR

19

10Ba. And now for the (older/next youngest) child. How old is this child?
ENTER YEARS [VALID RANGE 0-17]
IF ZERO YEARS, ENTER MONTHS
[VALID RANGE 0-11]
IF ZERO MONTHS, ENTER WEEKS
[VALID RANGE 0-4]
IF ZERO WEEKS, ENTERS DAYS
[VALID RANGE 1-6]
 IF AGE PROVIDED SKIP TO PASSPORT FORECAST 10Bb
DON’T KNOW
REFUSED

GO TO 10Bage
GO TO 10Bage

And now for the older child.
How old is this child?
Enter 0 for under 1 year old.
Refused

10Bage. Please estimate in which of the following general categories is this
child’s age as of today:
a)
b)
c)
d)
e)
f)
g)

Newborn through 5 years old,
6 through10 years old,
11 through13 years old,
14 through 15 years old, or
16 through18 years old?
DON’T KNOW
REFUSED

Please estimate in which of the following general categories is this child’s age
as of today:
o
o
o
o
o
o
o

Newborn through 5 years old
6 through 10 years old
11through 13 years old
14 through 15 years old
16 through 18 years old
Don't Know
Refused

20

10Bb. Is this child:
a) Male or
b) Female?
c) DON’T KNOW
d) REFUSED
Is this child male or female?
o
o
o

Male
Female
Refused

10Bc.Does [he/she/this child] currently have a valid U.S. passport?
a) YES
b) NO
c) DON’T KNOW
d) REFUSED
Does he/she currently have a valid U.S. passport?
Yes
No
o Don't know
o
o

10Bd. Will this child be applying for a new, renewed, or
replacement U.S. passport in the next 12 months?
a) YES
b) NO
 IF Q10 >2, SKIP TO Q10Ca, OTHERWISE
SKIP TO PASSPORT FORECAST Q11
c) DON’T KNOW
 IF Q10 > 2, SKIP TO Q10Ca, OTHERWISE
SKIP TO PASSPORT FORECAST Q11
d) REFUSED
 IF Q10 > 2, SKIP TO Q10Ca, OTHERWISE
SKIP TO PASSPORT FORECAST Q11

Will this child be applying for a new, renewed, or replacement U.S. passp ort in
the next 12 months?
o

Yes
21

No
o Don't know
o

10Be. In what month and year will [he/she] be applying for a new,
renewed, or replacement U.S. passport?
10Bea. ENTER MONTH
DON’T KNOW
REFUSED
10Beb. ENTER YEAR
 IF Q10 > 2, SKIP TO Q10Ca,
OTHERWISE SKIP TO PASSPORT FORECAST Q11
DON’T KNOW
 IF Q10 > 2, SKIP TO Q10Ca,
OTHERWISE SKIP TO PASSPORT FORECAST Q11
REFUSED
 IF Q10 >2, SKIP TO Q10Ca, OTHERWISE SKIP TO
PASSPORT FORECAST Q11

In what month and year will he be applying for a new, renewed, or replacement U.S.
passport?
If unsure, mark the earliest month likely to apply.
ENTER MONTH AND YEAR

10Ca. How old is the next oldest child?
ENTER YEARS [VALID RANGE 0-17]
IF ZERO YEARS, ENTER MONTHS
[VALID RANGE 0-11]
IF ZERO MONTHS, ENTER WEEKS
[VALID RANGE 0-4]
IF ZERO WEEKS, ENTERS DAYS
[VALID RANGE 1-6]
 IF AGE PROVIDED SKIP TO PASSPORT FORECAST 10Cb
DON’T KNOW
REFUSED

GO TO 10Cage
GO TO 10Cage

How old is this child?
Enter 0 for under 1 year old.
Refused

22

And now for the next oldest child.

