Cms-p-0015a Mcbs

Medicare Current Beneficiary Survey (MCBS)

IAQ

Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

OMB: 0938-0568

Document [pdf]
Download: pdf | pdf
Income and Assets (IAQ)
Variable Name
LFINTRO1

MR Screen Name
LFINTRO1

Question type
no entry

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

Code list
(01) CONTINUE
(-7) Empty

As with all information collected by the MCBS, the data are confidential and covered by the Privacy Act of
1974. Your answers will be combined with those of other respondents, and [your/his/her] Medicare
benefits will not be affected in any way by your answers to these questions.

LFINTRO2

BOX LFINTRO1

routing

LFINTRO2

no entry

WORKWEEK

LF1

code one

RETNEVWK

LF1B

code one

IAABSENT

LF2

code one

WORKMONTH

LF3

code one

MULTIJOB

LF4

yes/no

HOURSPERWEEK

LF5

quantity unit

HOURSLASTWEEK1

BOX LF1

routing

LF6

quantity unit

GIVE BROCHURE TO RESPONDENT. ALLOW A FEW MINUTES FOR RESPONDENT TO REVIEW BROCHURE IF
NECESSARY.
If SPAISTATUS = 3 (Deceased in Community) or 4 (Deceased in Institutition), go to IAQ50 TOTAL_COMBINED1.
Otherwise, go to LIFINTRO2 - LFINTRO2.
As the brochure explains, your responses to these questions can help us determine the impact of income
(01) CONTINUE
on [your/his/her] use and access to health care. I will be asking a series of questions about
(-7) Empty
[your/(SP’s)/you and your (wife’s/husband’s/partner's)/(SP) and (his/her) (wife’s/husband’s/partner's)]
income and other financial resources. First, I will ask whether [you/(SP)/you and your
(wife/husband/partner)/(SP) and (his/her) (wife/husband/partner)] had particular types of income or other
resources. All these questions can be answered with a "yes" or a "no." Then, I will ask you to estimate
[your/(SP's)/their] total income. [Please answer all questions for [you and your
(wife/husband/partner)/(SP) and (his/her) (wife/husband/partner)].
Please feel free to refer to any records or other persons who may be of assistance to you.
Did [you/(SP)] do any work for pay in the last week? By the last week, I mean the week beginning on
Sunday [MONTH, DAY OF SUNDAY PRIOR TO TODAY/MONTH, DAY OF SUNDAY PRIOR TO THE SATURDAY
BEFORE TODAY’S DATE] and ending [today/on Saturday (MONTH, DAY OF SATURDAY PRIOR TO TODAY’S
DATE)]?
Is this because [you were/(SP) was] retired or [you/(SP)] never worked?

(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
(01) RETIRED
(02) NEVER WORKED
(03) NO, NEITHER OF THESE IS TRUE
(-8) DON'T KNOW
(-8) REFUSED
[Do you/Does (SP)] have a job from which [you were/(he/she) was] absent last week because of illness,
(1) YES
vacation, or some other reason?
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
Now think about last month, that is [MONTH BEFORE INTERVIEW MONTH]. Did [you/(SP)] do any work for (1) YES
pay at any time in the last month?
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
Last week, did [you/(SP)] have more than one job, including part-time, evening, or weekend work?
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
How many hours per week [do you/does (SP)] usually work at [your/his/her] [job/main job]? [By main job, I (1) [continuous response]
mean the job at which (you work/{he/she} works) the most hours.]
(-8) DON’T KNOW
(-9) REFUSED
ENTER NUMBER OF HOURS USUALLY WORK
IF NUMBER OF HOURS VARY EACH WEEK, ENTER 997
If LF2=1 (YES, ABSENT LAST WEEK), go to LF7.
Otherwise, go to LF6.
How many hours did [you/(SP)] work last week?
ENTER NUMBER OF HOURS

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

Income and Assets (IAQ)
Variable Name
HOURSLASTWEEK2

MR Screen Name
LF7

Question type
quantity unit

PAYSCHEDULE

LF8

code one

OSPAYSCHEDULE
LASTPAYCHECK

LF8A
LF9

verbatim
code one

Question text/description
Code list
You said [you were/(SP) was] absent from work last week. How many hours did [you/he/she] work the last (1) [continuous response]
week [you were/(he/she) was] at work?
(-8) DON’T KNOW
(-9) REFUSED
ENTER NUMBER OF HOURS
[Are you/Is (SP)/In (your/{SP}’s)] main job, [are you/is (he/she)] paid every week, every two weeks, two
(1) EVERY WEEK
times a month, or on some other schedule?
(2) EVERY TWO WEEKS
(3) TWO TIMES A MONTH
(4) ONCE A MONTH
(5) DAILY
(9) OTHER SCHEDULE (SPECIFY)
(-8) DON’T KNOW
(-9) REFUSED
SPECIFY OTHER PAYMENT SCHEDULE
(1) [continuous response]
How much was [your/(SP)’s] last paycheck before taxes and any other deductions [for (your/his/her) main (1) ENTER PAYCHECK AMOUNT
job]?
(2) ENTER PAY PER HOUR
(3) ENTER PAY PER DAY
IF NEEDED: We don’t need an exact dollar amount. An approximate amount is fine.
(-8) DON’T KNOW
(-9) REFUSED
IF NEEDED: If it is easier, you can just tell me how much [you earn/(SP) earns] per hour or per day.

PAYCHECKAMT

LF9A

quantity unit

IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER PAYCHECK AMOUNT

PAYCHECKHOURLY

LF9B

quantity unit

$
ENTER PAY PER HOUR

(1) [continuous response]

PAYCHECKDAILY

LF9C

quantity unit

$
ENTER PAY PER DAY

(1) [continuous response]

MONTHPAY

LF10

quantity unit

(1) [continuous response]

$
Now thinking about the month of [CURRENT MONTH -1 MONTH], how much did [you/(SP)] earn altogether (1) [continuous response]
from any work [you/he/she] did in [CURRENT MONTH -1 MONTH], before taxes and before any other
(-8) DON’T KNOW
deductions?
(-9) REFUSED
IF NEEDED: We don’t need an exact dollar amount. An approximate amount is fine.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.

SPOUSEWORK

BOX LF13

routing

LF13

code one

ENTER DOLLAR AMOUNT
$
If the SP has a spouse or partner who is living in the household (ROSTREL=2 or 56, HHFLAG=1), go to LF13.
Otherwise, go to HO1.
Did [you/(your/{SP}’s) (husband/wife/partner)] do any work for pay in the month of [CURRENT MONTH-1
MONTH]?

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

Income and Assets (IAQ)
Variable Name
SPOUSEEARN

MR Screen Name
LF14

Question type
quantity unit

Question text/description
Code list
In [CURRENT MONTH -1 MONTH], how much altogether did [you/your/(SP)’s] [husband/wife/partner] earn (1) [continuous response]
before taxes and before any other deductions?
(-8) DON’T KNOW
(-9) REFUSED
IF NEEDED: We don’t need an exact dollar amount. An approximate amount is fine.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.

