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pdfATTACHMENT A
2021 SIPP INSTRUMENT BOOKLET QUESTIONNAIRE
H_PURPOSE
Frequently Asked Questions
1. Why are you interviewing me?
2. Why do you need all this information?
3. How is my information relevant?
4. How am I supposed to remember?
5. Is my information kept confidential?
6. Why do you need the monthly amounts I received?
7. Program Quick Reference Guide
8. Why are you asking me about health insurance?
9. Proceed with the interview
H_PURPOSE1
Why are you interviewing me and not my neighbor?
In order to make this survey more cost effective, minimizing the amount of tax payer dollars used
to collect data, a sample is drawn at random based on several key components, like the purpose
of the survey and its target population. The decennial census is used to determine basic
characteristics of all households in the U.S. Based on the population size and characteristics,
individual households are then chosen to represent larger groups of the population. Your
household in particular was randomly chosen to represent a portion of the population.
1. Enter 1 to continue
H_PURPOSE2
Why do you need all this information?
The information collected through this survey is used to make decisions about programs that
affect millions of Americans. SIPP is used by researchers to provide elected officials with the
information necessary to determine funding for social welfare programs, aid these officials in
making voting decisions on legislation, as well as the distribution of these programs and federal
funding. Without this information, the allocation of resources would be completely ineffective and
those in need of public assistance would go unrecognized.
1. Enter 1 to continue
H_PURPOSE3
How is my income, health, wealth, program participation relevant?
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The information you provide is used to make decisions about social programs like how much is
spent and where the funding is needed. As the economic situation in the U.S. is constantly
changing, the information you provide in this interview is used to assess the effectiveness and
further need for social welfare programs and other sources of economic stimulation. The unique
design of SIPP provides information that can more clearly determine the effectiveness of federal
programs, child well-being, and other social policy issues.
1. Enter 1 to continue
H_PURPOSE4
That was a long time ago; how am I supposed to remember?
Remember your probing techniques and the importance of the calendar aid:
- Pause to give respondent time to think
- Repeat the question, emphasizing the critical words or phrases
- Acknowledge the respondent's answer and ask additional questions such as best estimate
- Ask if something else was happening at the time (i.e. snow storm, summer vacation, etc).
1. Enter 1 to continue
H_PURPOSE5
Some of these questions are very personal; how do I know the government isn't going to use this
information to deport me or take away my benefits?
The U.S. Census Bureau is required by law to protect your information. The Census Bureau is not
permitted to publicly release your responses in a way that could identify you or this household.
We are conducting this survey under the authority of Title 13, United States Code, Sections 141
and 182. Federal law protects your privacy and keeps your answers confidential (Title 13, United
States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are
protected from cybersecurity risks through screening of the systems that transmit your data.
Additionally, data access is restricted and prior to the release of any data, all products must meet
the Disclosure Review Board standards, ensuring the protection of your confidentiality. Not only
is personally identifiable information not released, but neither is any information that may lead to
your identification through a combination of any of the answers you provided, which simply
means we use statistical methods to protect the data before we release it to the public. For
example, if you are the only small business owner in your geographic location with two children
in day care, you could be identified if we did not modify the data prior to its release. Our
modifications maintain the integrity of the data while preventing you from being identified.
1. Enter 1 to continue
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H_PURPOSE6
Why do you need to know how much I receive from these programs per month?
Because circumstances change sporadically, monthly income information produces the most
useful data. We need to collect both the source and the amount of income, labor force
information, program participation and eligibility data, and other more general characteristics to
measure the effectiveness of existing federal, state, and local programs. Because most program
eligibility is based on monthly information, these amounts are necessary to estimate future costs
and coverage for government programs, such as food stamps. Additionally, monthly amounts
provide improved statistics on the distribution of income and measures of economic well-being
in the country.
1. Enter 1 to continue
H_PURPOSE7
Program Quick Reference Guide
1. Earned Income Tax Credit (EITC)
2. Energy Assistance
3. Food Stamps (FSP or SNAP)
4. Free/Reduced-Price School Lunch
5. General Assistance
6. TANF
7. Supplemental Security Income (SSI)
8. Unemployment Compensation
9. VA Benefits
10. WIC
11. Workers' Compensation
12. Medicare
13. Health Insurance and Health Care Terms
14. Return to Previous Menu
H_REFERENCE1
Earned Income Tax Credit (EITC)
The Earned Income Tax Credit or the EITC is a refundable federal income tax credit for low to
moderate income working individuals and families. When EITC exceeds the amount of taxes
owed, it results in a tax refund to those who claim and qualify for the credit. To qualify, taxpayers
must meet certain requirements and file a tax return, even if they do not have a filing requirement.
To qualify, income has to be earned from employment, self-employment, or another source and
meet certain rules that include specifications for qualifying children. Amounts and eligibility vary
annually based on congressional decisions and income by family size. Additionally, if you are
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married you have to file jointly to qualify.
1. Enter 1 to continue
H_REFERENCE2
Energy Assistance
The Low-Income Home Energy Assistance Program (LIHEAP) provides financial assistance to
eligible households to help them pay their home energy costs. Each State has great flexibility in
deciding how to distribute the money to low income households. The Federal government
provides the funds for this program to the States and has made over $1 billion available for the
last several winters. In addition to Federal funds, some States provided their own money for
energy assistance. To qualify, a household must pay a high proportion of the household income
for home energy, primarily in meeting their immediate home energy needs. Income eligibility
varies by state and is generally granted to those household with the highest home energy costs
or needs in relation to income. Receiving assistance from TANF, SSI, of food stamps does not
disqualify a household. Eligibility criteria can include an assets test, living in nonsubsidized
housing, having a household member who is elderly, disabled, or a young child, or the receipt of
a utility disconnection notice.
1. Enter 1 to continue
H_REFERENCE3
Food Stamps (FSP or SNAP)
Also referred to as the Supplemental Nutrition Assistance Program (SNAP), provides assistance
to 29 million people per month. The food stamp program provides coupons or ATM cards for
low-income households to purchase food. The food stamp program is a joint federal-state
program which is administered by state and local governments and therefore can have a different
name in each state. All U.S. citizens, nationals, and qualified aliens are eligible for SNAP, as are
legal aliens after a five year waiting period. People between the ages of 18 and 60 must register
for work to qualify, and may as a result participate in employment or training programs.
Household resources cannot exceed $2,000 (or $3,000 in households with disabled persons),
excluding other forms of assistance like SSI or TANF. Eligibility and monthly amounts are
determined by the Social Security office where the food stamp representative works. Monthly
amounts vary by state, individual or familial income, and family size or number of dependents.
1. Enter 1 to continue
H_REFERENCE4
Free or Reduced-Price School Lunch
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The Federal School Lunch Program is sponsored by the U.S. Department of Agriculture and Food
and Consumer Service, which subsidizes the cost of all school lunches in the country. In
addition to these standard subsidies, students whose household income falls below a certain
level are eligible to receive their lunches free or at a reduced price. In order to qualify, the
household must apply to the local school district. The district determines who qualifies for this
additional aid, as well as the amount and duration of the aid.
1. Enter 1 to continue
H_REFERENCE5
General Assistance
State and local programs provide cash assistance to persons not eligible for cash assistance,
(formerly AFDC or ADC) or Supplemental Security Income (SSI), and to persons awaiting
enrollment in SSI. These programs are also available to persons out of work who cannot qualify
for unemployment insurance or whose benefits under that program are inadequate or have been
exhausted. General assistance or general relief programs are often called by other names
because like many assistance programs they are state-based. This program is restricted to
adults without dependents (families with children are offered assistance under TANF).
1. Enter 1 to continue
H_REFERENCE6
TANF
Temporary Assistance for Needy Families (TANF), provides grants to states to achieve the
following: assisting needy families so that children can be cared for in their own homes
reducing the dependency of needy parents by promoting job preparation, work and marriage
preventing out-of-wedlock pregnancies encouraging the formation and maintenance of
two-parent families.As with the design of the food stamps programs, this is a state level program
and can therefore have a different name in each state, and benefits are subject to the same
income eligibility and verification requirements as other income assistance programs.
1. Enter 1 to continue
H_REFERENCE7
SSI
Supplemental Security Income is a federally administered program that pays monthly benefits to
aged, disabled, and blind people who have limited income and assets. The SSI payments can
also be paid to disabled or blind persons regardless of age. Further, a person may be eligible for
SSI payments even if they have never worked. Even though the Social Security Administration
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administers the basic SSI program, income from SSI is NOT the same as Social Security. A
person is considered disabled if he or she has a medically determinable physical or mental
impairment which results in the inability to do any substantial gainful activity (i.e. work performed
for pay or profit), can be expect to result in death, or has lasted or can be expected to last for a
continuous period of not less than 12 months. To qualify, an individual must have resources not
exceeding $2,000 (or $3,000 for a couple).
SSI provides cash to meet basic needs for food, clothing, and shelter. The money for these
programs comes from two distinct sources, and if eligible, persons can get SSI in addition to
Social Security. Persons in this program will receive a U.S. Treasury Check, or direct deposit.
1. Enter 1 to continue
H_REFERENCE8
Unemployment Compensation
Unemployment compensation serves as a type of employment insurance, such that money can
be received from state government unemployment insurance funds to help replace wages lost
during times of layoff or unemployment. Though funds are disbursed by the state, it is done
under federal regulation. To qualify for benefits, an unemployed person must have worked
recently for a covered employer for a specified period of time and earned a certain amount of
wages. The amount of benefits is dependent upon the state, the amount of recent employment
and earnings, the ability and willingness to seek and accept suitable employment, and there are
certain disqualifications related to a claimant's most recent job separation or job offer refusal.
1. Enter 1 to continue
H_REFERENCE9
VA Benefits
Disability Compensation - Disability compensation is a benefit paid to a veteran because of
injuries or diseases that happened while on active duty, or were made worse by active military
service. It is also paid to certain veterans disabled from VA health care. The benefits are tax-free,
and eligibility is determined through a disability rating (from 10 to 100%) assigned to veterans
who were discharged under other than dishonorable conditions. The disability rating determines
the monthly amount received, corresponding to the percent of the final pay rate. Additional
benefits may be paid if the disability is sever or a loss of limb(s), the veteran has a spouse,
child(ren), or dependent parent(s), or a seriously disabled spouse.
Pension - This benefit is paid to wartime veterans who have limited or no income, are age 65 or
older, or if under 65, who are permanently and totally disabled. Eligibility includes an other than
dishonorable discharge conditions, served a minimum of 90 days, 1 of which was during a war
time period, and taxable income is below the limit set by Congress.
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Survivor's Benefits - Spouses, children, and dependent parents who survive an active duty
military member are usually eligible to receive survivor benefits. Widows can receive these
benefits as early as age 50, while unmarried children can only receive benefits to age 18 (19 if still
attending high school full time), unless the child was permanently disabled before age 22—in
which case survivor benefits are payable for the remainder of their life. Dependent parents are
eligible at age 62 and over.
Educational Benefits - Composed of several separate programs—the Montgomery GI Bill, the
Post 9/11 GI Bill, Reserve Educational Assistance (REAP), Survivor and Dependents Assistance
(DEA), Veterans Educational Assistance Program (VEAP), Vocational Rehabilitation, and
Educational Assistance Test Program, National Call to Service Program—the Veterans'
Administration funds multiple forms of educational endeavors. This funding may be restricted to
tuition, but many of these programs include an additional monthly stipend.
1. Enter 1 to continue
H_REFERENCE10
WIC
The Supplemental Food Program for Women, Infants and Children (WIC) provides food, or
vouchers which can be exchanged for food for children under the age of five in low income
families determined to be nutritionally at-risk based on either medical or dietary circumstances.
Pregnant and breast-feeding women with or without children qualify for this program up to the
first birthday of the child. Non-breastfeeding women qualify up to six months after the birth of the
child. Children are covered up to their fifth birthday. WIC benefits include supplemental nutritious
foods, nutrition education and counseling, and screening and referrals to other health, welfare,
and social services. Eligibility is based on income by family size, and those who qualify for food
stamps (SNAP), Medicaid, or TANF are automatically eligible. WIC can only be used to purchase
food high in at least one of the following nutrients: protein, calcium, iron, and vitamins A and C.
Additionally, WIC provides an infant formula rebate system as well as the WIC Farmers' Market
Nutrition Program.
1. Enter 1 to continue
H_REFERENCE11
Workers' Compensation
Workers' Compensation payments are generally made under state laws set up to compensate
workers for loss of pay because of accidents or illnesses caused by or happening on the job in
exchange for the employee relinquishing their right to sue. Workers' comp effectively serves as a
form of health or life insurance for employees. Employees of the Federal government,
longshoremen, and harbor workers are also covered under special Federal programs. Payments
may be one-time compensation awards or may be made for longer periods if received for a
long-term disability. In cases of permanent and total disability, about three out of four states
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make payments for life. The great majority of cases involve cash payments in situations where a
worker is unable to work for a temporary period after which the employee will be able to return to
work. Payment amounts are calculated as a fraction of the workers' usual wage – most
commonly about two-thirds. One-third of the states provide for additional benefits for
dependents. Administration of workers' compensation payments is not uniform across states or
even within each state. Payments may come directly from the employer, from an insurance
company retained by the employer or from a state workers' compensation fund.
1. Enter 1 to continue
H_REFERENCE12
Medicare
Medicare is health insurance for people age 65 or older, under 65 with certain disabilities, and
any age with End-Stage Renal Disease (ESRD). ESRD is permanent kidney failure requiring
dialysis or a kidney transplant. The different parts of Medicare help cover specific services if you
meet certain conditions. Medicare has the following parts:
Part A: Hospital Insurance
· Helps cover inpatient care in hospitals (includes critical access hospitals, inpatient
rehabilitation facilities, and long-term care hospitals).
· Helps cover skilled nursing facility (not custodial or long-term care), hospice, and home
health care services.
Part B: Medical Insurance
· Helps cover doctor services and outpatient care.
· Helps cover some preventive services to help maintain a person's health and to keep certain
illnesses from getting worse.
· Generally pays 80% of the Medicare-approved amount for covered services
Part C: Medicare Advantage Plans
· A way to get Medicare benefits through private companies approved by and under contract
with Medicare.
· Includes Part A, Part B, and usually other benefits Medicare doesn't cover. Most plans also
provide prescription drug coverage.
Part D: Prescription Drug Coverage
· Run by private companies approved by Medicare, which can either be Medicare Advantage
Plans or separate Medicare Prescription Drug Plans.
· Helps cover the cost of prescription drugs.
· Each plan can vary in cost and drugs covered.
1. Enter 1 to continue
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H_REFERENCE13
Health Insurance and Health Care Terms
The Affordable Care Act (ACA):
• The Affordable Care Act (ACA) is the 2010 health care reform law that mandates that most
Americans have health insurance by 2014.
• The ACA (which is sometimes referred to as Obamacare) gives individuals, families, and
small businesses an option to purchase health insurance coverage through a health insurance
market website, known as the Marketplace (or Exchange).
• Marketplace (or Exchange) coverage may be purchased through an employer or a job, a
former employer, or bought directly. It is considered private coverage.
• The ACA also expanded the Medicaid assistance program to include more people who
cannot afford healthcare. Medicaid (or Medical Assistance) is public coverage. It is different
from the Marketplace or Exchange coverage, which is considered private coverage.
Copayment or Copay:
• Fixed amount paid for a health care service or prescription, usually at the time of service or
receipt of the prescription.
• Amounts can vary by the type of service or prescription.
Deductible:
• Fixed amount of money paid for health care services before your health insurance or plan
begins to pay.
• For many health insurance policies, you can use some services, like an emergency room
visit, without meeting the deductible first.
• Deductible amount is calculated yearly, so you have to meet a new deductible for each year
of the policy.
Exchange, Health Exchange, Insurance Exchange, Health Insurance Exchange, Marketplace,
Health Marketplace, Insurance Marketplace, or Health Insurance Marketplace:
• State specific website that helps individuals, families, and small businesses find health
insurance coverage by comparing health insurance plans and prices, and to see if they qualify
for reduced premiums and out-of-pocket costs.
• Plans purchased through the marketplace may be partly or completely subsidized.
• Subsidies sometimes received in the form of tax credits.
Premium:
• Fixed amount of money people pay at regular intervals to purchase health insurance
coverage.
• Does not include copays or other expenses such as prescription costs.
Small Business Health Options Program (SHOP) Marketplace:
• SHOP is a section of the marketplace where small businesses can purchase health coverage
for their employees.
Subsidy:
• Money paid by the government to cover all or part of a marketplace health insurance plan
premiums.
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• May be in the form of a tax credit, or you may not pay any money for the plan, and think its
free.
• If no money is paid for a health insurance plan, it is subsidized.
1. Enter 1 to continue
H_PURPOSE8
Why do you need to know my health insurance information?
In order to better understand people's health care needs, we would like to learn more about their
health insurance coverage. This survey has asked respondents about their health insurance
coverage since 1984. It is important that we collect this data to be able to evaluate questions
related to health insurance coverage such as differences in coverage between groups of people
and how coverage changes over time.
1. Enter 1 to continue
wave
SHOW_HH
Please display a table with 12 columns and a row for every person ever listed on any roster in all
waves.
Column 1: ^OSP_FIL; labeled as "OSP" vertically
Column 2: ^LNO_FIL; labeled as "LN"
Column 3: Full Name; labeled as "Name"
Column 4: ^GENDER_FIL; labeled as "Sex" vertically
Column 5: ^AGEFIL; labeled as "Age"
Column 6: ^RELRP_FIL; labeled as "RelRp"
Column 7: ^MARSTATUS_FIL; labeled as "Marital Status" on two lines
Column 8: ^LNSP_FIL; labeled as "LN SP" on two lines
Column 9: ^LNGD_FIL; labeled as "LNGD" on two lines
Column 10 ^LNPAR2_FIL; labeled as "LN OtherParent"
Column 11: ^HHSTAT_FIL; labeled as "Status"
Column 12: ^STATDATE_FIL; labeled as "Date"
Page 19 of 578
1. Enter 1 to continue
SHOW_STATUS
Please display a table with 9 columns and a row for every household member age >= 15 listed on
the final household roster.
Column 1: ^LNO_FIL; labeled "LNO"
Column 2: Full Name; labeled "Name"
Column 3: Labeled "Demo"; Display "C" in this column for all respondents when HH respondent
T2_ALLYR=(1,2,DK,R); Else leave blank.
Column 4: Labeled "EHC"; Display "C" in this column when NOESI=(0,1); Else leave blank.
Column 5: Labeled "Prog"; Display "NA" in this column if AGE<15; Display "C" in this column
when AST1B=(1,2,DK,R); Else leave blank.
Column 6: Labeled "Asset"; Display "NA" in this column if AGE<15; Display "C" in this column
when HEALTH_STATUS=(1,...,5,DK,R); Else leave blank.
Column 7: Labeled "Disab"; Display "C" in this column when (ERRANDS = (1,2,DK,R) AND
FINDJOB = Blank) OR FINDJOB = (2,DK,R) OR JOBCANT = (1,2,DK,R) OR SKOOLWK = (1,2,DK,R)
OR DDELAY = (1,2,DK,R); Else leave blank.
Column 8: Labeled "Well"; Display "NA" is this colunm if AGE<15; Dipslay "C" in this column
when RIP=(1,2,DK,R); Else leave blank.
Column 9: Labeled "Back"; Display "C" in this column for all respondents when THANKYOU=1;
Else leave blank.
**If HHSTAT ne 1 or 3, please fill all columns with "NA".
1. Enter 1 to continue
HOLIDAY_LIST
Display the attached table.
**Table needs to be updated annually.**
1. Enter 1 to continue
RECORDING
Turn off CARI recording.
The CARI recording should be turned off if the respondent changes and the new respondent has not
given consent, OR if the respondent has already consented, then no longer consents to being recorded.
1. Yes
2. No
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movers_flag
marcopy
CONTACT_NUM
**NON-DISPLAYED ITEM**
MAILADDRCHG
**NON-DISPLAYED ITEM**
MOVERFLG
**NON-DISPLAYED ITEM**
PEOPLE_TO_ROSTER
**NON-DISPLAY ITEM**
SPAWN_EXTRA
**NON-DISPLAY ITEM**
SUFFPAR
**NON-DISPLAYED ITEM**
TOTSPAWN
**NON-DISPLAY ITEM**
UREFLAG
**NON-DISPLAYED ITEM**
W1PERSON
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
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START
CENSUS CATI/CAPI SYSTEM
^VERDATE
^VERSION
SIPP
SURVEY OF INCOME AND PROGRAM PARTICIPATION
PSU: ^I_PSU
DATE IS: ^DATE
TIME IS: ^TIME
O.M.B. Number: 0607-1000
Expiration Date: November 30, 2020
CASE STATUS IS: ^CSTATUS
INTERVIEW MODE: ^I_NXTINTFLG
APPOINTMENT: ^CALLBACK
ADDRESS:
HNO HNOSUF STRNAME
UNITDES
GQUNITINFO
NONCITYADD
PHYSDES
PO, ST ZIP5-ZIP4
BLDGNAME
1. Proceed - Personal interview
2. Proceed - Telephone interview
3. Set appointment for visit or call back
4. Quit - Do not attempt now
5. Ready to transmit, no more follow-up needed
FIX206
The current outcome code for this case is a 206 - At least one household member's interview is a
sufficient partial.
If you have incomplete person-level interviews in this case, you will be asked to Type Z these people
on the following screens, after completing contact information.
If you proceed, this 206 will be changed to a 207, and the case will be transmitted to your RO in your
next transmission. If you do NOT wish to wrap up this case, back up now using your Left or Up arrow
key. If you need to make this case a noninterview (Type A, B, or C), you must first proceed to wrap this
case up as a partial and then restart the case BEFORE transmitting.
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1. Closeout the case with an outcome code of 207
INTRO_D
^NAMEFIL_INTROD
Some of the questions have already been answered. Let me see where we should begin.
Enter 1 to continue, ask the CARI consent question.
Then press END to go to the first unanswered question.
1. Enter 1 to continue
INTRO
Hello. I'm ... from the United States Census Bureau. Here is my identification card.
Show ID card.
We are conducting a survey on the economic situation of people who live in the United States. I
have some questions to ask you.
^INCENTIVE_FIL
Did you receive our letter?
If the respondent did not receive an advance letter, give or read the letter to the respondent before
proceeding.
1. Proceed
2. Inconvenient time - try again later
3. Reluctant respondent - hold for refusal follow-up
4. Noninterview or ENTIRE household moved
5. Contacted incorrect household - END INTERVIEW
CARICON1
? [F1]
This interview may be recorded for quality control purposes. Is that okay?
1. Yes
2. No
Page 23 of 578
NONINTERVIEW
^NONINTFILL
1. Type A noninterview
2. Type B noninterview
3. Type C noninterview or ENTIRE household moved
4. Type D noninterview
TYPE_A
Enter Type A noninterview code.
1. No one home
2. Temporarily absent
3. Refused
4. Language problem
5. Unable to locate
6. Other Type A
TYPEA__SP
Specify the kind of 'other' Type A noninterview.
TYPE_B
Enter Type B noninterview code.
1. Vacant regular (REG)
2. Vacant - storage of household furniture
3. Unfit or to be demolished
4. Under construction, not ready
5. Converted to temporary business or storage
6. Unoccupied tent or trailer site
7. Permit granted, construction not started
8. Temporarily occupied by persons with URE
9. Occupied by persons under 15 years of age
10. ENTIRE household institutionalized
11. ENTIRE household on active duty in the Armed Forces
12. Other Type B
TYPEB__SP
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Specify the kind of 'other' Type B noninterview.
TYPE_C
Enter code for Type C noninterview or ENTIRE household moved.
1. Demolished
2. House or trailer moved
3. Address outside segment
4. Converted to permanent business or storage
5. Merged
6. Condemned
7. Unused Serial number/Listing sheet line
8. Removed during subsampling
10. ENTIRE household deceased
11. ENTIRE household moved out of the country
13. ENTIRE household moved together to known address OUTSIDE of FR's area
14. ENTIRE household moved together to known address WITHIN FR's area
15. ENTIRE household moved together to unknown address
16. ENTIRE household merged with another SIPP household
17. ENTIRE household moved and split into several new SIPP households
18. ENTIRE household moved - further work needed to obtain address (NOTE: the parent case will remain on your l
19. Other Type C
20. Spawned in error
21. Unlocatable sample address
22. Unit does not exist or unit is out of scope
TYPEC_SP
Specify the kind of 'other' Type C noninterview.
SPAWN_SP
Enter the reason why the household was spawned in error.
TYPE_D
Enter Type D noninterview code.
1. ENTIRE household moved, address unknown
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2. ENTIRE household moved within the U.S.; RO determined case is outside SIPP limits
CTRLNUM
**NON-DISPLAYED ITEM**
NI_RACE
Enter your best guess as to the Race of the reference person.
Mark all that apply.
1. White
2. Black/African American
3. American Indian or Alaska Native
4. Asian
5. Native Hawaiian or Other Pacific Islander
6. Other
NI_SEX
Enter your best guess as to the sex of the reference person.
^ENTERFIL
1. Male
2. Female
NI_SIZE
Ask or verify with some knowledgeable individual.
Enter your best guess as to the total number of people in the household. Count all children and
adults.
^ENTERFIL
NI_TENURE
Ask or verify with a knowledgeable individual, or enter your best guess.
Are the living quarters...
Page 26 of 578
Read answer categories.
1. Owned or being bought by someone in the household?
2. Rented?
3. Occupied without payment of rent?
TYPEA_DISCUSS
You must discuss this case with your supervisor before transmitting it as a ^TYPEAD noninterview.
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
DIAL
Dial this number: (^I_AREA) ^I_PREFIX-^I_SUFFIX ^I_EXTN
Secondary number: (^SAREA) ^SPREFIX-^SSUFFIX ^SEXTN
Previous Wave Roster: Display the ROST_FNAME, ROST_MNAME, and ROST_LNAME of
all people who were listed on final household roster for the previous wave
1. Someone answers - BEGIN INTERVIEW
2. Someone answers - SET APPOINTMENT
3. No contact - answering machine/busy/no answer
4. New telephone number or telephone disconnected
5. Not attempted now
HHAPPT1
^INTRO_HHAPPT1
^HHRESP_FIL
STREET ADDRESS: ^I_HNO ^I_HNOSUF ^I_STRNAME
TELEPHONE NUMBER: (^I_AREA) ^I_PREFIX - ^I_SUFFIX ^I_EXTN
Is there a convenient time I can contact your household to complete this interview?
Page 27 of 578
1. YES - Set appointment for interview
2. No - Cannot set up appointment
3. Need to contact Directory Assistance
4. All sample persons moved to a new address
5. Conduct interview NOW
HHAPPT2
When would be a convenient time to conduct an interview with your household?
CTRLNUM
**NON-DISPLAYED ITEM**
DASSIST_AREA
Call Directory Assistance in your area, if necessary, to obtain the correct telephone number for this
household.
CURRENT TELEPHONE NUMBER: (^I_AREA) ^I_PREFIX - ^I_SUFFIX ^I_EXTN
What is the new telephone number for the ^REFPER_DASSIST household?
Enter new area code.
Enter 000 if the household does not have a telephone.
Display the household address as follows:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
^I_BLDGNAME
DASSIST_PREFIX
Call Directory Assistance in your area, if necessary, to obtain the correct telephone number for this
household.
CURRENT TELEPHONE NUMBER: (^I_AREA) ^I_PREFIX - ^I_SUFFIX ^I_EXTN
(What is the new telephone number for the ^REFPER_DASSIST household?
Page 28 of 578
Enter new prefix.
Display the household address as follows:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
^I_BLDGNAME
DASSIST_SUFFIX
Call Directory Assistance in your area, if necessary, to obtain the correct telephone number for this
household.
CURRENT TELEPHONE NUMBER: (^I_AREA) ^I_PREFIX - ^I_SUFFIX ^I_EXTN
(What is the new telephone number for the ^REFPER_DASSIST household?
Enter new suffix.
Display the household address as follows:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
^I_BLDGNAME
DASSIST_EXTN
Call Directory Assistance in your area, if necessary, to obtain the correct telephone number for this
household.
CURRENT TELEPHONE NUMBER: ^I_AREA ^I_PREFIX - ^I_SUFFIX ^I_EXTN
(What is the new telephone number for the ^REFPER_DASSIST household?
