Quarterly Interview

Consumer Expenditure Surveys: Quarterly Interview and Diary

Attachment G - 2019 Interview Information Booklet

Quarterly Interview

OMB: 1220-0050

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TABLE OF CONTENTS
Page
Privacy Act Statement

4

Demographics

5

Section 1 – General Housing Characteristics

7

Section 2 – Rented Living Quarters

8

Section 3 – Owned Living Quarters and Other Owned Real Estate

9

Section 4 – Utilities and Fuels

12

Section 5 – Construction, Repairs, Alterations, and Maintenance of Property

13

Section 6 – Appliances, Household Equipment and Other Selected Items

16

Section 7 – Household Item Repairs, Service Contracts, and Extended Warranties

23

Section 8 – Home Furnishings and Related Household Items

24

Section 9 – Clothing and Clothing Services

28

Sections 10 and 11 – Rented, Leased, and Owned Vehicles

31

Section 12 – Vehicle Operating Expenses

32

Section 13 – Health Insurance

34

Section 14 – Medical and Health Expenses

35

Section 15 – Insurance Other than Health

37

Section 16 – Educational Expenses

38

Section 17 – Subscriptions, Memberships, Books, and Entertainment Expenses

39

Section 18 – Trips and Vacations

41

Section 19 – Miscellaneous Expenses

43

Section 20 – Expense Patterns for Selected Services and Goods

46

Section 21 – Occupations

47

Section 21 – Work Experience and Income

48

Section 22 – Assets and Liabilities

51

2019 Calendar

53

2020 Calendar

54

Fraction Conversion Chart

55

Language Identification Cards

56

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PRIVACY ACT STATEMENT
The U.S. Census Bureau is conducting the Consumer Expenditure
Quarterly Interview Survey for the Bureau of Labor Statistics of the U.S.
Department of Labor under Title 29, United States Code. The survey’s
purpose is to obtain information on what people in the U.S. are purchasing
in order to update the Consumer Price Index. All survey information will be
used for statistical purposes only.
Any information you provide for this survey is confidential, by law, under
Title 13, United States Code. Participation in this survey is voluntary and
there are no penalties for refusing to answer any question(s). However,
your cooperation is extremely important to help ensure the completeness
and accuracy of these data.

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DEMOGRAPHICS

Hispanic Origin
1. Mexican
2. Mexican-American
3. Chicano
4. Puerto Rican
5. Cuban

Race
(Please choose one or more)
1. White
2. Black or African American
3. American Indian or Alaska Native
4. Asian
5. Native Hawaiian
6. Guamanian or Chamorro
7. Samoan
8. Other Pacific Islander

Asian Origin
1. Chinese
2. Filipino
3. Japanese
4. Korean
5. Vietnamese
6. Asian Indian

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Demographics

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

Active Duty
A person is considered to be on active duty if
they are on full-time duty in the U.S. Armed
Forces. Active duty does not include training in
the Reserve or National Guard, but does include
activation from the Reserve or National Guard.

Armed Forces
A person is considered to be in the Armed
Forces if he or she serves in any branch of the
U.S. military. This includes the Army, Navy,
Marine Corps, Air Force, and Coast Guard; their
Reserve components; and the Air and Army
National Guard.

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SECTION 1 – GENERAL HOUSING CHARACTERISTICS
Type of Structure
1. Single family detached
A detached structure with only one primary residence;
however, the structure could include a rental unit(s) in the
basement, attic, etc.
2. Row or townhouse
An inner unit (2, 3, or 4 story structure) with 2 walls in common with other units and a
private ground level entrance; it may have a rental unit as part of the structure.
3. End row or end townhouse
Shares only one common wall with other units.
4. Duplex
A detached two unit structure with all units occupying the same level or levels.
5. 3-plex or 4-plex
3 or 4 unit structure with all units occupying the same level or levels.
6. Garden
A multi-unit structure, usually wider than it is high, having 2, 3, or possibly 4 floors;
characteristically the units not only have common walls but are also stacked on top of one
another.
7. High rise
A multi-unit structure which has 4 or more floors.
8. Apartment or flat
A unit not described above; it could be located in the basement, attic, second floor, or over
the garage of one of the units described above.
9. Mobile home or trailer
10. College dormitory

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SECTION 2 – RENTED LIVING QUARTERS
Included in the Housing Unit
Cooking stove, range, or oven
Refrigerator or home freezer
Built-in dishwasher
Portable dishwasher
Clothes washer
Clothes dryer

Included with the Rental Payment
Electricity
Gas
Piped-in water
Heating
Trash/garbage collection
Garage and parking facilities
Telephone services
Television services
Internet services
Furniture

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SECTION 3 – OWNED LIVING QUARTERS AND OTHER
OWNED REAL ESTATE
Included with this Housing Unit
1. Swimming pool
2. Off-street parking
3. Porch, terrace, patio, or balcony
4. Apartment or guest house
5. Central air conditioning
6. Window air conditioning
7. Solar panels

Types of Owned Real Estate
1. A home in which you used to live
2. Other homes, vacation homes, and recreational
properties including timeshares
3. Commercial real estate or farmland
4. Homes rented out or owned only for investment purposes
5. Land with no buildings on it

Closing Costs
advertising costs

property survey changes

deed preparation

real estate listing fees

escrow payment

recording fees

lawyer’s fees

title search

points paid by buyer

transfer taxes

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Section 3 – Owned Living Quarters and Other Owned Real Estate

Costs for Selling a Property
advertising costs

mortgage penalties

closing costs

points for financing

commission to realtor

property inspection

deferred mortgage
interest payment

real estate listing fees

lawyer’s fees

Mortgage Payment Items
1. Principal
2. Interest
3. Property taxes
4. Property insurance
5. Mortgage guarantee insurance (PMI)
6. Any other payments (specify)

Fees for Cooperatives
1. Repayment of loans owed by cooperative
2. Property taxes
3. Property insurance
4. Management
5. Repairs or maintenance, including lawn care or snow
removal
6. Improvements
7. Recreational, including swimming, golf, or tennis, facilities
8. Security, including guards or alarm systems
9. Utilities, such as gas, electricity, water, heat
10. Trash collection
11. Other (specify)

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Section 3 – Owned Living Quarters and Other Owned Real Estate

Homeowner’s Association Fees or
Condominium Fees
1. Management
2. Repairs or maintenance, including lawn care or snow
removal
3. Improvements
4. Utilities, such as gas, electricity, water, heat
5. Parking
6. Recreational, including swimming, golf, or tennis facilities
7. Security, including guards or alarm systems
8. Maid service
9. Medical services
10. Trash collection
11. Other (specify)

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SECTION 4 – UTILITIES AND FUELS
Part A – Telephone, Internet, and Cable/Satellite TV Expenses
1. Telephone service, including –
residential service, including Voice over IP (VoIP)
mobile/cellular service, including pre-paid
2. Internet service, including –
dial-up

DSL

high-speed

3. Cable or satellite TV service, including –
cable TV
DirecTV
Dish
DVR service and on-demand/pay-per-view

TiVo service

Part B – Other Telephone or Internet Expenses
Pre-paid cellular cards/minutes
Internet or wireless internet access away from home, at places such as cafés, hotels, or
airplanes