IAOWNHOME

MORTGAGE

HO1

HO2

code one

code one

ENTER DOLLAR AMOUNT
$
Next, I'd like to ask you some questions about the [home/apartment or condo] [at SP’s (ADDRESS 1,
ADDRESS 2) from PERSON ROSTER].
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
FIRSTNAME LASTNAME)] own the [home/apartment or condo] at [SP’s (ADDRESS 1, ADDRESS 2) from
PERSON ROSTER], rent it, or is there some other arrangement?
Is [your/(SP)’s] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)'s] mortgage paid off or are monthly mortgage payments still being made?
IF NEEDED: Include any payments on a home equity loan or second mortgage.

MORTGAGE_AMT1

MORTGATE_AMT2

HO3

HO3A

quantity unit

How much altogether is that each month?

code one

ENTER DOLLAR AMOUNT
SHOW CARD IA1
Please look at this card and tell me which is closest.
IF NEEDED: Include any payments on a home equity loan or second mortgage.

MORTGAGELGNTH

HO3B

code one

[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
FIRSTNAME LASTNAME)] expect to pay off the mortgage within 5 years, 10 years, or longer?
IF NEEDED: Include any payments on a home equity loan or second mortgage.

MORTGAGEOWE1

HO3C

quantity unit

About how much [do you/does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] still owe on the mortgage?

(1) OWN
(2) RENT (OR PAY MONTHLY AMOUNT)
(3) SOME OTHER ARRANGEMENT
(-8) DON’T KNOW
(-9) REFUSED
(1) PAID OFF
(2) STILL MAKE PAYMENTS
(3) REVERSE MORTGAGE
(-8) DON’T KNOW
(-9) REFUSED
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) LESS THAN $250
(2) $250 TO LESS THAN $500
(3) $500 TO LESS THAN $1,000
(4) $1,000 TO LESS THAN $3,000
(5) $3,000 TO LESS THAN $5,000
(6) $5,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
(1) WITHIN 5 YEARS
(2) WITHIN 10 YEARS
(3) LONGER THAN 10 YEARS
(-8) DON’T KNOW
(-9) REFUSED
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED

IF NEEDED: The nearest $10,000 is fine.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
IF NEEDED: Include any payments on a home equity loan or second mortgage.

MORTGAGEOWE2

HO3D

code one

ENTER DOLLAR AMOUNT
Is the amount owed…

(1) less than $50,000,
(2) $50,000 to less than $100,000, or
(3) $100,000 or more?
(-8) DON’T KNOW
(-9) REFUSED

Income and Assets (IAQ)
Variable Name
PRESENTVALUE1

MR Screen Name
HO4

Question type
quantity unit

Question text/description
What is the present value of this [home/apartment or condo]? I mean, about what would it bring if it was
sold today, not counting any loans or outstanding mortgages?

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

IF NEEDED: Your best guess or the nearest $10,000 is fine.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.

PRESENTVALUE2

HO4A

code one

ENTER DOLLAR AMOUNT
SHOW CARD IA2
Please look at this card and tell me which is closest.

PAYRENT

HO5

yes/no

[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
FIRSTNAME LASTNAME)] pay rent to live here?

RENTAMT1

HO6

quantity unit

How much is that each month?

code one

ENTER DOLLAR AMOUNT
SHOW CARD IA3

RENTAMT2

HO6A

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

BOX HO1

routing

SECTION8

HO7

yes/no

IAQINTRO1

IAQINTRO1

no entry

(1) LESS THAN $50,000
(2) $50,000 TO LESS THAN $75,000
(3) $75,000 TO LESS THAN $100,000
(4) $100,000 TO LESS THAN $200,000
(5) $200,000 TO LESS THAN $300,000
(6) $300,000 TO LESS THAN $500,000
(7) $500,000 TO LESS THAN $750,000
(8) $750,000 OF MORE
(-8) DON’T KNOW
(-9) REFUSED
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) LESS THAN $250
(2) $250 TO LESS THAN $500
(3) $500 TO LESS THAN $1,000
(4) $1,000 TO LESS THAN $3,000
(5) $3,000 TO LESS THAN $5,000
(6) $5,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

If HO6>=$750 or HO6A=4 ($1,000 TO LESS THAN $3,000), 5 ($3,000 TO LESS THAN $5,000), OR 6 ($5,000 OR
MORE) go to IAQINTRO1.
Otherwise, go to HO7.
Is this home in Section 8 or public housing or housing for low-income seniors?
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
We are interested in how people are getting along financially these days. The next few questions are about
income and other resources. Your responses can help us understand how people manage financially as they
age.
Please feel free to refer to any records or other persons that may be of assistance in answering these
questions.
Many of these questions ask about “last month.” By last month, I mean in [CURRENT MONTH – 1].

Income and Assets (IAQ)
Variable Name
SSRR_LASTMONTH

MR Screen Name
IAQ1

Question type
code all

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

SSDEPOSIT

BOX IAQ1
IAQ2

routing
code one

[SELECT ALL THAT APPLY]
IF IAQ1 NE (1) SP PAYMENT THEN GO TO IAQ4, ELSE GO TO IAQ2
[Do you/Does (SP)] get payments by direct deposit, on a prepaid card, or by mail?

MMSTARTSS

IAQ3

quantity unit

What month and year did [you/(SP)] start receiving Social Security? ENTER MONTH

YYSTARTSS

IAQ3

quantity unit

What month and year did [you/(SP)] start receiving Social Security? ENTER YEAR

SSI_LASTMONTH

IAQ4

code all

Did [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)] receive Supplemental Security Income, which is also called SSI, last month?
IF NEEDED: These are monthly government payments to lower-income people in need.
[SELECT ALL THAT APPLY]

VA_LASTMONTH

IAQ5

code all

Did [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)] receive any payments from the Veteran’s Administration, last month related to military
service or veteran survivor’s benefits?
[IF NEEDED: The Veteran's Administration is also known as the U.S. Department of Veterans Affairs.]

PENSION_LASTMONTH

IAQ6

code all

[SELECT ALL THAT APPLY]
People sometimes have other retirement income. This may be from pensions or retirement plans related
to their jobs.
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME/SPOUSE FIRSTNAME LASTNAME/PARTNER FIRSTNAME
LASTNAME)] have any pension plans that were a job-related or union benefit?
IF NEEDED: These plans often require that a person work for a certain number of years before they qualify
or “are vested” in the pension plan.
[SELECT ALL THAT APPLY]

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

(1) MAIL
(2) DIRECT DEPOSIT
(3) PREPAID CARD
(-8) DON’T KNOW
(-9) REFUSED
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) YES, SP RECEIVED PAYMENT FROM SOURCE
(2) YES, SPOUSE/PARTNER RECEIVED PAYMENT
FROM
SOURCE
(3) NO PAYMENT RECEIVED FROM THIS SOURCE
(-8) DON’T KNOW
(-9) REFUSED
(1) YES, SP RECEIVED PAYMENT FROM SOURCE
(2) YES, SPOUSE/PARTNER RECEIVED PAYMENT
FROM
SOURCE
(3) NO PAYMENT RECEIVED FROM THIS SOURCE
(-8) DON’T KNOW
(-9) REFUSED
(1) YES, SP HAS PENTION
(2) YES, SPOUSE/PARTNER HAS PENSION
(3) NO PENSIONS
(-8) DON’T KNOW
(-9) REFUSED

Income and Assets (IAQ)
Variable Name

MR Screen Name
IAQ7

Question type
code all

Question text/description
SHOW CARD IA4

401K_LASTMONTH
Please look at the types of retirement plans on this card. [Do you/Does (SP)] [or (SP FIRSTNAME
LASTNAME/SPOUSE FIRSTNAME LASTNAME/PARTNER FIRSTNAME LASTNAME)] have any of these?
IF NEEDED: 401Ks and 403Bs are plans where you contribute an amount each month from your paycheck,
and your employer may match some of your contribution.