Enter new extension (if applicable).
Display the household address as follows:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
Page 29 of 578
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
^I_BLDGNAME
CTRLNUM
**NON-DISPLAYED ITEM**
HHAPPT3
Before I go, let me verify some information. Is your address still
Read address:
ADDRESS:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5 - ^I_ZIP4
^I_BLDGNAME
If answer category 2 is selected, remember to move the household via the noninterview screen and
NOT the change of address screens.
1. Yes
2. No
3. Address correction -- household did not move
4. End interview
HHAPPT4_HNO
? [F1]
Enter the correct House Number or press ENTER for Same.
HHAPPT4_HNOSUF
? [F1]
Enter the correct House Number Suffix or press ENTER for Same.
HHAPPT4_STRNAME
Page 30 of 578
? [F1]
Enter the correct Street Name or press ENTER for Same.
HHAPPT4_UNITDES
? [F1]
Enter the correct Apartment and Unit Number or press ENTER for Same.
HHAPPT4_GQUNITINFO
? [F1]
Enter the correct GQ Unit Information or press ENTER for Same.
HHAPPT4_NONCITYADD
? [F1]
Enter the correct Non-City Style Address or press ENTER for Same.
Enter a P.O. Box here.
HHAPPT4_PHYSDES
? [F1]
Enter the correct Physical Description or press ENTER for Same.
HHAPPT4_PO
? [F1]
Enter the correct Locality or press ENTER for Same.
HHAPPT4_ST
? [F1]
Enter the correct State Abbreviation or press ENTER for Same.
AL. Alabama
AK. Alaska
Page 31 of 578
AZ. Arizona
AR. Arkansas
CA. California
CO. Colorado
CT. Connecticut
DC. District of Columbia
DE. Delaware
FL. Florida
GA. Georgia
HI. Hawaii
ID. Idaho
IL. Illinois
IN. Indiana
IA. Iowa
KS. Kansas
KY. Kentucky
LA. Louisiana
ME. Maine
MD. Maryland
MA. Massachusetts
MI. Michigan
MN. Minnesota
MS. Mississippi
MO. Missouri
MT. Montana
NE. Nebraska
NV. Nevada
NH. New Hampshire
NJ. New Jersey
NM. New Mexico
NY. New York
NC. North Carolina
ND. North Dakota
OH. Ohio
OK. Oklahoma
OR. Oregon
PA. Pennsylvania
RI. Rhode Island
SC. South Carolina
Page 32 of 578
SD. South Dakota
TN. Tennessee
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
WA. Washington
WV. West Virginia
WI. Wisconsin
WY. Wyoming
HHAPPT4_ZIP5
? [F1]
Enter the correct Zip Code or press ENTER for Same.
HHAPPT4_ZIP4
? [F1]
Enter the correct 4-Digit Zip Code or press ENTER for Same.
HHAPPT4_BLDGNAME
? [F1]
Enter the correct Building Name or press ENTER for Same.
HHAPPT5
I have listed
Read name(s) as living in this household. Are all of these people still living here?
Display the ROST_FNAME, ROST_MNAME, and ROST_LNAME of all people who were
listed on final household roster for the previous wave
1. Yes
2. No
HHAPPT99
Thank you for your assistance. I will visit your household ^CALLBACK.
Page 33 of 578
This household has persons who have moved since the last interview. You may wish to review
procedures for movers before this interview. Remember to deal with mover cases early in the month, so
that you have sufficient time to locate and interview the people who moved.
Enter 1 to continue.
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
YR_BUILT
TTABX
TEXTRA
TABX_INTRO
TABX_FR
OTHLIVQTR
BEGINT
We will begin the interview with questions about who lives here, their ages, how they're related to
each other, and other information. Then I will ask you questions about your jobs and other
sources of income. After that, I'll have similar questions about the other people who live here.
^BEGINT_FIL
Enter 1 to continue.
1. Enter 1 to continue
VERIFY_ADDRESS
? [F1]
I have your address listed as:
ADDRESS:
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_GQUNITINFO
^I_NONCITYADD
^I_PHYSDES
Page 34 of 578
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
^I_BLDGNAME
(Is this your exact address, or correct with only minor changes?)
Do not use the address change screen to indicate that an entire household has moved.
1. YES, address is EXACTLY CORRECT as listed
2. Address is MOSTLY CORRECT, but needs some minor changes
3. INCORRECT ADDRESS - terminate interview, find correct address
CTRLNUM
**NON-DISPLAYED ITEM**
NEW_HNO
? [F1]
Enter the correct House Number or press ENTER for Same.
NEW_HNOSUF
? [F1]
Enter the correct House Number Suffix or press ENTER for Same.
NEW_STRNAME
? [F1]
Enter the correct Street Name or press ENTER for Same.
NEW_UNITDES
? [F1]
Enter the correct Apartment or Unit Number or press ENTER for Same.
NEW_GQUNITINFO
? [F1]
Page 35 of 578
Enter the correct GQ Unit Information or press ENTER for Same.
NEW_NONCITYADD
? [F1]
Enter the correct Non-City Style Address or press ENTER for Same.
Enter a P.O. Box here.
NEW_PHYSDES
? [F1]
Enter the correct Physical Description or press ENTER for Same.
NEW_PO
? [F1]
Enter the correct Locality or press ENTER for Same.
NEW_ST
? [F1]
Enter the correct State Abbreviation or press ENTER for Same.
AL. Alabama
AK. Alaska
AZ. Arizona
AR. Arkansas
CA. California
CO. Colorado
CT. Connecticut
DC. District of Columbia
DE. Delaware
FL. Florida
GA. Georgia
HI. Hawaii
ID. Idaho
IL. Illinois
IN. Indiana
Page 36 of 578
IA. Iowa
KS. Kansas
KY. Kentucky
LA. Louisiana
ME. Maine
MD. Maryland
MA. Massachusetts
MI. Michigan
MN. Minnesota
MS. Mississippi
MO. Missouri
MT. Montana
NE. Nebraska
NV. Nevada
NH. New Hampshire
NJ. New Jersey
NM. New Mexico
NY. New York
NC. North Carolina
ND. North Dakota
OH. Ohio
OK. Oklahoma
OR. Oregon
PA. Pennsylvania
RI. Rhode Island
SC. South Carolina
SD. South Dakota
TN. Tennessee
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
WA. Washington
WV. West Virginia
WI. Wisconsin
WY. Wyoming
NEW_ZIP5
? [F1]
Page 37 of 578
Enter the correct Zip Code or press ENTER for Same.
NEW_ZIP4
? [F1]
Enter the correct 4-Digit Zip Code or press ENTER for Same.
NEW_ZIP
**NON-DISPLAYED ITEM**
NEW_BLDGNAME
? [F1]
Enter the correct Building Name or press ENTER for Same.
VERIFY_MAILADDR
? [F1]
Is this also your mailing address?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
NEW_MHNO
? [F1]
Enter the correct House Number for the mailing address or press ENTER for Same.
NEW_MHNOSUF
? [F1]
Page 38 of 578
Enter the correct House Number Suffix for the mailing address or press ENTER for Same.
NEW_MSTRNAME
? [F1]
Enter the correct Street Name for the mailing address or press ENTER for Same.
NEW_MUNITDES
? [F1]
Enter the correct Apartment or Unit Number of the mailing address or press ENTER for Same.
NEW_MGQUNITINFO
? [F1]
Enter the correct GQ Unit Information of the mailing address or press ENTER for Same.
NEW_MNONCITYADD
? [F1]
Enter the correct Non-City Style Mailing Address or press ENTER for Same.
Enter a P.O. Box here.
NEW_MPO
? [F1]
Enter the correct Locality of the mailing address or press ENTER for Same.
NEW_MST
? [F1]
Enter the correct State Abbreviation of the mailing address or press ENTER for Same.
AL. Alabama
AK. Alaska
AZ. Arizona
AR. Arkansas
Page 39 of 578
CA. California
CO. Colorado
CT. Connecticut
DC. District of Columbia
DE. Delaware
FL. Florida
GA. Georgia
HI. Hawaii
ID. Idaho
IL. Illinois
IN. Indiana
IA. Iowa
KS. Kansas
KY. Kentucky
LA. Louisiana
ME. Maine
MD. Maryland
MA. Massachusetts
MI. Michigan
MN. Minnesota
MS. Mississippi
MO. Missouri
MT. Montana
NE. Nebraska
NV. Nevada
NH. New Hampshire
NJ. New Jersey
NM. New Mexico
NY. New York
NC. North Carolina
ND. North Dakota
OH. Ohio
OK. Oklahoma
OR. Oregon
PA. Pennsylvania
RI. Rhode Island
SC. South Carolina
SD. South Dakota
TN. Tennessee
Page 40 of 578
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
WA. Washington
WV. West Virginia
WI. Wisconsin
WY. Wyoming
NEW_MZIP5
? [F1]
Enter the correct Zip Code of the mailing address or press ENTER for Same.
NEW_MZIP4
? [F1]
Enter the correct 4-Digit Zip Code of the mailing address or press ENTER for Same.
NEW_MZIP
**NON-DISPLAYED ITEM**
ACCESS
? [F1]
Ask if not apparent.
Do you have direct access to your home, either from the outside or through a common hall?
1. Yes
2. No
MERGE
This household must be merged with the household through which access is gained.
Refer to your Interviewer's manual to determine if the merged household is in or out of the SIPP
sample.
Page 41 of 578
1. Merged - in SIPP sample
2. Merged - NOT in SIPP sample
LIVQTR
Enter type of living quarters.
1. House, apartment, flat
2. Unit in rooming house, hotel, motel, etc.
3. Mobile home or trailer
4. Other housing unit
5. Student quarters
6. Other group quarters unit
7. Tent or trailer site
NUMBER_UNITS
Ask if not apparent.
How many housing units, both occupied and vacant, are there in this structure?
1. One, detached
2. One, attached
3. Two
4. 3 - 4
5. 5 - 9
6. 10 - 19
7. 20 - 49
8. 50 or more
TENURE
Are your living quarters...
Read answer categories.
1. Owned or being bought by someone in the household?
2. Rented?
3. Occupied without payment of rent?
Page 42 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
RENTSUB
^RENTSUBQTEXT
Include respondents who live in a building owned by a Public Housing Authority (i.e., the housing
authority is the respondent's landlord) as receiving a rent subsidy.
1. Yes
2. No
VOUCHER
Does anyone in this household receive a housing voucher?
A housing voucher gives a renter the right to choose where to live AND it helps pay the rent.
1. Yes
2. No
AMOUNTSPELL
**NON-DISPLAYED ITEM**
ASTCODE
**NON-DISPLAYED ITEM**
ASTCODE2
**NON-DISPLAYED**
ASTCODE_RET
**NON-DISPLAYED ITEM**
BUSINESS_CODE
**NON-DISPLAYED ITEM**
Page 43 of 578
CARICONFLAG
***NON-DISPLAYED ITEM****
1. Yes
2. No
CARNO
**NON-DISPLAYED ITEM**
CHILD_LNO
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
DAD_IN_HOUSE
*** NON-DISPLAYED ITEM ***
DISABLECODE
**NON-DISPLAYED ITEM**
ED_RETURNING
**NON-DISPLAYED ITEM**
FS_RETURNING
**NON-DISPLAYED ITEM**
GA_RETURNING
**NON-DISPLAYED ITEM**
INVBUSINESS_CODE
**NON-DISPLAYED ITEM**
LNBIODAD
Page 44 of 578
**NON-DISPLAYED ITEM**
LNBIOMOM
**NON-DISPLAYED ITEM**
LNGD_MEALS
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
LNPAR1
**NON-DISPLAYED ITEM**
LNPAR2
**NON-DISPLAYED ITEM**
LNOPRX
**NON-DISPLAYED ITEM**
LNSP
**NON-DISPLAYED ITEM**
MARITAL_RETURNING
**NON-DISPLAYED ITEM**
MHLOAN_CODE
**NON-DISPLAYED ITEM**
MOM_IN_HOUSE
*** NON-DISPLAYED ITEM ***
Page 45 of 578
MONTHCODE
**NON-DISPLAY ITEM**
MOVER_LNO
**NON-DISPLAY ITEM**
PLPCNTLT5T2
**NON-DISPLAYED ITEM**
PLINTDATE
**NON-DISPLAYED ITEM**
PROPLOAN_CODE
**NON-DISPLAYED ITEM**
PSTATUS
**NON-DISPLAYED ITEM**
REL_FLG
** NON-DISPLAY ITEM **
RES_RETURNING
**NON-DISPLAYED ITEM**
RETIRECODE
**NON-DISPLAYED ITEM**
SLFPRX
**NON-DISPLAYED ITEM**
SSI_RETURNING
**NON-DISPLAYED ITEM**
Page 46 of 578
SSCHLDFLAG
**NON-DISPLAYED ITEM**
SUPPORTPMTCODE
**NON-DISPLAYED ITEM**
SURVRCODE
**NON-DISPLAYED ITEM**
TANF_RETURNING
**NON-DISPLAYED ITEM**
TYPE_RECVEH_NUM
**NON-DISPLAYED ITEM**
UEMP_COMP_CODE
**NON-DISPLAYED ITEM**
URE_NUM
**NON-DISPLAYED ITEM**
VABENEFITCODE
**NON-DISPLAYED ITEM**
WIC_RETURNING
**NON-DISPLAYED ITEM**
NBIOKIDHHROS
**NON-DISPLAYED ITEM**
NUMCLD27
**NON-DISPLAYED ITEM**
Page 47 of 578
NUMCLD314
**NON-DISPLAYED ITEM**
NUMCLD014
**NON-DISPLAYED ITEM**
NUMCLD617
**NON-DISPLAYED ITEM**
NUMCLD05
**NON-DISPLAYED ITEM**
NALLKIDALLROS
NUM_BIOKIDS
*** NON-DISPLAYED ITEM ***
CHILDLIST05
CHILDLIST617
BIOCHILDLIST
PAR_BIOCHILDLIST
NCLD27_HH
**NON-DISPLAYED ITEM**
NCLD314_HH
**NON-DISPLAYED ITEM**
NCLD014_HH
**NON-DISPLAYED ITEM**
NCLD617_HH
**NON-DISPLAYED ITEM**
NCLD05_HH
Page 48 of 578
**NON-DISPLAYED ITEM**
NCLD017_HH
**NON-DISPLAYED ITEM**
INFANTC
**NON-DISPLAYED ITEM**
CHILDLIST0
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
ORIG_NROSIZE
BHHLD_MBR_LEAVE
**NON-DISPLAYED ITEM**
ROSTER_CHANGE
*** NON-DISPLAYED ITEM ***
1. Yes
2. No
PREROST
^QSTNTXT_PREROST
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
Page 49 of 578
**NON-DISPLAYED ITEM**
PNUM
**NON-DISPLAYED ITEM**
PERMOVED
PERDECEASED
PERSTAT
^PERSTATFILL
1. Deceased
2. Institutionalized or in other group quarters (e.g., nursing home, hospital, correctional facility)
3. On active duty in the Armed Forces
4. Moved outside of U.S.
5. Marital-status reasons (e.g., marriage, civil union, partnership, cohabitation, separation or divorce)
6. Job-related reasons
7. Attending college or boarding school, or other educational reason
8. Other family changes (e.g., change in custody, child moves out on his own)
9. Listed in error in prior wave
10. Other
11. Reinstate person
CN_PERSTAT
**NON-DISPLAYED ITEM**
1. Active Household Member
3. Inactive, but may come back
4. Deceased
ROST_FNAME
^QSTNTXT_ROSTER
Enter first name.
Confirm the spelling of the person's first name. This information will be important for tracking movers in
future waves.
Enter 999 if no more people or no new people.
Page 50 of 578
^MAX20
ROST_MNAME
^QSTNTXT_ROSTER
Enter middle name.
LAST_NAME
^QSTNTXT_ROSTER
Enter last name.
Confirm the spelling of the person's last name. This information will be important for tracking movers in
future waves.
ROSTER_ONAME
^QSTNTXT_ROSTER
Enter other or maiden name.
HHRESP2
HHRESP2TEXT
1. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
2. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
3. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
4. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
5. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
6. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
7. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
8. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
9. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
10. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
11. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
12. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
13. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
14. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
Page 51 of 578
15. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
16. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
17. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
18. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
19. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
20. Display the LNO, ^FNAME, and ^LNAME where HHSTAT = (1, 3) AND AGE(LNO) >= 15
USUAL
? [F1]
^QSTNTXT_USUAL
1. Yes
2. No
NOTHERE
NOTHERE_FILL
1. LNO ROST_FNAME ROST_LNAME
2. LNO ROST_FNAME ROST_LNAME
3. LNO ROST_FNAME ROST_LNAME
4. LNO ROST_FNAME ROST_LNAME
5. LNO ROST_FNAME ROST_LNAME
6. LNO ROST_FNAME ROST_LNAME
7. LNO ROST_FNAME ROST_LNAME
8. LNO ROST_FNAME ROST_LNAME
9. LNO ROST_FNAME ROST_LNAME
10. LNO ROST_FNAME ROST_LNAME
11. LNO ROST_FNAME ROST_LNAME
12. LNO ROST_FNAME ROST_LNAME
13. LNO ROST_FNAME ROST_LNAME
14. LNO ROST_FNAME ROST_LNAME
15. LNO ROST_FNAME ROST_LNAME
16. LNO ROST_FNAME ROST_LNAME
17. LNO ROST_FNAME ROST_LNAME
18. LNO ROST_FNAME ROST_LNAME
19. LNO ROST_FNAME ROST_LNAME
20. LNO ROST_FNAME ROST_LNAME
Page 52 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
URE_NUM
**NON-DISPLAYED ITEM**
NITESTAY
During a typical week over the last month or so, how many nights did ^NAME_NOTHERE stay
here overnight, or was there no usual pattern?
11. Three or fewer
12. Four or more
13. No usual pattern
14. Other
NITESTAY_SP
What 'other' living arrangement?
ASKURE
Is there another place where ^NAME_NOTHERE ^LIVES_ASKURE and ^SLEEPS_ASKURE most
of the time?
1. Yes
2. No
AWAYSCH
Ask if necessary:
AREIS ^NAME_NOTHERE...
... a student away attending school,
... non-married,
... whose permanent residence is here?
1. Yes to all 3
Page 53 of 578
2. No
AWAYTRV
Ask if necessary:
^DODOES ^NAME_NOTHERE usually live here but AREIS away traveling for work, or on vacation,
or in the hospital?
1. Yes
2. No
MISSED_PER
? [F1]
MISSEDPER_TEXT
1. Yes
2. No
ANYMOREPEOPLE
We've listed 20 people living in this household, which is the maximum number that can be
collected on the household roster. How many additional people (not counting the 20 already listed
on the household roster) live here?
USUAL1
Is this the address where
Read name(s) lives and sleeps most of the time?
Display the names of the people added to the household roster via MISSED_PER.
1. Yes
2. No
NOTHERONE
Ask or verify.
Who doesn't live or sleep here most of the time? Anyone else?
Mark all that apply.
Page 54 of 578
1. LNO ROST_FNAME ROST_LNAME
2. LNO ROST_FNAME ROST_LNAME
3. LNO ROST_FNAME ROST_LNAME
4. LNO ROST_FNAME ROST_LNAME
5. LNO ROST_FNAME ROST_LNAME
6. LNO ROST_FNAME ROST_LNAME
7. LNO ROST_FNAME ROST_LNAME
8. LNO ROST_FNAME ROST_LNAME
9. LNO ROST_FNAME ROST_LNAME
10. LNO ROST_FNAME ROST_LNAME
11. LNO ROST_FNAME ROST_LNAME
12. LNO ROST_FNAME ROST_LNAME
13. LNO ROST_FNAME ROST_LNAME
14. LNO ROST_FNAME ROST_LNAME
15. LNO ROST_FNAME ROST_LNAME
16. LNO ROST_FNAME ROST_LNAME
17. LNO ROST_FNAME ROST_LNAME
18. LNO ROST_FNAME ROST_LNAME
19. LNO ROST_FNAME ROST_LNAME
20. LNO ROST_FNAME ROST_LNAME
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
URE_NUM
**NON-DISPLAYED ITEM**
CHECKPT
According to the rules of this survey,
Read name(s) will be included in this interview.
Display the ROST_FNAME, and ROST_LNAME of all non-deleted people on the final
household roster.
If everyone on the household is deleted or the list of people is otherwise empty, display:
Page 55 of 578
There are no
persons remaining to interview. To wrap up this case as a Type B, type 1 and press Enter.
1. Enter 1 to continue
NOHHRESP
Since you do not stay or live here most of the time, who is available to answer the remaining
questions?
Read name(s).
1. Display the LNO ROST_FNAME ROST_LNAME
2. Display the LNO ROST_FNAME ROST_LNAME
3. Display the LNO ROST_FNAME ROST_LNAME
4. Display the LNO ROST_FNAME ROST_LNAME
5. Display the LNO ROST_FNAME ROST_LNAME
6. Display the LNO ROST_FNAME ROST_LNAME
7. Display the LNO ROST_FNAME ROST_LNAME
8. Display the LNO ROST_FNAME ROST_LNAME
9. Display the LNO ROST_FNAME ROST_LNAME
10. Display the LNO ROST_FNAME ROST_LNAME
11. Display the LNO ROST_FNAME ROST_LNAME
12. Display the LNO ROST_FNAME ROST_LNAME
13. Display the LNO ROST_FNAME ROST_LNAME
14. Display the LNO ROST_FNAME ROST_LNAME
15. Display the LNO ROST_FNAME ROST_LNAME
16. Display the LNO ROST_FNAME ROST_LNAME
17. Display the LNO ROST_FNAME ROST_LNAME
18. Display the LNO ROST_FNAME ROST_LNAME
19. Display the LNO ROST_FNAME ROST_LNAME
20. Display the LNO ROST_FNAME ROST_LNAME
OTHRRP
All people listed have another residence where they usually live. They will not be included in this
interview. Take one of the following actions:
Enter 0 if the residence information is incorrect.
Enter a 1 if no other adult maintains this address as his or her usual place of residence. This designates
this address as a Type B noninterview.
0. The information about usual residence is incorrect
Page 56 of 578
1. No other adult maintains this address as his/her usual residence
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
LEAVE_MO
^INTROLEAVE_FIL When did ^FNAME ^LNAME ^WHYLEFTFIL?
Enter the month.
0. Before ^MONTH1 ^CALENDAR_YRFIL
1. ^MONTH1 ^CALENDAR_YRFIL
2. ^MONTH2 ^CALENDAR_YRFIL
3. ^MONTH3 ^CALENDAR_YRFIL
4. ^MONTH4 ^CALENDAR_YRFIL
5. ^MONTH5 ^CALENDAR_YRFIL
6. ^MONTH6 ^CALENDAR_YRFIL
7. ^MONTH7 ^CALENDAR_YRFIL
8. ^MONTH8 ^CALENDAR_YRFIL
9. ^MONTH9 ^CALENDAR_YRFIL
10. ^MONTH10 ^CALENDAR_YRFIL
11. ^MONTH11 ^CALENDAR_YRFIL
12. ^MONTH12 ^CALENDAR_YRFIL
13. ^MONTH13 ^INTYEARFIL
14. ^MONTH14 ^INTYEARFIL
15. ^MONTH15^INTYEARFIL
16. ^MONTH16 ^INTYEARFIL
17. ^MONTH17 ^INTYEARFIL
18. ^MONTH18 ^INTYEARFIL
LNO
**NON-DISPLAYED ITEM**
Page 57 of 578
OTHRRP_WHO
Whose information is incorrect?
1. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
2. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
3. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
4. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
5. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
6. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
7. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
8. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
9. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
10. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
11. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
12. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
13. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
14. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
15. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
16. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
17. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
18. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
19. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
20. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
21. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
22. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
23. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
24. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
25. LNO ROST_FNAME, ROST_LNAME where UREFLAG = 1
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
OTHRRP_FIX
What information about ^HISHER residence needs to be corrected...
Page 58 of 578
Read answer categories.
Mark all that apply.
1. Is this the place where ^TEMPNAME ^LIVESLEEPFIL most of the time?
2. How many night ^DODOES ^TEMPNAME stay here overnight?
3. Is there another place where ^TEMPNAME ^LIVESLEEPFIL most of the time?
4. ^C_AREIS ^TEMPNAME a non-married student away attending school whose permanent residence is here?
5. C_DODOES ^TEMPNAME usually live here but is away traveling for work , or on vacation, or in a hospital?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
ENTER_MO
^INTROLEAVE_FIL When did ^YOUHEORSHE start living here?
Enter the month.
0. Before ^MONTH1 ^CALENDAR_YRFIL
1. ^MONTH1 ^CALENDAR_YRFIL
2. ^MONTH2 ^CALENDAR_YRFIL
3. ^MONTH3 ^CALENDAR_YRFIL
4. ^MONTH4 ^CALENDAR_YRFIL
5. ^MONTH5 ^CALENDAR_YRFIL
6. ^MONTH6 ^CALENDAR_YRFIL
7. ^MONTH7 ^CALENDAR_YRFIL
8. ^MONTH8 ^CALENDAR_YRFIL
9. ^MONTH9 ^CALENDAR_YRFIL
10. ^MONTH10 ^CALENDAR_YRFIL
11. ^MONTH11 ^CALENDAR_YRFIL
12. ^MONTH12 ^CALENDAR_YRFIL
13. ^MONTH13 ^INTYEARFIL
14. ^MONTH14 ^INTYEARFIL
15. ^MONTH15^INTYEARFIL
16. ^MONTH16 ^INTYEARFIL
Page 59 of 578
17. ^MONTH17 ^INTYEARFIL
18. ^MONTH18 ^INTYEARFIL
ENTER_REASON
^QSTNTXT_REASONENT
Mark all that apply.
1. Birth
2. Marital-status reasons (e.g., marriage, civil union, partnership, cohabitation, separation, or divorce)
3. Returned to household after missing one or more waves
4. Other family changes (e.g., change in custody, adoption, or parent/child joins the household)
5. From an institution or other group quarters (e.g., nursing home, hospital, correctional facility)
6. From Armed Forces barracks
7. From outside the U.S.
8. Should have been listed as a member in Wave 1
9. Job-related reasons
10. Lived at this address before sample person(s) entered
11. Other
MAIN_REASON
What was the main reason ^FNAME ^LNAME ^JOINFIL the household?
1. Fill with 1st. reason selected in TRSNENT
2. Fill with 2nd. reason selected in TRSNENT
3. Fill with 3rd. reason selected in TRSNENT
4. Fill with 4th. reason selected in TRSNENT
5. Fill with 5th. reason selected in TRSNENT
6. Fill with 6th. reason selected in TRSNENT
7. Fill with 7th. reason selected in TRSNENT
8. Fill with 8th. reason selected in TRSNENT
9. Fill with 9th. reason selected in TRSNENT
10. Fill with 10th. reason selected in TRSNENT
11. Fill with 11th. reason selected in TRSNENT
RSNENT_SP
What is the 'other' reason ^FNAME ^LNAME joined this household?
Page 60 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SEX
Ask if not apparent.
^C_AREISWAS ^TEMPNAME male or female?
1. Male
2. Female
REFPER2
Who ^OWNRENTFIL this home - that is, what names are on the ^DEEDLEASEFIL?
If the respondent can't identify an owner or renter, enter the line number of the head of household.
Mark all that apply.