Part C – Utilities, Fuels, and Services
1. Electricity
2. Natural or utility gas
3. Fuel oil
4. Bottled or tank gas
kerosene

propane

5. Other fuels including wood
6. Piped-in water and sewerage maintenance
7. Garbage and recycling collection, including –
hazardous waste
recyclable material
collection
collection

waste disposal

8. Water softening service
9. Septic tank cleaning

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SECTION 5 – CONSTRUCTION, REPAIRS, ALTERATIONS,
AND MAINTENANCE OF PROPERTY
Job Types
1. Homes under construction, including a vacation
home or second home
2. Building an addition to the house or a new structure,
such as a porch, garage, or new rooms, including –
attached garages, carports, breezeways,
greenhouses, and sheds
decks, porches, patio, and terraces added or improved
detached garages or carports added or improved
kitchen, bedrooms, family rooms, general purpose rooms, basement, etc.
other detached outside buildings added or improved (sheds, greenhouses, storm cellars)
other outside additions or alterations (boat docks, terracing, grading and filling, retaining
walls)
3. Finishing a basement or an attic or enclosing a porch
4. Remodeling one or more rooms in the house, including –
bathroom remodeling
interior restructuring or other areas (removing or adding walls and/or the creation of new
rooms within the structure or the demolition of part of the structure)
kitchen remodeling
5. Landscaping the grounds or planting new shrubs or trees
Do not landscaping maintenance or routine lawn care.
6. Building outdoor patios, walks, fences, or other enclosures, driveways, permanent
swimming pools, or hot tubs, including –
detached building
driveways and walkways added or improved
fences added or improved
patios and terraces
recreational facilities

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Section 5 – Construction, Repairs, Alterations, and Maintenance of
Property

7. Repairing outdoor patios, walks, fences, driveways, or permanent swimming pools
(including permanent above-ground swimming pools) , including –
fences
patios and terraces
recreational facilities
8. Painting, either interior or exterior, or wallpapering, including –
combination of painting and wallpapering
Wallpaper
varnish, sealant, lacquer, and waterproofing
9. Plastering or paneling, including –
drywall patching
10. Plumbing or water heating installations or repairs, including –
all interior water pipes
garbage disposal
built-in dishwasher or laundry tubs
plumbing fixtures
external sprinkler systems, septic tanks,
septic tank
and wells
water heater
11. Electrical work, including –
garage door opener
12. Heating or air conditioning jobs
13. Flooring installation, repair, or replacement, including carpeting, wood, vinyl, and
tile, including –
carpet
wood, slate, marble, or concrete flooring
tile, linoleum, or vinyl
14. Insulation
15. Roofing, gutters, or downspouts, including –
combined maintenance and repairs
complete re-roofing
including roofing
repair of shingles, gutters, downspouts, etc.
combined replacements including re-roofing
16. Siding
17. Installation, repair, or replacement of window panes, screens, storm doors, awnings,
and the like, including –
doors (interior or exterior)
windows (interior or exterior)
18. Masonry, brick, or stucco work
19. Other improvements or repairs (include security systems that are hard-wired into

the home)
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Section 5 – Construction, Repairs, Alterations, and Maintenance of
Property

Appliances
1. Cooking stove, range, or oven
2. Microwave oven
3. Refrigerator or home freezer, including –
mini refrigerator

wine refrigerator

4. Built-in dishwasher
5. Portable dishwasher
6. Garbage disposal
7. Clothes washer or dryer
8. Range hood
9. Smoke alarms and detectors, including –
burglar alarm
carbon monoxide detector
home security device

smoke detector
water leak alarm

10. Window air conditioner
11. Portable cooling and heating equipment, including –
fans
portable dehumidifiers
humidifiers
space heaters
12. Lamps, lighting fixtures, or ceiling fans
13. Other major home appliances and equipment, including –
central air conditioner
trash compactor
furnace
water softener
heat pump

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SECTION 6 – APPLIANCES, HOUSEHOLD EQUIPMENT,
AND OTHER SELECTED ITEMS
Part A – Major Household Appliances
1. Microwave oven
2. Cooking stove, range, or oven
3. Range hood
4. Refrigerator or home freezer, including –
mini refrigerator

wine refrigerator

5. Built-in dishwasher
6. Portable dishwasher
7. Garbage disposal
8. Clothes washer or dryer

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Section 6 – Appliances, Household Equipment, and Other Selected Items

Part B – Household Appliances and Other Selected Items
SMALL HOUSEHOLD APPLIANCES
1. Small electrical kitchen appliances, including –
blender
bread maker
coffee grinder
coffee maker
crockpot
deep fryer
electric barbecue
electric can opener
electric fondue set
electric frying pan

electric grill
electric iron
electric knife
electric timer
electric wine chiller
electric wok
food processor
hot plate
ice cream maker
juicer

2. Electrical personal care appliances, including –
curling iron
electric toothbrush
denture cleaner
facial sauna
digital scale
flat iron
electric hair trimmer
foot bath
electric razor
hair dryer

mixer
pizza oven
popcorn maker
rice cooker
sandwich grill
slow cooker
smoothie maker
toaster
toaster oven
waffle iron

heating pad
make-up mirror
massager
Waterpik

3. Electrical floor cleaning equipment, including –
floor polisher/buffer
rug shampooer
hand vacuum
vacuum cleaner
4. Other household appliances, including –
air purifier
burglar alarm
carbon monoxide detector
home security device

smoke detector
trash compactor
water filters
water leak alarm

5. Sewing machines (with or without cabinet), including –
knitting machines
quilting machines

sergers

6. GPS devices, calculators, and fax machines, including –
copy machines
paper shredder
Garmin
typewriters
graphing calculator
7. Digital book readers or tablets, including –
iPad
Nook
Kindle
Samsung tablet
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Section 6 – Appliances, Household Equipment, and Other Selected Items
8. Computers, computer systems, or related hardware, including
cables
memory
CD/DVD drive
modems
computer printers
monitors
external hard drive
mouse
keyboards
netbooks
laptops
scanner
9. Computer software, including computer games
10. Computer accessories, including –
mouse pads

printer cartridges

11. Portable memory, such as flash drives, memory cards, and recordable discs and
tapes, including –
blank CDs/DVDs
SD card
memory stick
USB flash drive
12. Video game hardware or accessories, including –
Nintendo 3DS
Wii U
PlayStation
Xbox
PlayStation Vita
Do not include video games.
13. Telephones or accessories, including –
Apple Watch
answering machines
Bluetooth accessories
cell phones
cell phone covers
chargers

cordless telephones
headsets
phone jacks and cords
selfie stick
smartphones
smartwatch

14. Photographic equipment, including –
battery pack
lens
camera bag
motor driven film advancer
camera or lens cases
projection screen
digital camera
projector
enlarger
strobe light (for photographs)
filter
tripod
film camera
winder
flashes
Do not include film, film processing, or other photographic supplies.