Code list
(1) YES, SP HAS 401K, 403B, IRA, OR OTHER
RETIREMENT PLANS
(2) YES, SPOUSE/PARTNER HAS 401K, 403B, IRA, OR
OTHER RETIREMENT PLANS
(3) NO PLANS
(-8) DON’T KNOW
(-9) REFUSED

IF NEEDED: IRAs, also known as Individual Retirement Accounts, are a type of plan you set up on your own.
[SELECT ALL THAT APPLY]
MUTUALFUNDS

IAQ8

code all

BONDS

IAQ9

code all

CHECKING

IAQ10

code all

SAVINGS

IAQ11

code all

CERTDEPOSIT

IAQ12

code all

OTHER_LAND

IAQ13

code all

[(Not including the retirement accounts we have already talked about, {do you/does [SP]})/(Do you/Does
{SP})] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)] own any mutual funds or stocks?

(1) YES, SP HAS ASSET
(2) YES, SPOUSE/PARTNER HAS ASSET
(3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
JOINTLY
[SELECT ALL THAT APPLY]
(4) NO ASSET OF THIS TYPE
(-8) DON’T KNOW
(-9) REFUSED
Not including what we’ve already talked about, [do you/does (SP)] [or (SP FIRSTNAME
(1) YES, SP HAS ASSET
LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] own any bonds, such as (2) YES, SPOUSE/PARTNER HAS ASSET
Government Savings Bonds, corporate, municipal, or other types of bonds?
(3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
JOINTLY
[SELECT ALL THAT APPLY]
(4) NO ASSET OF THIS TYPE
(-8) DON’T KNOW
(-9) REFUSED
The next questions ask about different kinds of bank or savings accounts people sometimes have or
(1) YES, SP HAS ASSET
property they own.
(2) YES, SPOUSE/PARTNER HAS ASSET
(3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
Not counting what we’ve already talked about, [do you/does (SP)] [or (SP FIRSTNAME
JOINTLY
LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have...
(4) NO ASSET OF THIS TYPE
(-8) DON’T KNOW
A checking account?
(-9) REFUSED
[IF NEEDED: Not counting what we’ve already talked about, [do you/does (SP)] [or (SP FIRSTNAME
(1) YES, SP HAS ASSET
LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have...]
(2) YES, SPOUSE/PARTNER HAS ASSET
(3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
A savings account or money market account?
JOINTLY
(4) NO ASSET OF THIS TYPE
(-8) DON’T KNOW
(-9) REFUSED
[IF NEEDED: Not counting what we’ve already talked about, [do you/does (SP)] [or (SP FIRSTNAME
(1) YES, SP HAS ASSET
LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have...]
(2) YES, SPOUSE/PARTNER HAS ASSET
(3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
Certificates of deposit?
JOINTLY
(4) NO ASSET OF THIS TYPE
(-8) DON’T KNOW
(-9) REFUSED
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
(1) YES, SP HAS ASSET
FIRSTNAME LASTNAME)] own a business, a farm, or any other real estate [besides (your/{SP}’s) home],
(2) YES, SPOUSE/PARTNER HAS ASSET
including land or rental properties?
(3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
JOINTLY
[SELECT ALL THAT APPLY]
(4) NO ASSET OF THIS TYPE
(-8) DON’T KNOW
(-9) REFUSED

Income and Assets (IAQ)
Variable Name
IAQINTRO2

SSRR_COMBINED1

MR Screen Name
IAQINTRO2

Question type
no entry

BOX IAQ2

routing

IAQ14

code one

Question text/description
We now have a few questions about income which are important for understanding how
people manage financially as they age.
If IAQ1 = 1 (SP RECEIVED SS/RR) and 2 (SPOUSE RECEIVED SS/RR), go to IAQ14.
Else if IA1 = 1 (SP RECEIVED SS/RR), go to IAQ15A.
Else if IA1 = 2 (SPOUSE RECEIVED SS/RR), go to IAQ16A.
Otherwise, go to BOX IAQ3.
First, what was the amount of [your/(SP)’s] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)]’s most recent monthly Social Security or Railroad
Retirement payment (for the month of [CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.

SSRR_COMBINED2

IAQ14A

quantity unit

SSRR_COMBINED3

IAQ14B

code one

SSRR_SP_AMT1

IAQ15A

quantity unit

Code list

(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED

IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER COMBINED SP AND SPOUSE/PARTNER SOCIAL SECURITY/RAILROAD RETIREMENT AMOUNT

(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
SHOW CARD IA5
(1) LESS THAN $1,300
(2) $1,300 TO LESS THAN $1,700
Please look at this card and tell me which is closest.
(3) $1,700 TO LESS THAN $2,200
(3) $2,200 TO LESS THAN $2,600
(5) $2,600 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
What was the amount of [your/(SP)’s] most recent monthly Social Security or Railroad Retirement payment (1) [continuous response]
(for the month of [CURRENT MONTH – 1])?
(-8) DON’T KNOW
(-9) REFUSED
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.

SSRR_SP_AMT2

IAQ15B

code one

ENTER SP SOCIAL SECURITY/RAILROAD RETIREMENT AMOUNT
SHOW CARD IA6
Please look at this card and tell me which is closest.

SSRR_SPOUSE_AMT1

BOX IAQ2A

routing

IAQ16A

quantity unit

(1) LESS THAN $700
(2) $700 TO LESS THAN $1,000
(3) $1,000 TO LESS THAN $1,300
(4) $1,300 TO LESS THAN $1,600
(5) $1,600 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

If IAQ14 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ16A.
Otherwise, go to BOX IAQ3.
What was the amount of [your/(SPOUSE FIRSTNAME LASTNAME)'s/(PARTNER FIRSTNAME LASTNAME)’s]
(1) [continuous response]
most recent monthly Social Security or Railroad Retirement payment (for the month of [CURRENT MONTH (-8) DON’T KNOW
– 1])?
(-9) REFUSED
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER SOCIAL SECURITY/RAILROAD RETIREMENT AMOUNT

Income and Assets (IAQ)
Variable Name
SSRR_SPOUSE_AMT2

MR Screen Name
IAQ16B

Question type
code one

Question text/description
SHOW CARD IA6
Please look at this card and tell me which is closest.

SSRR_COMBINED1

BOX IAQ3

routing

IAQ17

code one

If IAQ4 = 1 (SP RECEIVED SSI) and 2 (SPOUSE RECEIVED SSI), go to IAQ17.
Else if IAQ4 = 1 (SP RECEIVED SSI), go to IAQ18A.
Else if IAQ4 = 2 (SPOUSE RECEIVED SSI), go to IAQ19A.
Otherwise, go to BOX IAQ4.
What was the amount of [your/(SP)’s] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)]’s most recent monthly SSI payment (for the month of
[CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.