10Cage. Please estimate in which of the following general categories is this
child’s age as of today:
a) Newborn through 5 years old,
b) 6 through 10 years old,
c) 11 through 13 years old,
d) 14 through 15 years old, or
e) 16 through 18 years old?
f) DON’T KNOW
g) REFUSED
Please estimate in which of the following general categories is this child’s age
as of today:
o
o
o
o
o
o
o

Newborn through 5 years old
6 through 10 years old
11 through 13 years old
14 through 15 years old
16 through 18 years old
Don't Know
Refused

10Cb. Is this child:
a) Male or
b) Female?
c) DON’T KNOW
d) REFUSED

23

Will this child be applying for a new, renewed, or replacement U.S. pa ssport in
the next 12 months?
o
o
o

Yes
No
Don't know

10Cc.Does [he/she/this child] currently have a valid U.S. passport?
a) YES
b) NO
c) DON’T KNOW
d) REFUSED
Does he/she currently have a valid U.S. passport?
o
o
o

Yes
No
Don't know

10Cd. Will this child be applying for a new, renewed, or
replacement U.S. passport in the next 12 months?
a) YES
b) NO
IF Q10 < 4, SKIP TOPASSPORT FORECAST 11,
OTHERWISE SKIP TO Q10Da
c) DON’T KNOW
 IF Q10 < 4, SKIP TO PASSPORT FORECAST
11, OTHERWISE SKIP TO Q10Da
d) REFUSED
 IF Q10 < 4, SKIP TO PASSPORT FORECAST
11, OTHERWISE SKIP TO Q10Da

Will this child be applying for a new, renewed, or replacement U.S. pa ssport in
the next 12 months?
o
o
o

Yes
No
Don't know

10Ce. In what month and year will [he/she] be applying for a new,
renewed, or replacement U.S. passport?
24

10Cea.

ENTER MONTH
DON’T KNOW
REFUSED
10Ceb. ENTER YEAR
 IF Q108 < 4, SKIP TO PASSPORT
FORECAST 11, OTHERWISE SKIP TO Q10Da
DON’T KNOW
 IF Q10 < 4, SKIP TO PASSPORT
FORECAST 11, OTHERWISE SKIP TO Q10Da
REFUSED
 IF Q10 < 4, SKIP TO PASSPORT
FORECAST 11, OTHERWISE SKIP TO Q10Da

In what month and year will he be applying for a new, renewed, or replacement U.S.
passport?
If unsure, mark the earliest month likely to apply.
ENTER MONTH AND YEAR

REPEAT SERIES (10Da through 10Deb, 10Ea through 10Eeb, 10Fa
through 10Feb, etc.) AS NEEDED FOR NUMBER OF CHILDREN
RECORDED IN Q10.

11. (To help predict the future demand for U.S. passports,)Passport
Services would like to know about the possible passport plans for the
other adults currently living in your household. Not counting
yourself, how many other adults, aged 18 or older, currently live in
your household?
ZERO

 Skip to Q12

ENTER NUMBER IN VALID RANGE OF ONE-TWENTY
DON’T KNOW
REFUSED

 Skip to Q12
 Skip to Q12

25

To help predict the future demand for U.S. passports, Passport Services would
like to know about the possible passport plans for the OTHER ad ults currently
living in your household. Not counting yourself, how many other adults, aged
18 or older, currently live in your household?
Enter 0 if there are no OTHER adults over 18 in your household
01

Refused

11Aa. (Let’s start with the oldest other adult living in your household.) How
old is this adult?
ENTER YEARS [VALID RANGE 18-99]  Skip to 11Ab
DON’T KNOW
REFUSED
How old is this adult?
ENTER YEARS [VALID RANGE 18-99]
Refused

11Aage. Age is an important factor in understanding passport service needs.
Please estimate in which of the following general categories is this
other adult’s age as of today:
a) Age 18 through 24,
b) 25 through 34,
c) 35 through 44,
d) 45 through 54,
e) 55 through 64, or
f) Age 65 or older?
g) DON’T KNOW
h) REFUSED