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Section 6 – Appliances, Household Equipment, and Other Selected Items
15. Musical instruments, supplies, or accessories, including –
brass instruments
rosin
carrying case
saxophone
clarinet
sheet music
drums
stringed instruments
guitar
strings for musical instruments
keyboards
trombone
music books
trumpet
music stand
valve oil
piano picks
woodwinds
reeds
any other musical accessories
Do not include repairs, music lessons, or band uniforms.
16. Lawn mowing machinery or other yard equipment, including –
edger
snow blower
electric lawn trimmer
spreader
garden hose
tiller
lawn mower
tractor (farm, garden, etc.)
rake
weed digger
shovel
wheelbarrow
TOOLS FOR HOME USE
17. Power tools, including –
air compressor
cordless circular saw
cordless drill
electric drill
electric plane

electric polisher
electric saw
electric swimming pool
cleaning equipment
lathe

router
sander
trouble light

18. Non-power tools, including –
axe
caulking gun
hammer
hand tools

level
plane
pliers
saw

screwdriver
sockets
wrench

HEATING AND COOLING EQUIPMENT
19. Window air conditioners
20. Portable cooling or heating equipment, including –
dehumidifier
humidifier
fan
space heater

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Section 6 – Appliances, Household Equipment, and Other Selected Items
TVS, RADIOS, VIDEO, AND SOUND EQUIPMENT INCLUDING IN VEHICLES
21. Televisions, all types including those installed in vehicles, such as –
3-D TV
HD TV
combo TV/DVD player
TVs in cars
22. DVD players, VCRs, DVRs, or video cameras, including –
Blu-ray disc player
TiVo unit
combination of VCR/DVD player
video cassette recorder/player
digital TV converter box
video laser disc player
GoPro
video tape recorder/player
high definition disc player
23. Satellite dishes, receivers, or accessories
24. Handheld personal music players, including –
iPod
personal mp3 players
25. Stereos, radios, speakers, and sound components, including those installed in
vehicles, such as –
amplifier
satellite radio
audio cassette players/recorders
short-wave radio
car stereo
speakers
CB radio
stereo
clock radio
stereo system
compact disc players
tuner
equalizer
turntable
mixer
walkie talkie
receiver
26. Other sound or video equipment, including accessories, such as –
adapter for sound equipment
headset
antenna (TV, radio, etc.)
microphone
base station CB antenna
power booster
battery packs
power converter
earphones/headphones

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Section 6 – Appliances, Household Equipment, and Other Selected Items
SPORTS, RECREATION, AND EXERCISE EQUIPMENT
27. General sports equipment, including –
badminton set
lawn games
baseball bat
pads
baseball glove
racquetball
basketball
racquetball racket
basketball hoop
roller blades
bowling ball
skateboard
boxing equipment
soccer ball
football
sports protective equipment
Frisbee
sports uniform
golf bag
table tennis equipment
golf clubs
tennis racket
helmets
volleyball
karate equipment
Do not include any shoes for sports.
Do not include any equipment for water sports.
28. Health and exercise equipment, including –
exercise mat
exercycle
Fitbit
home gym
pedometer
29. Camping equipment, including –
air mattress
camping cookware
camping stove
canteen
frame packs and other camping packs
kerosene lantern

rowing machine
trampoline
treadmill
weight bench
weights

portable heater
screenhouse
sleeping bag
sleeping pad
tent

30. Hunting and fishing equipment, including all guns, such as –
ammunition
handgun
BB/pellet gun
knife
bow and arrow
rifle
crossbow
scopes
fishing lures
shotgun
fishing rod and tackle

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Section 6 – Appliances, Household Equipment, and Other Selected Items
31. Winter sports equipment, including –
ice boat
ice skates
ski boots
ski poles
sled

sledding equipment
snow skis
snowboard
snowboard equipment
toboggan

32. Water sports equipment, including –
boogie board
diving equipment
life jacket
raft
skim board
snorkel

surf board
swim cap
wake board
water ski vest
water skis
wind/paddle board

33. Outboard motors
34. Bicycles or bicycle equipment, including –
bicycle helmet
bicycle parts
bike pump
lock
rack

stand
supplies
tires
tubes

35. Tricycles or battery powered riders, including –
Big Wheels
36. Playground equipment, including –
gym set
portable swimming pool

sand box
swing set

37. Other sports or recreation equipment, including –
metal detector
telescope
paintball equipment

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SECTION 7 – HOUSEHOLD ITEM REPAIRS, SERVICE
CONTRACTS, AND EXTENDED WARRANTIES

1. Garbage disposal, range hood, or built-in dishwasher
2. Other household appliances, such as –
clothes washer
dehumidifier
portable air conditioning equipment
portable fan
portable heating equipment

range/oven
refrigerator
sewing machine
vacuum cleaner
window air conditioner

3. Televisions, radios, video and sound equipment, including those installed in
automobiles or other vehicles
4. Computers, computer systems, or related equipment for non-business use,
including –
accidental damage
AppleCare
Geek Squad
5. Lawn and garden equipment, including –
lawn mower repair
Do not include lawn care service.

smartphone repair
technical support

snow blower repair

6. Musical instruments or accessories, including –
professional tuning
7. Hand or power tools
8. Photographic equipment
9. Sport or recreational equipment, including –
bicycle repair
gun repair
exercise equipment repair
outdoor sports equipment repair
golf club repair
tennis racket repair
10. Termite or pest control
11. Heating or air conditioning service contracts, covering –
central air conditioners
furnaces
central coolers
heat pumps
Do not include repairs.

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SECTION 8 – HOME FURNISHINGS AND RELATED
HOUSEHOLD ITEMS
Part A – Purchases
LIVING, FAMILY, OR RECREATION ROOM FURNITURE
1. Sofas, including –

futon
loveseat

sectionals
sofabed

2. Living room chairs, including –

bean bag chair
convertible chair

recliner
rocker

swivel chair

3. Living room tables, including –

coffee table
end tables

lamp table
TV table

4. Ping-pong tables, pool tables, or other similar recreation room items
5. Other living, family, or recreation room furniture including desks, wall units, and

shelving, including –
bar stools
bookcase
card table/chairs
coat rack

curio cabinet
desk/chair
entertainment center
foot stool (ottoman)

gun cabinet
portable bar or cart
room divider

6. Living room furniture combinations, including –

sofa, chair, and table combinations or suites
DINING ROOM OR KITCHEN FURNITURE
7. Dining room or kitchen furniture, including –

buffet/hutch
china cabinet

dinette set
dining table and chairs

kitchen chairs
serving table or cart

BEDROOM FURNITURE
8. Mattresses or box springs, including roll-aways
9. Bedroom furniture other than mattresses or box springs, including –

armoire
bed frames
bunk bed
24

chairs
chest
dresser

headboard
mattress topper
mirrors

night tables
vanity
water bed
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Section 8 – Home Furnishings and Related Household Items
INFANTS’ FURNITURE AND EQUIPMENT
10. Infants’ furniture, including –

bassinet
changing table
chest
crib
dresser

high chair
mattress
playpen
portable crib
toy chest

11. Infants’ equipment, including –

baby bottle sterilizer
baby carrier/backpack
baby gate
baby monitor
baby travel systems
car seat

carriage
guard rail
jogging stroller
stroller
swing

OUTDOOR FURNITURE AND EQUIPMENT
12. Patio, porch, or outdoor furniture, including –

beach chair
canopy
chaise lounge
hammock

patio set
patio umbrella
picnic table
porch swing

13. Barbecue grills or outdoor decorative items, including –

bird bath
bird houses
fountain
inflatable lawn decorations
outdoor flag

patio lanterns
patio statues
planters
tiki torches
wind chimes

OFFICE FURNITURE FOR HOME USE
14. Office furniture for home use, including –

computer furniture
office chairs
drafting table
safe
file cabinet
Do not include any furniture used exclusively for business.