SSRR_COMBINED2

IAQ17A

quantity unit

IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER COMBINED SP AND SPOUSE/PARTNER SSI AMOUNT

SSRR_COMBINED3

IAQ17B

code one

SHOW CARD IA7
Please look at this card and tell me which is closest.

SSI_SP_AMT1

IAQ18A

quantity unit

What was the amount of [your/(SP)’s] most recent monthly SSI payment (for the month of [CURRENT
MONTH – 1])?

Code list
(1) LESS THAN $700
(2) $700 TO LESS THAN $1,000
(3) $1,000 TO LESS THAN $1,300
(4) $1,300 TO LESS THAN $1,600
(5) $1,600 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED

(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) LESS THAN $300
(2) $300 TO LESS THAN $700
(3) $700 TO LESS THAN $1,000
(4) $1,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED

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

SSI_SP_AMT2

IAQ18B

code one

ENTER SP SSI AMOUNT
SHOW CARD IA8
Please look at this card and tell me which is closest.

SSI_SPOUSE_AMT3

BOX IAQ3A

routing

IAQ19A

quantity unit

If IAQ17 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ19A.
Otherwise, go to BOX IAQ4.
What was the amount of [your/(SPOUSE FIRSTNAME LASTNAME)'s/(PARTNER FIRSTNAME LASTNAME)'s]
most recent monthly SSI payment (for the month of [CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER SSI AMOUNT

(1) LESS THAN $100
(2) $100 TO LESS THAN $200
(3) $200 TO LESS THAN $400
(4) $400 TO LESS THAN $700
(5) $700 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

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

Income and Assets (IAQ)
Variable Name
SSI_SPOUSE_AMT4

MR Screen Name
IAQ19B

Question type
code one

Question text/description
SHOW CARD IA8
Please look at this card and tell me which is closest.

VA_AMT_COMBINED1

BOX IAQ4

routing

IAQ20

code one

If IAQ5 = 1 (SP RECEIVED VA) and 2 (SPOUSE RECEIVED VA), go to IAQ20.
Else if IAQ5 = 1 (SP RECEIVED VA), go to IA21A.
Else if IAQ5 = 2 (SPOUSE RECEIVED VA), go to IAQ22A.
Otherwise, go to BOX IAQ5.
What was the amount of [your/(SP)’s] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
(1) ENTER COMBINED AMOUNT
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)]’s most recent monthly Veteran’s Administration payment (2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
(for the month of [CURRENT MONTH – 1])?
SEPARATELY
(-8) DON’T KNOW
IF NEEDED: We don’t need an exact dollar amount.
(-9) REFUSED

VA_AMT_COMBINED2

IAQ20A

quantity unit

IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER COMBINED SP AND SPOUSE/PARTNER VA AMOUNT

VA_AMT_COMBINED3

IAQ20B

code one

SHOW CARD IA9
Please look at this card and tell me which is closest.

VA_SP_AMT1

IAQ21A

quantity unit

Code list
(1) LESS THAN $100
(2) $100 TO LESS THAN $200
(3) $200 TO LESS THAN $400
(4) $400 TO LESS THAN $700
(5) $700 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

What was the amount of [your/(SP)’s] most recent monthly Veteran’s Administration payment (for the
month of [CURRENT MONTH – 1])?

(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) LESS THAN $1,000
(2) $1,000 TO LESS THAN $1,400
(3) $1,400 TO LESS THAN $1,800
(4) $1,800 TO LESS THAN $2,200
(5) $2,200 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED

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

VA_SP_AMT2

IAQ21B

code one

ENTER SP VA AMOUNT
SHOW CARD IA10
Please look at this card and tell me which is closest.

BOX IAQ4A

routing

If IAQ20 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ22A.
Otherwise, go to BOX IAQ5.

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

Income and Assets (IAQ)
Variable Name
VA_SPOUSE_AMT1

MR Screen Name
IAQ22A

Question type
quantity unit

Question text/description
What was the amount of [your/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)’s]
most recent monthly Veteran’s Administration payment (for the month of [CURRENT MONTH – 1])?

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

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

VA_SPOUSE_AMT2

IAQ22B

code one

ENTER SPOUSE/PARTNER VA AMOUNT
SHOW CARD IA10
Please look at this card and tell me which is closest.

PENSION_COMBINED1

BOX IAQ5

routing

IAQ23

code one

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

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

(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED

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

PENSION_COMBINED2

IAQ23A

quantity unit

IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER COMBINED SP AND SPOUSE/PARTNER PENSION PLAN AMOUNT

PENSION_COMBINED3

IAQ23B

code one

SHOW CARD IA11
Please look at this card and tell me which is closest.

PENSION_SP_AMT1

IAQ24A

quantity unit

[You told me earlier that (you have/{SP} has) a job-related pension plan.] In all, how much was received
from [(your/{SP}'s) job-related/this] pension plan in the last month, before any federal or state taxes were
taken out (for the month of [CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER SP PENSION PLAN AMOUNT

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

Income and Assets (IAQ)
Variable Name
PENSION_SP_AMT2

MR Screen Name
IAQ24B

Question type
code one

Question text/description
SHOW CARD IA12
Please look at this card and tell me which is closest.

PENSION_SPOUSE_AMT1

BOX IAQ5A

routing

IAQ25A

quantity unit

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

If IAQ23 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ25A.
Otherwise, go to BOX IAQ6.
[You told me earlier that (you have/{(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME) (1) [continuous response]
has}) a job-related pension plan.] In all, how much was received from [(your/{SPOUSE FIRSTNAME
(-8) DON’T KNOW
LASTNAME}'s/{PARTNER FIRSTNAME LASTNAME}'s job-related)/this] pension plan in the last month, before (-9) REFUSED
any federal or state taxes were taken out (for the month of [CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER PENSION PLAN AMOUNT

PENSION_SPOUSE_AMT2

IAQ25B

code one

SHOW CARD IA12
Please look at this card and tell me which is closest.

401K_COMBINED1

BOX IAQ6

routing

IAQ26

code one

If IAQ7 = 1 (SP HAS RETIREMENT ACCT) and 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ26.
Else if IAQ7 = 1 (SP HAS RETIREMENT ACCT), go to IAQ27A.
Else if IAQ7 = 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ28A.
Otherwise, go to BOX IAQ9.
This next question is a bit different. You mentioned that [you/(SP)] and [(SP FIRSTNAME
LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have retirement
accounts. In total, about how much is currently in all of these retirement accounts?
IF NEEDED: Retirement accounts include 401K, 403B, IRA, and other retirement accounts.

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

(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED

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

401K_COMBINED2

IAQ26A

quantity unit

IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT ACCOUNT AMOUNT

401K_COMBINED3

IAQ26B

code one

SHOW CARD IA13
Please look at this card and tell me which is closest.

(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) LESS THAN $34,000
(2) $34,000 TO LESS THAN $82,000
(3) $82,000 TO LESS THAN $175,000
(4) $175,000 TO LESS THAN $413,000
(5) $413,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

Income and Assets (IAQ)
Variable Name
401K_SP_AMT1

MR Screen Name
IAQ27A

Question type
quantity unit

Question text/description
This next question is a bit different. You mentioned that [you have/(SP) has] retirement accounts. In total,
about how much is currently in all of these retirement accounts?