1. Display the LNO ROST_FNAME ROST_LNAME
2. Display the LNO ROST_FNAME ROST_LNAME
3. Display the LNO ROST_FNAME ROST_LNAME
4. Display the LNO ROST_FNAME ROST_LNAME
5. Display the LNO ROST_FNAME ROST_LNAME
6. Display the LNO ROST_FNAME ROST_LNAME
7. Display the LNO ROST_FNAME ROST_LNAME
8. Display the LNO ROST_FNAME ROST_LNAME
9. Display the LNO ROST_FNAME ROST_LNAME
10. Display the LNO ROST_FNAME ROST_LNAME
Page 61 of 578
11. Display the LNO ROST_FNAME ROST_LNAME
12. Display the LNO ROST_FNAME ROST_LNAME
13. Display the LNO ROST_FNAME ROST_LNAME
14. Display the LNO ROST_FNAME ROST_LNAME
15. Display the LNO ROST_FNAME ROST_LNAME
16. Display the LNO ROST_FNAME ROST_LNAME
17. Display the LNO ROST_FNAME ROST_LNAME
18. Display the LNO ROST_FNAME ROST_LNAME
19. Display the LNO ROST_FNAME ROST_LNAME
20. Display the LNO ROST_FNAME ROST_LNAME
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
RELRP
**NON-DISPLAYED ITEM**
1. Spouse (Husband/Wife)
2. Unmarried Partner
3. Child (Biological, Step, Adopted)
4. Grandchild
5. Parent (Mother/Father)
6. Brother/Sister
7. Other Relative (Uncle, cousin, mother-in-law, father-in-law, etc.)
8. Foster Child
9. Housemate/Roommate
10. Roomer/Boarder
11. Other non-relative
12. Current or Former Spouse (Husband/Wife)
13. Current or Former Unmarried Partner
RELRPEXP
A, ? [F1]
Page 62 of 578
Ask or verify
^QSTNTXT_RELRP
1. Opposite sex husband/wife/spouse
2. Opposite sex unmarried partner
3. Same sex husband/wife/spouse
4. Same sex unmarried partner
5. Child
6. Grandchild
7. Parent
8. Sibling
9. Parent/Child In-law (mother/father, son/daughter in-law)
10. Brother/Sister in-law
11. Aunt/Uncle, Niece/Nephew
12. Other relative
13. Foster child
14. Housemate/Roommate
15. Roomer/Boarder
16. Other non-relative
17. Current or former opposite sex husband/wife/spouse
18. Current or former opposite sex unmarried partner
19. Current or former same sex husband/wife/spouse
20. Current or former same sex unmarried partner
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
DOB_BMONTH
^ASKORVERIFY
What ^ISWAS ^PTEMPNAME date of birth?
Page 63 of 578
Enter month.
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
DOB_BDAY
^ASKORVERIFY
(What ^ISWAS ^PTEMPNAME date of birth?)
Enter day.
DOB_BYEAR
^ASKORVERIFY
(What ^ISWAS ^PTEMPNAME date of birth?)
Enter year.
WHICH_AGE
^C_AREIS ^TEMPNAME now?
1. ^AGEX or
2. ^AGEX+1 years old?
3. Neither is correct
Page 64 of 578
AGEGES
? [F1]
How old would you say ^TEMPNAME ^AREISWAS?
Enter best estimate of age.
FRGES
Enter your best estimate of ^NAMEFIL age.
PWAVE_EXISTS
UNDERAGE
Both the household reference person and the household respondent must be 15 years of age or older.
You reported that the ^WHICHPERSONFIL is under 15. Since no one in the household is 15 years of
age or older, the household is a Type B Noninterview.
Enter 1 to continue.
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
ORIGIN
B
^ASKORVERIFY
^C_AREISWAS ^TEMPNAME Spanish, Hispanic or Latino? (Such as Mexican, Mexican American,
Chicano, Puerto Rican, Cuban, Salvadoran, Dominican, Colombian, or some other Spanish, Hispanic, or
Latino group.)
1. Yes
2. No
Page 65 of 578
HISPAN
B
^ASKORVERIFY
^C_AREISWAS ^TEMPNAME Mexican, Mexican American, Chicano, Puerto Rican, Cuban,
Salvadoran, Dominican, Colombian, or some other Spanish, Hispanic, or Latino group?
Mark all that apply.
1. Mexican, Mexican American, Chicano
2. Puerto Rican
3. Cuban
4. Salvadoran
5. Dominican
6. Colombian
7. Other Spanish, Hispanic, or Latino group
OROTSP
What is the name of ^PTEMPNAME other Spanish, Hispanic, or Latino group?
Please use the category "Other Spanish, Hispanic, or Latino origin" for responses that do not appear
elsewhere on the list.
PWAVE_ORIGIN
PWAVE_HISPAN
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
RACE
C, ? [F1]
^ASKORVERIFY
Please choose one or more races that ^NAME1FIL_RACE ^NAME2FIL_RACE to be.
Page 66 of 578
Probe if response is 'Hispanic' or 'Latino', or a specific Hispanic Origin (e.g., 'Mexican', 'Cuban', etc.)
Mark all that apply.
1. White
2. Black or African American
3. American Indian or Alaska Native
4. Asian
5. Native Hawaiian or Other Pacific Islander
6. Other DO NOT READ
RACEAS
^ASKORVERIFY
Which of the following Asian groups ^CONSIDERFIL_RACE...
Read answer categories.
Mark all that apply.
1. Asian Indian?
2. Chinese?
3. Filipino?
4. Japanese?
5. Korean?
6. Vietnamese?
7. Other Asian DO NOT READ
RACEPI
^ASKORVERIFY
Which of the following Native Hawaiian or Other Pacific Islander groups ^CONSIDERFIL_RACE...
Read answer categories.
Mark all that apply.
1. Hawaiian?
2. Guamanian or Chamorro?
3. Samoan?
4. Other Pacific Islander DO NOT READ
Page 67 of 578
RACEOT
^ASKORVERIFY
Read only if necessary.
(What is ^PTEMPNAME other race?)
1. African American
2. Aleut
3. American
4. American Indian or Alaska Native
5. American Nation, Ethnic Group or Tribe
6. Anglo-Saxon
7. Arab
8. Asian
9. Asian Indian
10. Black
11. Brazilian
12. Caucasian
13. Chicano
14. Chinese
15. Creole
16. Cuban or Cuban American
17. Eskimo
18. European
19. Filipino
20. German
21. Guamanian or Chamorro
22. Hispanic
23. Jamaican
24. Japanese
25. Korean
26. Latin American
27. Latino
28. Mexican or Mexican American
29. Native American
30. Native Hawaiian or Other Pacific Islander
31. Negro
32. No race given
33. Other DO NOT READ
34. Puerto Rican
Page 68 of 578
35. Samoan
36. Scotch-Irish
37. Spanish
38. Vietnamese
39. West Indian
40. White
RACEOS
What 'other' race?
PWAVE_RACE
PWAVE_RACAEAS
PWAVE_RACEPI
PWAVE_RACEOT
HHSPEAK
Do not read to the respondent.
So far, has any part of this interview been conducted in a language other than English?
Count American Sign Language as an English Language.
1. Yes
2. No, all in English
HHSPEAK2
? [F1]
^INTROFIL_HHSPEAK2 speak a language other than English at home?
Count American Sign Language as an English Language.
1. Yes
2. No, only English
WHOSPEAK
? [F1]
Who ^OTHERTHANFIL_WHOSPEAK speaks a language other than English at home?
Page 69 of 578
Anyone else?
Mark all that apply.
1. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
2. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
3. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
4. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
5. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
6. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
7. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
8. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
9. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
10. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
11. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
12. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
13. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
14. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
15. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
16. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
17. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
18. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
19. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
20. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 5
AF_HHLD
Did ^YOUANYONE ever serve on active duty in the U.S. Armed Forces?
1. Yes
2. No
AF_WHO
Who?
Mark all that apply.
1. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
2. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
Page 70 of 578
3. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
4. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
5. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
6. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
7. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
8. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
9. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
10. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
11. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
12. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
13. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
14. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
15. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
16. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
17. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
18. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
19. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
20. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 17 and PEOPLE_TO_ROSTER = 1
FALLOUT
^FALLOUT
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
MARITAL_STATUS
? [F1]
^C_AREIS ^TEMPNAME currently...
Read answer categories.
Page 71 of 578
1. Married?
2. Married, spouse absent DO NOT READ
3. Widowed?
4. Divorced?
5. Separated?
6. Never Married?
WHO_SPOUSE
Ask if necessary:
Who is ^PTEMPNAME spouse?
0. Person's spouse is not a member of the household
1. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
2. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
3. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
4. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
5. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
6. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
7. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
8. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
9. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
10. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
11. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
12. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
13. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
14. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
15. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
16. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
17. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
18. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
19. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
20. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15
CTRLNUM
**NON-DISPLAYED ITEM**
Page 72 of 578
LNO
**NON-DISPLAYED ITEM**
PAR1HHLD
^DODOES ^NAMEFIL2 have a parent in the household?
Please include biological, step and adoptive parents.
1. Yes
2. No
PAR1_WHO
Ask or verify:
Who is that? (Who is ^PNAMEFIL2 parent?)
1. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
2. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
3. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
4. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
5. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
6. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
7. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
8. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
9. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
10. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
11. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
12. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
13. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
14. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
15. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
16. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
17. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
18. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
19. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
20. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
PAR1TYPE
? [F1]
Page 73 of 578
^C_AREISWAS ^NAMEFIL2 ^PPAR1NAME biological, step, or adopted child?
1. Biological child
2. Stepchild
3. Adopted child
4. Foster child
PAR2HHLD
Ask or verify:
^DODOES ^NAMEFIL2 have another parent in the household?
Please include biological, step and adoptive parents.
1. Yes
2. No
PAR2_WHO
Ask or verify:
Who is that? (Who is ^PNAMEFIL2 other parent?)
1. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
2. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
3. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
4. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
5. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
6. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
7. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
8. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
9. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
10. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
11. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
12. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
13. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
14. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
15. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
16. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
17. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
Page 74 of 578
18. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
19. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
20. Display the LNO ROST_FNAME ^ROST_MNAME ROST_LNAME where AGE >= 15 and not equal WHO_SPOU
PAR2TYPE
? [F1]
^C_AREISWAS ^NAMEFIL2 ^PPAR2NAME biological, step, or adopted child?
1. Biological child
2. Stepchild
3. Adopted child
4. Foster child
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
I_BORNUS
BORNUS
^ASKORVERIFY
^C_WASWERE ^TEMPNAME born in the United States?
1. Yes
2. No
I_BORNST
BORNST
^ASKORVERIFY
In what state ^WEREWAS ^TEMPNAME born?
1. Alabama
Page 75 of 578
2. Alaska
3. American Samoa
4. Arizona
5. Arkansas
6. California
7. Colorado
8. Connecticut
9. Delaware
10. District of Columbia
11. Florida
12. Georgia
13. Guam
14. Hawaii
15. Idaho
16. Illinois
17. Indiana
18. Iowa
19. Kansas
20. Kentucky
21. Louisiana
22. Maine
23. Maryland
24. Massachusetts
25. Michigan
26. Minnesota
27. Mississippi
28. Missouri
29. Montana
30. Nebraska
31. Nevada
32. New Hampshire
33. New Jersey
34. New Mexico
35. New York
36. North Carolina
37. North Dakota
38. Northern Marianas
39. Ohio
40. Oklahoma
Page 76 of 578
41. Oregon
42. Other place
43. Pennsylvania
44. Puerto Rico
45. Rhode Island
46. South Carolina
47. South Dakota
48. Tennessee
49. Texas
50. U.S. Virgin Islands
51. Utah
52. Vermont
53. Virginia
54. Washington
55. West Virginia
56. Wisconsin
57. Wyoming
BORNSTATE
^ASKORVERIFY
In what state ^WEREWAS ^TEMPNAME born?
1. Alabama
2. Alaska
3. American Samoa
4. Arizona
5. Arkansas
6. California
7. Colorado
8. Connecticut
9. Delaware
10. District of Columbia
11. Florida
12. Georgia
13. Guam
14. Hawaii
15. Idaho
16. Illinois
Page 77 of 578
17. Indiana
18. Iowa
19. Kansas
20. Kentucky
21. Louisiana
22. Maine
23. Maryland
24. Massachusetts
25. Michigan
26. Minnesota
27. Mississippi
28. Missouri
29. Montana
30. Nebraska
31. Nevada
32. New Hampshire
33. New Jersey
34. New Mexico
35. New York
36. North Carolina
37. North Dakota
38. Northern Marianas
39. Ohio
40. Oklahoma
41. Oregon
42. Other place
43. Pennsylvania
44. Puerto Rico
45. Rhode Island
46. South Carolina
47. South Dakota
48. Tennessee
49. Texas
50. U.S. Virgin Islands
51. Utah
52. Vermont
53. Virginia
54. Washington
55. West Virginia
Page 78 of 578
56. Wisconsin
57. Wyoming
I_BORNCOUNTRY
BORNCOUNTRY
BORNCNTRY
? [F1]
^ASKORVERIFY
In what country ^WEREWAS ^TEMPNAME born?
1. United States (US, USA)
2. Afghanistan
3. American Samoa
4. Argentina
5. Armenia
6. Australia
7. Austria
8. Azores
9. Bahamas
10. Bangladesh
11. Barbados
12. Belgium
13. Belize
14. Bermuda
15. Bolivia
16. Bosnia and Herzegovina
17. Brazil
18. Burma/Myanmar
19. Cambodia
20. Canada
21. Caribbean
22. Chile
23. China
24. Colombia
25. Costa Rica
26. Cuba
27. Czech Republic
Page 79 of 578
28. Czechoslovakia
29. Denmark
30. Dominica
31. Dominican Republic
32. Ecuador
33. Egypt
34. El Salvador
35. England
36. Ethiopia
37. Fiji
38. Finland
39. France
40. Germany
41. Ghana
42. Great Britain
43. Greece
44. Grenada
45. Guam
46. Guatemala
47. Guyana
48. Haiti
49. Honduras
50. Hong Kong
51. Hungary
52. India
53. Indonesia
54. Iran
55. Iraq
56. Ireland
57. Israel
58. Italy
59. Jamaica
60. Japan
61. Jordan
62. Kenya
63. Korea
64. Laos
65. Latvia
66. Lebanon
Page 80 of 578
67. Lithuania
68. Malaysia
69. Mexico
70. Morocco
71. Netherlands
72. New Zealand
73. Nicaragua
74. Nigeria
75. Northern Marianas
76. Norway
77. Pakistan
78. Palestine
79. Panama
80. Peru
81. Philippines
82. Poland
83. Portugal
84. Puerto Rico
85. Romania
86. Russia
87. Scotland
88. Slovakia
89. South Africa
90. South Korea
91. Spain
92. Sweden
93. Switzerland
94. Syria
95. Taiwan
96. Thailand
97. Trinidad and Tobago
98. Turkey
99. U.S. Virgin Islands
100. Ukraine
101. United Kingdom
102. United States (US, USA)
103. Uruguay
104. USSR
105. Venezuela
Page 81 of 578
106. Vietnam
107. Yugoslavia
108. Other Africa
109. Other Asia
110. Other Central America
111. Other Europe
112. Other Pacific Islands
113. Other South America
114. Other
I_CITIZEN
CITIZEN
^ASKORVERIFY
^C_AREISWAS ^TEMPNAME a citizen of the United States?
1. Yes
2. No
I_NATCIT
NATCIT
D, ? [F1]
^ASKORVERIFY
How did ^TEMPNAME become a U.S. citizen?
1. Naturalized
2. Through ^HISHER or spouse's military service in the Armed Forces
3. Adopted by U.S. citizen parent or parents
4. Born in a U.S. Island Area or born in the United States
5. Born abroad of U.S. citizen parent or parents
I_YRENTRY
YRENTRY
^ASKORVERIFY
Page 82 of 578
What year did ^TEMPNAME first come to live in the United States?
I_IMSTAT
IMSTAT
E
^ASKORVERIFY
When ^TEMPNAME first moved to the United States to live, what was ^HISHER immigration
status?
1. Relative or family sponsored
2. Employment-based
3. Other permanent
4. Refugee or asylum
5. Non-immigrant (e.g., student, tourist, etc.)
6. Other
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
LANG1
? [F1]
What language ^DODOES ^TEMPNAME speak at home?
If more than one, mark the 'main' other language.
1. Spanish or Spanish Creole
2. Chinese
3. French (including Patois, Cajun)
4. French Creole
5. Tagalog, Filipino
6. Vietnamese
7. German
Page 83 of 578
8. Korean
9. Russian
10. Italian
11. Hindi, Urdu
12. Arabic
13. Portuguese or Portuguese Creole
14. Polish
15. Persian
16. Gujarati
17. Other
HOWWELL
^INTROFIL_HOWWELL
How well ^DODOES ^TEMPNAME speak English - would you say very well, well, not well, or not
at all?
1. Very well
2. Well
3. Not well
4. Not at all
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
EDUC
F, ? [F1]
EDUC_FILL1
31. Less than 1st grade
32. 1st, 2nd, 3rd or 4th grade
33. 5th or 6th grade
34. 7th or 8th grade
Page 84 of 578
35. 9th grade
36. 10th grade
37. 11th grade
38. 12th grade, no diploma
39. High School Graduate (diploma or GED or equivalent)
40. Some college credit, but less than 1 year (regular Jr.coll./coll./univ.)
41. 1 or more years of college, no degree (regular Jr.coll./coll./univ.)
42. Associate's degree (2-year college)
43. Bachelor's degree (for example: BA, AB, BS)
44. Master's degree (for example: MA, MS, MBA, MSW)
45. Professional School degree (for example: MD (doctor), DDS (dentist), JD (lawyer))
46. Doctorate degree (for example: Ph.D., Ed.D.)
GED_TEST
Had ^TEMPNAME completed high school by means of a GED or other equivalency test or
program?
1. Yes
2. No
HSGRAD_GED
? [F1]
Ask or verify.
Did ^TEMPNAME get ^HISHER high school diploma by graduating from high school, or by
passing a GED exam or other equivalent?
1. Graduated from high school
2. GED or other test
3. No diploma or GED
PWAVE_GED_TEST
PWAVE_HSGRAD_GED
CTRLNUM
**NON-DISPLAYED ITEM**
Page 85 of 578
LNO
**NON-DISPLAYED ITEM**
AFWHEN
When did ^TEMPNAME serve on active duty?
Any other times?
Mark all that apply.
1. September 2001 to present
2. August 1990 to August 2001 (including Persian Gulf War)
3. May 1975 to July 1990
4. Vietnam Era (August 1964 to April 1975)
5. Februrary 1955 to July 1964
6. Korean War (July 1950 to January 1955)
7. January 1947 to June 1950
8. World War II (December 1941 to December 1946)
9. November 1941 or earlier
AFNOW
^C_AREIS ^TEMPNAME now on active duty?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
HHSPEAK3
? [F1]
C_DODOES ^TEMPNAME speak a language other than English at home?
Page 86 of 578
Count American Sign Language as an English Language.
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
LNO_HHSTAT
**NON-DISPLAYED ITEM**
HHSTAT2_REL
BB
^HHSTAT2_RELATIONSHIPQFILL2. When this person lived here, ^HHSTAT2_ROSTNAMEFIL was
^PTEMPNAME ______________.
If more than one relationship is applicable, enter the relationship that applied for most of the time spent
living together between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL.
If relationship is parent/child, probe for biological, step or adoptive.
If the exact relationship is unknown, mark 'Other Relatives' if the person is related or mark 'Other
Non-Relatives' if the person is not related.
1. Opposite sex husband/wife/spouse
Page 87 of 578
2. Opposite sex unmarried partner
3. Same sex husband/wife/spouse
4. Same sex unmarried partner
5. Biological parent/child
6. Step parent/child
7. Adoptive parent/child
8. Grandparent/Grandchild
9. Brother/Sister
10. Parent/Child in-law
11. Brother/Sister in-law
12. Aunt/Uncle, Niece/Nephew
13. Other relative (cousin, etc.)
14. Foster parent/child
15. Other non-relative
16 . Not in the household with this person
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
LFPGINTRO
Since ^TEMPNAME is no longer in the household, I have a couple of questions about ^HISHER
circumstances before ^HESHE ^DIEDMOVEDOUT.
1. Enter 1 to continue
Page 88 of 578
LFPARTPTN
Last time we interviewed ^TEMPNAME, ^HESHE was working for Provisional Job fill. When did
^HESHE stop working for Provisional Job fill?
For persons who have been institutionalized or working outside the country, they may still be employed
or working for the same company. In this instance, select the month in which they left the household.
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
19. Person still working for same company DO NOT READ
LFPRT_AMT
What would you guess was ^HISHER total gross income from Provisional Job fill between
^BMONTHFILL 1st ^CALENDAR_YRFIL and LVMONTHYR?
1. Less than $20,000?
2. Between $20,000 and $34,999?
3. Between $35,000 and $49,999?
4. $50,000 or more?
NOWORKJOB
Did ^TEMPNAME work for pay at all between ^MONTH1 1st ^CALENDAR_YRFIL and
LVMONTHYR?
Page 89 of 578
1. Yes
2. No
NWKJBAMT
What would you guess was ^HISHER gross income from ^HISHER job between ^MONTH1 1st
^CALENDAR_YRFIL and LVMONTHYR?
If respondent reports former household member held multiple jobs during the reference period, please
collect amount for the main or highest grossing job.
1. Less than $20,000?
2. Between $20,000 and $34,999?
3. Between $35,000 and $49,999?
4. $50,000 or more?
PRGMPRPTN
Last time we interviewed ^TEMPNAME, ^HESHE was receiving income from Read list of
programs. Between ^MONTH1 1st ^CALENDAR_YRFIL and LVMONTHYR, what would you guess
was ^HISHER average monthly income from all of the programs combined?
Display List of Programs Received Last Wave:
SSI
TANF
Food Stamps
WIC
Social Security
Unemployment Compensation
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
NOPROGRAM
Between ^MONTH1 1st ^CALENDAR_YRFIL and LVMONTHYR, did ^TEMPNAME receive income
from any of the following programs?
List of Programs
SSI
Page 90 of 578
TANF
Food Stamps
WIC
Social Security
Unemployment Compensation
1. Yes
2. No
NOPGMAMT
What would you guess was ^HISHER average monthly income from these programs between
^MONTH1 1st ^CALENDAR_YRFIL and LVMONTHYR?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
HIPRTCPTN
I'm showing that when we last interviewed ^TEMPNAME, ^HESHE
(read list)
HI insurance fill.
Did ^HESHE have this coverage when ^HESHE ^DIEDMOVEDOUT?
1. Yes
2. No
HICVGENO
Did ^TEMPNAME have any health insurance coverage when ^HESHE ^DIEDMOVEDOUT?
1. Yes
2. No
HICVGETYP
What type of coverage did ^TEMPNAME have?
Mark all that apply.
Page 91 of 578
1. Private health insurance
2. Medicare
3. Medicaid
4. Military or VA health coverage
DCPRTCPTN
Before ^HESHE ^DIEDMOVEDOUT, did anyone in the household pay for care or hospitalization
for ^TEMPNAME?
1. Yes
2. No
DPCAREAMT
What was the total cost of these care arrangements between ^MONTH1 1st ^CALENDAR_YRFIL
and LVMONTHYR?
CTRLNUM
**NON-DISPLAYED ITEM**
INLIST
**NON-DISPLAYED ITEM**
BCHILD_INTRO
NEVER_MARRIED_SPELL
NEVER_MARRIED_SPELL_PER
MARRIED_ALLYEAR_PER
BFERT_INTRO
PWAVE_RIP
RIP
? [F1]
^RIPINTRO_W2_FIL
We Wave 4 RIP Introduction recontact this household in the future to update information. We
would like to ^RIPYES_FIL use some of the information you have provided today to make that
interview shorter and more efficient. When we come back next time, whether we speak to you or
Page 92 of 578
someone else you are living with, is it OK if we use some of your answers as a starting point?
(Only a limited amount of information, such as whether you attended school and whether you are
married, is passed forward into the next interview.)
To see a comprehensive list of content that would be passed forward, see the Help Screen.
1. Yes
2. No
BPROGINCOME_INTRO
RIPCONTINUE
EHC_PGM_SCRN
**NON-DISPLAYED ITEM**
1. Yes
2. No
INC_SCRN
**NON-DISPLAYED ITEM**
1. Yes
2. No
SCREENER_CLUMP
**NON-DISPLAYED ITEM**
1. Yes
2. No
PWAVE_SCREENER_CLUMP
PCNT_TYPE2
*** NON-DISPLAYED ITEM ***
AGESALL
*** NON-DISPLAYED ITEM ***
Page 93 of 578
AGEUNDER15T2
PCNTFEGE15T2
**NON-DISPLAYED ITEM**
PCNTLT5T2
**NON-DISPLAYED ITEM**
PCNTLT18T2
**NON-DISPLAYED ITEM**
PCNTLT22T2
**NON-DISPLAYED ITEM**
PLPCNT_TYPE2
**NON-DISPLAYED ITEM**
PCNTGE15T2
*** NON-DISPLAYED ITEM ***
PLPCNTLE18T2
**NON-DISPLAYED ITEM**
PCNTGE18T2
**NON-DISPLAYED ITEM**
BEHCSCREEN
LNDCUPT
**NON-DISPLAYED ITEM**
HASDOMPART
HASSPDPT2SP
T2SPLNO
LATESTSPMONTH
Page 94 of 578
SPDPT2SLNO
GAPMSGCOUNT
RESCOPY
CARICON_ARRAY
? [F1]
This interview may be recorded for quality control purposes. Is that okay?
1. Yes
2. No
CARICON2_FLG
***NON-DISPLAYED ITEM***
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CLUMPALL
This is a survey about people's economic situation since ^MONTH1 1st ^CALENDAR_YRFIL. The
picture would be incomplete if we didn't get a little information about people ^TEMPNAME used
to live with.
Did ^TEMPNAME and Read name(s) ^BOTHALL continuously live together
^DURATION_REFPERDFIL?
"Continuously" means separations not longer than one month. This question is used to cluster all
listed household members together.
Display the first and last name of all people on the final household roster
(excluding the HH respondent).
1. Yes
2. No
Page 95 of 578
CLUMPANY
^CLUMPANY_INTROFIL
Did ^TEMPNAME live together ^ENTIRE_TIMEFIL with ^EITHERANY of the people ^HESHE
currently ^LIVE_LIVESFIL with?
1. Yes
2. No
CLUMPWHO
Who was that? (Which of these people did ^TEMPNAME live with the entire time between ^MONTH1
1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?)
Mark all that apply.
1. Display the LNO ROST_FNAME ROST_LNAME
2. Display the LNO ROST_FNAME ROST_LNAME
3. Display the LNO ROST_FNAME ROST_LNAME
4. Display the LNO ROST_FNAME ROST_LNAME
5. Display the LNO ROST_FNAME ROST_LNAME
6. Display the LNO ROST_FNAME ROST_LNAME
7. Display the LNO ROST_FNAME ROST_LNAME
8. Display the LNO ROST_FNAME ROST_LNAME
9. Display the LNO ROST_FNAME ROST_LNAME
10. Display the LNO ROST_FNAME ROST_LNAME
11. Display the LNO ROST_FNAME ROST_LNAME
12. Display the LNO ROST_FNAME ROST_LNAME
13. Display the LNO ROST_FNAME ROST_LNAME
14. Display the LNO ROST_FNAME ROST_LNAME
15. Display the LNO ROST_FNAME ROST_LNAME
16. Display the LNO ROST_FNAME ROST_LNAME
17. Display the LNO ROST_FNAME ROST_LNAME
18. Display the LNO ROST_FNAME ROST_LNAME
19. Display the LNO ROST_FNAME ROST_LNAME
20. Display the LNO ROST_FNAME ROST_LNAME
CTRLNUM
**NON-DISPLAYED ITEM**
Page 96 of 578
LNO
**NON-DISPLAYED ITEM**
T2_ALLYR
T2_YN
^OTHERWAS there anyone else who lived with ^TEMPNAME for one month or more, either here
or at any other previous address, at any time between ^MONTH1 1st and the end of
^LASTMONTH ^CALENDAR_YRFIL?
Prechart all partial period people (HHSTAT=5) and movers (HHSTAT=2 and not
URE) people here (If no one on the roster is HHSTAT=5 or a mover then
prechart should be blank).
(This is a survey about people's economic situation between ^MONTH1 1st and the end of
^LASTMONTH ^CALENDAR_YRFIL. The picture would be incomplete if we didn't get a little information
about people ^TEMPNAME used to live with.)
'One month or more' must be CONTINUOUS time, not a day or week here or there.
1. Yes
2. No
TYPE2_READY
T2_MORE
That's ten other people who lived with ^TEMPNAME between ^MONTH1 1st and the end of
^LASTMONTH ^CALENDAR_YRFIL, which is all this questionnaire has room for. How many
more were there?
Enter 0 for none.
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
T2SLOT
**NON-DISPLAY ITEM**
Page 97 of 578
T2LNO
**NON-DISPLAYED ITEM**
T2_ROST_NUM
T2 Who question text (That is, the people who lived with ^TEMPNAME^OTHERADD_COMMA at any
time between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL.)