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Section 8 – Home Furnishings and Related Household Items
HOUSEHOLD DECORATIVE ITEMS
15. Lamps, lighting fixtures, or ceiling fans, including –

chandeliers
ceiling fans with/without
lights

floor lamps
recessed lighting
sconces

table lamps
track lights

16. Other household decorative items, including –

baskets
book ends
Christmas lights
clocks
fireplace equipment and
accessories

mirror
painting
plant stand
seasonal decorations
(Christmas)

silk flowers
vase
wall hangings
wreaths

CLOSET, STORAGE, AND TRAVEL ITEMS
17. Closet and storage items, including –

drawer organizers
drawers
garment bag
garment racks

hampers
hangers
hanging bags
shelf organizers

shoe bag
shoe rack
storage bins
underbed storage

18. Travel items including luggage, such as –

backpack
briefcase
messenger bag

passport holder
toiletry bag
tote bag

travel garment bags
travel pillow
trunk

DISHES, DINNERWARE, FLATWARE, GLASSWARE, AND COOKWARE
19. Stainless, silver, or other flatware, except plastic
20. Non-electric cookware, including –

casserole dishes
pans
pots

pressure cooker
roaster
saucepan

skillet
teakettle

21. Dishes, glasses, or serving pieces, including –

bowls
china
cups
crystal

26

mugs
pitchers
plates
platters

stemware
trays
Tupperware

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Section 8 – Home Furnishings and Related Household Items
HOUSEHOLD LINENS
22. Bedroom linens, including –

baby blanket
bedspread
blanket
comforter
duvet
electric blanket

mattress pad
pillowcases
pillows
quilt sheets

23. Bathroom linens, including –

bath mat
face cloths
hand towels
shower curtain

toilet cover
towels
tub mat
wash cloths

24. Kitchen, dining room, or other linens, including –

chair pads
cloth napkins
covers for living room tables
dish cloths
dish towels
doilies

furniture protectors
placemats
small appliance covers
table pads
tablecloths

25. Slipcovers, decorative pillows, or cushions, custom or ready-made

FLOOR AND WINDOW COVERINGS
26. Rugs or other non-permanent floor coverings, including carpet squares
27. Curtains or drapes (either custom or ready-made)
28. Blinds, shades, or other window coverings (either custom or ready-made)

Part B – Rental, Leasing, or Repair of Furniture
Rental or leasing of furniture
Repairing, refinishing, or reupholstering furniture, including the cost for fabric

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SECTION 9 – CLOTHING AND CLOTHING SERVICES
Part A – Clothing, Footwear, and Accessories
1. Coats or jackets, including –
down vest
hunting jacket
fur
raincoat

shawl/stole
snowsuit

2. Sport coats, tailored jackets, or blazers
3. Suits, including –
formal suit
man’s suit (of two or more pieces)
Do not include tuxedo rentals.

tuxedo
woman’s suit (of two or more pieces)

4. Vests (purchased separately, not with a suit), excluding sweater vests and outerwear
vests
5. Shirts, sweaters, blouses, or tops, including –
athletic shirt
dress shirts
maternity tops
bodysuit
knit blouses
polo shirt
cardigan
leotard
pullover

sweater
sweatshirt
sweater-vest

tank top
t-shirt

6. Pants, jeans, or shorts, including –
athletic shorts
crops/capris
bike shorts
dress slacks

overalls
rompers

short sets

7. Dresses, including –
formals or semi-formals
jump suit

leggings
maternity pants

maternity dresses
two-piece dresses

wedding gown
tennis dress

8. Skirts, including skorts
9. Undergarments, including –
bras
shapewear

slips
thermal underwear

undershirts
underwear

10. Hosiery, including –
knee-highs
pantyhose
socks
Do not include medical compression or surgical hosiery.
11. Nightwear or loungewear, including –
house coat
night shirt
night gown
pajamas

28

tights

robe
thermal sleeping garments

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Section 9 – Clothing and Clothing Services
12. Accessories, including –
apron
bandannas
belts
bridal headpiece
ear muffs
fold-up rain accessories

gloves
hand bag
handkerchiefs
hat mittens
non-prescription sunglasses
purse

13. Swimwear or swim cover-ups, including –
beach cover-up
rashguard
board short
swim shirt

scarves
suspenders
ties
umbrellas
wallet

swim shorts
swimsuit

14. Uniforms, other than sport, for which the cost is not reimbursed, including –
barber smocks
military uniforms
work uniforms
lab smocks
school uniforms
medical scrubs
scout uniforms
15. Costumes, including –
dance and ballet performances
Halloween

stage performances

16. Footwear, including athletic footwear, such as –
aerobic, basketball, jogging, casual shoes
sneakers
or tennis shoes
cleats
work boots
bedroom slippers
dress shoes
boots
sandals
Include specialized athletic shoes such as for football, soccer, bowling, biking, or
baseball, except if included in the rental or activity fee for the sport.
17. Diapers, including disposable
Do not include diaper service.
18. Layettes
19. Watches, including –
pocket watches
wristwatches
Do not include GPS or heartrate watches or “smartwatches” such as Apple Watch.
20. Jewelry, including –
bracelets
costume jewelry
cufflinks

CE-305 (4-1-2019)

earrings
infants jewelry
necklaces

rings

29

Section 9 – Clothing and Clothing Services

Part B – Clothing Services
1. Repair, alteration, and tailoring for clothing and accessories, including –
dress alterations
sew buttons
handbag repair
wallet repair
hemming
zipper replacement
2. Shoe repair or other shoe services, including –
dyeing
re-stitching
inserting lifts
replace heel
new soles
stretching
orthopedic modification
waterproofing
3. Watch or jewelry repair, including cleaning, such as –
cleaning
replace/add stones
replace battery
ring sizing
replace setting
4. Clothing or accessory rental, including formal wear, such as –
handbag rental
tuxedo or suit rental
5. Clothing storage outside the home, including –
cold storage for furs

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SECTIONS 10 AND 11 – RENTED, LEASED, AND OWNED
VEHICLES
1. Automobile, truck, minivan, van, and SUV
Include fees for car sharing services such as Zipcar with rented vehicles.
2. Motor home
3. Camper, trailer or attachable
4. Motorcycle, motor scooter, or moped (motorized bicycle)
5. Boat with a motor, including –
boat with outboard motor
cabin cruiser
jet skis
launch

pontoon boat
power boat
yacht

6. Boat without a motor, including –
canoes
kayaks
rowboats
7. Trailer other than camper, including –
ATV trailer
boat trailer
cargo trailer

rowing shells
sailboats

horse trailer
motorcycle trailer
utility trailer

8. Private aircraft, including –
gliders
helicopters

planes

9. Any other vehicle, including –
ATV
dune buggy
riding golf cart (except if rental included in
golfing fees)

Segway
snowmobile

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31

SECTION 12 – VEHICLE OPERATING EXPENSES
Part A – Vehicle Maintenance and Repair, Parts, and
Equipment
1. Oil change, lubrication, or oil filter
2. Motor tune-up, including –
air/fuel filters
computer sensor
distributor cap, rotor

emission controls
ignition timing or mixture
adjustment

PCV valve
spark plugs
valve adjustment

3. Battery purchases or installation
4. Repairs to tires, including patches and plugs
5. Tire purchases or mounting
6. Front end alignment, wheel balancing, or wheel rotation
7. Shock absorber replacement, including MacPherson struts
8. Body work or painting, including –
accident repairs
convertible top