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

IF NEEDED: Retirement accounts include 401K, 403B, IRA and other retirement accounts.
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.

401K_SP_AMT2

IAQ27B

code one

ENTER SP RETIREMENT ACCOUNT AMOUNT
SHOW CARD IA14
Please look at this card and tell me which is closest.

401K_SPOUSE_AMT1

BOX IAQ6A

routing

IAQ28A

quantity unit

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

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

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

IF NEEDED: Retirement accounts include 401K, 403B, IRA and other retirement accounts.
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.

401K_SPOUSE_AMT2

IAQ28B

code one

ENTER SPOUSE/PARTNER RETIREMENT ACCOUNT AMOUNT
SHOW CARD IA14
Please look at this card and tell me which is closest.

RECIEVE_COMBINED1

RECIEVE_COMBINED2

BOX IAQ7

routing

IAQ29

code one

IAQ29A

quantity unit

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

If IAQ7 = 1 (SP HAS RETIREMENT ACCT) and 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ29.
Else if IAQ7 = 1 (SP HAS RETIREMENT ACCT), go to IAQ30A.
Else if IAQ7 = 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ31A.
Otherwise, go to BOX IAQ8.
Last month, how much altogether did [you/(SP)] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
(1) ENTER COMBINED AMOUNT
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] receive or withdraw from all of these retirement accounts (2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
(for the month of [CURRENT MONTH – 1])?
SEPARATELY
(-8) DON’T KNOW
IF NEEDED: We don’t need an exact dollar amount.
(-9) REFUSED
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT

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

Income and Assets (IAQ)
Variable Name
RECIEVE_COMBINED3

MR Screen Name
IAQ29B

Question type
code one

Question text/description
SHOW CARD IA15
Please look at this card and tell me which is closest.

RECEIVE_SP1

IAQ30A

quantity unit

Last month, how much altogether did [you/(SP)] receive or withdraw from [your/his/her] retirement
accounts (for the month of [CURRENT MONTH – 1])?

Code list
(1) LESS THAN $200
(2) $200 TO LESS THAN $500
(3) $500 TO LESS THAN $1,000
(4) $1,000 TO LESS THAN $2,500
(5) $2,500 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED

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

RECEIVE_SP2

RECEIVE_SPOUSE1

IAQ30B

code one

BOX IAQ7A

routing

IAQ31A

quantity unit

ENTER SP RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT
SHOW CARD IA16
Please look at this card and tell me which is closest.

If IAQ29 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ31A.
Otherwise, go to BOX IAQ8.
Last month, how much altogether did [you/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)] receive or withdraw from [your/his/her] retirement accounts (for the month of [CURRENT
MONTH – 1])?

(1) LESS THAN $100
(2) $100 TO LESS THAN $300
(3) $300 TO LESS THAN $700
(4) $700 TO LESS THAN $1,700
(5) $1,700 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

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

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

RECEIVE_SPOUSE2

IAQ31B

code one

ENTER SPOUSE/PARTNER RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT
SHOW CARD IA16
Please look at this card and tell me which is closest.

YRRECIEVE_COMBINED1

BOX IAQ8

routing

IAQ32

code one

If IAQ7 = 1 (SP HAS RETIREMENT ACCT) and 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ32.
Else if IAQ7 = 1 (SP HAS RETIREMENT ACCT), go to IAQ33A.
Else if IAQ7 = 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ34A.
Otherwise, go to BOX IAQ9.
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much altogether did
[you/(SP)] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)] receive or withdraw from all of these retirement accounts?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on
their health.

(1) LESS THAN $100
(2) $100 TO LESS THAN $300
(3) $300 TO LESS THAN $700
(4) $700 TO LESS THAN $1,700
(5) $1,700 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED

Income and Assets (IAQ)
Variable Name
YRRECIEVE_COMBINED2

MR Screen Name
IAQ32A

Question type
quantity unit

Question text/description
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT

YRRECIEVE_COMBINED3

IAQ32B

code one

SHOW CARD IA17
Please look at this card and tell me which is closest.

YRRECEIVE_SP1

IAQ33A

quantity unit

Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much altogether did
[you/(SP)] receive or withdraw from all of [your/his/her] retirement plans?

Code list
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) LESS THAN $2,400
(2) $2,400 TO LESS THAN $6,000
(3) $6,000 TO LESS THAN $12,000
(4) $12,000 TO LESS THAN $30,000
(5) $30,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED

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

YRRECEIVE_SP2

IAQ33B

code one

ENTER SP RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT
SHOW CARD IA18
Please look at this card and tell me which is closest.

YRRECEIVE_SPOUSE1

BOX IAQ8A

routing

IAQ34A

quantity unit

(1) LESS THAN $1,200
(2) $1,200 TO LESS THAN $3,600
(3) $3,600 TO LESS THAN $8,400
(4) $8,400 TO LESS THAN $20,400
(5) $20,400 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

If IAQ32 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ34A.
Otherwise, go to BOX IAQ9.
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much altogether did
(1) [continuous response]
[you/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] receive or withdraw from all of (-8) DON’T KNOW
[your/his/her] retirement plans?
(-9) REFUSED
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.

YRRECEIVE_SPOUSE2

IAQ34B

code one

ENTER SPOUSE/PARTNER RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT
SHOW CARD IA18
Please look at this card and tell me which is closest.

BOX IAQ9

routing

If [IAQ8 = 1 (SP MUTUAL FUNDS) and IAQ8 = 2 (SPOUSE MUTUAL FUNDS)] or IAQ8 = 3 (JOINT MUTUAL
FUNDS) or [IAQ9 = 1 (SP BONDS) and IAQ9 = 2 (SPOUSE BONDS)] or IAQ9 = 3 (JOINT BONDS), go to IAQ35.
Else if IAQ8 = 1 (SP MUTUAL FUNDS) or IAQ9 = 1 (SP BONDS), go to IAQ36A.
Else if IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2 (SPOUSE BONDS), go to IAQ37A.
Otherwise, go to BOX IAQ10.

(1) LESS THAN $1,200
(2) $1,200 TO LESS THAN $3,600
(3) $3,600 TO LESS THAN $8,400
(4) $8,400 TO LESS THAN $20,400
(5) $20,400 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

Income and Assets (IAQ)
Variable Name
OTHER_COMBINED1

MR Screen Name
IAQ35

Question type
code one

Question text/description
You told me earlier that [you/(SP)] and [(SP FIRSTNAME LASTNAME)/(SPOUSE/PARTNER FIRSTNAME
LASTNAME)] own [mutual funds or stocks] [government, corporate, or other bonds] that are not part of
retirement accounts. About how much are these worth?
IF NEEDED: We don’t need an exact dollar amount.

OTHER_COMBINED2

IAQ35A

quantity unit

IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER COMBINED SP AND SPOUSE’S/PARTNER'S MUTUAL FUNDS/STOCKS/BONDS AMOUNT

OTHER_COMBINED3

IAQ35B

code one

SHOW CARD IA19
Please look at this card and tell me which is closest.