26

Age is an important factor in understanding passport service needs. Please estimate
in which of the following general categories is this other adult’s age as of today:
Age 18 through 24
25 through 34
35 through 44
45 through 54
55 through 64
Age 65 or older
Refused

11Ab. Is this adult:
a) Male or
b) Female?
c) DON’T KNOW
d) REFUSED
Is this adult a male or female?
Male
Female
Refuse

11Ac.Does [he/she/this adult] currently have a valid U.S. passport?
a) YES
b) NO
c) DON’T KNOW
d) REFUSED
Does he currently have a valid U.S. passport?
Yes
No
Don't know

27

11Ad. Will this adult be
replacement U.S.
a) YES
b) NO
TO 11Ba
c) DON’T KNOW
TO 11Ba
d) REFUSED
TO 11Ba

applying for a new, renewed, or
passport in the next 12 months?
 IF Q11=1, SKIP TO Q12, OTHERWISE SKIP
 IF Q11=1, SKIP TO Q12, OTHERWISE SKIP
 IF Q11=1, SKIP TO Q12, OTHERWISE SKIP

Will this adult be applying for a new, renewed, or replacement U.S. passport in the
next 12 months?
Yes
No
Don't know
11Ae. In what month and year will [he/she] be applying for a new,
renewed, or replacement U.S. passport?
11Aea. ENTER MONTH
DON’T KNOW
REFUSED
11Aeb. ENTER YEAR
DON’T KNOW
REFUSED
ALL

 IF Q11=1, SKIP TO Q12, OTHERWISE SKIP TO 11Ba

In what month and year will he be applying for a new, renewed, or replacement U.S.
passport?
If unsure, mark the earliest month likely to apply.
ENTER MONTH AND YEAR

28

11Ba. And now for the (younger/next youngest) adult. How old is this
person?
ENTER YEARS [VALID RANGE 18-99]  Skip to 11Bb
DON’T KNOW
REFUSED

And now for the younger adult.
How old is this adult?
ENTER YEARS [VALID RANGE 18-99]
Refused
11Bage. Age is an import factor in understanding passport service needs.
Please estimate in which of the following general categories is this
other adult’s age as of today:
a)
b)
c)
d)
e)
f)
g)
h)

Age 18 through 24,
25 through 34,
35 through 44,
45 through 54,
55 through 64, or
Age 65 or older?
DON’T KNOW
REFUSED

Age is an important factor in understanding passport service needs. Please
estimate in which of the following general categories is this other adult’s age
as of today:
Age 18 through 24
25 through 34
35 through 44
45 through 54
55 through 64

29

Age 65 or older
Refused

11Bb. Is this adult:
a) Male or
b) Female?
c) DON’T KNOW
d) REFUSED
Is this adult a male or female?
Male
Female
Refused
11Bc.Does [he/she/this adult] currently have a valid U.S. passport?
a) YES
b) NO
c) DON’T KNOW
d) REFUSED
Does she currently have a valid U.S. passport?
Yes
No
Don't know

11Bd. Will this adult be
replacement U.S.
a) YES
b) NO
SKIP TO Q12
c) DON’T KNOW
SKIP TO Q12
d) REFUSED
SKIP TO Q12

applying for a new, renewed, or
passport in the next 12 months?
 IF Q11 > 2, SKIP TO Q11Ca, OTHERWISE
 IF Q11 > 2, SKIP TO Q11Ca, OTHERWISE
 IF Q11 > 2, SKIP TO Q11Ca, OTHERWISE

30

Will this adult be applying for a new, renewed, or replacement U.S. passport
in the next 12 months?
Yes
No
Don't know
11Be. In what month and year will [he/she] be applying for a new,
renewed, or replacement U.S. passport?
11Bea. ENTER MONTH
DON’T KNOW
REFUSED
11Beb. ENTER YEAR
 IF Q11 > 2, SKIP TO Q11Ca,
OTHERWISE SKIP Q12
DON’T KNOW
 IF Q11 > 2, SKIP TO Q11Ca,
OTHERWISE SKIP TO Q12
REFUSED
 IF Q11 >2, SKIP TO Q11Ca, OTHERWISE
SKIP TO Q12