doors
glass replacement

rust proofing
sanding

T-roof
window repair

9. Any other vehicle or engine repairs, including –
air conditioning
carburetor
engine work
alternator
car computer
exhaust system
axle
clutch
fan switch or belt
battery
condenser
fuel injector or pump
bearings
differential
hydraulic system
brakes
electrical system
ignition system

muffler
radiator
steering
suspension
timing belt
transmission

10. Vehicle accessories or customizing, including –
alarm system
bike, luggage, or ski racks
bumper guards

carpeting
fender skirts
running boards

seat covers
spoilers
steering wheel covers

11. Other vehicle services, parts, or equipment, including –
battery cables
charcoal canister filters
gas cable/cap/can
gasket sets

jack
lights
speedometer cable
upholstery work

vent filters
wheel lugs
wheels/rims/hub caps
windshield wipers

12. Vehicle cleaning services including car washes, including –
boat cleaning services
vacuuming
vehicle detailing services

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Section 12 – Vehicle Operating Expenses

Part B – Licensing, Registration, and Inspection of Vehicles
1. Driver’s licenses
Do not include other forms of identification such as passports.
2. Vehicle inspection, including –
emissions inspection
3. State vehicle registration, including –
license plates
renewals

safety inspection

tags

4. Local vehicle registration
5. Personal property taxes for vehicles

Part C – Other Vehicle Operating Expenses
Average monthly expense for gasoline
Paid for electric vehicle charging away from home
Purchased any antifreeze, brake fluid, transmission fluid, windshield wiper fluid, or
additives
Parking, including –
parking garages
parking lot fees

parking meters

Do not include expenses that are part of your property ownership or rental costs, a
business expense, or expenses that will be totally reimbursed.
Local tolls or electronic toll passes
Docking and landing fees for boats and planes
Auto repair service policies such as extended warranties
Do not include service policies for vehicles used entirely for business.
Automobile service clubs such as AAA or services such as OnStar or LoJack
Towing charges, not already reported
Bottled or tank gas for recreational vehicles, including vans, campers, and boats

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33

SECTION 13 – HEALTH INSURANCE

1. Private health insurance, including employer and healthcare exchange plans
Health insurance provided in part or full by an employer (excluding military) or union or
purchased directly by the household, such as –
COBRA/Temporary Continuation of
Individual Practice Association (IPAs))
Coverage
Point of Service Plans (POS)
Fee for service plans
PPO (Preferred Provider Organizations)
HMOs (Health Maintenance Organizations
2. Medicare
Federal health insurance coverage for persons 65+ years of age and certain disabled
persons under 65, including –
Medicare Advantage
Medicare HMOs
Medicare Part C

Medicare Part D
Medicare Plus Choice
Medicare prescription drug plans

3. Medicare Supplemental Insurance (Medi-Gap)
Private health insurance purchased to supplement Medicare.
4. Medicaid
Medical assistance program that provides health care coverage to low income and disabled
persons. Medicaid is run by the states and is often called different names in different states.
5. Children’s Health Insurance Program (CHIP/SCHIP)
Health care coverage for low-income, uninsured children under age 19 who are not
currently eligible for Medicaid or covered by private health insurance. This program is run
by the states and is often called different names in different states.
6. Military health care, including –
CHAMP-VA
Tricare

VA (Veterans Administration)

7. Indian Health Service (IHS)
Federal health care program for Native Americans and Alaska Natives.
8. Single service plans
Health insurance coverage that provides for only one type of service, such as dental care,
vision care, prescriptions, and long-term care.
Do not include Medicare Part D prescription drug plans.
9. No coverage of any type

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CE-305 (4-1-2019)

SECTION 14 – MEDICAL AND HEALTH EXPENSES
EYE CARE
1. Eye examinations, treatment, or surgery, such as –
eye examinations

eye treatments

laser surgery

2. Purchase of eye glasses or contact lenses, such as –
contact lenses
contact lens insurance
eye glasses

fittings
kits and equipment
prescription sunglasses

warranty expenses

DENTAL CARE
3. Dental care, such as –
braces/Invisalign
bridges
caps or crowns
cleanings

cosmetic dentistry
dentures
extractions
fillings

implants
root canals
teeth whitening in a
dental office

x-rays

INPATIENT CARE
4. Hospital room or hospital services, including –
anesthetics
blood transfusions
drugs and medicine
examinations

injections
intensive care unit
laboratory tests
nursing services

From facilities, such as –
birthing centers
general care hospitals

operating room
oxygen
recovery room
therapy

treatment rooms
x-rays

psychiatric hospitals
substance abuse hospitals

SERVICES BY MEDICAL PROFESSIONALS OTHER THAN PHYSICIANS
5. All services provided by medical professionals other than physicians, such as –
acupuncturist
medical massage therapist
podiatrist
chiropractor
midwife
psychologist
homeopath
nurse practitioners
substance abuse
marriage counselor
physical therapist
professionals
Include services provided both inside and outside the home.
PHYSICIAN SERVICES
6. All services provided and billed by physicians, such as –
dermatologist
internist
plastic surgeon
general practitioner
osteopath
psychiatrist
gynecologist
pediatrician
surgeon
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urologist

35

Section 14 – Medical and Health Expenses
OTHER MEDICAL CARE SERVICES
7. Lab tests or x-rays, such as –
blood tests
MRI
CAT scan
x-rays
Exclude services received in a hospital as an inpatient or services for eye or dental care.
8. Care in convalescent or nursing homes
Include all services provided and billed by a convalescent or nursing home.
9. Care for invalids, convalescents, handicapped, or elderly persons in the home
Do not include institutional or medical care.
10. Adult day care centers
11. Other medical care and services, such as –
ambulance services
emergency room services
blood donation
outpatient hospital care
dialysis services
oxygen services

rescue services

If medical care is given in outpatient department or emergency room, include –
allergy shots
cancer treatment
immunizations
baby shots
cardiology test
injections
blood pressure check
electro cardiogram
physicians check up
broken bones/sprains
hearing test
skin treatment
MEDICINE OR MEDICAL SUPPLIES
12. Hearing aids
13. Prescription drugs, including –
asthma inhalers
birth control

insulin

medical marijuana

14. Purchase or rental of supportive or rehabilitative medical equipment, such as –
ace bandages
orthotics
walkers
braces
power chair/scooter
wheelchairs
canes
prosthetics
whirlpools
cervical collars
slings
crutches
splints
15. Purchase or rental of medical or surgical equipment for general use, such as –
blood pressure kits
heating pads
home defibrillator
hot water bottles

ice bags
insulin needles
orthopedic supports
ostomy supplies

oxygen
pollen masks
vaporizers
syringes

Do not include items such as Band-Aids, gauze, cotton roll, and cotton balls.