OTHER_COMBINED4

BOX IAQ9A

routing

IAQ35C

code one

If [IAQ8 = 1 (SP MUTUAL FUNDS) and IAQ8 = 2 (SPOUSE MUTUAL FUNDS)] or IAQ8= 3 (JOINT MUTUAL
FUNDS), go to IAQ35B.
Otherwise, go to IAQ35C.
SHOW CARD IA20
Please look at this card and tell me which is closest.

OTHER_SP1

IAQ36A

quantity unit

You told me earlier that [you own/(SP) owns] [mutual funds or stocks] [government, corporate, or other
bonds] that are not part of retirement accounts. About how much are these worth?

Code list
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED

(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) LESS THAN $9,000
(2) $9,000 TO LESS THAN $18,000
(3) $18,000 TO LESS THAN $93,000
(4) $93,000 TO LESS THAN $350,000
(5) $350,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

(1) LESS THAN $600
(2) $600 TO LESS THAN $5,000
(3) $5,000 TO LESS THAN $16,000
(4) $16,000 TO LESS THAN $62,000
(5) $62,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED

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

OTHER_SP2

BOX IAQ9B

routing

IAQ36B

code one

ENTER SP MUTUAL FUNDS/STOCKS/BONDS AMOUNT
If IAQ8 = 1 (SP MUTUAL FUNDS), go to IAQ36B.
Otherwise, go to IAQ36C.
SHOW CARD IA21
Please look at this card and tell me which is closest.

OTHER_SP3

IAQ36C

code one

SHOW CARD IA22
Please look at this card and tell me which is closest.

BOX IAQ9C

routing

If IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2 (SPOUSE BONDS), go to IAQ37A.
Otherwise, go to BOX IAQ10.

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

Income and Assets (IAQ)
Variable Name
OTHER_SPOUSE1

MR Screen Name
IAQ37A

Question type
quantity unit

Question text/description
You told me earlier that [you own/(SPOUSE FIRSTNAME LASTNAME) owns/(PARTNER FIRSTNAME
LASTNAME) owns] [mutual funds or stocks] [government, corporate, or other bonds] that are not part of
retirement accounts. About how much are these worth?

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

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

OTHER_SPOUSE2

BOX IAQ9D

routing

IAQ37B

code one

ENTER SPOUSE’S/PARTNER’S MUTUAL FUNDS/STOCKS/BONDS AMOUNT
If IAQ8 = 2 (SPOUSE MUTUAL FUNDS), go to IAQ37B.
Otherwise, go to IA37B.
SHOW CARD IA21
Please look at this card and tell me which is closest.

OTHER_SPOUSE3

IAQ37C

code one

SHOW CARD IA22
Please look at this card and tell me which is closest.

ACCTS_COMBINED1

BOX IAQ10

routing

IAQ38

code one

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

If [IAQ10 = 1 (SP CHECKING) and IAQ10 = 2 (SPOUSE CHECKING)] or [IAQ10 = 3 (JOINT CHECKING) or [IAQ11
= 1 (SP SAVINGS) and IAQ11 = 2 (SPOUSE SAVINGS)] or IAQ11 = 3 (JOINT SAVINGS), or [IAQ12 = 1 (SP CDS)
and IAQ12= 2 (SPOUSE CDS)] or IAQ12 = 3 (JOINT CDS), go to IAQ38.
Else if IAQ10 = 1 (SP CHECKING) or IAQ11 = 1 (SP SAVINGS) or IAQ13 = 1 (SP CDS), go to IAQ39A.
Else if IAQ10 = 2 (SPOUSE CHECKING) or IAQ11 = 2 (SPOUSE SAVINGS) or IAQ13 = 2 (SPOUSE CDS), go to
IAQ40A.
Otherwise, go to BOX IAQ11.
You told me earlier that [you/(SP)] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
(1) ENTER COMBINED AMOUNT
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have [checking accounts] [savings or money market
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
accounts] [certificates of deposit or CDs].
SEPARATELY
(-8) DON’T KNOW
If you added up all of these accounts, about how much were they worth early last month (meaning in the (-9) REFUSED
beginning of [CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.

ACCTS_COMBINED2

IAQ38A

quantity unit

BOX IAQ10A

routing

IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER COMBINED SP AND SPOUSE'S/PARTNER'S ACCOUNTS TOTAL AMOUNT

If IAQ12 = [1 (SP CDs) and 2 (SPOUSE CDs)] or 3 (JOINT CDs), go to IAQ38B.
Otherwise, go to IAQ38C.

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

Income and Assets (IAQ)
Variable Name
ACCTS_SEPARATE1

MR Screen Name
IAQ38B

Question type
code one

Question text/description
SHOW CARD IA23

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

ACCTS_SEPARATE2

IAQ38C

code one

SHOW CARD IA24

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

ACCTS_SP1

IAQ39A

quantity unit

You told me earlier that [you have/(SP) has] [a checking account] [a savings or money market account]
[certificates of deposit or CDs].

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

If you added up all of these accounts, about how much were they worth early last month (meaning in the
beginning of [CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.

ACCTS_SP2

BOX IAQ10B

routing

IAQ39B

code one

ENTER SP ACCOUNTS TOTAL AMOUNT
If IAQ12 = 1 (SP CDs), go to IAQ39b.
Otherwise, go to IAQ39c.
SHOW CARD IA25
Please look at this card and tell me which is closest.

ACCTS_SP3

IAQ39C

code one

SHOW CARD IA26
Please look at this card and tell me which is closest.

BOX IAQ10C

routing

If IAQ10 = 2 (SPOUSE CHECKING) or IAQ11 = 2 (SPOUSE SAVINGS) or IAQ12 = 2 (SPOUSE CDS), go to IAQ40A.
Otherwise, go to BOX IAQ11.

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

Income and Assets (IAQ)
Variable Name
ACCTS_SPOUSE1

MR Screen Name
IAQ40A

Question type
quantity unit

Question text/description
You told me earlier that [you have/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)
has] [a checking account] [a savings or money market account] [certificates of deposit or CDs].

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

If you added up all of these accounts, about how much were they worth early last month (meaning in the
beginning of [CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER ACCOUNTS TOTAL AMOUNT

ACCTS_SPOUSE2

BOX IAQ10D

routing

IAQ40B

code one

If IAQ12 = 2 (SPOUSE CDS), go to IAQ40b.
Otherwise, go to IAQ40c.
SHOW CARD IA25
Please look at this card and tell me which is closest.

ACCTS_SPOUSE3

IAQ40C

code one

SHOW CARD IA26
Please look at this card and tell me which is closest.