As each name is added, consider whether this is a duplicate name to one previously entered and
probe to make sure the responses are consistent.
Enter 0 to add a new person.
Enter 999 for none or no more.
Display the fist and last name of the people aready entered.
T2_ROST_FNAME
^T2FNAMETEXT
Enter 999 for none or no more.
T2_ROST_LNAME
^T2LNAMETEXT
Enter 999 for none or no more.
T2_RELEXP
BB
^T2_REL_RELATIONSHIPQFILL
Text to fill when limiting to only the first five type 2 people identified
If more than one relationship is applicable, enter the relationship that applied for most of the time spent
living together between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL.
If relationship is parent or child, probe for biological, step or adoptive.
If the exact relationship is unknown, mark 'Other Relatives' if the person is related or mark 'Other
Non-Relatives' if the person is not related.
1. Opposite sex husband/wife/spouse
Page 98 of 578
2. Opposite sex unmarried partner
3. Same sex husband/wife/spouse
4. Same sex unmarried partner
5. Biological parent/child
6. Step parent/child
7. Adoptive parent/child
8. Grandparent/Grandchild
9. Brother/Sister
10. Parent/Child in-law
11. Brother/Sister in-law
12. Aunt/Uncle, Niece/Nephew
13. Other relative (cousin, etc.)
14. Foster parent/child
15. Other non-relative
16 . Not in the household with this person
T2_REL
**NON-DISPLAYED ITEM**
1. Spouse (Husband/Wife)
2. Unmarried Partners
3. Biological Parent/Child
4. Step-parent/child
5. Adoptive parent/child
6. Grandparent-grandchild
7. Siblings (e.g. brother/sister)
8. Other Relatives (e.g., aunt/uncle, niece/nephew, cousins, parent/child-in-laws, etc.)
9. Foster Parent/Child
10. Friends, Roommates or Other Non-Relatives
T2_1_MONTHS
In which months, between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME and ^T2_ROSTNAMEFIL live together?
Mark all that apply.
Mark all months in which these people lived together for at least half of the month.
1. ^MONTH1 ^CALENDAR_YR
Page 99 of 578
2. ^MONTH2 ^CALENDAR_YR
3. ^MONTH3 ^CALENDAR_YR
4. ^MONTH4 ^CALENDAR_YR
5. ^MONTH5 ^CALENDAR_YR
6. ^MONTH6 ^CALENDAR_YR
7. ^MONTH7 ^CALENDAR_YR
8. ^MONTH8 ^CALENDAR_YR
9. ^MONTH9 ^CALENDAR_YR
10. ^MONTH10 ^CALENDAR_YR
11. ^MONTH11 ^CALENDAR_YR
12. ^MONTH12 ^CALENDAR_YR
T2_SEX
Ask if necessary:
Is ^T2_ROSTNAMEFIL male or female?
1. Male
2. Female
TW_AGE
What was ^T2HISHER age as of the beginning of last year (^MONTH1 1st, ^CALENDAR_YEAR)?
(Your best guess is fine.)
TW_AGERANGE
Was ^HESHE...
Read answer categories.
1. Under 5 years old?
2. 5 - 14 years old?
3. 15 - 19 years old?
4. 20 - 29 years old?
5. 30 - 49 years old?
6. 50 - 69 years old?
7. 70 years old or over?
Page 100 of 578
T2_HIED
What is the highest level of school that ^T2_ROSTNAMEFIL has completed, or the highest degree
^T2HESHE has received?
1. Did NOT graduate from high school
2. Graduated from high school (Diploma or GED)
3. College graduate (Bachelor's degree or higher)
T2_WORK
Did ^T2_ROSTNAMEFIL work for pay at any time when ^TEMPNAME and ^T2_ROSTNAMEFIL
lived together?
Display months listed in the filed T2_1_MONtHS
1. Yes
2. No
T2_INC
Including all income sources, what would you guess was ^T2HISHER annual income?
(We don't expect an exact amount. Your best guess is fine.)
If a specific time is asked for, use ^MONTH1 1st, ^CALENDAR_YEAR.
If the person's income is $1 million or more, enter 999,999.
Round the amount to the nearest dollar.
T2_INCDK1
Was it more than $25,000?
If a specific time is asked for, use ^MONTH1 1st, ^CALENDAR_YEAR.
1. Yes, more than $25,000
2. No
T2_INCDK2A
Was it more than $50,000?
If a specific time is asked for, use ^MONTH1 1st, ^CALENDAR_YEAR.
Page 101 of 578
1. Yes, more than $50,000
2. No
T2_INCDK2B
Was it more than $10,000?
If a specific time is asked for, use ^MONTH1 1st, ^CALENDAR_YEAR.
1. Yes, more than $10,000
2. No
TYPE2_COMP
The Type 2 section is complete.
Enter 1 to continue.
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
ECVD_EIP
Since April 1, 2020, did ^COVIDPER_FILL receive any stimulus payment or payments from the
Department of the Treasury due to the coronavirus pandemic?
Do not include refunds on annual income taxes, unemployment compensation, or payments from an
employer.
ECVD_MTH
What month or months did ^TEMPNAME receive a stimulus payment or payments?
Mark all that apply.
Page 102 of 578
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
ECVD_AMT
What was the amount of the stimulus payment that ^COVIDPER_FILL received in
^COVIDMTH_FIL?
Probe for best guess if necessary.
ECVD_USE
Thinking about the stimulus ^COVIDPMT_FIL, did ^TEMPNAME mostly spend
^COVIDTHEM_FIL, save ^COVIDTHEM_FIL, use ^COVIDTHEM_FIL to pay off debt, or give
^COVIDTHEM_FIL away?
1. Mostly spent
2. Mostly saved
3. Mostly paid off debt
4. Mostly given away (to charity or someone in need)
ECVD_SPND
What did ^TEMPNAME mostly spend the stimulus ^COVIDPMT_FIL on?
Mark all that apply.
1. Food (groceries, eating out, take out)
Page 103 of 578
2. Gasoline
3. Clothing (clothing, accessories, shoes)
4. Rent
5. Mortgage
6. Utilities and telecommunications (natural gas, electricity, cable, internet, cellphone)
7. Major household items (TV, electronics, furniture, appliances or other big ticket goods)
8. Gave to charity DO NOT READ
9. Other, specify DO NOT READ
ECVD_SPDOTH
What was the other thing on which ^TEMPNAME spent ^HISHER stimulus ^COVIDPMT_FIL?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
PROCERT
? [F1]
Now I have some preliminary questions about ^TEMPNAME that will help streamline the
interview.
^C_DODOESDID ^TEMPNAME have a professional certification or a state or industry license?
A professional certification or license shows you are qualified to perform a specific job and includes
things like Licensed Realtor, Certified Medical Assistant, Certified Construction Manager, a Project
Management Professional (PMP) certification, or an IT Certification.
1. Yes
2. No
WHOCERT
Who issued this certification or license?
Mark all that apply.
Page 104 of 578
1. Federal, state, or local government
2. Professional or trade association (for example, Pediatric Nursing Certification Board, National Exercise and Spor
3. Business or company (for example, Microsoft, 3M Company, Xerox)
4. Other group or organization
CERT
? [F1]
Some people decide to enroll at a college, university, community college, or trade school to earn
a certificate rather than a degree. ^C_HAVHASDID ^TEMPNAME ever ^EARN_FIL this type of
certificate?
An educational certificate is typically earned by completing a program of study offered by a college or
university, a community college, or a trade school, but it does not lead to an Associate's, Bachelor's, or
graduate degree. Sometimes these are called vocational diplomas (for example, a cosmetology or
mechanic's diploma), which differs from a high school diploma.
1. Yes
2. No
TIMES_MARRIED
How many times ^HAVEHAS ^TEMPNAME been married?
If the person has been married but the marriage was annulled, consider the marriage never to have
occurred.
1. Once
2. Twice
3. Three times
4 or more. Four or more times
0. Never Married
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
Page 105 of 578
MSFLAG
**NON-DISPLAYED ITEM**
MAR_MO
^MARMO_FIL
Enter month.
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
MAR_YR
^MARYR_FIL
Enter year.
WIDIV
Did ^PTEMPNAME ^12CUR_FIL marriage end in widowhood or divorce?
^WIDIV_FRNOTEFIL
1. Widowhood
2. Divorce
END_MO
^ENDMO_FIL
Page 106 of 578
Enter month.
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
END_YR
^ENDYR_FIL
Enter year.
STOPLIV_MO
^STOPLIVMO_FIL actually stop living together?
Enter month.
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
Page 107 of 578
STOPLIV_YR
^STOPLIVYR_FIL actually stop living together?)
Enter year.
YR_CURR_MARR
***Non-displayed item***
EVRWID
^C_HAVHAS ^TEMPNAME ever been widowed?
1. Yes
2. No
PWAVE_EVRWID
EVRDIV
^C_HAVHAS ^TEMPNAME ever been divorced?
1. Yes
2. No
PWAVE_EVRDIV
PARFLAG
*********** NON-DISPLAYED ITEM ****************
1. Yes
2. No
PARENT_SCRN
^DEMO_Q_INTRO2
C_DODOES ^TEMPNAME have any children?
Please include biological, step or adopted children, both living and deceased.
1. Yes
2. No
Page 108 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
HHINCSCR_YR
I also have a couple of preliminary questions about income. In ^CALENDAR_YEAR was
^PINCPER_FILL gross or net annual income below $^INCYR_FILL?
1. Yes
2. No
HHINCSCR_MTH
During any month in ^CALENDAR_YEAR, was ^PINCPER_FILL gross or net monthly income ever
below $^INCMTH_FILL?
1. Yes
2. No
HHPGMSCR
Just to be sure nothing is missed, at any time since ^MONTH1 ^CALENDAR_YRFIL, did
^PPROGRAM_FILL receive assistance such as Food Stamps or SNAP, WIC, Medicaid,
^TANFFIL1, ^TANFFIL2, ^TANFFIL3, or General Assistance from a federal, state, or local agency?
1. Yes
2. No
EHC_INTRO
In this section of the interview, we are interested in ^YOURHISHER residence, INCOREDUC, and
other circumstances since ^MONTH1 1st ^CALENDAR_YRFIL.
Enter 1 to continue.
1. Enter 1 to continue
Page 109 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
BRESIDENCY_SCREENER
^RESSCREENERTEXT
1. Yes
2. No
BRESIDENCY_SCREENER2
BRESIDENCY_DESC
BRESIDENCY_RETURNING
**NON-DISPLAYED ITEM**
BMARITAL_HISTORY_SCREENER
^MHXSCREEN_QTEXT
Enter 1 to continue.
1. Enter 1 to continue
BMARITAL_HISTORY_SCREENER2
BMARITAL_HISTORY_DESC
BMARITAL_HISTORY_RETURNING
**NON-DISPLAYED ITEM**
BEDUC_ENROLLMENT_SCREENER
^C_AREIS ^YOUHESHE currently attending ^ENROLLSCREENERTEXT?
1. Yes
2. No
Page 110 of 578
BEDUC_ENROLLMENT_SCREENER2
^ENROLLSCREENER2TEXT
1. Yes
2. No
BEDUC_ENROLLMENT_RETURNING
**NON-DISPLAYED ITEM**
BEDUC_ENROLLMENT_DESC
BJOB_SCREENER
^JOBSCREENER
1. Yes
2. No
BJOB_SCREENER2
^JOBSCREENER2
1. Yes
2. No
BJOB_DESC
BJOB_RETURNING
**NON-DISPLAYED ITEM**
BNOJOB_SCREENER
Read if necessary:
I have recorded that ^YOUHESHE AREIS currently NOT working for pay.
Is that correct?"
1. Yes
2. No
NOJOB_SCREENER2
Page 111 of 578
"I have recorded that there were times ^YOUHESHE WASWERE NOT working for pay since
^MONTH1 1st ^CALENDAR_YRFIL. Is that correct?"
1. Yes
2. No
BNOJOB_DESC
BNOJOB_RETURNING
BSSI_SCREENER
AREIS ^YOUHESHE currently receiving SSI?
Do NOT include disability, retirement, or survivor income from Social Security.
1. Yes
2. No
BSSI_SCREENER2
Did ^YOUHESHE receive SSI ^SCREENER2TEXT?
Do NOT include disability, retirement, or survivor income from Social Security.
1. Yes
2. No
BSSI_DESC
BSSI_RETURNING
**NON-DISPLAYED ITEM**
BFS_SCREENER
^C_AREIS ^YOUHESHEFAM currently receiving Food Stamp or SNAP benefits?
1. Yes
2. No
BFS_SCREENER2
Did ^YOUHESHEFAM receive Food Stamps or SNAP benefits ^SCREENER2TEXT?
Page 112 of 578
1. Yes
2. No
BFS_DESC
BFS_RETURNING
**NON-DISPLAYED ITEM**
BTANF_SCREENER
^C_AREIS ^YOUHESHEFAM currently receiving TANF benefits, or any other cash assistance
from a state or local welfare program^TANFLE18FIL?
1. Yes
2. No
BTANF_SCREENER2
Did ^YOUHESHEFAM receive TANF benefitsClosing text for the second TANF screener?
1. Yes
2. No
BTANF_DESC
BTANF_RETURNING
**NON-DISPLAYED ITEM**
BGENASSIS_SCREENER
^C_AREIS ^YOUHESHEFAM currently receiving General Assistance (either for
^YOURHIMHERSELF or on behalf of a child)?
1. Yes
2. No
BGENASSIS_SCREENER2
Did ^YOUHESHEFAM receive General Assistance ^GASCREENER2TEXT?
1. Yes
Page 113 of 578
2. No
BGENASSIS_DESC
BGENASSIS_RETURNING
**NON-DISPLAYED ITEM**
BWIC_SCREENER
^C_AREIS ^YOUHESHE currently receiving WIC benefits^WICLT5FIL?
1. Yes
2. No
BWIC_SCREENER2
Did ^YOUHESHE receive WIC benefits Closing text for the second WIC screener?
1. Yes
2. No
BWIC_DESC
BWIC_RETURNING
**NON-DISPLAYED ITEM**
BPRIVATE_SCREENER
^C_AREIS ^YOUHESHE currently covered by a private health insurance plan?
Do NOT include Military or VA coverage, or coverage through a Medicare Supplement, Medigap, or
Medicare Advantage (Part C) plan.
1. Yes
2. No
BPRIVATE_SCREENER2
^PRIVATE_SCREENER2QTEXT
1. Yes
2. No
Page 114 of 578
BPRIVATE_DESC
BPRIVATE_RETURNING
**NON-DISPLAYED ITEM**
BMEDICARE_SCREENER
^C_AREIS ^YOUHESHE currently covered by Medicare?
Include coverage through any type of Medicare plan, such as a Medicare Supplement, Medigap, or
Medicare Advantage (Part C).
1. Yes
2. No
BMEDICARE_SCREENER2
BMEDICARE_DESC
BMEDICARE_RETURNING
**NON-DISPLAYED ITEM**
BMEDICAID_SCREENER
^C_AREIS ^YOUHESHE currently covered by Medicaid, or CHIP, or any other government
program that helps pay health care costs for low-income people?
1. Yes
2. No
BMEDICAID_SCREENER2
Were ^YOUHESHE covered by Medicaid, or CHIP, or any other government program that helps
pay health care costs for low-income people ^SCREENER2TEXT?
1. Yes
2. No
BMEDICAID_DESC
BMEDICAID_RETURNING
**NON-DISPLAYED ITEM**
BMILITARY_SCREENER
Page 115 of 578
^C_AREIS ^YOUHESHE currently covered by any health insurance through one of those
sources?
1. Yes
2. No
BMILITARY_SCREENER2
Were ^YOUHESHE covered by health insurance provided by the military or Department of
Veterans Affairs ^SCREENER2TEXT?
1. Yes
2. No
BMILITARY_DESC
BMILITARY_RETURNING
**NON-DISPLAYED ITEM**
BOTHERCOVERAGE_SCREENER
CC
(Other than what we've already talked about,) AREIS ^YOUHESHE currently covered by any other
type of health insurance plan? (Perhaps a government program, Indian Health Services, or a policy
through a parent, a foreign government, or any other source?)
1. Yes
2. No
BOTHERCOVERAGE_SCREENER2
CC
^C_WASWERE ^YOUHESHE covered by any other type of health insurance plan at any time since
^MONTH1 1st ^CALENDAR_YRFIL? (Perhaps a government program, Indian Health Services, or a
policy through a parent, a foreign government, or any other source?)
1. Yes
2. No
BOTHERCOVERAGE_DESC
Page 116 of 578
BOTHERCOVERAGE_RETURNING
BNOCOVERAGE_DESC
BNOCOVERAGE_RETPERNUM
BNOCOVERAGE_SCREENER
NOCOVINDEX
HEALTHGAPCTR
BRESIDENCY_RETPERNUM
BMARITAL_HISTORY_RETPERNUM
BEDUC_ENROLLMENT_RETPERNUM
BEDUC_ENROLLMENT_PWAVEGRADE_INT
BJOB_RETPERNUM
BNOJOB_RETPERNUM
BSSI_RETPERNUM
BFS_RETPERNUM
BTANF_RETPERNUM
BGENASSIS_RETPERNUM
BWIC_RETPERNUM
BPRIVATE_RETPERNUM
BMEDICARE_RETPERNUM
BMEDICAID_RETPERNUM
BMILITARY_RETPERNUM
BOTHERCOVERAGE_RETPERNUM
PROVIS_MS_EHC
PROVIS_WHO_SPOUSE_EHC
BJOB_AT_EMPNAME
JOB1INDEX
BOB2INDEX
JOB3INDEX
JOB4INDEX
JOB5INDEX
JOB6INDEX
JOB7INDEX
JOB8INDEX
B9INDEX
PRIV1INDEX
Page 117 of 578
PRIV2INDEX
MEDCINDEX
MEDDINDEX
MILINDEX
OTCINDEX
RESINDEX
EDUINDEX
FSINDEX
TANFINDEX
GENINDEX
WICINDEX
SSIINDEX
MARINDEX
NOJOBCOUNT
MIL_COVFLAG
*Non-Displayed Field*
MED_COVFLAG
*Non-Displayed Field*
PRIV1_COVFLAG
*Non-Displayed Field*
PRIV2_COVFLAG
*Non-Displayed Field*
MIL_FLAG
MED_FLAG
PRIV1_FLAG
PRIV2_FLAG
TANF_BLKLNFLG
*** NON-DISPLAYED ITEM ***
FS_BLKLNFLG
Page 118 of 578
*** NON-DISPLAYED ITEM ***
GA_BLKLNFLG
*** NON-DISPLAYED ITEM ***
EHC_Incomplete
The interview for ^TEMPNAME cannot be continued. The following sections have not been completed
in the EHC:
Incomplete EHC items
Either go back and finish the EHC, OR Enter 1 to continue to another person's interview.
1. Enter 1 to continue
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
spellnumber
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
bmonth
^RESFROMTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
Page 119 of 578
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
emonth
^RESTOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
Page 120 of 578
RESIDENCECODE
**NON-DISPLAYED ITEM**
pick_address_old
INTRO
^RESINTROTEXT
pick_address_ehc
pick_address
? [F1]
What was the address where ^TEMPNAME lived ^BETWEEN_BMONTH_EMONTH?
Select from below list of previously entered addresses OR select 'Add new address' to enter a new
address.
INFO
All months of the reference period must be accounted for; this includes both ^YR_FIL PLUS any months
to date in ^INTYEARFIL.
A maximum of 5 addresses is collected per household member for the reference period.
When recording changes in residences, FROM and TO months should be selected for the residence
where the respondent lived for the majority of the month.
ehc_cntry
? [F1]
In what country did ^TEMPNAME live ^BETWEEN_BMONTH_EMONTH?
1. United States (US, USA)
2. Afghanistan
3. American Samoa
4. Argentina
5. Armenia
6. Australia
7. Austria
8. Azores
9. Bahamas
10. Bangladesh
Page 121 of 578
11. Barbados
12. Belgium
13. Belize
14. Bermuda
15. Bolivia
16. Bosnia and Herzegovina
17. Brazil
18. Burma/Myanmar
19. Cambodia
20. Canada
21. Caribbean
22. Chile
23. China
24. Colombia
25. Costa Rica
26. Cuba
27. Czech Republic
28. Czechoslovakia
29. Denmark
30. Dominica
31. Dominican Republic
32. Ecuador
33. Egypt
34. El Salvador
35. England
36. Ethiopia
37. Fiji
38. Finland
39. France
40. Germany
41. Ghana
42. Great Britain
43. Greece
44. Grenada
45. Guam
46. Guatemala
47. Guyana
48. Haiti
49. Honduras
Page 122 of 578
50. Hong Kong
51. Hungary
52. India
53. Indonesia
54. Iran
55. Iraq
56. Ireland
57. Israel
58. Italy
59. Jamaica
60. Japan
61. Jordan
62. Kenya
63. Korea
64. Laos
65. Latvia
66. Lebanon
67. Lithuania
68. Malaysia
69. Mexico
70. Morocco
71. Netherlands
72. New Zealand
73. Nicaragua
74. Nigeria
75. Northern Marianas
76. Norway
77. Pakistan
78. Palestine
79. Panama
80. Peru
81. Philippines
82. Poland
83. Portugal
84. Puerto Rico
85. Romania
86. Russia
87. Scotland
88. Slovakia
Page 123 of 578
89. South Africa
90. South Korea
91. Spain
92. Sweden
93. Switzerland
94. Syria
95. Taiwan
96. Thailand
97. Trinidad and Tobago
98. Turkey
99. U.S. Virgin Islands
100. Ukraine
101. United Kingdom
102. United States (US, USA)
103. Uruguay
104. USSR
105. Venezuela
106. Vietnam
107. Yugoslavia
108. Other Africa
109. Other Asia
110. Other Central America
111. Other Europe
112. Other Pacific Islands
113. Other South America
114. Other
ehc_hno
What was the house number where ^TEMPNAME lived ^BETWEEN_BMONTH_EMONTH?
ehc_hnosuf
What was the house number suffix (where ^YOUHESHE lived ^BETWEEN_BMONTH_EMONTH)?
(For example, did this address have an apartment and a unit number?)
ehc_strname
What was the street name (where ^TEMPNAME lived ^BETWEEN_BMONTH_EMONTH)?
Page 124 of 578
ehc_noncityadd
? [F1]
What was the non-city address (where ^YOUHESHE lived ^BETWEEN_BMONTH_EMONTH)?
(For example, any description you can add to the address to make it more specific.)
ehc_po
What was the city (where ^YOUHESHE lived ^BETWEEN_BMONTH_EMONTH)?
EHC_COUNTRY
ehc_cnty
What was the county (where ^YOUHESHE lived ^BETWEEN_BMONTH_EMONTH)?
Address:
^HNO ^STRNM ^HNOSUF
^CITY ^NONCITYADD, ^STATE ^ZIP
ehc_state
What was the state (where ^YOUHESHE lived ^BETWEEN_BMONTH_EMONTH)?
1. Alabama
2. Alaska
3. American Samoa
4. Arizona
5. Arkansas
6. California
7. Colorado
8. Connecticut
9. Delaware
10. District of Columbia
11. Florida
12. Georgia
13. Guam
14. Hawaii
15. Idaho
16. Illinois
17. Indiana
18. Iowa
Page 125 of 578
19. Kansas
20. Kentucky
21. Louisiana
22. Maine
23. Maryland
24. Massachusetts
25. Michigan
26. Minnesota
27. Mississippi
28. Missouri
29. Montana
30. Nebraska
31. Nevada
32. New Hampshire
33. New Jersey
34. New Mexico
35. New York
36. North Carolina
37. North Dakota
38. Northern Marianas
39. Ohio
40. Oklahoma
41. Oregon
42. Other place
43. Pennsylvania
44. Puerto Rico
45. Rhode Island
46. South Carolina
47. South Dakota
48. Tennessee
49. Texas
50. U.S. Virgin Islands
51. Utah
52. Vermont
53. Virginia
54. Washington
55. West Virginia
56. Wisconsin
57. Wyoming
Page 126 of 578
ehc_st
What was the state (where ^YOUHESHE lived ^BETWEEN_BMONTH_EMONTH)?
1. Alabama
2. Alaska
3. American Samoa
4. Arizona
5. Arkansas
6. California
7. Colorado
8. Connecticut
9. Delaware
10. District of Columbia
11. Florida
12. Georgia
13. Guam
14. Hawaii
15. Idaho
16. Illinois
17. Indiana
18. Iowa
19. Kansas
20. Kentucky
21. Louisiana
22. Maine
23. Maryland
24. Massachusetts
25. Michigan
26. Minnesota
27. Mississippi
28. Missouri
29. Montana
30. Nebraska
31. Nevada
32. New Hampshire
33. New Jersey
34. New Mexico
35. New York
36. North Carolina
37. North Dakota
Page 127 of 578
38. Northern Marianas
39. Ohio
40. Oklahoma
41. Oregon
42. Other place
43. Pennsylvania
44. Puerto Rico
45. Rhode Island
46. South Carolina
47. South Dakota
48. Tennessee
49. Texas
50. U.S. Virgin Islands
51. Utah
52. Vermont
53. Virginia
54. Washington
55. West Virginia
56. Wisconsin
57. Wyoming
ehc_zip
What was the zip code (where ^YOUHESHE lived ^BETWEEN_BMONTH_EMONTH)?
temp_livewith
ehc_livewith
? [F1]
Ask or verify
During this period, (^BETWEEN_BMONTH_ALTEMONTH,) did ^TEMPNAME live with any of the
following people...
Read answer categories.
Mark all that apply.
1. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
2. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
Page 128 of 578
3. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
4. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
5. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
6. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
7. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
8. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
9. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
10. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
11. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
12. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
13. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
14. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
15. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
16. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
17. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
18. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
19. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
20. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
21. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
22. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
23. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
24. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
25. LNO ^FNAME ^LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER =
26. Did not live with any of these people or lived alone?
prvlvqrt
^ASKORVERIFY
What type of living quarters ^ISWAS
Read address?
Address:
^HNO ^STRNM ^HNOSUF
^CITY ^NONCITYADD, ^STATE ^ZIP
1. House, apartment, flat
2. Unit in rooming house, hotel, motel, etc.
3. Mobile home or trailer
4. Other housing unit
5. Correctional institution
6. Medical institution/nursing home
Page 129 of 578
7. Military quarters (barracks, ship at sea)
8. Student quarters
9. Other group quarters unit
10. Emergency or transitional shelter
11. Tent or trailer site
12. Car, van, or other non-permanent accommodations
ehc_ten
^ASKORVERIFY
C_ISWAS
Read address:
Address:
^HNO ^STRNM ^HNOSUF
^CITY ^NONCITYADD, ^STATE ^ZIP
Read answer categories.
1. Owned or being bought by someone in the household?
2. Rented?
3. Occupied without payment of rent?
ehc_rentsub
^ASKORVERIFY
^EHCRENTSUBQTEXT
Include respondents who live in a building owned by a Public Housing Authority (i.e., the housing
authority is the respondent's landlord) as receiving a rent subsidy.
Address:
^HNO ^STRNM ^HNOSUF
^CITY ^NONCITYADD, ^STATE ^ZIP
1. Yes
2. No
ehc_voucher
^ASKORVERIFY
Page 130 of 578
C_DOESDID ^PTEMPNAME household receive a housing voucher for
Read address?
A housing voucher gives a renter the right to choose where to live AND it helps pay the rent.
Address:
^HNO ^STRNM ^HNOSUF
^CITY ^NONCITYADD, ^STATE ^ZIP
1. Yes
2. No
ehc_why
W, ? [F1]
What was the main reason ^TEMPNAME moved to
Address:
^HNO ^STRNM ^HNOSUF
^CITY ^NONCITYADD, ^STATE ^ZIP
1. Change in marital/relationship status
2. To move into own apartment or house
3. Other family-related reason
4. New job or job transfer
5. To look for work or lost job
6. To be closer to work or school
7. Other job-related reason
8. Wanted to own home, not rent
9. Wanted a better quality apartment or house
10. Wanted a better neighborhood
11. Cheaper housing
12. Other housing-/neighborhood-related reason
13. Disaster loss (fire, flood, hurricane, etc.)
14. Eviction/foreclosure
15. Always lived here (never moved)
16. Other reason (specify)
Page 131 of 578
Read address?
ehc_whyot
What was the other reason ^TEMPNAME moved?
ehc_mvyr
What year did ^TEMPNAME move to
Read address?