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CE-305 (4-1-2019)

SECTION 15 – INSURANCE OTHER THAN HEALTH

1. Life insurance or other policies which provide benefits in case of death or disability,
including –
annuities
life endowments
burial insurance
straight-life insurance
cash benefits
term insurance
flight insurance
veterans insurance
group-life insurance
whole-life insurance
income or disability insurance
2. Homeowners' insurance, which protects your home, furniture, personal effects, or
other property against fire, flood, theft, loss, or damage, including –
fire and extended coverage

flood insurance

3. Renters' insurance, which protects your furniture, personal effects, or other property
against fire, flood, theft, loss, or damage
4. Automobile or other vehicle insurance, including –
bodily injury insurance
liability insurance
collision insurance
no-fault insurance
comprehensive insurance
property damage insurance
5. Other types of non-health insurance, including –
ambulance insurance
personal liability insurance
credit card insurance
pet insurance
mortgage guarantee insurance
private mortgage insurance (PMI)
Do not include malpractice insurance.

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37

SECTION 16 – EDUCATIONAL EXPENSES
1. Recreational lessons or other instructions, including –
cooking
music
dancing
needlepoint
driving
painting
golf
photography
horseback riding
sailing
instructional day camps
self defense

sewing
skiing
skydiving
swimming
tennis

2. Preschool or child day care centers, including non-instructional day camps
3. Tuition, including pre-paid tuition, for –
adult education
high school
secretarial school
business school
middle/junior high
seminary
college or university
parochial school
technical school
elementary school
preparatory school
vocational school
Include only expenses paid directly to the school or other educational facility.
Do not report student loan payments.
4. Housing while attending school, including –
fraternity
sorority
housing for married students
student dormitory
Include only expenses paid directly to the school or other educational facility.
5. Food or board while attending school
Include only expenses paid directly to the school or other educational facility.
6. Private school bus service
7. Test preparation or tutoring services
8. Purchase of any school books, supplies, or equipment, which has not already been
reported, including –
art supplies
laboratory equipment
technical books
cap and gown
microscopes
text books
drafting equipment
ruler
9. Other school related expenses not already reported, including the rental of any
school books or expenses, including –
administration fees
laboratory fees
rental of school equipment
athletic fees
laundry fees
SAT, ACT, GRE test fees
cap and gown rentals
matriculation fees
student union fees
conferences and seminars
registration fees
transportation fees
health fees
rental of school books
Do not report student loan payments.

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CE-305 (4-1-2019)

SECTION 17 – SUBSCRIPTIONS, MEMBERSHIPS,
BOOKS, AND ENTERTAINMENT EXPENSES
1. Golf courses or country clubs
2. Health clubs, fitness centers, swimming pools, weight loss centers, or other sports
or recreational organizations
3. Fees for participating in sports such as golf, bowling, biking, hockey, football, or
swimming, including –
baseball
club sports
running races
basketball
fishing or hunting licenses
tennis
billiards
martial arts
triathlons
4. Bike-sharing
5. Vacation clubs, including –
Disney Vacation Club

Hilton Grand Vacations

RCI

6. Civic, service, fraternal, or other social organizations
7. Credit card membership fees
8. Shopping club memberships including warehouse clubs like Sam’s Club and
discount memberships like Amazon Prime
9. Direct or online dating services, including –
eHarmony

Match.com

OurTime

10. Single or season tickets to spectator sporting events, including –
auto racing
football
track events
baseball
hockey
basketball
soccer
11. Single or season tickets to plays, operas, or concerts
12. Movie tickets
13. Tickets to parks or museums, including –
amusement parks
historic sites
Disney World
national/state parks

water parks
zoos

14. Single copies of newspapers, magazines, or periodicals including digital
15. Subscriptions to newspapers, magazines, or periodicals including digital
16. Books, digital books, or book subscriptions, including –
Audible.com Listener
digital books
audio books
hardcovers
Do not include reference books or school books.
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Kindle Unlimited
paperbacks

39

Section 17 – Subscriptions, Memberships, Books, and Entertainment
Expenses
17. Photo printing or processing, including –
digital photo processing
photo books

video film processing

18. Photographic film or disposable cameras, including –
35 mm film
single-use film cameras
8 mm film
19. Purchased music files, CDs, or records, including –
Amazon
iTunes
Google Play
Do not include blank/recordable discs or tapes.
20. Sirius or XM satellite radio service
21. Subscription music services such as Spotify or Pandora, including –
Apple Music
SoundCloud
Google Play Music
22. Purchased video files, Blu-Ray discs, or DVDs, including –
Amazon Instant Video
iTunes
Google Play
Do not include blank/recordable discs or tapes.
23. Rented video files or DVDs or streaming video subscriptions, including –
Amazon Instant Video
Netflix
Hulu Plus
Playstation Vue
iTunes
RedBox
MLB.TV
Sling TV
Do not include on-demand movies or pay-per-view paid through your TV service.
24. Purchased video games, not including computer games, such as –
Nintendo games
Wii games
PlayStation games
Xbox games
25. Rented video games, including –
GameFly

Gamerang

26. Applications, games, or ringtones for a cellphone or mobile device, not already
reported, including –
Amazon App Store

App Store

Google Play

27. Online games or other internet entertainment sites
PlayStationPlus
Xbox Live

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SECTION 18 TRIPS AND VACATIONS
Types of Trips
1. Visiting relatives or friends
2. Business trips
3. Recreational trips, such as –
club or organizational meetings
outdoor recreation

sightseeing
sports events

4. Any other trips that occur overnight or longer
5. Any day trips to a place at least 75 miles away

Types of Transportation
COMMERCIAL
1. Local, including –
bus
ferries

local rail

subway

SuperShuttle

taxi

Uber

2. Airplane
3. Train
4. Bus, including –
Greyhound
5. Ship, including –
cruise ships

Hampton Jitney

Megabus

long-distance ferries

Trailways
river cruises

RENTED
6. Automobile, truck, van
7. Motorcycle, moped
8. Private plane
9. Boat, trailer
10. Camper
11. Other vehicles
PRIVATE
12. Automobiles or other vehicles privately owned or leased by household
13. Vehicle owned by someone else
14. Other transport

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41

Section 18 – Trips and Vacations

Fees to Play Sports, Exercise, or Rent Sports Equipment
Bikesharing
Boating
Bowling
Exercise classes
Fishing
Golf
Scuba/snorkeling
Skiing/snowboarding
Swimming
Tennis
Other sports

Entertainment or Admissions
Concerts
Movies
Museums
Sports events
Theater
Tours
Other entertainment events

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CE-305 (4-1-2019)

SECTION 19 – MISCELLANEOUS EXPENSES
Part A – Miscellaneous Expenses
1. Fresh flowers or potted plants
bouquets
corsages
funeral flowers
Do not include outdoor plants or gardening.

wedding flowers

2. Professional photography
3. Services of lawyers or other legal professionals, including –
arbitration services
civil litigation
divorce
mediation
bail bonds
contracts
estate settlement
will
bankruptcies
criminal litigation
lawsuits
Do not include legal fees for business purposes or for real estate closing costs.
Do not include parking or traffic tickets.
4. Accounting fees, including –
estate management
income tax preparation
Do not include fees for business purposes.

trust management

5. Occupational expenses, such as union dues or professional licenses
6. Gardening or lawn care services, including –
fertilizing
lawn cutting
plowing
tree pruning
hedge trimming
planting
tilling
tree removal
Include any services provided under service contracts.
Do not include services covered by management or maintenance fees.
7. Housekeeping services, including –
carpet cleaning
cooking
cleaning
laundering

window washing

8. Home security system service fees
9. Other home services or small repair jobs around the house, not previously reported
diaper service

pool maintenance

snow removal

10. Moving, storage, or freight, including –
cargo shipping
moving companies
mini-warehouses
self-storage units
Exclude expenses reimbursed by employers or other persons outside of the household.
11. Stamp or coin collecting, including –
coin albums
first day covers
Do not include postage.