INTEREST_COMBINED1

BOX IAQ11

routing

If [IAQ8 = 1 (SP MUTUAL FUNDS) and IAQ8 = 2 (SPOUSE MUTUAL FUNDS)] or IAQ8 = 3 (JOINT MUTUAL
FUNDS) or
[IAQ9 = 1 (SP BONDS) and IAQ9 = 2 (SPOUSE BONDS)] or IAQ9 = 3 (JOINT BONDS), or
[IAQ10 = 1 (SP CHECKING) and IAQ10 = 2 (SPOUSE CHECKING)] or IAQ10 = 3 (JOINT CHECKING) or
[IAQ11 = 1 (SP SAVINGS) and IAQ11 = 2 (SPOUSE SAVINGS)] or IAQ11 = 3 (JOINT SAVINGS), or
[IAQ12 = 1 (SP CDS) and IAQ12= 2 (SPOUSE CDS)] or IAQ12 = 3 (JOINT CDS), go to IAQ41.
Else if IAQ8 = 1 (SP MUTUAL FUNDS) or IAQ9 = 1 (SP BONDS) or IAQ10 = 1 (SP CHECKING) or IAQ11 = 1 (SP
SAVINGS) or IAQ12 = 1 (SP CDS), go to IAQ42A.
Else if IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2 (SPOUSE BONDS) or IAQ10 = 2 (SPOUSE CHECKING)
or
IAQ11 = 2 (SPOUSE SAVINGS) or IAQ12 = 2 (SPOUSE CDS), go to IAQ43A.
Otherwise, go to BOX IAQ12.

IAQ41

code one

Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much interest and
dividend income did [you/(SP)] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have altogether from [mutual funds or stocks]
[government, corporate, or other bonds] [bank accounts or CDs]?

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

(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED

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

INTEREST_COMBINED2

IAQ41A

quantity unit

IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER SP AND SPOUSE’S/PARTNER’S INTEREST AND DIVIDEND INCOME AMOUNT

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

Income and Assets (IAQ)
Variable Name
INTEREST_COMBINED3

MR Screen Name
IAQ41B

Question type
code one

Question text/description
SHOW CARD IA27
Please look at this card and tell me which is closest.

INTEREST_SP1

IAQ42A

quantity unit

Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much interest and
dividend income did [you/(SP)] have altogether from [mutual funds or stocks] [bonds] [bank accounts or
CDs]?

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

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

INTEREST_SP2

IAQ42B

code one

ENTER SP INTEREST AND DIVIDEND INCOME AMOUNT
SHOW CARD IA28
Please look at this card and tell me which is closest.

INTEREST_SPOUSE1

BOX IAQ11A

routing

IAQ43A

quantity unit

If IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2 (SPOUSE BONDS) or IAQ10 = 2 (SPOUSE CHECKING) or
IAQ11 = 2 (SPOUSE SAVINGS) or IAQ12 = 2 (SPOUSE CDS), go to IAQ43A.
Otherwise, go to BOX IAQ12.
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much interest and
dividend income did [you/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have
altogether from [mutual funds or stocks] [bonds] [bank accounts or CDs]?

(1) LESS THAN $400
(2) $400 TO LESS THAN $1,000
(3) $1,000 TO LESS THAN $2,000
(4) $2,000 TO LESS THAN $11,000
(5) $11,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

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

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

INTEREST_SPOUSE2

IAQ43B

code one

ENTER SPOUSE/PARTNER INTEREST AND DIVIDEND INCOME AMOUNT
SHOW CARD IA28
Please look at this card and tell me which is closest.

BOX IAQ12

routing

If [IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE) and IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE)] or
IAQ13 =3 (JOINT BUSINESS/FARM/REAL ESTATE), go to IAQ44.
Else if IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE), go to IAQ45A.
Else if IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE), go to IAQ46A.
Otherwise, go to BOX IAQ13.

(1) LESS THAN $400
(2) $400 TO LESS THAN $1,000
(3) $1,000 TO LESS THAN $2,000
(4) $2,000 TO LESS THAN $11,000
(5) $11,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

Income and Assets (IAQ)
Variable Name
LAND_COMBINED1

MR Screen Name
IAQ44

Question type
code one

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

LAND_COMBINED2

IAQ44A

quantity unit

IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER SP AND SPOUSE/PARTNER BUSINESS/FARM/REAL ESTATE COMBINED AMOUNT

LAND_COMBINED3

IAQ44B

code one

SHOW CARD IA29
Please look at this card and tell me which is closest.

LAND_SP1

IAQ45A

quantity unit

You told me earlier that [you have/(SP) has] a business, a farm, or real estate [other than (SP)’s home]. If
that were sold today and any debts on it were paid off, about how much would it bring?

Code list
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED

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

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

LAND_SP2

IAQ45B

code one

ENTER SP BUSINESS/FARM/REAL ESTATE AMOUNT
SHOW CARD IA30
Please look at this card and tell me which is closest.

BOX IAQ12A
LAND_SPOUSE1

routing
quantity unit

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

(1) LESS THAN $18,000
(2) $18,000 TO LESS THAN $68,000
(3) $68,000 TO LESS THAN $122,000
(4) $122,000 TO LESS THAN $293,000
(5) $293,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

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

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

LAND_SPOUSE2

IAQ46B

code one

ENTER SPOUSE/PARTNER BUSINESS/FARM/REAL ESTATE AMOUNT
SHOW CARD IA30
Please look at this card and tell me which is closest.

(1) LESS THAN $18,000
(2) $18,000 TO LESS THAN $68,000
(3) $68,000 TO LESS THAN $122,000
(4) $122,000 TO LESS THAN $293,000
(5) $293,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

Income and Assets (IAQ)
Variable Name

INCOME_COMBINED1

MR Screen Name
BOX IAQ13

Question type
routing

IAQ47

code one

Question text/description
If [IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE) and IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE)] or
IAQ13 = 3 (JOINT BUSINESS/FARM/REAL ESTATE), go to IAQ47.
Else if IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE), go to IAQ48A.
Else if IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE), go to IAQ49A.
Otherwise, go to IAQ50.
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much income did
[you/(SP)] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)] receive from these businesses or property before any federal or state taxes were taken out?
IF NEEDED: We don’t need an exact dollar amount.

Code list

(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED

IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
INCOME_COMBINED2

IAQ47A

quantity unit

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

INCOME_COMBINED3

IAQ47B

code one

SHOW CARD IA31
Please look at this card and tell me which is closest.

INCOME_SP1

IAQ48A

quantity unit

Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much income did
[you/(SP)] receive from these businesses or property before any federal or state taxes were taken out?

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

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

INCOME_SP2

IAQ48B

code one

ENTER SP BUSINESS/FARM/REAL ESTATE AMOUNT
SHOW CARD IA32
Please look at this card and tell me which is closest.

INCOME_SPOUSE1

BOX IAQ13A

routing

IAQ49A

quantity unit

If IAQ3 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE), go to IAQ49A.
Otherwise, go to IAQ50.
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much income did
[you/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] receive from these businesses
or property before any federal or state taxes were taken out?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER BUSINESS/FARM/REAL ESTATE AMOUNT

(1) LESS THAN $3,600
(2) $3,600 TO LESS THAN $7,200
(3)$7,200 TO LESS THAN $14,000
(4) $14,000 TO LESS THAN $38,000
(5) $38,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED

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

Income and Assets (IAQ)
Variable Name
INCOME_SPOUSE2

MR Screen Name
IAQ49B

Question type
code one

Question text/description
SHOW CARD IA32
Please look at this card and tell me which is closest.