In what month and year will she be applying for a new, renewed, or replacement
U.S. passport?
If unsure, mark the earliest month likely to apply.
ENTER MONTH AND YEAR

REPEAT SERIES (11Ca through 11Ceb, 11Da through 11Deb, 11Ea
through 11Eeb, etc.) AS NEEDED FOR NUMBER OF ADULTS RECORDED
IN Q11.

31

DEMOGRAPHICS
As a reminder, the following questions are used for statistical purposes only .
Your answers will be kept private to the extent permitted by law and
identifying information will not be released outside of the Department of
State.
12.
a)
b)
c)
d)

[ASK IF NECESSARY] Are you:
Male or
Female?
DON’T KNOW
REFUSED

As a reminder, the following questions are used for statistical purposes only. No
personal information is ever identified or shared.
Are you male or female?
Male
Female
Refused

13.

In what year were you born?
ENTER NUMBER [valid range 1900 - 1994]
FORECAST Q14

 SKIP TO PASSPORT

DON’T KNOW
REFUSED

In what year were you born? ENTER NUMBER (VALID RANGE 1900 -1994)
Refused

32

13A. Age is an important factor in understanding passport service needs as
well as in creating statistical summaries of the data we are collecting for
this study. Please estimate in which of the following general categories
is your age as of today:
a) Age 18 through 24,
b) 25 through 34,
c) 35 through 44,
d) 45 through 54,
e) 55 through 64, or
f) Age 65 or older?
g) DON’T KNOW
h) REFUSED

Age is an important factor in understanding passport service needs as well as in
creating statistical summaries of the data we are collecting for this study. Please
estimate in which of the following general categories is your age as of today:
Age 18 through 24
25 through 34
35 through 44
45 through 54
55 through 64
Age 65 or older
Refused

14.
a)
b)
c)
d)

Are you of Hispanic, Latino, or Spanish origin?
YES
NO
DON’T KNOW
REFUSED

Are you of Hispanic, Latino, or Spanish origin?
o

Yes

o

No

33

o

Refused

15. I am going to read you a list of six race categories. Please choose one or
more races that you consider yourself to be:
MULTIPLE RESPONSES ALLOWED
a) White or Caucasian,
b) Black or African American,
c) American Indian or Alaska Native,
d) Asian,
e) Native Hawaiian or Other Pacific Islander, or
f) Some other race?
g) DON’T KNOW
h) REFUSED

Please choose one or more races that you consider yourself
to be:
MULTIPLE RESPONSES ALLOWED
o

White or Caucasian

o

Black or African American

o

American Indian or Alaska Native

o

Asian

o

Native Hawaiian or Other Pacific Islander

o

Some other race

o

Refused

16. What is the highest level of school you have completed or the highest
degree you have received?
If currently enrolled, please choose the previous grade or highest
degree you have already received.
a) LESS THAN HIGH SCHOOL DIPLOMA
b) HIGH SCHOOL DIPLOMA
c) SOME COLLEGE OR TECHNICAL SCHOOL
d) COLLEGE GRADUATE (2-YEAR PROGRAM)
34

e)
f)
g)
h)
i)