stamp albums

12. Lotteries or games of chance

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43

Section 19 – Miscellaneous Expenses
13. Babysitting, nanny services, or other child care inside or outside your home
Do not include nursery school care or care in a day care center.
14. Toys or games, including –
action figures
dolls
dart board
games

infant toys
stuffed animals

trains
trucks

15. Arts or crafts kits, including –
model kits
needlepoint kits

rug kits

scrapbook supplies

16. Sewing, knitting, or quilting materials and items, including –
beads
felt
needles
buttons
fiberfill
patterns
crochet hooks
interfacing
quilt pad
embroidery hoops
knitting equipment
rug material
fabric
measuring tapes
seam binding
17. Purchase of pets, pet supplies, or medicine for pets, including –
aquarium
collars
guinea pig
bird
dog
hamster
bird cage
dog house
hamster cage
cat
gerbil
pet toys
Do not include pet food.
18. Pet services, including –
dog walking
kennels
grooming
license

pet daycare
pet resorts

sequins
sewing kit
stuffing
thread/yarn
zipper

tropical fish

training

19. Veterinarian expenses for pets, including –
surgery
vaccinations
vet visits

veterinary treatment

20. Catering, for –
anniversaries
Bar/Bat Mitzvahs

quinceañeras
weddings

bridal showers
confirmations

graduations
parties

21. Arrangement of live entertainment for special occasions
22. Rental of party supplies
23. Purchase or upkeep of cemetery lots or vaults
24. Funerals, burials, or cremation, including –
burial fees
footstones
burial plans
funeral transcript
clergy
headstones
44

limousines (used during
funeral)
musician honoraria
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Section 19 – Miscellaneous Expenses

Part B – Contributions
GIVEN ANY MONEY BY CASH, CHECKS, OR GIVEN ANY GIFT CARDS TO –
1. College students living away from home
Money to pay for tuition, room, board, books, fees, transportation, clothing, or
entertainment expenses
2. Any other people not in your household, including –
birthday money
friends
cash gifts at the office
homeless persons
co-workers
money to assist others

street musicians
wedding money

PAID ANY OF THE FOLLOWING –
3. Child support
4. Alimony
GIVEN ANY MONEY BY CASH, CHECKS, MONEY ORDERS, OR CREDIT CARDS TO BENEFIT –

5. Educational institutions, including –
alumni funds
parochial schools
educational endowments
scholarship funds

school fund raisers

6. Political organizations, including –
political action committees
political candidates
(PACs)

political parties

7. Religious organizations, including churches, temples, and mosques, such as –
building funds
religious television/radio ministries
religious fund raisers
tithes and offerings
8. Charities or other organizations, including –
ACLU
Combined Federal
American Cancer Society
Campaign (CFC)
American Heart Association fine arts and literary
civic organizations
Humane Society

Red Cross
Salvation Army
United Way

GIVEN ANY STOCKS, BONDS, OR MUTUAL FUNDS
9. Stocks, bonds, mutual funds
Include only securities given to persons or organizations outside of your household.

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45

SECTION 20 – EXPENSE PATTERNS FOR SELECTED
SERVICES AND GOODS
Grocery shopping
Restaurants, fast food places, cafeterias, carry-outs, or other such places
Cigarettes
Do not include e-cigarettes.
Other tobacco products such as cigars, pipe tobacco, chewing, tobacco, or vaping
products, including –
e-cigarettes
Alcohol, including beer and wine
Meals at school for preschool through high school
Self-service laundry machines, for laundering items such as –
clothing
drapes
quilts
coats
linens
rugs
Dry cleaning or laundry service, for laundering items such as –
clothing
drapes
quilts
coats
linens
rugs
Haircutting, styling, attached hair pieces, manicures, massages and other salon
services, including –
facials
hair weaves
tanning
hair coloring
pedicures
waxing
Removable hairpieces, wigs, or toupees, including –
temporary hair extensions
Safe deposit box rental in a bank or similar financial institution
Charges or fees for bank services such as ATM or overdraft fees or account service
charges from a bank or similar financial institution, including –
below minimum balance fee
management fees for trust, custodial, or
bill payment fee
escrow accounts
certified check fee
money order fee
check cashing fee check order fee
online banking fee
personal loan fees
regular service charges
Taxis, limousine service, or car rides booked through an app, including Lyft
SuperShuttle
Uber
Public transportation services such as bus, subway, train, or passenger ferry

46

CE-305 (4-1-2019)

SECTION 21 – OCCUPATIONS
1. Administrator, Manager
funeral director
2. Teacher
guidance counselor
3. Professional
accountant
clergy

engineer
IT analyst

lawyer
photographer

4. Administrative Support, including Clerical
assistant
bookkeeper
clerk
5. Sales, Retail
apparel salesperson
cashier

physician
registered nurse

social worker

receptionist

secretary

commodity salesperson
door-to-door salesperson

6. Sales, Business Goods and Services
financial services
manufacturing sales
insurance salesperson
representative
mining sales representative

motor vehicle salesperson

real estate salesperson
wholesale sales
representative

7. Technician
clinical laboratory technician
drafter

electronic technician
health technician

practical nurse

8. Protective Service
firefighter

police officer

private guard

9. Private Household Service
household worker

nanny

10. Other Service (except private household)
childcare worker
food preparer
cook
hairstylist

janitor
maid/houseman

orderly
waiter/waitress

11. Machine or Transportation Operator, Laborer
assembler
freight handler
material handler
bus driver
inspector
packager
construction laborer
machine operator
stock handler

taxi driver
tractor operator
truck driver

12. Construction Workers, Mechanics
automobile mechanic machine repairer
carpenter
machinist
electrician
meat cutter

mining worker
painter
plumber

13. Farming
farm worker

farmer

14. Forestry, Fishing, Groundskeeping
animal caretaker
fisher

forestry worker

sheet metal worker

groundskeeper

15. Armed Forces

CE-305 (4-1-2019)

47

SECTION 21 – WORK EXPERIENCE AND INCOME

CARD A

0. Loss
1. $ 1

– $ 4,999

2. $ 5,000

– $ 9,999

3. $ 10,000 – $ 14,999
4. $ 15,000 – $ 19,999
5. $ 20,000 – $ 29,999
6. $ 30,000 – $ 39,999
7. $ 40,000 – $ 49,999
8. $ 50,000 – $ 69,999
9. $ 70,000 – $ 89,999
10. $ 90,000 – $ 119,999
11. $ 120,000 and over

48

CE-305 (4-1-2019)

Section 21 – Work Experience and Income

CARD B

1. Less than $500
2. $ 500

– $ 699

3. $ 700

– $ 999

4. $ 1,000 – $ 1,299
5. $ 1,300 – $ 1,699
6. $ 1,700 and over

CE-305 (4-1-2019)

49

Section 21 – Work Experience and Income

CARD C

0. Loss
1. $ 1

– $ 999

2. $ 1,000

– $ 1,999

3. $ 2,000

– $ 2,999

4. $ 3,000

– $ 3,999

5. $ 4,000

– $ 4,999

6. $ 5,000

– $ 9,999

7. $ 10,000 – $ 14,999
8. $ 15,000 – $ 19,999
9. $ 20,000 – $ 29,999
10. $ 30,000 – $ 39,999
11. $ 40,000 – $ 49,999
12. $ 50,000 and over
50