Address:
^HNO ^STRNM ^HNOSUF
^CITY ^NONCITYADD, ^STATE ^ZIP
ehc_mvmo
What month did ^TEMPNAME move to
Read address?
Address:
^HNO ^STRNM ^HNOSUF
^CITY ^NONCITYADD, ^STATE ^ZIP
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
ehc_pvten
? [F1]
Was the address ^TEMPNAME lived in before
Read address:
Address:
Page 132 of 578
^HNO ^STRNM ^HNOSUF
^CITY ^NONCITYADD, ^STATE ^ZIP
Read answer categories.
1. Owned or being bought by someone in the household?
2. Rented?
3. Occupied without payment of rent?
residencycontinue
Enter 1 to continue.
1. Continue
residenceid
*** NON-DISPLAYED ITEM ***
resid
*** NON-DISPLAYED ITEM ***
rescopied
i_ehc_country
i_ehc_hno
i_ehc_strname
i_ehc_hnosuf
i_ehc_po
i_ehc_noncityadd
i_ehc_state
i_ehc_cnty
i_ehc_zip
anymorespells
Now let's talk about the other places ^TEMPNAME lived since ^MONTH1 1st
Page 133 of 578
^CALENDAR_YRFIL.
Enter 1 to return to calendar and enter a new residence spell.
1. Continue
howmany
We've talked about five residences. In how many more residences did ^TEMPNAME live since
^MONTH1 1st ^CALENDAR_YRFIL?
nomorespells
The residences topic is complete.
Enter 1 to continue.
1. Continue
pwave_complete
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SPELLNUMBER
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
INTRO
Let's talk about ^YOURHISHER marital history since ^MONTH1 1st ^CALENDAR_YRFIL.
Page 134 of 578
INFO
All people age 15 and over should complete the marital status section since it also asks about
cohabitation during the reference period.
Edit or extend the provisional spell by either moving the cursor to the Period box and typing 1, or
pressing tab 2 times.
BMONTH
When did that start?
If prior to ^MONTH1 ^CALENDAR_YRFIL, select ^MONTH1 ^CALENDAR_YRFIL
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
EMONTH
^MARITALTOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
Page 135 of 578
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
MS_EHC
? [F1]
^ASKORVERIFY_MH
What ^ISWAS ^PTEMPNAME marital status ^BETWEEN_BMONTH_EMONTH...
Read answer categories.
1. Married?
2. Married, spouse absent - DO NOT READ
3. Widowed?
4. Divorced?
5. Separated?
6. Never Married?
WHO_SPOUSE_EHC
Who ^ISWAS ^PTEMPNAME spouse (^BETWEEN_BMONTH_EMONTH)?
1. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
2. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
3. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
4. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
5. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
6. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
7. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
Page 136 of 578
8. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
9. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
10. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
11. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
12. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
13. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
14. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
15. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
16. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
17. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
18. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
19. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
20. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
21. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
22. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
23. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
24. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
25. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
26. Someone not listed
GOT_PARTNER
? [F1]
Ask or verify
During this period, (^BETWEEN_B_EMONTH,) did ^TEMPNAME have a boyfriend, girlfriend, or
partner who lived in the household?
1. Yes
2. No
WHO_PARTNER_EHC
Who ^ISWAS_MH ^PTEMPNAME boyfriend, girlfriend, or partner?
1. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
2. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
3. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
4. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
5. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
Page 137 of 578
6. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
7. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
8. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
9. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
10. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
11. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
12. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
13. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
14. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
15. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
16. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
17. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
18. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
19. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
20. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
21. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
22. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
23. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
24. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
25. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
26. Someone not listed
MARCOPIED
SPELLCOMPLETE
ANYMORESPELLS
Now let's talk about the rest of ^PTEMPNAME marital history since ^MONTH1 1st
^CALENDAR_YRFIL.
Enter 1 to return to the calendar and enter a new marital history spell.
1. Continue
HOWMANY
We've talked about three different marital statuses. How many other marital statuses ^HAVEHAS
^TEMPNAME had since ^MONTH1 1st ^CALENDAR_YRFIL?
NOMORESPELLS
Page 138 of 578
The marital history topic is complete.
Enter 1 to continue.
1. Continue
PWAVE_COMPLETE
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SPELLNUMBER
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
IN_GRADE
INTRO
^ENROLLINTROTEXT
INFO
(Include only nursery or preschool, kindergarten, elementary school, home school, and schooling that
leads to a high school diploma, a college or graduate degree, or an educational certificate.)
BMONTH
^FROMTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
Page 139 of 578
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
EMONTH
^TOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
Page 140 of 578
EDGRADE1
**NON-DISPLAYED ITEM**
EDGRADE2
**NON-DISPLAYED ITEM**
GRADE
? [F1]
What level of school ISAREWASWERE ^TEMPNAME enrolled in
^BETWEEN_BMONTH_EMONTH?
1. 1st
2. 2nd
3. 3rd
4. 4th
5. 5th
6. 6th
7. 7th
8. 8th
9. 9th
10. 10th
11. 11th
12. 12th
13. College year 1 (Freshman)
14. College year 2 (Sophomore)
15. College year 3 (Junior)
16. College year 4 (Senior)
17. College year 5 (First year graduate or professional school)
18. College year 6+ (Second year or higher in graduate or professional school)
19. Enrolled in college, but not working towards degree
20. Vocational, technical, or business school beyond high school level
21. Nursery school or preschool
22. Kindergarten
EDTYPE
What type of school ISAREWASWERE ^TEMPNAME enrolled in...
Read answer categories.
Page 141 of 578
If the respondent ^ISWAS enrolled in more than one type of school, select the type of school in which
he or she was enrolled for the most time.
1. Public?
2. Private?
3. Charter school?
4. Home school?
CRED
What degree or certificate ISAREWASWERE ^TEMPNAME working on?
1. Associate's Degree
2. Bachelor's Degree
3. Master's Degree
4. Doctoral or Professional Degree (Including JD)
5. Undergraduate certificate or diploma leading to a license (for example: nursing, mechanics, cosmetology)
6. Undergraduate certificate or diploma, NOT including those leading to a license
7. Post-baccalaureate certificate
8. Post-master's certificate
9. Not enrolled for a degree or certificate
EDHEADST
Some preschool programs are federally sponsored and are primarily for children from
low-income families. Some examples of these are Head Start, Even Start and Fair Start.
C_ISWAS ^TEMPNAME enrolled in a federally-sponsored program like this?
1. Yes
2. No
GRADEREP
You said that ^TEMPNAME WASWERE enrolled in the same grade at the beginning and end
^CALENDAR_YRFIL. Was this because ^YOUHESHE had to repeat a grade or WASWERE held
back for any reason?
1. Yes - repeated grade or was held back
2. No - enrolled in same grade
3. No - grade entered for ^BMONTHFILL to ^EMONTHFILL is incorrect
Page 142 of 578
4. No - grade entered in previously recorded spell is incorrect
PREV_GRADE
What is the correct grade?
This refers to the grade of the previous spell.
1. 1st
2. 2nd
3. 3rd
4. 4th
5. 5th
6. 6th
7. 7th
8. 8th
9. 9th
10. 10th
11. 11th
12. 12th
13. College year 1 (Freshman)
14. College year 2 (Sophomore)
15. College year 3 (Junior)
16. College year 4 (Senior)
17. College year 5 (First year graduate or professional school)
18. College year 6+ (Second year or higher in graduate or professional school)
19. Enrolled in college, but not working towards degree
20. Vocational, technical, or business school beyond high school level
21. Nursery school or preschool
22. Kindergarten
FTPT
C_ISAREWASWERE ^TEMPNAME enrolled full-time or part-time?
1. Full-time
2. Part-time
SPELLCOMPLETE
Page 143 of 578
ANYMORESPELLS
Did ^TEMPNAME attend ^EDUCLEVEL at any other times since ^MONTH1 1st
^CALENDAR_YRFIL?
1. Yes
2. No
HOWMANY
We've talked about three periods of school enrollment. How many other times WASWERE
^TEMPNAME enrolled in school since ^MONTH1 1st ^CALENDAR_YRFIL?
NOMORESPELLS
The enrollment topic is complete.
Enter 1 to continue.
1. Continue
PWAVE_COMPLETE
**NON-DISPLAYED ITEM**
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
spellnumber
**NON-DISPLAYED ITEM**
jobid
**NON-DISPLAYED ITEM**
jobnum
**NON-DISPLAYED ITEM**
Page 144 of 578
periodnum
**NON-DISPLAYED ITEM**
bmonth_wave
pvjobblank
cpyspell
bmonth
^FROMTEXT
INTRO
^JOBINTROTEXT
emonth
^TOTEXT
INFO
If necessary probe with additional question: Did ^YOUHESHE have a paid job, or do any work at all,
no matter how small, that earned some money?
jborse
? [F1]
C_DIDDODOES ^TEMPNAME work for an employer, or ISAREWASWERE ^YOUHESHE
self-employed, or DIDDODOES ^YOUHESHE have some other work arrangement?
1. Employer
2. Self-employed (owns a business)
3. Other work arrangement
conchk1
?[F1]
C_DIDDODOES ^TEMPNAME have a definite arrangement with one or more employers to work on
an ongoing basis?
1. Yes
2. No
Page 145 of 578
startjan
Did ^TEMPNAME begin this JOBBUS in ^MONTH1 ^CALENDAR_YRFIL?
1. Yes
2. No
startyear
? [F1]
In what year did ^TEMPNAME begin this JOBBUS?
startmonth
In what month did ^TEMPNAME begin this JOBBUS?
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
COPYJOB
Enter 1 to continue.
startweek
T
During which week did ^TEMPNAME begin this JOBBUS?
^ASKORVERIFY
endweek
T
Page 146 of 578
During which week did ^TEMPNAME end this JOBBUS?
rsend
G, ? [F1]
What is the main reason ^YOUHESHE stopped working for ^YOURHISHER employer?
1. Plant or company closed down or moved
2. Slack work or business conditions, such as from coronavirus pandemic
business closures
3. Position or shift abolished
4. Temporary or seasonal job completed
5. Discharged or fired
6. Other involuntary reason
7. Quit to take another job
8. Unsatisfactory work arrangements
9. Quit for some other reason
10. Retirement
11. Taking care of children, such as from coronavirus pandemic school closures
12. Other family or personal obligations
13. Own health concerns or own illness
14. Own injury
15. School or training
16. Other personal reason
rendb
G
What is the main reason ^TEMPNAME gave up or ended this business?
1. Retirement
2. Taking care of children, such as from coronavirus pandemic
school closures
3. Other family or personal problems
4. Own health concerns or own illness
5. Own injury
6. School or training
7. Went bankrupt or business failed
8. Sold business or transferred ownership
9. To start other business or take a job
10. Season ended for a seasonal business
Page 147 of 578
11. Quit for some other reason
empbsname
? [F1]
What ^ISWAS the name of ^PTEMPNAME Fill for Employer/Business?
^EBSNAMEFILL
jbaddstrnum
? [F1]
What is the address of the main location where ^TEMPNAME WORKSWORKED at ^EMPNAME?
Street Number
jbaddstrname
? [F1]
(What is the address of the main location where ^TEMPNAME WORKSWORKED at ^EMPNAME?)
Street Name
jbaddnumsuf
? [F1]
(What is the address of the main location where ^TEMPNAME WORKSWORKED at ^EMPNAME?)
Suite or Office Number
jbaddcity
? [F1]
(What is the address of the main location where ^TEMPNAME WORKSWORKED at ^EMPNAME?)
City
jbaddst
Page 148 of 578
? [F1]
(What is the address of the main location where ^TEMPNAME WORKSWORKED at ^EMPNAME?)
State
AL. Alabama
AK. Alaska
AZ. Arizona
AR. Arkansas
CA. California
CO. Colorado
CT. Connecticut
DC. District of Columbia
DE. Delaware
FL. Florida
GA. Georgia
HI. Hawaii
ID. Idaho
IL. Illinois
IN. Indiana
IA. Iowa
KS. Kansas
KY. Kentucky
LA. Louisiana
ME. Maine
MD. Maryland
MA. Massachusetts
MI. Michigan
MN. Minnesota
MS. Mississippi
MO. Missouri
MT. Montana
NE. Nebraska
NV. Nevada
NH. New Hampshire
NJ. New Jersey
NM. New Mexico
NY. New York
NC. North Carolina
Page 149 of 578
ND. North Dakota
OH. Ohio
OK. Oklahoma
OR. Oregon
PA. Pennsylvania
RI. Rhode Island
SC. South Carolina
SD. South Dakota
TN. Tennessee
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
WA. Washington
WV. West Virginia
WI. Wisconsin
WY. Wyoming
jbaddzip5
? [F1]
(What is the address of the main location where ^TEMPNAME WORKSWORKED at ^EMPNAME?)
Zip code
clwrk
? [F1]
^CUREMONTH ^ISWAS ^EMPNAME...
Read answer categories.
1. A government organization, including the Armed Forces?
2. A private, for-profit company?
3. A non-profit organization, including tax-exempt and charitable organizations?
kindg
Page 150 of 578
? [F1]
What type of government DIDDODOES ^TEMPNAME work for ^INEMONTHFILL...
Read answer categories.
1. Federal Military Departments (CIVILIAN ONLY) (ex. Dept. of Defense, Dept. of Army, and other military departme
2. All other Federal Departments (CIVILIAN ONLY)?
3. State Government?
4. Local Government?
5. U.S. Armed Forces (ACTIVE DUTY ONLY)?
kindg2
What type of government DIDDODOES ^TEMPNAME work for ^INEMONTHFILL...
Read answer categories.
1. Federal Military Departments (CIVILIAN ONLY) (ex. Dept. of Defense, Dept. of Army, and other military departme
2. U.S. Armed Forces (ACTIVE DUTY ONLY)?
kndin
? [F1]
^CUREMONTH what kind of business, industry, or organization ^ISWAS this?
Read if necessary:
What do they make or do where ^TEMPNAME WORKSWORKED?
typin
? [F1]
C_ISWAS this kind of business, industry, or organization mainly...
Read answer categories.
Read if necessary:
^C_BETWEEN_BMONTH_EMONTH, when this JOBBUS was held, at the location where
^TEMPNAME WORKSWORKED, what ^ISWAS this ^EMPBUSPOS primary activity?
Page 151 of 578
1. Manufacturing?
2. Wholesale trade?
3. Retail trade?
4. Service?
5. Or something else (agriculture, construction, government, etc.)?
kndwk
? [F1]
What kind of work DIDDODOES ^TEMPNAME do ^INEMONTHFILL, that is, what ^ISWAS
^YOURHISHER occupation?
(For example: bookkeeper, plumber, registered nurse)
actvt
? [F1]
What ^AREWERE ^YOURHISHER usual activities at ^EMPNAME ^INEMONTHFILL?
(For example: keeping account books, repairing pipes, patient care)
union
? [F1]
At ^EMPNAME, ISAREWASWERE ^TEMPNAME a member of either a labor union or an employee
association like a union?
1. Yes
2. No
cntrc
? [F1]
C_ISAREWASWERE ^TEMPNAME covered by either a union contract or something like a union
contract?
1. Yes
2. No
Page 152 of 578
emploc
Does ^EMPNAME operate in more than one location?
1. Yes
2. No
empall
? [F1]
About how many people are employed by ^EMPNAME at ALL LOCATIONS together?
1. Less than 10
2. 10 to 25
3. 26 to 50
4. 51 to 100
5. 101 to 200
6. 201 to 500
7. 501 to 1000
8. Greater than 1000
empsize
? [F1]
About how many people ^AREWERE employed by ^EMPNAME at the location where
^TEMPNAME WORKSWORKED?
1. Less than 10
2. 10 to 25
3. 26 to 50
4. 51 to 100
5. 101 to 200
6. 201 to 500
7. 501 to 1000
8. Greater than 1000
empb
^C_BETWEEN_BMONTH_EMONTH, what ^ISWAS the maximum number of employees, including
^TEMPNAME, working for ^EMPNAME at any one time?
1. 1 (Only self)
Page 153 of 578
2. 2 to 9
3. 10 to 25
4. 26 to 50
5. 51 to 100
6. 101 to 200
7. 201 to 500
8. 501 to 1000
9. Greater than 1000
incpb
? [F1]
C_ISWAS ^EMPNAME incorporated?
1. Yes
2. No
propb
? [F1]
DIDDODOES ^TEMPNAME own ^EMPNAME Fill for SELF or ^ISWAS it a partnership?
1. Alone
2. Partnership
hprtb
C_ISWAS any other member of this household an owner or partner in ^EMPNAME?
1. Yes
2. No
partb
Who ^ISWAS that?
Mark all that apply.
1. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
2. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
Page 154 of 578
3. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
4. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
5. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
6. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
7. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
8. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
9. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
10. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
11. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
12. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
13. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
14. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
15. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
16. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
17. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
18. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
19. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
20. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
21. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
22. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
23. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
24. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
25. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 or AGE = DK or REF either on the T2 roster or whe
26. Someone not listed
bslryb
DIDDODOES ^YOUHESHE draw a regular salary from ^EMPNAME - that is, take a regular
paycheck, as opposed to just treating the profits as ^YOURHISHER income?
1. Yes
2. No
typpay
^TYPPAYINTRO_FIL Which of the following types of pay DIDDODOES ^TEMPNAME receive
^INEMONTHFILL?
Read answer categories.
Mark all that apply.
Page 155 of 578
If payment is given per service or per unit of production, enter commission and collect monthly total
amounts.
1. Salary or hourly rate?
2. Commission?
3. Tips?
4. Overtime?
5. Bonus pay?
payhr1
H, ? [F1]
Ask or verify
The next questions are about ^PTEMPNAME gross income from ^EMPNAME before taxes and
other deductions. What is the easiest way for you to report ^YOURHISHER pay rate or salary
information...
Read answer categories.
1. Annual salary (pay rate for the year)?
2. Actual gross amount earned in the year?
3. Pay per hour?
4. Pay per week?
5. Pay every two weeks?
6. Pay per month?
7. Pay twice a month?
8. Some other way (report monthly average)?
pyrat1
? [F1]
^QSTNTXT_PYRAT1 ^ISWAS the gross dollar amount of ^PTEMPNAME PHRFILL1 before any
taxes and other deductions?
Extra Pay FR Note
PYRAT1_RANGEANN
C_ISWAS the annual amount...
Page 156 of 578
Read answer categories.
1. Less than $20,000?
2. Between $20,000 and $34,999?
3. Between $35,000 and $49,999?
4. $50,000 or more?
PYRAT1_RANGEHOUR
C_ISWAS this hourly wage...
Read answer categories.
1. Less than $9 per hour?
2. Between $9 and $11.99 per hour?
3. Between $12 and $16.99 per hour?
4. $17 Per hour or more?
PYRAT1_RANGEWKLY
C_ISWAS this weekly pay...
Read answer categories.
1. Less than $400 per week?
2. Between $400 and $599 per week?
3. Between $600 and $999 per week?
4. $1000 or more per week?
PYRAT1_RANGEBWKLY
C_ISWAS this PHRFILL1...
Read answer categories.
1. Less than $800 per period?
2. Between $800 and $1199 per period?
3. Between $1200 and $1999 per period?
4. $2000 or more per period?
Page 157 of 578
PYRAT1_RANGEMTHLY
C_ISWAS this PHRFILL1...
Read answer categories.
1. Less than $1500 per month?
2. Between $1500 and $2499 per month?
3. Between $2500 and $4499 per month?
4. $4500 or more per month?
takehome1
? [F1]
C_ISWAS this take-home pay, or ^ISWAS it gross pay before any taxes and other deductions
^AREWERE taken out?
1. Take-home pay (net, after deductions)
2. Gross (total) pay (before deductions)
3. No deductions (gross pay = net pay)
jobhrs1
? [F1]
^QSTNTXT_JOBHRS1 How many hours per week DIDDODOES ^TEMPNAME usually work at
^EMPNAME ^INEMONTHFILL?
^JOBHRSFILL
ptyn1
? [F1]
C_DIDDODOES ^TEMPNAME usually work 35 hours or more per week for ^EMPNAME?
1. Yes
2. No
ptresn1
I, ? [F1]
Page 158 of 578
What ^ISWAS the main reason ^TEMPNAME WORKSWORKED less than 35 hours per week?
For those respondents who work part-time because they have multiple jobs, select option #2 (wanted
to work part-time).
1. Could not find full-time job
2. Wanted to work part-time
3. Temporarily unable to work full-time because of own injury
4. Temporarily unable to work full-time because of own health concerns or own illness
5. Unable to work full-time because of chronic health condition or disability
6. Taking care of children or other persons, such as from coronavirus pandemic
school closures
7. Full-time work week is less than 35 hours
8. Slack work or business conditions, such as reduced hours due to coronavirus
pandemic
9. Participated in a job-sharing arrangement
10. On vacation
11. In school
12. Other
chearn1
You said ^TEMPNAME ISAREWASWERE paid ^PYRAT1FIL ^PAYHR1FIL ^INEMONTHFILL. Did
^YOURHISHER pay rate change ^BETWEEN_BMONTH_ALTEMONTH?
1. Yes
2. No
chermnth1
In what month was ^PTEMPNAME most recent pay rate change?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
Page 159 of 578
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
cherweek1
T
In which week did ^PTEMPNAME pay rate change?
payhr2
H, ? [F1]
What type of pay rate or salary did ^TEMPNAME have at ^EMPNAME ^CHERMNTH1...
Read answer categories.
1. Paid an annual salary?
2. Paid by the hour?
3. Paid by the week?
4. Paid once every 2 weeks?
5. Paid once a month?
6. Paid twice a month?
7. Paid some other way (report monthly average)?
pyrat2
? [F1]
What was the gross dollar amount of ^PTEMPNAME PHRFILL2 before any taxes and other
deductions at ^EMPNAME ^CHERMNTH1?
PYRAT2_RANGEANN
Page 160 of 578
Was the annual salary amount...
Read answer categories.
1. Less than $20,000?
2. Between $20,000 and $34,999?
3. Between $35,000 and $49,999?
4. $50,000 or more?
PYRAT2_RANGEHOUR
Was this hourly wage...
Read answer categories.
1. Less than $9 per hour?
2. Between $9 and $11.99 per hour?
3. Between $12 and $16.99 per hour?
4. $17 Per hour or more?
PYRAT2_RANGEWKLY
Was this weekly pay...
Read answer categories.
1. Less than $400 per week?
2. Between $400 and $599 per week?
3. Between $600 and $999 per week?
4. $1000 or more per week?
PYRAT2_RANGEBWKLY
Was this PHRFILL2...
Read answer categories.
1. Less than $800 per period?
2. Between $800 and $1199 per period?
3. Between $1200 and $1999 per period?
4. $2000 or more per period?
Page 161 of 578
PYRAT2_RANGEMTHLY
Was this PHRFILL2...
Read answer categories.
1. Less than $1500 per month?
2. Between $1500 and $2499 per month?
3. Between $2500 and $4499 per month?
4. $4500 or more per month?
takehome2
? [F1]
Was this take-home pay, or was it gross pay before any taxes and other deductions were taken
out?
1. Take-home pay (net, after deductions)
2. Gross (total) pay (before deductions)
3. No deductions (gross pay = net pay)
chhour1
^CHHOUR1FILL
1. Yes
2. No
chhomon1
In what month did ^PTEMPNAME hours change?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
Page 162 of 578
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
chhoweek1
T
In which week did ^PTEMPNAME hours change?
jobhrs2
? [F1]
How many hours per week did ^TEMPNAME usually work at ^EMPNAME before ^CHHOMON1?
^JOBHRSFILL
ptyn2
Did ^TEMPNAME usually work 35 hours or more per week for ^EMPNAME before this change?
1. Yes
2. No
ptresn2
I
What was the main reason ^TEMPNAME worked less than 35 hours per week?
1. Could not find full-time job
Page 163 of 578
2. Wanted to work part-time
3. Temporarily unable to work full-time because of own injury
4. Temporarily unable to work full-time because of own health concerns or own illness
5. Unable to work full-time because of chronic health condition or disability
6. Taking care of children or other persons, such as from coronavirus pandemic
school closures
7. Full-time work week is less than 35 hours
8. Slack work or business conditions, such as reduced hours due to coronavirus
pandemic
9. Participated in a job-sharing arrangement
10. On vacation
11. In school
12. Other
chearn2
You said ^TEMPNAME WASWERE paid ^PYRAT2FIL ^PAYHR2FIL ^CHERMNTH1. Did
^PTEMPNAME pay rate change Again ^BTWN_BMONTH_CHERMNTH1?
1. Yes
2. No
chermnth2
When did ^PTEMPNAME pay rate change ^BTWN_BMONTH_CHERMNTH1?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
Page 164 of 578
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
cherweek2
T
In which week did ^PTEMPNAME pay rate change?
payhr3
H, ? [F1]
What type of pay rate or salary did ^TEMPNAME have at ^EMPNAME ^CHERMNTH2...
Read answer categories.
1. Paid an annual salary?
2. Paid by the hour?
3. Paid by the week?
4. Paid once every 2 weeks?
5. Paid once a month?
6. Paid twice a month?
7. Paid some other way (report monthly average)?
pyrat3
? [F1]
What was the gross dollar amount of ^PTEMPNAME PHRFILL3 before any taxes and other
deductions ^CHERMNTH2?
PYRAT3_RANGEANN
Was the annual salary amount...
Read answer categories.
1. Less than $20,000?
2. Between $20,000 and $34,999?
3. Between $35,000 and $49,999?
4. $50,000 or more?
Page 165 of 578
PYRAT3_RANGEHOUR
Was this hourly wage...
Read answer categories.
1. Less than $9 per hour?
2. Between $9 and $11.99 per hour?
3. Between $12 and $16.99 per hour?
4. $17 Per hour or more?
PYRAT3_RANGEWKLY
Was this weekly pay...
Read answer categories.
1. Less than $400 per week?
2. Between $400 and $599 per week?
3. Between $600 and $999 per week?
4. $1000 or more per week?
PYRAT3_RANGEBWKLY
Was this PHRFILL3...
Read answer categories.
1. Less than $800 per period?
2. Between $800 and $1199 per period?
3. Between $1200 and $1999 per period?
4. $2000 or more per period?
PYRAT3_RANGEMTHLY
Was this PHRFILL3...
Read answer categories.
1. Less than $1500 per month?
2. Between $1500 and $2499 per month?
3. Between $2500 and $4499 per month?
4. $4500 or more per month?
Page 166 of 578
takehome3
? [F1]
Was this take-home pay, or was it gross pay before any taxes and other deductions were taken
out?
1. Take-home pay (net, after deductions)
2. Gross (total) pay (before deductions)
3. No deductions (gross pay = net pay)
chhour2
^CHHOUR2FILL
1. Yes
2. No
chhomon2
When did ^PTEMPNAME hours change CHHOMONFILL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
Page 167 of 578
chhoweek2
T
In which week did ^PTEMPNAME hours change?
jobhrs3
? [F1]
How many hours per week did ^TEMPNAME usually work ^CHHOMON2?
^JOBHRSFILL
ptyn3
Did ^TEMPNAME usually work 35 hours or more per week for ^EMPNAME ^CHHOMON2?
1. Yes
2. No
ptresn3
I
What was the main reason ^TEMPNAME worked less than 35 hours per week?
1. Could not find full-time job
2. Wanted to work part-time
3. Temporarily unable to work full-time because of own injury
4. Temporarily unable to work full-time because of own health concerns or own illness
5. Unable to work full-time because of chronic health condition or disability
6. Taking care of children or other persons, such as from coronavirus pandemic
school closures
7. Full-time work week is less than 35 hours
8. Slack work or business conditions, such as reduced hours due to coronavirus
pandemic
9. Participated in a job-sharing arrangement
10. On vacation
11. In school
12. Other
Page 168 of 578
chhour3
^CHHOUR3FILL
1. Yes
2. No
chhomon3
When did ^PTEMPNAME hours change CHHOMON3FILL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
chhoweek3
T
In which week did ^PTEMPNAME hours change?
jobhrs4
? [F1]
Page 169 of 578
How many hours per week did ^TEMPNAME usually work ^CHHOMON3?
^JOBHRSFILL
ptyn4
Did ^TEMPNAME usually work 35 hours or more per week for ^EMPNAME before ^CHHOMON3?