UNIVERSITY GRADUATE (4-YEAR PROGRAM)
MASTER’S DEGREE
BEYOND MASTER’S DEGREE
DON’T KNOW
REFUSED

17. Approximately what was your household’s total income, before taxes, last
year for all members of your household, including yourself? Please
include wages and salaries, remittances from family members living
elsewhere, farming, and all other sources. Would you say your
approximate household’s pre-tax income was:
a) Under $50,000,
b) At least $50,000 but less than $100,000, or
 SKIP TO PASSPORT
FORECAST Q17b
c) $100,000 or more last year?  SKIP TO PASSPORT FORECAST Q17c
d) DON’T KNOW
 SKIP TO CLOSING
e) REFUSED
 SKIP TO CLOSING
What was your household's approximate total income, before taxes, last year for
all members of your household, including yourself? Please include wages and
salaries, remittances from family members living elsewhere, farming, and all other
sources.
Which of the following best represents your household's pre-tax income?
o

Under $50,000

o

At least $50,000 but less than $100,000

o

$100,000 or more last year

o

Refused

17a. And would you say it was:
a) Under $15,000,
b) More than $15,000 but less than $25,000,
c) At least $25,000 but less than $35,000, or
d) At least $35,000 but less than $50,000?
e) DON’T KNOW
f) REFUSED
 ALL SKIP TO CLOSING

35

And would you say it was:

o

Under $15,000

o

More than $15,000 but less than $25,000

o

At least $25,000 but less than $35,000

o

At least $35,000 but less than$50,000

o

Refused

17b. And would you say it was:
a) At least $50,000 but less
b) At least $62,500 but less
c) At least $75,000 but less
d) At least $87,500 but less
e) DON’T KNOW
f) REFUSED

than
than
than
than

$62,500,
$75,000,
$87,500, or
$100,000?

 ALL SKIP TO CLOSING

And would you say it was:
o

At least $50,000 but less than $62,500

o

At least $62,500 but less than $75,000

o

At least $75,000 but less than $87,500

o

At least $87,500 but less than $100,000

o

Refused

17c. And would you say it was:
a) At least $100,000 but less than $125,000,
36

b)
c)
d)
e)
f)
g)

At least $125,00 but less than $150,000,
At least $150,000 but less than $175,000,
At least $175,000 but less than$200,000, or
$200,000 or more?
DON’T KNOW
REFUSED

And would you say it was:
o

At least $50,000 but less than $62,500

o

At least $62,500 but less than $75,000

o

At least $75,000 but less than $87,500

o

At least $87,500 but less than $100,000

o

Refused

18. Please estimate in minutes how long it took for
you to complete this interview, starting with the
first question. (Please include only time spent
actually participating in the interview; do not
include any time spent in interruptions.)
ENTER MINTUES TO COMPLETE

EXIT
Thank you for participating in the Department of State, Passport Services’
study. Your input will be used to improve delivery of passport services.
Thank you for participating in the Department of State, Passport Services'
study.
Your input will be used to improve delivery of passport services.

QUESTIONS
Do you have any questions or would you like the contact information for
Passport Services?
37

a) YES
b) NO
Do you have any questions or would you like the contact information for Passport
Services?
o
o

Yes
No

IF YES:
CLOSING OMB INFORMATION
OMB Public Reporting Burden Notification
Your participation, while voluntary, will be essential to the success of the
study. This interview is estimated to take less than 10 minutes to complete.
Your answers will be kept private to the extent permitted b y law and
identifying information will not be released outside of the Department of
State. Additional information on the study can be found in the Federal
Register under the OMB control # 1405-0177, expiration date XX-XX-XXXX, at
https://www.federalregister.gov/. The estimated burden is 10 minutes. If you
have comments regarding the interview length or content, please email
[email protected].
The public reporting burden for this collection of information is estimated to
average 10 minutes per response. You do not have to supply this information
unless this collection displays a currently valid OMB control number. If you
have comments on the accuracy of this burden estimate and/or
recommendations for reducing it, please send them to: A/GIS/DIR, Room
2400 SA-22, US Department of State, Washington, DC 20520-2202.Additional
Information on the study can be found in the Federal Register under the OMB
control # 1405-0177,expiration date XX/XX/XXX at
https://www.federalregister.gov/. If you have any additional questions or
issues concerning the content of this research, please email
[email protected].

38