TOTAL_COMBINED1

IAQ50

quantity unit

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

Code list
(1) LESS THAN $3,600
(2) $3,600 TO LESS THAN $7,200
(3)$7,200 TO LESS THAN $14,000
(4) $14,000 TO LESS THAN $38,000
(5) $38,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED

Now think about that total income from:
[Social Security or Railroad Retirement] [Supplemental Security Income] [the Veteran’s Administration] [a
pension plan] [any retirement accounts] [mutual funds or stocks] [bonds] [bank accounts] [CDs] [business,
farm or real estate] [jobs] and from any other sources.
How much was [your/(SP)’s] [and (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
FIRSTNAME LASTNAME)'s] total income before taxes for last year (this is, for the 12 months ending in
December [CURRENT YEAR - 1])?
IF NEEDED: We don’t need an exact dollar amount – the nearest $1,000 is fine.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to
understand how people manage financially as they age and what effect this might have on their health.
ENTER TOTAL INCOME FOR LAST YEAR.

TOTAL_COMBINED2

BOX IAQ13B

routing

BOX IAQ14

routing

IAQ51A

code one

DO NOT INCLUDE LUMP SUM PAYMENTS RECEIVED FROM AN INHERITANCE, A TRUST FUND, AN
INSURANCE SETTLEMENT, A PENSION SETTLEMENT, OR A GIFT.
If SPAISTATUS = 3 (Deceased in Community) or 4 (Deceased in Institution), go to BOX ENDIAQ.
Otherwise, go to IAQ52-LUMP.
If SP has a spouse or partner who is living in the household (ROSTREL=2 or 65, HHFLAG=1), go to IAQ51A.
Otherwise, go to IAQ51B.
SHOW CARD IA33
Please look at this card and tell me which is closest.

TOTAL_SP1

IAQ51B

code one

SHOW CARD IA34
Please look at this card and tell me which is closest.

BOX IAQ15

routing

If SPAISTATUS = 3 (Deceased in Community) or 4 (Deceased in Institution), go to BOX ENDIAQ.
Otherwise, go to IAQ52-LUMP.

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

Income and Assets (IAQ)
Variable Name
LUMP

MR Screen Name
IAQ52

Question type
code one

LUMPFORM

IAQ52A

code one

LUMP_OTH

IAQ52A

verbatim text

LUMP_SUM1

IAQ52B

quantity unit

LUMP_SUM2

IAQ52C

code one

Question text/description
SHOWCARD IA35

Code list
(1) YES, SP OR SPOUSE/PARTNER RECEIVED PAYMENT
FROM SOURCE
People sometimes receive large amounts of money or property in the form of an inheritance, a trust fund, (2) NO PAYMENT RECEIVED FROM THIS SOURCE
an insurance settlement, and so on. Now thinking about last year, that is, the calendar year ending in
(-8) DON’T KNOW
December [CURRENT YEAR - 1], [have you/has (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
(-9) REFUSED
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] received money or property in the form of an inheritance,
a trust fund, an insurance settlement, a pension settlement, a gift, or a lawsuit?
SHOWCARD IA35
(1) INSURANCE SETTLEMENT
(2) PENSION SETTLEMENT
What was the largest lump sum [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
(3) INHERITANCE (OR TRUST)
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] received - was it from an inheritance, a trust, an insurance (4) GIFT
settlement, a pension settlement, a gift, a lawsuit, or what?
(5) LASWSUIT
(91) OTHER (SPECIFY)
(-8) DON'T KNOW
(-9) REFUSED
OTHER (SPECIFY)
(1) [continuous response]
(-8) DON'T KNOW
(-9) REFUSED
About how much did [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
(1) [continuous response]
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] receive from the [insurance settlement/pension
(-8) DON’T KNOW
settlement/inheritance or trust/gift/lawsuit/(OTHER)]?
(-9) REFUSED
DO NOT PROBE.
Did it amount to less than $50,000, more than $50,000, or what?
DO NOT PROBE.

OWNCAR

CO1

yes/no

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

NUMCAR

CO2

quantity unit

BOX CO2

routing

PVCAR1

CO3

quantity unit

PVCAR2

CO3A

code one

FSINTRO1

FSINTRO1

no entry

IF NEEDED: Do not include recreational vehicles, such as motorcycles, trailers, motor homes, boats, or
airplanes.
How many vehicles [do you/does (SP)] [or (your/his/her) (husband/wife/partner)] own?

(1) LESS THAN $50K
(2) ABOUT $50K
(3) MORE THAN $50K
(-8) DON'T KNOW
(-9) REFUSED
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED

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

ENTER NUMBER OF VEHICLES
If CO2 NE 2, go to CO3.
Otherwise, go to FSINTRO1.
Altogether, what is their present value, that is, about how much would they bring if [you/(SP)] sold them on (1) [continuous response]
today’s market?
(-8) DON’T KNOW
(-9) REFUSED
ENTER DOLLAR AMOUNT
SHOW CARD IA36
(1) LESS THAN $2,500
(2) $2,500 TO LESS THAN $5,000
Please look at this card and tell me which is closest.
(3) $5,000 TO LESS THAN $7,500
(4) $7,500 TO LESS THAN $10,000
(5) $10,000 TO LESS THAN $20,000
(6) $20,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
These next questions are about the food eaten in [your/(SP)'s] household in the last 12 months, since
[current month] of last year and whether [you were/he was/she was/they were] able to afford the food
[you need/he needs/she needs/they need].

Income and Assets (IAQ)
Variable Name
FOODLAST

MR Screen Name
FS1

Question type
code one

Question text/description
I’m going to read you some statements that people have made about their food situation. For these
statements, please tell me whether the statement was often true, sometimes true, or never true for
[you/your household/(SP)/(SP)'s household] in the last 12 months—that is, since last [current month].
The first statement is, The food that [I/we/(SP)/(SP) or other adults in (SP)'s household] bought just didn’t
last, and [I/we/he/she/they] didn’t have money to get more.

FOODLAST_OFTEN

FS2

code one

Was that often, sometimes, or never true for [you/your household/(SP)/(SP)'s household] in the last 12
months?
The next statement is: [I/we/(SP)/(SP) or other adults in (SP)'s household] couldn’t afford to eat balanced
meals.
Was that often, sometimes, or never true for [you/your household/(SP)/(SP)'s household] in the last 12
months?

SKIPMEAL

FS3

code one

SKIPMEAL_OFTEN

FS3A

code one

EATLESS

FS4

code one

HUNGRY

FS5

code one

BOX ENDIAQ

routing

[IF NEEDED: For these statements, please tell me whether the statement was often true, sometimes true,
or never true for [you/your household/(SP)/(SP)'s household] in the last 12 months—that is, since last
[current month].]
In the last 12 months, since last (name of current month), did [you/you or other adults in your
household/(SP)/((SP) or other adults in (SP)'s household] ever cut the size of your [your/his/her/their]
meals or skip meals because there wasn't enough money for food?

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

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

(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
How often did this happen—almost every month, some months but not every month, or in only 1 or 2
(1) ALMOST EVERY MONTH
months?
(2) SOME MONTHS BUT NOT EVERY MONTH
(3) IN ONLY 1 OR 2 MONTHS
(-8) DON’T KNOW
(-9) REFUSED
In the last 12 months, did [you/(SP)] ever eat less than [you/he/she] felt [you/he/she] should because there (1) YES
wasn't enough money for food?
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
In the last 12 months, [were you/was (SP)] ever hungry but didn't eat because there wasn't enough money (1) YES
for food?
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
section end


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