1. Yes
2. No
ptresn4
I
What was the main reason ^TEMPNAME worked less than 35 hours per week?
1. Could not find full-time job
2. Wanted to work part-time
3. Temporarily unable to work full-time because of own injury
4. Temporarily unable to work full-time because of own health concerns or own illness
5. Unable to work full-time because of chronic health condition or disability
6. Taking care of children or other persons, such as from coronavirus pandemic
school closures
7. Full-time work week is less than 35 hours
8. Slack work or business conditions, such as reduced hours due to coronavirus
pandemic
9. Participated in a job-sharing arrangement
10. On vacation
11. In school
12. Other
oincb
? [F1]
Besides what has already been reported, did ^TEMPNAME receive any other income for Fill for
SELF out of the money that ^EMPNAME brought in?
1. Yes
2. No
Page 170 of 578
oincamt
^QSTNTXT_OINCAMT In ^CALENDAR_YEAR, what was the average monthly amount of other
income ^YOUHESHE usually received from ^EMPNAME?
prftloss
? [F1]
Did ^EMPNAME make a net profit, net loss, or break even for the year ^CALENDAR_YRFIL?
1. Profit (positive)
2. Loss (negative)
3. No profit/break even
prftb
? [F1]
For ^EMPNAME, what was the dollar amount of ^PTEMPNAME share of the ^PRFTLOSSFIL for
the year ^CALENDAR_YRFIL?
prftb_range
Was the amount less than $7,000, between $7,000 and $20,000, between $20,000 and $40,000, or
more than $40,000?
1. Less than $7,000
2. $7,000 to $19,999
3. $20,000 to $39,999
4. $40,000 or more
prftbchk
C_ISWAS ^HISHER own income from ^EMPNAME (that we talked about earlier) reported in this
^PRFTLOSSFIL? Or do we need to subtract ^HISHER income to get a total ^PRFTLOSSFIL?
1. Salary/draw is included in the net profit/loss amount
2. Subtract salary/draw to get total ^PRFTLOSSFIL
fpawopyn1
Page 171 of 578
? [F1]
^C_FPAWOPYN1FILL, did ^TEMPNAME have any time away without pay from ^EMPNAME for a
period of at least two weeks?
Examples include being furloughed due to coronavirus pandemic business closures, or taking care of
children due to school closures.
1. Yes
2. No
fpawopsm1
^C_BEMIN which month did the most recent period of leave without pay begin?
FR Note for FPAWOPSM
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
fpawopsw1
T
In which week did this period of leave without pay begin?
FR notes for FPAWOPSW
Page 172 of 578
fpawopem1
Between ^FPAWOPSM1 and ^EMONTHFILL, in which month did the most recent period of leave
without pay end?
FR note for FPAWOPEM
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
fpawopew1
T
In which week did this period of leave without pay end?
FR note for FPAWOPEW
fpawopre1
J, ? [F1]
What was the main reason that ^TEMPNAME did not get paid during this period?
1. On layoff, such as furloughed due to coronavirus pandemic
business closures
2. Slack work or business conditions
3. Vacation, scheduled time off, or personal days
Page 173 of 578
4. Teacher on an 8-, 9-, or 10-month contract
5. Own health concerns, injury, illness, or medical problems
6. Taking care of children, such as from coronavirus pandemic
school closures
7. Other family or personal obligations
8. Pregnancy, childbirth, maternity leave, or paternity leave
9. Labor dispute
10. Weather affected job
11. Civic, jury, or military duty
12. Other
fpawopch1
Did this period of being away from work without pay reduce the earnings from the annual salary
reported for ^YOURSELF earlier?
1. Yes
2. No
fpawopyn2
? [F1]
^C_FPAWOPYN2FILL ^TEMPNAME have a second period of time away without pay from
^EMPNAME for at least two weeks?
Examples include being furloughed due to coronavirus pandemic business closures, or taking care of
children due to school closures.
1. Yes
2. No
fpawopsm2
^C_FPAWOPSM2FILL what month did the second period of leave without pay begin?
FR Note for FPAWOPSM
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
Page 174 of 578
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
fpawopsw2
T
In which week did the second period of leave without pay begin?
FR notes for FPAWOPSW
fpawopem2
^C_FPAWOPEM2FILL, in which month did the second period of leave without pay end?
FR note for FPAWOPEM
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
Page 175 of 578
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
fpawopew2
T
In which week did the second period of leave without pay end?
FR note for FPAWOPEW
fpawopre2
J, ? [F1]
What was the main reason that ^TEMPNAME did not get paid during this period?
1. On layoff, such as furloughed due to coronavirus pandemic
business closures
2. Slack work or business conditions
3. Vacation, scheduled time off, or personal days
4. Teacher on an 8-, 9-, or 10-month contract
5. Own health concerns, injury, illness, or medical problems
6. Taking care of children, such as from coronavirus pandemic
school closures
7. Other family or personal obligations
8. Pregnancy, childbirth, maternity leave, or paternity leave
9. Labor dispute
10. Weather affected job
11. Civic, jury, or military duty
12. Other
fpawopch2
Did this period of being away from work without pay reduce the earnings from the annual salary
reported for ^YOURSELF earlier?
1. Yes
2. No
Page 176 of 578
fpawopyn3
? [F1]
^C_FPAWOPYN3FILL ^TEMPNAME have a third period of time away without pay from
^EMPNAME for at least two weeks?
Examples include being furloughed due to coronavirus pandemic business closures, or taking care of
children due to school closures.
1. Yes
2. No
fpawopsm3
^C_FPAWOPSM3FILL which month did the third period of leave without pay begin?
FR Note for FPAWOPSM
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
fpawopsw3
T
In which week did the third period of leave without pay begin?
Page 177 of 578
FR notes for FPAWOPSW
fpawopem3
^C_FPAWOPEM3FILL, in which month did the third period of leave without pay end?
FR note for FPAWOPEM
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
fpawopew3
T
In which week did the third period of leave without pay end?
FR note for FPAWOPEW
fpawopre3
J, ? [F1]
What was the main reason that ^TEMPNAME did not get paid during this period?
Page 178 of 578
1. On layoff, such as furloughed due to coronavirus pandemic
business closures
2. Slack work or business conditions
3. Vacation, scheduled time off, or personal days
4. Teacher on an 8-, 9-, or 10-month contract
5. Own health concerns, injury, illness, or medical problems
6. Taking care of children, such as from coronavirus pandemic
school closures
7. Other family or personal obligations
8. Pregnancy, childbirth, maternity leave, or paternity leave
9. Labor dispute
10. Weather affected job
11. Civic, jury, or military duty
12. Other
fpawopch3
Did this period of being away from work without pay reduce the earnings from the annual salary
reported for ^YOURSELF earlier?
1. Yes
2. No
spellcomplete
anymorespells
Did ^TEMPNAME work for ^EMPNAME2 at any other times since ^MONTH1 1st
^CALENDAR_YRFIL?
1. Yes
2. No
howmany
We've talked about two periods working for ^EMPNAME2. How many other times did
^TEMPNAME work for ^EMPNAME2 since ^MONTH1 1st ^CALENDAR_YRFIL?
anyotherwork
^OTHERWORK
Page 179 of 578
1. Yes
2. No
nojobscreener
I'm showing ^TEMPNAME WASWERE not working for pay during the following ^TIME_S since
^MONTH1 1st ^CALENDAR_YRFIL:
^LFGAPS_TEXTFIL
Have we talked about all times, since ^MONTH1 1st ^CALENDAR_YRFIL, when ^YOUHESHE
worked for pay?
1. Yes
2. No
nomorespells
The jobs and no job topics are complete. Enter 1 to continue.
pwave_complete
**NON-DISPLAYED ITEM**
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
jobnum
**NON-DISPLAYED ITEM**
spellnumber
**NON-DISPLAYED ITEM**
Page 180 of 578
periodnum
**NON-DISPLAYED ITEM**
bmonth
**NON-DISPLAYED ITEM**
emonth
**NON-DISPLAYED ITEM**
pvworktran
U, ? [F1]
Let's talk about ^PTEMPNAME commuting expenses, job-related expenses and work schedule
with ^EMPNAME.
During a typical week, what modes of transportation DIDDODOES ^TEMPNAME use to get to
work?
Mark all that apply.
Include all work-related travel.
1. Drove own vehicle
2. Rider in someone else's vehicle/van pool
3. Bus
4. Rail
5. Other public transportation
6. Walked
7. Bicycled
8. Drove company vehicle
9. Worked at home
10. Other
pvtranprim
? [F1]
Which of these methods ^ACCOUNTSACCOUNTED for the greatest distance travelled as part of
^PTEMPNAME work commute?
Page 181 of 578
1. Drove own vehicle
2. Rider in someone else's vehicle/van pool
3. Bus
4. Rail
5. Other public transportation
6. Walked
7. Bicycled
8. Drove company vehicle
9. Worked at home
10. Other
pvtime
? [F1]
How many minutes ^DIDDOES it usually take ^TEMPNAME to get from home to work as part of
^YOURHISHER work commute?
pvmile
? [F1]
How many miles DIDDODOES ^TEMPNAME drive from home to work as part of ^YOURHISHER
work commute?
pvreimbmi
? [F1]
^DIDDOES ^EMPNAME reimburse ^TEMPNAME for the miles driven to work?
1. Yes
2. No
pvreimbmic
? [F1]
How many of those PVMILES miles ^AREWERE reimbursed by ^EMPNAME?
Page 182 of 578
pvpark
? [F1]
DIDDODOES ^TEMPNAME have to pay for parking or tolls as a part of ^YOURHISHER
work-commuting expenses?
Enter 1 for "yes" if ANY parking costs or tolls are out of pocket; enter 2 for "no" if ALL such costs are
reimbursed.
1. Yes
2. No
pvparkc
? [F1]
Typically, how much DIDDODOES^TEMPNAME spend per day for parking or tolls?
Include only costs that were NOT reimbursed.
pvothrc
? [F1]
In a typical day,PVOTHRCFILL about how much ^AREWERE ^PTEMPNAME PVOTHRCFILL2 work
commuting expensesPVOTHRCFILL3?
Enter 0 for "none." Include only work-commuting expenses that were NOT reimbursed.
pvoexpns
? [F1]
^C_BETWEEN_BMONTH_EMONTH, not counting expenses ^PTEMPNAME employer ^PAYSPAID,
DIDDODOES ^TEMPNAME have any work-related expenses such as licenses, permits, union
dues, special tools, or uniforms for ^YOURHISHER work at ^EMPNAME?
1. Yes
2. No
pvoexpnsc
Page 183 of 578
? [F1]
Altogether, ^PVOEXPNS_EMONTHFILL, how much ^AREWERE ^PTEMPNAME expenses for such
items?
Include only work-related expenses that were required for employment and were NOT reimbursed.
wswhdy
? [F1]
During a typical week at ^EMPNAME, which days DIDDODOES ^TEMPNAME work?
Mark all that apply.
If the days that the respondent ^WRKD varies, enter the days that ^HESHE most recently worked for
this job.
1. Monday through Friday
2. Sunday
3. Monday
4. Tuesday
5. Wednesday
6. Thursday
7. Friday
8. Saturday
9. All seven days (every day in a typical week)
wsbeg
? [F1]
(During a typical week at ^EMPNAME,) what time DIDDODOES ^TEMPNAME usually begin work?
Enter the time followed by a.m. or p.m.
12:00 a.m. is midnight and 12:00 p.m. is noon.
If the start time varies, enter the most common start time for this job.
wsend
? [F1]
Page 184 of 578
(During a typical week at ^EMPNAME,) what time DIDDODOES ^TEMPNAME usually end work?
Enter the time as well as a.m. or p.m.
12:00 a.m. is midnight and 12:00 p.m. is noon.
If the end time varies, enter the most common end time for this job.
wshmwrk
? [F1]
As part of ^PTEMPNAME typical work schedule for ^EMPNAME, ^AREWERE there any days
when ^TEMPNAME WORKSWORKED only at home?
1. Yes
2. No
wshomdy
? [F1]
Which days DIDDODOES ^TEMPNAME work only from home?
Mark all that apply.
1. Monday through Friday
2. Sunday
3. Monday
4. Tuesday
5. Wednesday
6. Thursday
7. Friday
8. Saturday
9. All seven days (every day in a typical week)
wsjob
M, ? [F1]
Page 185 of 578
Which of the following best describes ^PTEMPNAME work schedule at ^EMPNAME?
Mark variable work schedules as 6 ("Irregular").
1. Regular daytime schedule
2. Regular evening shift
3. Regular night shift
4. Rotating shift (one that changes regularly from days to evenings to nights)
5. Split shift (one that consists of two distinct periods each day)
6. Irregular schedule (one that changes from day to day)
7. Other - specify
wsoth
Please describe the 'other' type of work schedule.
wsmnr
What is the MAIN reason ^TEMPNAME WORKSWORKED this type of schedule?
DO NOT read answer categories.
1. Requirement of the job
2. Could not get any other job
3. Other involuntary reasons
4. Better pay
5. Better child care arrangements
6. Better arrangements for care of other family members
7. Allows time for school
8. Other voluntary reasons
Page 186 of 578
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
jobnum
**NON-DISPLAYED ITEM**
spellnumber
**NON-DISPLAYED ITEM**
periodnum
**NON-DISPLAYED ITEM**
bmonth
**NON-DISPLAYED ITEM**
emonth
**NON-DISPLAYED ITEM**
typexpay
Earlier you said ^TEMPNAME received ^TYPEXPAY_FILL while working at ^EMPNAME. Did
these ^TYPEXPAY_FILL ^PAYMENTS occur every month?
1. Yes
2. No
exearnamt1
^QSTNTXT_EXEARNAMT1 In ^CALENDAR_YEAR, ^L_EXEARNFILL much did ^TEMPNAME
usually earn per month in ^TYPEXPAY_FILL?
exearnmnth
^QSTNTXT_EXEARNMNTH During which ^PWEXEARNMNTH_FILL months did ^TEMPNAME earn
^TYPEXPAY_FILL while working for ^EMPNAME?
Page 187 of 578
One Month Spell Fill
Mark all that apply.
1. ^EXMNTH1_CALFIL
2. ^EXMNTH2_CALFIL
3. ^EXMNTH3_CALFIL
4. ^EXMNTH4_CALFIL
5. ^EXMNTH5_CALFIL
6. ^EXMNTH6_CALFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
exearnamt2
How much ^SPELL_AREWERE these ^TYPEXPAY_FILL ^PAYMENTS ^EXEARNMNTH_FILL?
Enter 0 if no ^TYPEXPAY_FILL ^PAYMENTS were earned this month.
typpaycode
**NON-DISPLAYED ITEM**
pwexearnamt1
pwexearnmnth
pwexearnamt2
Page 188 of 578
pwtyppay
pwpayhr1
pwpyrat1
pwpyrat1_rangeann
pwpyrat1_rangehour
pwpyrat1_rangewkly
pwpyrat1_rangebwkly
pwpyrat1_rangemthly
pwjobhrs1
pwptyn1
1. Yes
2. No
pwoincamt
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
spellnumber
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
INTRO
^OJINTRO_QTEXT
bmonth
INFO
This job line collects summary information about all remaining jobs and businesses beyond the 7 jobs
reported on lines 1-7. Ask respondent to think about and report all of ^HISHER work as a WHOLE rather
Page 189 of 578
than separately.
Record separate spells when ^HESHE reports disconnected time periods of employment for these
additional employers.
emonth
SCREENER2
Did ^YOUHESHE have any more time working for pay since ^MONTH1 1st ^CALENDAR_YRFIL
that you have not yet told me about?
1. Yes
2. No
startjan
Did ^TEMPNAME begin this work in ^MONTH1 ^CALENDAR_YRFIL?
1. Yes
2. No
startweek
T
During which week did ^TEMPNAME begin this other work?
endweek
T
During which week did ^TEMPNAME end this other work?
number_of_jobs
How many additional jobs, businesses, or other arrangements DIDDODOES ^TEMPNAME have
^BETWEEN_BMONTH_EMONTH?
jborseoth
Page 190 of 578
? [F1]
^OTHJBFIL you reported ^BETWEEN_BMONTH_EMONTH for ^EMPLOYER, was it
self-employment, was it some other kind of arrangement, or a combination of these?
Mark all that apply.
1. Employer
2. Self-employed (owns a business)
3. Other work arrangement
earn
Including all wages, salaries, tips, commissions, bonuses, and profits, what ^ISWAS the total
amount of ^YOURHISHER gross earnings from ^NOTHJOB ^BETWEEN_BMONTH_EMONTH?
Gross earnings are earnings before any taxes or other deductions.
takehome
C_ISWAS this a take-home amount or ^ISWAS it a gross amount before any taxes and
deductions ^AREWERE taken out?
1. Take-home pay (net, after deductions)
2. Gross (total) pay (before deductions)
3. No deductions (gross pay = net pay)
hours
^C_BETWEEN_BMONTH_EMONTH, DIDDODOES ^YOUHESHE usually work 35 hours or more per
week at ^NOTHJOB?
1. Yes
2. No
ptresn
What ^ISWAS the main reason ^TEMPNAME WORKSWORKED fewer than 35 hours per week at
^NOTHJOB?
1. Worked at one or more other jobs or businesses
Page 191 of 578
2. Could not find full-time job
3. Wanted to work part-time
4. Temporarily unable to work full-time because of injury
5. Temporarily unable to work full-time because of illness
6. Unable to work full-time because of chronic health condition/disability
7. Taking care of children/other persons
8. Full-time work week is less than 35 hours
9. Slack work or material shortage
10. Participated in a job-sharing arrangement
11. On vacation
12. In school
13. Other
spellcomplete
anymorespells
Did ^TEMPNAME work at ^NOTHJOB at any other times since ^MONTH1 1st ^CALENDAR_YRFIL
that you have not yet told me about?
1. Yes
2. No
howmany
We've talked about three periods of employment at ^NOTHJOB. How many other times, since
^MONTH1 1st ^CALENDAR_YRFIL, WASWERE ^YOUHESHE employed at ^NOTHJOB?
anyotherwork
nojobscreener
nomorespells
The job and no job topics are complete. Enter 1 to continue.
1. Continue
pwave_complete
nojobscreener
I'm showing ^TEMPNAME WASWERE not working for pay during the following ^TIME_S since
^MONTH1 1st ^CALENDAR_YRFIL:
Page 192 of 578
^LFGAPS_TEXTFIL
Have we talked about all times, since ^MONTH1 1st, when ^YOUHESHE worked for pay?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SPELLNUMBER
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
PSLOT
INTRO
Now I'm going to talk to you about time when ^YOUHESHE WASWERE not working for pay.
BMONTH
When did this period of not working for pay start?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
Page 193 of 578
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
EMONTH
When did the period ^YOUHESHE did not work for pay end?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
NOWRK_1
K
Why This is the fill for DIDDODONT ^TEMPNAME work for pay
^NWBETWEEN_BMONTH_EMONTH?
Page 194 of 578
Read or show the respondent the answer list.
After each response, ask: Any other reason?
1. Temporarily unable to work because of own injury?
2. Temporarily unable to work because of own health concerns or own illness?
3. Unable to work because of chronic health condition or disability?
4. Retired?
5. Pregnancy or childbirth?
6. Taking care of children or other persons, such as from coronavirus pandemic school
closures?
7. Going to school?
8. Unable to find work?
9. On layoff, such as furloughed due to coronavirus pandemic business closures?
10. Not interested in working at a job?
11. Usually worked 15 or more hours per week without pay in a family business or farm?
12. Other DO NOT READ
UNPDWRKYN
? [F1]
^C_BETWEEN_BMONTH_EMONTH_NOW did ^TEMPNAME work 15 or more hours per week
without pay in a related household member's family business or farm?
1. Yes
2. No
FAM_BUS_KNDIN_1
? [F1]
What kind of business or enterprise is the family business?
(What do they make or do?)
FAM_BUS_TYPIN_1
Is it mainly...
Read answer categories.
1. Manufacturing?
2. Wholesale trade?
Page 195 of 578
3. Retail trade?
4. Service?
5. Or something else (agriculture, construction, government, etc.)?
FAM_BUS_KNDWK_1
What kind of work DIDDODOES ^TEMPNAME do? That is, what ^ISWAS ^YOURHISHER
occupation?
(For example: bookkeeper, plumber, registered nurse)
FAM_BUS_ACTVT_1
What ^AREWERE ^YOURHISHER usual work activities?
(For example: Keeping account books, repairing pipes, patient care)
LAYOFF_1
? [F1]
^LAYOFFFILL ^TEMPNAME spend any time on layoff from a job?
Examples include being forced to leave a job due to slack work, shortages, or business closures such
as those due to coronavirus pandemic (rather than personal misconduct or the completion of a
temporary job).
1. Yes
2. No
LAYOFF_TYPE_1
When ^TEMPNAME WASWERE laid off, WASWERE ^YOUHESHE either informed that
^YOUHESHE would be recalled to work within 6 months, or given a date to return to work?
Answer YES if the respondent was told to come back to work after government-ordered
coronavirus pandemic business closures are lifted.
1. Yes
2. No
LAYOFF_DURATION
Page 196 of 578
^C_WASWERE ^TEMPNAME on layoff for the entire period?
1. Yes
2. No
LAYOFF_ENDMNTH
In which month did the layoff end?
FR note for ENDMONTH
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
LAYOFF_ENDWEEK
T
In which week did the layoff end?
FR note for ENDWEEK
LKWRK_1
? [F1]
Page 197 of 578
^LKWRKFILL ^TEMPNAME ACTIVELY look for work in one or more weeks?
1. Yes
2. No
FROM_LKMNTH_11
^C_BEMIN what month did ^TEMPNAME FIRST begin looking for work?
FR note for FROM_LKMNTH
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
FROM_LKWEEK_11
T
In which week did ^TEMPNAME first begin looking for work?
FR note for FROM_LKWEEK
TO_LKMNTH_11
From ^FROM11FILL to ^EMONTHFILL, in what month did ^TEMPNAME stop looking for work?
Page 198 of 578
FR Note for TO_LKMNTH
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
TO_LKWEEK_11
T
In which week did ^TEMPNAME stop looking for work?
^TO_LKWEEKFRNOTE
MORE_STRETCH_12
^C_BTWN_TO11_EMONTH there any more time periods when ^TEMPNAME WASWERE looking
for work?
1. Yes
2. No
FROM_LKMNTH_12
^C_LKMNTH12 what month did ^TEMPNAME begin looking for work for the second time?
Page 199 of 578
FR note for FROM_LKMNTH
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
FROM_LKWEEK_12
T
In which week did ^TEMPNAME begin looking for work?
FR note for FROM_LKWEEK
TO_LKMNTH_12
From ^FROM12FILL to ^EMONTHFILL, in what month did ^TEMPNAME stop looking for work?
FR Note for TO_LKMNTH
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
Page 200 of 578
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
TO_LKWEEK_12
T
In which week did ^TEMPNAME stop looking for work?
^TO_LKWEEKFRNOTE
MORE_STRETCH_13
^C_BTWN_TO12_EMONTH there any more time periods when ^TEMPNAME WASWERE looking
for work?
1. Yes
2. No
FROM_LKMNTH_13
^C_LKMNTH13 what month did ^TEMPNAME begin looking for work for the third time?
FR note for FROM_LKMNTH
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
Page 201 of 578
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
FROM_LKWEEK_13
T
In which week did ^TEMPNAME begin looking for work?
FR note for FROM_LKWEEK
TO_LKMNTH_13
From ^FROM13FILL to ^EMONTHFILL, in what month did ^TEMPNAME stop looking for work?
FR Note for TO_LKMNTH
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
Page 202 of 578
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
TO_LKWEEK_13
T
In which week did ^TEMPNAME stop looking for work?
^TO_LKWEEKFRNOTE
MORE_STRETCH_14
^C_BTWN_TO13_EMONTH there any more time periods when ^TEMPNAME WASWERE looking
for work?
1. Yes
2. No
FROM_LKMNTH_14
^C_LKMNTH14 what month did ^TEMPNAME begin looking for work for the fourth time?
FR note for FROM_LKMNTH
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
Page 203 of 578
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
FROM_LKWEEK_14
T
In which week did ^TEMPNAME begin looking for work?
FR note for FROM_LKWEEK
TO_LKMNTH_14
From ^FROM14FILL to ^EMONTHFILL, in what month did ^TEMPNAME stop looking for work?
FR Note for TO_LKMNTH
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
TO_LKWEEK_14
Page 204 of 578
T
In which week did ^TEMPNAME stop looking for work?
^TO_LKWEEKFRNOTE
SPELLCOMPLETE
ANYMORESPELLS
Did ^TEMPNAME have any other times not working for pay since ^MONTH1 1st
^CALENDAR_YRFIL?
HOWMANY
We've talked about six periods of time not working for pay. How many other times, since
^MONTH1 1st ^CALENDAR_YRFIL, did ^YOUHESHE spend not working for pay?
ANYOTHERWORK
NOMORESPELLS
The no jobs topic is complete.
Enter 1 to continue.
1. Continue
PWAVE_COMPLETE
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SPELLNUMBER
**NON-DISPLAYED ITEM**
Page 205 of 578
PERIODNUM
**NON-DISPLAYED ITEM**
R_SSIWHY
SSI_FLG
INTRO
(Next are some questions about assistance programs for people in need.) ^SSIINTROTEXT
INFO
(SSI is not the same as Social Security. Income from Social Security is asked about later.
SSI provides assistance to low-income children and adults who are blind or disabled, as well as
low-income people over age 65 who are not blind or disabled.)
Do NOT include SSI received on behalf of someone else.
BMONTH
^FROMTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
Page 206 of 578
EMONTH
^TOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
SSI_LC_YEAR
Prior to ^MONTH1 ^CALENDAR_YRFIL, what YEAR did ^TEMPNAME first start receiving SSI
continuously?
If receipt began in ^MONTH1 ^CALENDAR_YRFIL, enter ^YR_FIL.
SSI_LC_MONTH
Prior to ^MONTH1 ^CALENDAR_YRFIL, what MONTH did ^TEMPNAME first start receiving SSI
continuously?
1. January
2. February
3. March
4. April
5. May
6. June
7. July
Page 207 of 578
8. August
9. September
10. October
11. November
12. December
SSI_WHY
Why did ^TEMPNAME begin receiving SSI^SSI_BMONTHFIL?
Mark all that apply.
1. Disabled
2. Blind
3. Aged (65 and over)
4. Other
SSI_STOP
? [F1]
What were the reasons ^TEMPNAME stopped receiving SSI in ^EMONTHFILL?
1. Increased earned income (wages from a job)
2. Increased unearned income (benefits from a program, such as Social Security)
3. Increased resources (assets, such as a car)
4. No longer disabled
5. Other program requirements not met
6. Chose not to collect/the money is not worth it
7. Other
SSI_PAYMENT
C_DIDDODOES ^TEMPNAME receive ^PTEMPNAME monthly SSI benefit in one or two
payments?
1. One
2. Two
Page 208 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SPELLNUMBER
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
SSI1_AMT
(Let's talk about the first payment you reported.)
How much DIDDODOES ^TEMPNAME receive ^IN_EMONTHFIL?
SSI1_GUESS
L
What would you estimate the monthly amount to be- less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
SSI1_AMT1_START
When did ^TEMPNAME start receiving ^SSIAMT1_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
Page 209 of 578
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
SSI1_AMT2
How much did ^TEMPNAME receive before ^AMT1_STARTFIL?
SSI1_AMT2_GUESS
L
What would you estimate the monthly amount to be- less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
SSI1_AMT2_START
When did ^TEMPNAME start receiving ^SSIAMT2_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
Page 210 of 578
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
SSI1_AMT3
How much did ^TEMPNAME receive before ^SSI_AMT2_STARTFIL?
SSI1_AMT3_GUESS
L
What would you estimate the monthly amount to be- less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
SSI1_AMT3_START
When did ^TEMPNAME start receiving ^SSIAMT3_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
Page 211 of 578
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
SSI1_AMT4
How much did ^TEMPNAME receive before ^SSI_AMT3_STARTFIL?
SSI1_AMT4_GUESS
L
What would you estimate the monthly amount to be- less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
SSI1_AMT4_START
When did ^TEMPNAME start receiving ^SSIAMT4_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
Page 212 of 578
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
SSI1_STARTAMT
How much did ^TEMPNAME receive in ^BMONTHFILL?