CE-305 (4-1-2019)

SECTION 22 – ASSETS AND LIABILITIES

CARD D

1. $ 1

– $ 1,999

2. $ 2,000

– $ 9,999

3. $ 10,000

– $ 49,999

4. $ 50,000

– $ 199,999

5. $ 200,000 – $ 449,999
6. $ 450,000 and over

CE-305 (4-1-2019)

51

Section 22 – Assets and Liabilities

CARD E

1. $ 1

– $ 499

2. $ 500

– $ 999

3. $ 1,000

– $ 2,499

4. $ 2,500

– $ 9,999

5. $ 10,000

– $ 34,999

6. $ 35,000 and over

52

CE-305 (4-1-2019)

2019 CALENDAR
JANUARY
S

JULY

M

T W T F S
1 2 3 4 5
6 7 8 9 10 11 12
13 14 15 16 17 18 19
20 21 22 23 24 25 26
27 28 29 30 31

M T W T F S
1 2 3 4 5 6
7 8 9 10 11 12 13
14 15 16 17 18 19 20
21 22 23 24 25 26 27
28 29 30 31

FEBRUARY

AUGUST

S

M

S

M

T

W

T

F S
1 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16
17 18 19 20 21 22 23
24 25 26 27 28

S

S

M

T F S
1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30 31

S
1
8
15
22
29

M T W T F S
2 3 4 5 6 7
9 10 11 12 13 14
16 17 18 19 20 21
23 24 25 26 27 28
30

S

M

S

M

MARCH
T

W

T

APRIL

OCTOBER

S

M T W T F S
1 2 3 4 5 6
7 8 9 10 11 12 13
14 15 16 17 18 19 20
21 22 23 24 25 26 27
28 29 30

T W T F S
1 2 3 4 5
6 7 8 9 10 11 12
13 14 15 16 17 18 19
20 21 22 23 24 25 26
27 28 29 30 31

MAY
M

T

S

M

T

NOVEMBER

W T F S
1 2 3 4
5 6 7 8 9 10 11
12 13 14 15 16 17 18
19 20 21 22 23 24 25
26 27 28 29 30 31

JUNE
T

T

W

T

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

DECEMBER

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

CE-305 (4-1-2019)

W

W

SEPTEMBER

F S
1 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16
17 18 19 20 21 22 23
24 25 26 27 28 29 30
31

S

T

F

S M T W T F S
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31

53

2020 CALENDAR

JANUARY
S

M

S

M

T

W T
1 2
5 6 7 8 9
12 13 14 15 16
19 20 21 22 23
26 27 28 29 30

JULY
F
3
10
17
24
31

S
4
11
18
25

S

M

W T F S
1 2 3 4
5 6 7 8 9 10 11
12 13 14 15 16 17 18
19 20 21 22 23 24 25
26 27 28 29 30 31

S

M

S

M

FEBRUARY
T

W

T

AUGUST

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

F

S
1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30 31

MARCH
S M T W T F S
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31

M

T

W T F S
1 2 3 4
5 6 7 8 9 10 11
12 13 14 15 16 17 18
19 20 21 22 23 24 25
26 27 28 29 30

S

M

T

T

F

6
13
20
27

S

M

OCTOBER
T

W

T F S
1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30 31

NOVEMBER

F S
1 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16
17 18 19 20 21 22 23
24 25 26 27 28 29 30
31

S M T W T F S
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30

JUNE

DECEMBER

S

T

M T W T F S
1 2 3 4 5 6
7 8 9 10 11 12 13
14 15 16 17 18 19 20
21 22 23 24 25 26 27
28 29 30

54

W

T W T F S
1 2 3 4 5
7 8 9 10 11 12
14 15 16 17 18 19
21 22 23 24 25 26
28 29 30

MAY
W

T

SEPTEMBER

APRIL
S

T

S

M

T W T F S
1 2 3 4 5
6 7 8 9 10 11 12
13 14 15 16 17 18 19
20 21 22 23 24 25 26
27 28 29 30 31

CE-305 (4-1-2019)

Fractions to Percentages
Fraction

%

Fraction

%

Fraction

%

1/2

50.00

1/7

14.29

3/9

33.33

1/3

33.33

2/7

28.57

4/9

44.44

2/3

66.67

3/7

42.86

5/9

55.55

1/4

25.00

4/7

57.14

6/9

66.67

2/4

50.00

5/7

71.42

7/9

77.78

3/4

75.00

6/7

85.71

8/9

88.89

1/5

20.00

1/8

12.50

1/10

10.00

2/5

40.00

2/8

25.00

2/10

20.00

3/5

60.00

3/8

37.50

3/10

30.00

4/5

80.00

4/8

50.00

4/10

40.00

1/6

16.67

5/8

62.50

5/10

50.00

2/6

33.33

6/8

75.00

6/10

60.00

3/6

50.00

7/8

87.50

7/10

70.00

4/6

66.67

1/9

11.11

8/10

80.00

5/6

83.33

2/9

22.22

9/10

90.00

CE-305 (4-1-2019)

55

LANGUAGE IDENTIFICATION CARDS

Hello, I’m from the U.S. Census Bureau. Is someone here now who
speaks English and can help us? If not, please give me your phone
number and someone may contact you in English.

01. English

Buenos días (Buenas tardes), soy de la Oficina del Censo de los Estados
Unidos. ¿Se encuentra alguien que hable inglés y pueda ayudarnos? Si
no, por favor, dígame su número de teléfono; es possible que alguien se
comunique con usted en español.

02. Español/Spanish

Insert Arabic text from Census Language Identification Card

03. [Arabic]/Arabic

Insert Cantonese-Simplified text from Census Language Identification
Card
04. [Cantonese
Simplified] /
CantoneseSimplified

Insert Mandarin-Simplified text from Census Language Identification
Card
05. [Mandarin
Simplified] /
MandarinSimplified

Insert Korean text from Census Language Identification Card

06. [Korean]/Korean

56

CE-305 (4-1-2019)

Language Identification Cards

Dzień dobry. Jestem z Amerykańskiego Biura Spisu Ludności. Czy ktoś
tutaj mówi po angielsku I czy mógłby nam pomóc? Jeżeli nie, proszę
podać mi swój numer telefonu, pod którym można skontaktować się z
Państwem po polsku.

07. Polski/Polish

Здравствуйте! Я представляю Бюро переписи населения
Соединенных Штатов. Присутствует ли здесь кто-нибудь, кто
говорит по-английски и мог бы нам помочь? Если нет, то,
пожалуйста, дайте нам свой номер телефона, чтобы при
необходимости наш сотрудник мог с вами поговорить по-русски.

08. Pусский/Russian

Xin chào, tôi là nhân viên của Cục Thống Kê Dân Số Hoa Kỳ. Ở đây
hiện có ai biết nói tiếng Anh và có thể giúp chúng tôi không? Nếu không
xin vui long cho biết số điện thoại của quý vị. Chúng tôi có thể liên lạc
với quý vị bằng tiếng Việt.

09. Tiếng Việt /
Vietnamese

CE-305 (4-1-2019)

57


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