SSI1_SRC
^SSISRC
Read answer categories.
1. Federal Government?
2. State Government?
3. Combined (both federal and state)?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SPELLNUMBER
Page 213 of 578
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
SSI2_AMT
Let's talk about the second payment you reported earlier.
How much DIDDODOES ^TEMPNAME receive ^IN_EMONTHFIL?
SSI2_GUESS
L
What would you estimate the monthly amount to be- less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
SSI2_AMT1_START
When did ^TEMPNAME start receiving ^SSIAMT1_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
Page 214 of 578
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
SSI2_AMT2
How much did ^TEMPNAME receive before ^AMT1_STARTFIL?
SSI2_AMT2_GUESS
L
What would you estimate the monthly amount to be- less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
SSI2_AMT2_START
When did ^TEMPNAME start receiving ^SSIAMT2_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
Page 215 of 578
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
SSI2_AMT3
How much did ^TEMPNAME receive before ^SSI_AMT2_STARTFIL?
SSI2_AMT3_GUESS
L
What would you estimate the monthly amount to be- less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
SSI2_AMT3_START
When did ^TEMPNAME start receiving ^SSIAMT3_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
Page 216 of 578
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
SSI2_AMT4
How much did ^TEMPNAME receive before ^SSI_AMT3_STARTFIL?
SSI2_AMT4_GUESS
L
What would you estimate the monthly amount to be- less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
SSI2_AMT4_START
When did ^TEMPNAME start receiving ^SSIAMT4_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
Page 217 of 578
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
SSI2_STARTAMT
How much did ^TEMPNAME receive in ^BMONTHFILL?
SSI2_SRC
^SSISRC
Read answer categories.
1. Federal Government?
2. State Government?
3. Combined (both federal and state)?
SSI_OWNER
Who received payments on behalf of ^TEMPNAME?
1. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
2. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
3. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
4. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
5. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
6. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
7. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
8. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
9. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
10. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
11. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
12. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
13. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
14. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
Page 218 of 578
15. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
16. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
17. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
18. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
19. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
20. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
21. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
22. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
23. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
24. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
25. LNO ^FNAME ^LNAME of all people on final household roster 18 years and older (and PEOPLE_TO_ROSTER=
26. Someone not listed
SPELLCOMPLETE
ANYMORESPELLS
Did ^TEMPNAME receive SSI at any other times since the ^MONTH1 1st ^CALENDAR_YRFIL?
1. Yes
2. No
HOWMANY
We've talked about three periods of SSI receipt. How many other times did ^YOUHESHE receive
SSI since ^MONTH1 1st ^CALENDAR_YRFIL?
NOMORESPELLS
The SSI topic is complete.
Enter 1 to continue.
1. Continue
PWAVE_COMPLETE
**NON-DISPLAYED ITEM**
CTRLNUM
Page 219 of 578
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SPELLNUMBER
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
INTRO
(Next are some questions about assistance programs for people in need.) ^FSINTROTEXT
INFO
(The Food Stamp Program, or Supplemental Nutrition Assistance Program - SNAP, was created to
assist low-income households in buying the food they need for good health and nutrition. The benefit
amount allowed to a household varies by the household's size and monthly cash income. Benefits are
generally provided through plastic electronic card called an Electronic Benefit Transfer (EBT).)
BMONTH
^FROMTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
Page 220 of 578
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
EMONTH
^TOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
FS_LC_YEAR
Prior to ^MONTH1 ^CALENDAR_YRFIL, what YEAR did ^TEMPNAME first start receiving Food
Stamps or SNAP continuously?
If receipt began in ^MONTH1 ^CALENDAR_YRFIL, enter ^YR_FIL.
FS_LC_MONTH
Prior to ^MONTH1 ^CALENDAR_YRFIL, what MONTH did ^TEMPNAME first start receiving Food
Stamps or SNAP continuously?
Page 221 of 578
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
FS_BEGIN
What changed in ^PTEMPNAME life to cause ^YOUHIMHER to receive Food Stamps or
SNAP^FS_BMONTHFIL?
Mark all that apply.
1. New child (or other dependent) or pregnancy
2. Separation, divorced or widowed
3. Job loss/layoff or wages reduced
4. Loss or reduction of other income
5. Became disabled or otherwise unable to work
6. No change - just decided it was time
7. No change - just heard about the program
8. Needed to re-certify
9. Other
FS_STOP
What were the reasons ^TEMPNAME stopped receiving Food Stamps or SNAP ^SPELLEND?
Mark all that apply.
1. Became ineligible because of an increase in income
2. Became ineligible because of family changes (family member left, over age limit, etc)
3. Still eligible but could not / chose not to collect
4. Became ineligible because program requirements were not met (did not attend school, job training, etc)
5. Eligibility ran out because of time limits
Page 222 of 578
6. The money/benefits were not worth the trouble to continue enrollment
7. Other
FS1_AMT
How much DIDDODOES ^TEMPNAME receive ^IN_EMONTHFIL?
FS1_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
FS_AMT1_START
When did ^TEMPNAME start receiving ^FSAMT1_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
Page 223 of 578
17. May ^INTYEARFIL
18. June ^INTYEARFIL
FS2_AMT
How much did ^TEMPNAME receive before ^AMT1_STARTFIL?
FS2_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
FS_AMT2_START
When did ^TEMPNAME start receiving ^FSAMT2_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
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17. May ^INTYEARFIL
18. June ^INTYEARFIL
FS3_AMT
How much did ^TEMPNAME receive before ^AMT2_STARTFIL?
FS3_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
FS_AMT3_START
When did ^TEMPNAME start receiving ^FSAMT3_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
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17. May ^INTYEARFIL
18. June ^INTYEARFIL
FS4_AMT
How much did ^TEMPNAME receive before ^AMT3_STARTFIL?
FS4_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
FS_AMT4_START
When did ^TEMPNAME start receiving ^FSAMT4_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
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17. May ^INTYEARFIL
18. June ^INTYEARFIL
FS_COV
Please list everyone (including yourself) who ^ISWAS_COV covered by ^YOURHISHER benefits at
any time ^BETWEEN_BMONTH_EMONTH.
Mark all that apply.
1. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
2. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
3. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
4. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
5. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
6. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
7. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
8. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
9. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
10. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
11. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
12. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
13. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
14. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
15. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
16. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
17. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
18. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
19. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
20. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
21. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
22. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
23. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
24. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
25. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
26. Someone not listed
FS_OWNER
Page 227 of 578
In whose name ^AREWERE benefits received?
1. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
2. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
3. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
4. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
5. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
6. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
7. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
8. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
9. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
10. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
11. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
12. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
13. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
14. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
15. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
16. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
17. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
18. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
19. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
20. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
21. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
22. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
23. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
24. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
25. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
SPELLCOMPLETE
ANYMORESPELLS
Did ^TEMPNAME receive Food Stamps or SNAP benefits at any other times since ^MONTH1 1st
^CALENDAR_YRFIL?
1. Yes
2. No
HOWMANY
We've talked about three periods of Food Stamps or SNAP benefit receipt. How many other times
Page 228 of 578
did ^YOUHESHE receive Food Stamps or SNAP benefits since ^MONTH1 1st
^CALENDAR_YRFIL?
NOMORESPELLS
The Food Stamps or SNAP topic is complete.
Enter 1 to continue.
1. Continue
PWAVE_COMPLETE
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SPELLNUMBER
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
INTRO
(Next are some questions about assistance programs for people in need.) ^TANFINTROTEXT.
INFO
(In this area you may know this as ^TANFFIL1 or ^TANFFIL2 or ^TANFFIL3. Pass-through child support
is also called called bonus child support and disregard payments.)
BMONTH
^FROMTEXT
Page 229 of 578
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
EMONTH
^TOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
Page 230 of 578
18. June ^INTYEARFIL
TANF_LC_YEAR
Prior to ^MONTH1 ^CALENDAR_YRFIL, what YEAR did ^TEMPNAME first start receiving
payments continuously?
If receipt began in ^MONTH1 ^CALENDAR_YRFIL, enter ^YR_FIL.
TANF_LC_MONTH
Prior to ^MONTH1 ^CALENDAR_YRFIL, what MONTH did ^TEMPNAME first start receiving
payments continuously?
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
TANF_BEG
What changed in ^PTEMPNAME life to cause ^YOUHIMHER to need
assistance^TANF_BMONTHFIL?
Mark all that apply.
1. New child (or other dependent) or pregnancy
2. Separation, divorce, or widowed
3. Job loss or wages reduced
4. Loss or reduction of other income
5. Became disabled or otherwise unable to work
6. No change - just decided it was time
7. No change - just heard about the program
Page 231 of 578
8. Needed to re-certify
9. Other
TANF_STOP
What were the reasons ^TEMPNAME stopped receiving payments ^SPELLEND?
Mark all that apply.
1. Got a job or earnings increased
2. Family situation changed
3. Others in the household earned enough money
4. Penalized or sanctioned for non-cooperation
5. Time limit expired
6. Didn't want to use up time limit
7. Chose not to participate
8. The money is not worth it
9. Other
TANF1_AMT
How much DIDDODOES ^TEMPNAME receive ^IN_EMONTHFIL?
TANF1_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
TANF_AMT1_START
When did ^TEMPNAME start receiving ^TANFAMT1_FIL?
1. January ^CALENDAR_YRFIL
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2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
TANF2_AMT
How much did ^TEMPNAME receive before ^AMT1_STARTFIL?
TANF2_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
TANF_AMT2_START
When did ^TEMPNAME start receiving ^TANFAMT2_FIL?
1. January ^CALENDAR_YRFIL
Page 233 of 578
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
TANF3_AMT
How much did ^TEMPNAME receive before ^AMT2_STARTFIL?
TANF3_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
TANF_AMT3_START
When did ^TEMPNAME start receiving ^TANFAMT3_FIL?
1. January ^CALENDAR_YRFIL
Page 234 of 578
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
TANF4_AMT
How much did ^TEMPNAME receive before ^AMT3_STARTFIL?
TANF4_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
TANF_AMT4_START
When did ^TEMPNAME start receiving ^TANFAMT4_FIL?
1. January ^CALENDAR_YRFIL
Page 235 of 578
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
TANF_ADULT_KID
Do these benefits cover children only, both children and adults, or only a pregnant woman?
1. Only children
2. Both children and adults
3. Only a pregnant woman
TANF_COV
Please list Coverage roster fill for TANF_COV question who ^ISWAS_COV covered by
^YOURHISHER benefits at any time ^BETWEEN_BMONTH_EMONTH.
Mark all that apply.
1. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
2. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
3. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
4. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
5. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
6. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
7. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
8. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
Page 236 of 578
9. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
10. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
11. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
12. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
13. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
14. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
15. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
16. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
17. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
18. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
19. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
20. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
21. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
22. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
23. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
24. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
25. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
26. Someone not listed
TANF_OWNER
In whose name ^AREWERE benefits received?
1. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
2. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
3. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
4. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
5. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
6. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
7. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
8. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
9. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
10. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
11. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
12. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
13. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
14. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
15. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
Page 237 of 578
16. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
17. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
18. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
19. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
20. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
21. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
22. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
23. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
24. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
25. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
PASSTHRU_YN
? [F1]
Now I am going to ask you questions about receipt of pass-through child support
^BETWEEN_BMONTH_EMONTH.
At any time during this period, DIDDODOES ^TEMPNAME receive any child support as a bonus
or pass-through from a state or county welfare program, or any disregard payment?
(Pass-through child support may also be known as "bonus child support" or "disregard payments.")
1. Yes
2. No
PASSTHRU_KID_COV
Which person or people under the age of 22 are or were covered by pass-through child support
payments ^BETWEEN_BMONTH_EMONTH?
Mark all that apply.
1. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
2. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
3. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
4. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
5. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
6. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
7. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
8. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
9. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
Page 238 of 578
10. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
11. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
12. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
13. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
14. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
15. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
16. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
17. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
18. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
19. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
20. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
21. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
22. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
23. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
24. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
25. LNO ^FNAME ^LNAME of all people where age <= 22on (the final HH roster, excluding the respondent, where P
26. Someone not listed
PASSTHRU_TYPE
Do the ^TANFFIL1 amounts you just reported include ^PTEMPNAME pass-through child support
payments?
1. Yes, bonus/pass through amounts are included
2. No, amounts do not include bonus/pass through
3. Did not receive any bonus/pass through income
PASSTHRU1_AMT
How much pass-through child support DIDDODOES ^TEMPNAME receive ^IN_EMONTHFIL?
PASSTHRU1_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
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3. $400-599
4. $600-799
5. $800 or more
PASSTHRU_AMT1_START
When did ^TEMPNAME start receiving ^PTAMT1_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
PASSTHR2_AMT
How much pass-through child support did ^TEMPNAME receive before ^AMT1_STARTFIL?
PASSTHUR2_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
Page 240 of 578
3. $400-599
4. $600-799
5. $800 or more
PASSTHRU_AMT2_START
When did ^TEMPNAME start receiving ^PTAMT2_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
PASSTHRU3_AMT
How much pass-through child support did ^TEMPNAME receive before ^AMT2_STARTFIL?
PASSTHRU3_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
Page 241 of 578
3. $400-599
4. $600-799
5. $800 or more
PASSTHRU_AMT3_START
When did ^TEMPNAME start receiving ^PTAMT3_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
PASSTHRU4_AMT
How much pass-through child support did ^TEMPNAME receive before ^AMT3_STARTFIL?
PASSTHRU4_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
Page 242 of 578
3. $400-599
4. $600-799
5. $800 or more
PASSTHRU_AMT4_START
When did ^TEMPNAME start receiving ^PTAMT4_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
PTAGENCY1_AMT
Now I am going to ask you about the child support that the government agency
COLLECTSCOLLECTED on ^PTEMPNAME behalf. How much child support ^ISWAS collected by
the agency on ^PTEMPNAME behalf ^IN_EMONTHFIL?
PTAGENCY1_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
Page 243 of 578
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
PTAGENCY_AMT1_START
When did the agency start receiving ^PTAAMT1_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
PTAGENCY2_AMT
How much did the agency receive on ^PTEMPNAME behalf before ^AMT1_STARTFIL?
PTAGENCY2_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
Page 244 of 578
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
PTAGENCY_AMT2_START
When did the agency start receiving ^PTAAMT2_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
PTAGENCY3_AMT
How much did the agency receive on ^PTEMPNAME behalf before ^AMT2_STARTFIL?
PTAGENCY3_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
Page 245 of 578
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
PTAGENCY_AMT3_START
When did the agency start receiving ^PTAAMT3_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
PTAGENCY4_AMT
How much did the agency receive on ^PTEMPNAME behalf before ^AMT3_STARTFIL?
PTAGENCY4_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
Page 246 of 578
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
PTAGENCY_AMT4_START
When did the agency start receiving ^PTAAMT4_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
SPELLCOMPLETE
ANYMORESPELLS
Did ^TEMPNAME receive TANF at any other times since ^MONTH1 1st ^CALENDAR_YRFIL?
1. Yes
2. No
HOWMANY
We've talked about three periods of TANF receipt. How many other times did ^TEMPNAME
receive TANF since ^MONTH1 1st ^CALENDAR_YRFIL?
Page 247 of 578
NOMORESPELLS
The TANF topic is complete.
Enter 1 to continue.
1. Continue
PWAVE_COMPLETE
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SPELLNUMBER
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
INTRO
(Next are some questions about assistance programs for people in need.) ^GAINTROTEXT.
INFO
(General Assistance or General Relief - which can be called something different depending on where
you live - is a program for people who do not qualify for federal assistance. It may help the disabled,
elderly, and unemployed, as well as families with children. Assistance may be cash or non-cash and
may be a one-time emergency payment or regular monthly payments.)
BMONTH
^FROMTEXT
1. January ^CALENDAR_YRFIL
Page 248 of 578
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
EMONTH
^TOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
Page 249 of 578
GA_LC_YEAR
Prior to ^MONTH1 ^CALENDAR_YRFIL, what YEAR did ^TEMPNAME first start receiving General
Assistance continuously?
If receipt began in ^MONTH1 ^CALENDAR_YRFIL, enter ^YR_FIL.
GA_LC_MONTH
Prior to ^MONTH1 ^CALENDAR_YRFIL, what MONTH did ^TEMPNAME first start receiving
General Assistance continuously?
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
GA_BEG
What changed in ^PTEMPNAME life to cause ^YOUHIMHER to need
assistance^GA_BMONTHFIL?
Mark all that apply.
1. New child (or other dependent) or pregnancy
2. Separation, divorce, or widowed
3. Job loss or wages reduced
4. Loss or reduction of other income
5. Became disabled or otherwise unable to work
6. No change - just decided it was time
7. No change - just heard about the program
8. Needed to re-certify
9. Other
Page 250 of 578
GA_STOP
What were the reasons ^TEMPNAME stopped receiving General Assistance ^SPELLEND?
Mark all that apply.
1. Got a job or earnings increased
2. Family situation changed
3. Others in the household earned enough money
4. Penalized or sanctioned for non-cooperation
5. Time limit expired
6. Didn't want to use up time limit
7. Chose not to participate
8. The money is not worth it
9. Other
GA1_AMT
How much DIDDODOES ^TEMPNAME receive ^IN_EMONTHFIL?
GA1_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
GA_AMT1_START
When did ^TEMPNAME start receiving ^GAAMT1_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
Page 251 of 578
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
GA2_AMT
How much did ^TEMPNAME receive before ^AMT1_STARTFIL?
GA2_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
GA_AMT2_START
When did ^TEMPNAME start receiving ^GAAMT2_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
Page 252 of 578
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
GA3_AMT
How much did ^TEMPNAME receive before ^AMT2_STARTFIL?
GA3_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
GA_AMT3_START
When did ^TEMPNAME start receiving ^GAAMT3_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
Page 253 of 578
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
GA4_AMT
How much did ^TEMPNAME receive before ^AMT3_STARTFIL?
GA4_GUESS
L
What would you estimate the monthly amount to be - less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
GA_AMT4_START
When did ^TEMPNAME start receiving ^GAAMT4_FIL?
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
Page 254 of 578
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
GA_COV
Please list everyone (including yourself) who ^ISWAS_COV covered by ^YOURHISHER benefits
at any time ^BETWEEN_BMONTH_EMONTH.
Mark all that apply.
1. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
2. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
3. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
4. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
5. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
6. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
7. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
8. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
9. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
10. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
11. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
12. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
13. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
14. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
15. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
16. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
17. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
18. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
19. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
Page 255 of 578
20. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
21. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
22. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
23. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
24. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
25. LNO ROST_FNAME ROST_LNAME of all people regardless of age on (the final HH roster where PEOPLE_TO_
26. Someone not listed
GA_OWNER
In whose name ^AREWERE benefits received?
1. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
2. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
3. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
4. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
5. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
6. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
7. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
8. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
9. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
10. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
11. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
12. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
13. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
14. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
15. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
16. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
17. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
18. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
19. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
20. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
21. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
22. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
23. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
24. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
25. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older
Page 256 of 578
SPELLCOMPLETE
ANYMORESPELLS
Did ^TEMPNAME receive General Assistance benefits at any other times since ^MONTH1 1st
^CALENDAR_YRFIL?
1. Yes
2. No
HOWMANY
We've talked about three periods of General Assistance benefit receipt. How many other times
did ^TEMPNAME receive General Assistance benefits since ^MONTH1 1st ^CALENDAR_YRFIL?
NOMORESPELLS
The General Assistance topic is complete.
Enter 1 to continue.
1. Continue
PWAVE_COMPLETE
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SPELLNUMBER
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
INTRO
Page 257 of 578
(Next are some questions about assistance programs for people in need.) ^WICINTROTEXT.
INFO
(The WIC program serves low-income pregnant or nursing women, and infants and children up to age 5,
by providing nutritious foods to supplement diets.)
BMONTH
^FROMTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
EMONTH
^TOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
Page 258 of 578
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
WIC_LC_YEAR
Prior to ^MONTH1 ^CALENDAR_YRFIL, what YEAR did ^TEMPNAME first start receiving WIC
continuously?
If receipt began in ^MONTH1 ^CALENDAR_YRFIL, enter ^YR_FIL.
WIC_LC_MONTH
Prior to ^MONTH1 ^CALENDAR_YRFIL, what MONTH did ^TEMPNAME first start receiving WIC
continously?
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
WIC_BEGIN
What changed in ^PTEMPNAME life to cause ^YOUHIMHER to need
Page 259 of 578
assistance^WIC_BMONTHFIL?
Mark all that apply.
1. New child (or other dependent) or pregnancy
2. Separation, divorced or widowed
3. Job loss/layoff or wages reduced
4. Loss or reduction of other income
5. Became disabled or otherwise unable to work
6. No change - just decided it was time
7. No change - just heard about the program
8. Needed to re-certify
9. Other
WIC_STOP
What were the reasons ^TEMPNAME stopped receiving WIC ^SPELLEND?
1. Became ineligible because of an increase in income
2. Became ineligible because of family changes (family member left, over age limit, etc)
3. Still eligible but could not / chose not to collect
4. Became ineligible because program requirements were not met (did not attend school, job training, etc)
5. Eligibility ran out because of time limits
6. The money/benefits were not worth the trouble to continue enrollment
7. Other
WIC_COV
^DIDDO these benefits cover only children, only pregnant or nursing women aged 15 or older, or
both?
1. Only children
2. Only a pregnant or nursing woman
3. Both a woman and children
WIC_ADULT_COV
Ask or verify
Which woman ^DIDDOES ^PTEMPNAME benefits cover?
1. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
Page 260 of 578
2. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
3. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
4. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
5. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
6. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
7. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
8. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
9. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
10. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
11. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
12. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
13. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
14. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
15. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
16. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
17. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
18. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
19. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
20. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
21. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
22. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
23. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
24. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
25. LNO ^FNAME ^LNAME of all women AGE >= 15 on (the final HH roster, excluding the respondent, where PEOP
26. Someone not listed
WIC_KID_COV
Which child or children DODID ^PTEMPNAME benefits cover?
Mark all that apply.
1. LNO ^FNAME ^LNAME of all childen AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
2. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
3. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
4. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
5. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
6. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
7. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
8. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
Page 261 of 578
9. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
10. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
11. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
12. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
13. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
14. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
15. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
16. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
17. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
18. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
19. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
20. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
21. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
22. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
23. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
24. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
25. LNO ^FNAME ^LNAME of all children AGE < 5 on (the final HH roster, excluding the respondent, where PEOPLE
26. Other child not listed
SPELLCOMPLETE
ANYMORESPELLS
Did ^TEMPNAME receive WIC at any other times since ^MONTH1 1st ^CALENDAR_YRFIL?
1. Yes
2. No
HOWMANY
We've talked about three periods of WIC receipt. How many other times did ^TEMPNAME receive
WIC since ^MONTH1 1st ^CALENDAR_YRFIL?
NOMORESPELLS
The WIC topic is complete.
Enter 1 to continue.
1. Continue
Page 262 of 578
PWAVE_COMPLETE
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SPELLNUMBER
**NON-DISPLAYED ITEM**
PRIVNUMBER
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
INTRO
^PRIVATE_INTROQTEXT
bmonth
^FROMTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
Page 263 of 578
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
emonth
^TOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
ownins
CC, ? [F1]
(Health insurance plans are usually obtained in one person's name even if other family members are
covered. That person is called the policyholder.) Who ^ISWAS the policyholder for this plan?
1. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
Page 264 of 578
2. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
3. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
4. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
5. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
6. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
7. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
8. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
9. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
10. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
11. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
12. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
13. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
14. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
15. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
16. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
17. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
18. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
19. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
20. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
21. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
22. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
23. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
24. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
25. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
26. Someone outside of the household
privtype
CC, ? [F1]
What ^ISWAS the source of ^HIPHOLDER coverage Health Insurance fill used to specify the
specific month(s) of coverage (during, if covered 1 month) (from...through, if covered 2 or more
month? C_ISWAS it through...
Read answer categories.
If the respondent obtained this insurance from a job that ended during the reference period, select
Option 1 (an employer or job).
1. An Employer or Job Fill used to specify type (current or former) of Employer or Union Private Health Insurance c
2. A Former Employer ?
Page 265 of 578
3. A Union or Association ?
4. Bought it directly?
5. School?
6. Or Something else?
privoth
CC
You said ^TEMPNAME HADHASHAVE some other type of coverage. Please explain.
hicost
CC,? [F1]
C_DOESDID ^HIPHOLDER ^EMPUNION pay all, part, or none of the premium of the plan?
1. All
2. Part
3. None
INFO
(Private health insurance includes comprehensive medical insurance plans provided through an
employer or union, as well as plans purchased directly from an insurance company individually or as part
of a group.)
DO NOT include plans that contain only one type of coverage, like dental-only or vision-only plans.
privunit
? [F1]
Other than ^TEMPNAME, who else ^ISWAS covered by this plan Health Insurance fill used to
specify the specific month(s) of coverage (during, if covered 1 month) (from...through, if covered
2 or more month?
Mark all that apply.
0. Nobody
1. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
2. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
3. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
Page 266 of 578
4. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
5. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
6. LNO FNAMEL NAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
7. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
8. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
9. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
10. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
11. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
12. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
13. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
14. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
15. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
16. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
17. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
18. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
19. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
20. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
21. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
22. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
23. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
24. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
25. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 f
26. Someone outside of the household
27. All household members
hiothr
C_DOESDID this plan also cover anyone else who ^DIDDOES NOT live in this household?
1. Yes
2. No
hiwho
Who outside of this household ^DIDDOES the plan cover?
Mark all that apply.
1. Child under 18
2. Child 18-25
Page 267 of 578
3. Child 26 or over
4. Spouse/partner
5. Other
privplan
? [F1]
C_ISWAS this plan...
Read answer categories.
Ask if necessary: (Please check ^YOURHISHER insurance card for type of coverage plan).
1. An HMO (Health Maintenance Organization) or IPA (Individual Practice Association)?
2. A PPO (Preferred Provider Organization)?
3. A POS (Point-of-service)?
4. A fee-for-service or indemnity?
5. Some other kind of plan?
hdedpln
CC,? [F1]
Is the ^HDEDFILL1 annual deductible for medical care for this plan ^HDEDFILL2 or more?
1. Yes (^HDEDFILL2 or more)
2. No (Less than ^HDEDFILL2)
hlthsav
? [F1]
As part of this plan, ^ISWAS there a special account or fund used to pay for medical expenses?
(These accounts are sometimes referred to as Health Savings Accounts (HSAs), Health Reimbursement
Accounts (HRAs), Personal Care Accounts, Personal Medical Funds, or Choice Funds and are different
from Flexible Spending Accounts.)
1. Yes
2. No
Page 268 of 578
PRIEXCH
CC
C_ISWAS this coverage through EXCHSHOP? In ^STATE, this is known as
Read List:
[Display list of program names as defined in 'SIPP State Fills.txt' for the appropriate state (i.e. where
^STATE=column 1 of input document). If PRIVTYPE=(1 or 2), use columns 16-19; Else, use columns
12-15.]
1. Yes
2. No
PRIPREM
CC
C_ISWAS there a monthly premium for this plan?
A monthly premium is a fixed amount of money people pay each month to have health coverage. It
does not include copays or other expenses such as prescription costs.
1. Yes
2. No
PRISUBS
CC
C_ISWAS the cost of the premium subsidized based on Fill to determine if Health Exchange
premium was subsidized. income?
A monthly premium is a fixed amount of money people pay each month to have health coverage. It
does not include copays or other expenses such as prescription costs.
1. Yes
2. No
privend
Page 269 of 578
? [F1]
What was the reason this insurance plan coverage ended?
Mark all that apply.
1. Fill for Reasons Uninsured Answer list
2. ^JOBLOSS
3. No longer eligible
4. Unhappy with plan
5. Fill for Reasons Uninsured Answer list
6. Other
spellcomplete
anymorespells
^C_WASWERE ^TEMPNAME covered by another private health insurance plan since ^MONTH1
1st ^CALENDAR_YRFIL?
^PRIVATE_ANYMOREFIL
1. Yes
2. No
howmany
^PRIVATE_HOWMANYQTEXT
nomorespells
^PRIVATE_NOMOREFRNOTE
1. Continue
pwave_complete
**NON-DISPLAYED ITEM**
Page 270 of 578
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
spellnumber
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
bmonth
^FROMTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
emonth
^MEDICARE_TOTEXT
Page 271 of 578
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
INTRO
^MEDICAREINTROTEXT
mcpart
AA
The Medicare Program contains a number of different kinds of plans. Please tell me which of
these plan types ^YOUHESHE ISAREWASWERE covered by...
Read answer categories.
Mark all that apply.
1. Part A (Hospital Insurance)?
2. Part B?
3. A Supplement?
4. Part C or Medicare Advantage?
5. Part D (Prescription Drug Coverage)?
Page 272 of 578
INFO
Respondents may confuse MediCAID, the health insurance program for low-income people, with
MediCARE. Medicare is mostly for the elderly, and it is NOT based on income. Respondents may have
both Medicare and Medicaid. Please report Medicare here, and Medicaid on the Medical Assistance
line.
spellcomplete
anymorespells
howmany
nomorespells
The Medicare topic is complete.
Enter 1 to continue.
1. Continue
PWAVE_COMPLETE
**NON-DISPLAYED ITEM**
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
spellnumber
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
bmonth
^FROMTEXT
Page 273 of 578
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
emonth
^TOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
Page 274 of 578
17. May ^INTYEARFIL
18. June ^INTYEARFIL
mdunit
Other than ^TEMPNAME, who else had this kind of coverage Health Insurance fill used to specify
the specific month(s) of coverage (during, if covered 1 month) (from...through, if covered 2 or
more month?
Mark all that apply.
Include persons even if they were covered by different Medicaid, S-CHIP, or Medical Assistance
programs.
0. Nobody
1. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
2. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
3. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
4. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
5. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
6. LNO FNAMEL NAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
7. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
8. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
9. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
10. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
11. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
12. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
13. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
14. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
15. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
16. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
17. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
18. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
19. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
20. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
21. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
22. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
23. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
24. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
25. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 f
26. Someone outside of the household
Page 275 of 578
27. All household members
INTRO
^MEDICAIDINTROTEXT
mdplan
? [F1]
C_ISWAS this plan...
Read answer categories.
1. An HMO (Health Maintenance Organization)?
2. A fee-for-service plan?
3. Another managed-care type program?
4. Some other kind of plan?
INFO
For example, Medical Assistance programs in ^STATE are called
Read list:
Respondents may have both Medicare and Medicaid. Please report Medicaid here, and Medicare
plans on the Medicare line above.
MDEXCH
CC
C_ISWAS this coverage through the Health Insurance Marketplace? In ^STATE, this is known as
Read list:
Display list of program names as defined in 'SIPP State Fills.txt' for the
appropriate state (i.e. where ^STATE=column 1 of the input document), using
columns 12-15.
1. Yes
2. No
Page 276 of 578
MDPREM
CC
C_ISWAS there a monthly premium for this plan?
A monthly premium is a fixed amount of money people pay each month to have health coverage. It
does not include copays or other expenses such as prescription costs.
1. Yes
2. No
MDSUBS
CC
C_ISWAS the cost of the premium subsidized based on Fill to determine if Health Exchange
premium was subsidized. income?
A monthly premium is a fixed amount of money people pay each month to have health coverage. It
does not include copays or other expenses such as prescription costs.
1. Yes
2. No
mdend
? [F1]
What was the reason this coverage ended?
Mark all that apply.
1. Fill for Reasons Uninsured Answer list
2. ^JOBLOSS
3. No longer eligible
4. Unhappy with plan
5. Fill for Reasons Uninsured Answer list
6. Other
spellcomplete
Page 277 of 578
anymorespells
WASWERE ^TEMPNAME covered by Medicaid, or CHIP, or any other government program that
helps pay health care costs for low-income people at any other times since ^MONTH1 1st
^CALENDAR_YRFIL?
1. Yes
2. No
howmany
We've talked about six periods of Medicaid coverage. How many other times WASWERE
^TEMPNAME covered by Medicaid since ^MONTH1 1st ^CALENDAR_YRFIL?
nomorespells
The Medicaid topic is complete.
Enter 1 to continue.
1. Continue
pwave_complete
**NON-DISPLAYED ITEM**
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
spellnumber
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
Page 278 of 578
bmonth
^FROMTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
emonth
^TOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
Page 279 of 578
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
militype
What type of health coverage DIDDODOES ^YOUHESHE have Health Insurance fill used to
specify the specific month(s) of coverage (during, if covered 1 month) (from...through, if covered
2 or more month...
Read answer categories.
1. TRICARE or CHAMPUS?
2. CHAMPVA?
3. VA?
4. Other?
INTRO
^MILIINTROTEXT
milioth
You said ^TEMPNAME HADHASHAVE some other type of coverage. Please explain.
INFO
("CHAMPVA" is the civilian health and medical program of the Department of Veterans Affairs.)
mownins
? [F1]
Who ^ISWAS the policyholder or sponsor for this plan?
1. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
2. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
3. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
4. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
Page 280 of 578
5. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
6. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
7. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
8. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
9. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
10. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
11. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
12. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
13. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
14. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
15. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
16. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
17. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
18. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
19. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
20. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
21. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
22. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
23. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
24. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
25. LNO ^FNAME ^LNAME of all people on final household roster 15 years and older (and PEOPLE_TO_ROSTER=
26. Someone outside of the household
miliunit
Other than ^TEMPNAME, who else ^ISWAS covered by this plan Health Insurance fill used to
specify the specific month(s) of coverage (during, if covered 1 month) (from...through, if covered
2 or more month?
Mark all that apply.
0. Nobody
1. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
2. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
3. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
4. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
5. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
6. LNO FNAMEL NAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
7. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
8. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
Page 281 of 578
9. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
10. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
11. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
12. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
13. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
14. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
15. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
16. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
17. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
18. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
19. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
20. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
21. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
22. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
23. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
24. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 fo
25. LNO FNAME LNAME of all people on final household roster regardless of age (and PEOPLE_TO_ROSTER=1 f
26. Someone outside of the household
27. All household members
mhioth
C_DOESDID this plan also cover anyone else who ^DIDDOES NOT live in this household?
1. Yes
2. No
MHIWHO
Who outside of this household ^DIDDOES the plan cover?
1. Child under 18
2. Child 18-25
3. Child 26 or over
4. Spouse/partner
5. Other
miliend
? [F1]
Page 282 of 578
What was the reason this Military-based health coverage ended?
Mark all that apply.
1. Fill for Reasons Uninsured Answer list
2. ^JOBLOSS
3. No longer eligible
4. Unhappy with plan
5. Fill for Reasons Uninsured Answer list
6. Other
spellcomplete
anymorespells
Did ^TEMPNAME have military or VA health coverage at any other time since ^MONTH1 1st
^CALENDAR_YRFIL?
1. Yes
2. No
howmany
We've talked about four periods of military health care coverage. How many other times
WASWERE ^TEMPNAME covered by military health care coverage since ^MONTH1 1st
^CALENDAR_YRFIL?
nomorespells
The military insurance topic is complete.
Enter 1 to continue.
1. Continue
pwave_complete
**NON-DISPLAYED ITEM**
Page 283 of 578
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
spellnumber
**NON-DISPLAYED ITEM**
PERIODNUM
**NON-DISPLAYED ITEM**
bmonth
^FROMTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
INFO
DO NOT include plans that contain only one type of coverage, like dental-only or vision-only plans.
Page 284 of 578
emonth
^TOTEXT
1. January ^CALENDAR_YRFIL
2. February ^CALENDAR_YRFIL
3. March ^CALENDAR_YRFIL
4. April ^CALENDAR_YRFIL
5. May ^CALENDAR_YRFIL
6. June ^CALENDAR_YRFIL
7. July ^CALENDAR_YRFIL
8. August ^CALENDAR_YRFIL
9. September ^CALENDAR_YRFIL
10. October ^CALENDAR_YRFIL
11. November ^CALENDAR_YRFIL
12. December ^CALENDAR_YRFIL
13. January ^INTYEARFIL
14. February ^INTYEARFIL
15. March ^INTYEARFIL
16. April ^INTYEARFIL
17. May ^INTYEARFIL
18. June ^INTYEARFIL
othcovtype
CC, ? [F1]
What type of health coverage is this...
Read answer categories.
1. Government or public assistance?
2. Through someone else (parent, relative)?
3. Indian Health Services?
4. Some other source?
othcovoth
You said ^TEMPNAME HADHASHAVE some other type of coverage. Please explain.
OTHEXCH
Page 285 of 578
CC
C_ISWAS this coverage through the Health Insurance Marketplace? In ^STATE, this is known as
Read list:
Display list of program names as defined in 'SIPP State Fills.txt' for the
appropriate state (i.e. where ^STATE=column 1 of input document), using
columns 12-15.
1. Yes
2. No
OTHPREM
CC
C_ISWAS there a premium for this plan?
A monthly premium is a fixed amount of money people pay each month to have health coverage. It
does not include copays or other expenses such as prescription costs.
1. Yes
2. No
OTHSUBS
CC
C_ISWAS the cost of the premium subsidized based on Fill to determine if Health Exchange
premium was subsidized. income?
A monthly premium is a fixed amount of money people pay each month to have health coverage. It
does not include copays or other expenses such as prescription costs.
1. Yes
2. No
othend
What was the reason this insurance plan coverage ended?
Page 286 of 578
Mark all that apply.
1. Fill for Reasons Uninsured Answer list
2. ^JOBLOSS
3. No longer eligible
4. Unhappy with plan
5. Fill for Reasons Uninsured Answer list
6. Other
spellcomplete
anymorespells
WASWERE ^TEMPNAME covered by another health insurance plan at any other times since
^MONTH1 1st ^CALENDAR_YRFIL? (Perhaps a government program, Indian Health Services, or a
policy through a parent, a foreign government, or any other source?)
1. Yes
2. No
howmany
We've talked about four periods of other health care coverage. How many other times
WASWERE ^TEMPNAME covered by other health insurance since ^MONTH1 1st
^CALENDAR_YRFIL?
nomorespells
The other health insurance topic is complete.
Enter 1 to continue.
1. Continue
pwave_complete
CTRLNUM
**NON-DISPLAYED ITEM**
Page 287 of 578
LNO
**NON-DISPLAYED ITEM**
EXCH
**NON_DISPLAYED ITEM**
NOESI
**NON-DISPLAYED ITEM**
NOPRIVCOV
**NON-DISPLAYED ITEM**
NOHICOV
**NON-DISPLAYED ITEM**
HIFU_INTRO
? [F1]
The next section of the interview includes a few follow-up questions based on the health
insurance information you have already provided.
1. Enter 1 to continue
EMPNOESI
During ^CALENDAR_YEAR, there was a time when ^TEMPNAME ^WEREWAS employed, but did
not have health coverage through ^HISHER job. Did ^HISHER employer offer health insurance to
any of its employees then?
If a respondent had more than one employer during this time, and at least one employer offered health
insurance to any of its employees, then answer Yes.
1. Yes
2. No
WHYNOESI
X, ? [F1]
Page 288 of 578
Why didn't ^TEMPNAME sign up for this insurance?
Mark all that apply.
If a respondent had more than one employer that offered health insurance to its employees during this
time, then mark all reasons the respondent did not sign up for health insurance through both or all of
these employers.
1. Fill for Reasons Uninsured Answer list
2. Haven't worked for this employer long enough
3. Part-Time, Temporary, or Contract employee
4. Fill for Reasons Uninsured Answer list
5. Healthy (haven't needed health insurance)
6. Able to get care elsewhere (such as a health clinic)
7. Fill for Reasons Uninsured Answer list
8. Dissatisfied or don't believe in insurance
9. Fill for Reasons Uninsured Answer list
10. Fill for Reasons Uninsured Answer list
11. Other
NOESIOTH
(What was that "other" reason?)
WHYNOPRI
Y, ? [F1]
Fill for WHYNOPRI based on coverage
Fill for WHYNOPRI based on coverage18
Mark all that apply.
Health Insurance exchange information
1. Fill for Reasons Uninsured Answer list
2. Haven't worked for this employer long enough
3. Part-Time, Temporary, or Contract employee
4. Fill for Reasons Uninsured Answer list
5. Healthy (haven't needed health insurance)
6. Able to get care elsewhere (such as a health clinic)
7. Fill for Reasons Uninsured Answer list
Page 289 of 578
8. Dissatisfied or don't believe in insurance
9. Fill for Reasons Uninsured Answer list
10. Fill for Reasons Uninsured Answer list
11. Other
NOPRIOTH
(What was that "other" reason?)
WHYNOPUB
Z, ? [F1]
Why didn't ^TEMPNAME get Medicaid or Medical Assistance?
Mark all that apply.
1. Fill for Reasons Uninsured Answer list
2. Haven't worked for this employer long enough
3. Part-Time, Temporary, or Contract employee
4. Fill for Reasons Uninsured Answer list
5. Healthy (haven't needed health insurance)
6. Able to get care elsewhere (such as a health clinic)
7. Fill for Reasons Uninsured Answer list
8. Dissatisfied or don't believe in insurance
9. Fill for Reasons Uninsured Answer list
10. Fill for Reasons Uninsured Answer list
11. Other
NOPUBOTH
(What was that "other" reason?)
INFANTINS_INTRO
These next questions will ask about health insurance coverage for the CHILD0INF in the
household. You may have reported some health insurance already but we want to make sure we
have not missed any insurance coverage.
1. Enter 1 to continue
Page 290 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
HVARINFANT
**NON-DISPLAY ITEM**
INFANTLNO
**NON-DISPLAYED ITEM**
LGINS
^LGINS_FILL
1. Yes
2. No
LGINSTYPE
^LGINSTYPE_FILL
Read answer categories.
Mark all that apply.
1. Private health insurance?
2. Medical assistance?
3. Military or VA?
4. Other health coverage?
NOWRK_0
K
Next, I'll ask some follow-up questions based on the employment information you have already
provided.
Page 291 of 578
Why ^DONTDOESNT ^TEMPNAME work for pay now...
Read answer categories.
After each response, ask: Any other reason?
1. Temporarily unable to work because of own injury?
2. Temporarily unable to work because of own health concerns or own illness?
3. Unable to work because of chronic health condition or disability?
4. Retired?
5. Pregnancy or childbirth?
6. Taking care of children or other persons, such as from coronavirus pandemic school
closures?
7. Going to school?
8. Unable to find work?
9. On layoff, such as furloughed from coronavirus pandemic business closures?
10. Not interested in working at a job?
11. Usually worked 15 or more hours per week without pay in a family business or farm?
12. Some other reason?
13. Error: Currently working DO NOT READ
LKWRK_0
? [F1]
Between January ^REFYEAR and now, did ^TEMPNAME ACTIVELY look for work in one or more
weeks?
1. Yes
2. No
PROGINCOME_INTRO
? [F1]
Next I'll ask some questions about additional ways money may enter or leave your household.
(This includes income from other sources such as Social Security, Unemployment Compensation,
Worker's Compensation, disability payments, and survivor's benefits.) I'll also ask you about This is
the fill if the respondent has children or has ever divorced any payments ^TEMPNAME might
have made for the support or care of non-household members.
1. Enter 1 to continue
Page 292 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CAREPAY_ANYONE
Now I have a few questions about the care of dependents.
In December ^CALENDAR_YEAR, did anyone here pay for the care of a child or a disabled
person so that a household member could work, attend training, or look for a job?
1. Yes
2. No
DEPENDENT_EXP
What was the total cost of these care arrangements in December, ^CALENDAR_YEAR?
EXPENSE_RANGE
Is the amount (for December, ^CALENDAR_YEAR) less than $200, between $200 and $400,
between $400 and $600, or more than $600?
1. Less than $200
2. $200 to $399
3. $400 to $599
4. $600 or more
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
Page 293 of 578
LNO
**NON-DISPLAYED ITEM**
VA_ANY
Earlier you indicated ^TEMPNAME served in the military.
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any payments from the VA that is, the Department of Veterans Affairs?
1. Yes
2. No
VA_TYPE
N
^QSTNTXT_VATYPE What type of VA payments did ^TEMPNAME receive since ^MONTH1
^CALENDAR_YRFIL?
If necessary, read response choices 1, 2, and 3. Do not read response choice 4, 5, or 6.
Mark all that apply.
1. Service-connected disability compensation
2. Veterans' pension
3. Other VA payments
4. G.I. Bill benefits
5. Insurance proceeds
6. Did not receive any VA benefits
VADISRATE
^QSTNTXT_VADISRATE. What was ^PTEMPNAME total service-connected disability rating since
^MONTH1 ^CALENDAR_YRFIL?
1. 0 percent
2. 10 - 20 percent
3. 30 - 40 percent
4. 50 - 60 percent
5. 70+ percent
VATYPE_SP
Page 294 of 578
What was that other type of VA payment?
VAQUES
^C_WASWERE ^TEMPNAME required to fill out an Eligibility Verification Report, or EVR, since
^MONTH1 ^CALENDAR_YRFIL in order to receive VA benefits?
1. Yes
2. No
PWAVE_VA_NOW
PWAVE_VA_TYPE
PWAVE_VADISRATE
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
VABENEFITCODE
***NON-DISPLAYED ITEM***
VA_NOW
C_DODOES ^TEMPNAME receive ^TYPEVAPMTFIL now?
1. Yes
2. No
VA_LAST_REC
When did ^TEMPNAME last receive ^TYPEVAPMTFIL?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
Page 295 of 578
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
VA_START_REC
When did ^TEMPNAME start receiving ^TYPEVAPMTFIL?
Enter 0 if the person started receiving ^TYPEVAPMTFIL prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
Page 296 of 578
VA_1STAMT
How much ^DIDDO ^TEMPNAME receive in ^TYPEVAPMTFIL ^VACURAMT_FIL?
VA_GUESS
What would you estimate the monthly amount to be?
VA_1STSTART
When did ^TEMPNAME start receiving ^VAAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
VA_2NDAMT
How much did ^TEMPNAME receive in ^TYPEVAPMTFIL ^VASTART1_FIL?
VA_2NDSTART
When did ^TEMPNAME start receiving ^VAAMT2_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
Page 297 of 578
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
VA_3RDAMT
How much did ^TEMPNAME receive in ^TYPEVAPMTFIL ^VASTART2_FIL?
VA_3RDSTART
When did ^TEMPNAME start receiving ^VAAMT3_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
Page 298 of 578
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
VA_4THAMT
How much did ^TEMPNAME receive in ^TYPEVAPMTFIL ^VASTART3_FIL?
VA_4THSTART
When did ^TEMPNAME start receiving ^VAAMT4_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
VA_STARTAMT
How much did ^TEMPNAME receive in ^TYPEVAPMTFIL in ^VASTARTAMT_FIL?
CTRLNUM
**NON-DISPLAYED ITEM**
Page 299 of 578
LNO
**NON-DISPLAYED ITEM**
WC_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any money from Workers'
Compensation as a result of any kind of job-related injury or illness?
1. Yes
2. No
UC_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any money from
Unemployment Compensation?
1. Yes
2. No
UC_TYPE
^QSTNTXT_UCTYPE What type of Unemployment Compensation payments did ^TEMPNAME
receive since ^MONTH1 ^CALENDAR_YRFIL?
Mark all that apply.
1. Regular, government-provided
2. Supplemental, employer-provided
3. Other, including union benefits
4. Did not receive Unemployment Compensation
UC_CVD
Did ^TEMPNAME have a period of unemployment due to the coronavirus pandemic?
1. Yes
2. No
PWAVE_WC_NOW
PWAVE_UC_NOW
PWAVE_UC_TYPE
Page 300 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
WC_NOW
C_DODOES ^TEMPNAME receive any money from Workers' Compensation (as a result of any kind
of job-related injury or illness) now?
1. Yes
2. No
WC_LAST_REC
When did ^TEMPNAME last receive money from Workers' Compensation (as a result of any kind of
job-related injury or illness)?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
19. ^FEEDBACKWRONG
WC_START_REC
Page 301 of 578
When did ^TEMPNAME start receiving money from Workers' Compensation (as a result of any kind
of job-related injury or illness)?
Enter 0 if the person started receiving money from Workers' Compensation prior to the start of the
reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
WC_1STAMT
How much ^DIDDO ^TEMPNAME receive in Workers' Compensation ^WCCURAMT_FIL?
WC_GUESS
What would you estimate the monthly amount to be?
WC_1STSTART
When did ^TEMPNAME start receiving ^WCAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
Page 302 of 578
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
WC_2NDAMT
How much did ^TEMPNAME receive in Workers' Compensation ^WCSTART1_FIL?
WC_2NDSTART
When did ^TEMPNAME start receiving ^WCAMT2_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
Page 303 of 578
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
WC_3RDAMT
How much did ^TEMPNAME receive ^WCSTART2_FIL?
WC_3RDSTART
When did ^TEMPNAME start receiving ^WCAMT3_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
WC_4THAMT
How much did ^TEMPNAME receive ^WCSTART3_FIL?
WC_4THSTART
When did ^TEMPNAME start receiving ^WCAMT4_FIL?
Page 304 of 578
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
WC_STARTAMT
How much did ^TEMPNAME receive ^WCSTARTAMT_FIL?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
UEMP_COMP_CODE
**NON-DISPLAYED ITEM**
UC_LAST_REC
When did ^TEMPNAME last receive ^TYPEUCFIL?
Page 305 of 578
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
UC_START_REC
When did ^TEMPNAME start receiving ^TYPEUCFIL?
Enter 0 if the person started receiving ^TYPEUCFIL prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
Page 306 of 578
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
UC_OTH_REC
In which months from UC_START_REC to UC_LAST_REC did ^TEMPNAME receive
^TYPEUCFIL?
Enter 0 if the respondent received unemployment compensation in all months.
Mark all that apply.
0. All Months
1. MONTH1, CALENDAR_YEAR
2. MONTH2, CALENDAR_YEAR
3. MONTH3, CALENDAR_YEAR
4. MONTH4, CALENDAR_YEAR
5. MONTH5, CALENDAR_YEAR
6. MONTH6, CALENDAR_YEAR
7. MONTH7,CALENDAR_YEAR
8. MONTH8, CALENDAR_YEAR
9. MONTH9, CALENDAR_YEAR
10. MONTH10, CALENDAR_YEAR
11. MONTH11, CALENDAR_YEAR
12. MONTH12, CALENDAR_YEAR
13. INTV_MONTH1, INTV_YEAR
14. INTV_MONTH2, INTV_YEAR
15. INTV_MONTH3, INTV_YEAR
16. INTV_MONTH4, INTV_YEAR
17. INTV_MONTH5, INTV_YEAR
18. INTV_MONTH6, INTV_YEAR
UC_LAST_AMT
How much ^DIDDOLAST_AMT ^TEMPNAME receive in ^TYPEUCFIL ^LASTMONTH_UCCS?
UC_GUESS
What would you estimate the monthly amount to be?
Page 307 of 578
UC_WHEN_AMT
Did ^TEMPNAME get UC_LAST_AMT during all months of receipt?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
MONTHCODE
**NON-DISPLAY ITEM**
UEMP_COMP_CODE
**NON-DISPLAYED ITEM**
UC_OTH_AMT
Intro fill to make FR aware of temporal switch much ^TYPEUCFIL did ^TEMPNAME receive in
^OTH_MONTHFIL?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
UTILITIES
^DIDFIL_UTILYN pay ^SEPARATE_UTILYN for water, electricity, gas, or oil?
1. Yes
2. No
Page 308 of 578
ENERGY_ASST
? [F1]
^HAVEYOUFIL_EGYASSYN received any energy assistance from the Federal, State, or Local
government at any time between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL?
1. Yes
2. No
ENERGY_PMT1
? [F1]
Was this assistance received in the form of...
...checks sent to the household?
(...coupons or vouchers sent to the household?)
(...payments sent directly to the utility company, fuel dealer, or landlord?)
1. Yes
2. No
ENERGY_PMT2
? [F1]
(Was this assistance received in the form of...)
(...checks sent to the household?)
...coupons or vouchers sent to the household?
(...payments sent directly to the utility company, fuel dealer, or landlord?)
1. Yes
2. No
ENERGY_PMT3
? [F1]
(Was this assistance received in the form of...)
(...checks sent to the household?)
(...coupons or vouchers sent to the household?)
...payments sent directly to the utility company, fuel dealer, or landlord?
Page 309 of 578
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SCHOOL_LUNCH
? [F1]
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,
^DIDFIL_SCHOOLMEALS usually get the lunch that ^THEIRFIL_SCHOOLMEALS school
provides?
Display the first and last name(s) of all children where LNGD_MEALS=LNO.
1. Yes
2. No
WHO_LUNCH
? [F1]
Which children usually got the school lunch?
Mark all that apply.
1. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
2. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
3. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
4. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
5. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
6. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
7. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
8. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
9. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
10. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
Page 310 of 578
11. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
12. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
13. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
14. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
15. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
16. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
17. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
18. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
19. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
20. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
21. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
22. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
23. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
24. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
25. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
26. Child not listed
FREE_LUNCH
? [F1]
Were these lunches...
Read answer categories.
1. Free?
2. Reduced-price?
3. Full price (did not qualify)?
SCHOOL_BREAKFAST
? [F1]
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,
^DIDFIL_SCHOOLMEALS usually get the breakfast that ^THEIRFIL_SCHOOLMEALS school
provides?
Display the first and last name(s) of all children where LNGD_MEALS=LNO.
1. Yes
2. No
Page 311 of 578
WHO_BREAKFAST
? [F1]
Which children usually got the school breakfast?
Mark all that apply.
1. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
2. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
3. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
4. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
5. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
6. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
7. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
8. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
9. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
10. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
11. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
12. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
13. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
14. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
15. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
16. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
17. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
18. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
19. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
20. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
21. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
22. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
23. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
24. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
25. Display the LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_ROS
26. Child not listed
FREE_BREAKFAST
? [F1]
Were these breakfasts...
Read answer categories.
Page 312 of 578
1. Free?
2. Reduced-price?
3. Full price (did not qualify)?
ECVDMEAL
Did ^PTEMPNAME child(ren) continue receiving free or reduced price meals through
^PTEMPNAME school or school district if schools were closed during the coronavirus
pandemic?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SSC_ANY
Since ^MONTH1 ^CALENDAR_YRFIL, did ^TEMPNAME receive any Social Security on behalf of a
child?
1. Yes
2. No
SSKIDCOV
^QSTNTXT_SSKIDCOV Who was covered by the Social Security income you received since
^MONTH1 ^CALENDAR_YRFIL?
Mark all that apply.
Page 313 of 578
1. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
2. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
3. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
4. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
5. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
6. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
7. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
8. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
9. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
10. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
11. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
12. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
13. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
14. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
15. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
16. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
17. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
18. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
19. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
20. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
21. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
22. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
23. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
24. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
25. Display the LNO, ^FNAME, ^LNAME where AGE<18 and the resondent is the child's parent or guardian (and PE
26. Someone not listed
27. Did not receive Social Security on behalf of a child
REASON_CHILD
What are the reasons ^TEMPNAME AREIS receiving Social Security on behalf of
since ^MONTH1 ^CALENDAR_YRFIL?
Read name(s)
Display the first and last name of all children selected in SSKIDCOV under
the heading Children. If SSKIDCOV=26, display "this child" instead of
nothing.
Mark all that apply.
1. Surviving child
2. Dependent child
Page 314 of 578
PWAVE_SSC_NOW
PWAVE_SSKIDCOV
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SSC_NOW
C_DODOES ^TEMPNAME receive Social Security on behalf of
Read name(s) now?
Display the first and last name of the children identified in SSKIDCOV under
the heading "Child(ren)". Display "this child" if SSKIDCOV=26.
1. Yes
2. No
SSC_LAST_REC
When did ^TEMPNAME last receive Social Security on behalf of ^THISTHESECHILDREN?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
Page 315 of 578
SSC_START_REC
When did ^TEMPNAME start receiving Social Security on behalf of ^THISTHESECHILDREN?
Enter 0 if the person starting receiving Social Security on behalf of ^THISTHESECHILDREN prior to
the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SSC_1STAMT
How much ^DIDDO ^TEMPNAME receive in Social Security, before any deductions were taken
out, on behalf of ^THISTHESECHILDREN before any deductions were taken out
^SSCCURAMT_FIL?
SSC_GUESS
What would you estimate the monthly amount to be?
Ask respondent to please report the gross amount, that is before any deductions are taken out.
SSC_1STSTART
When did ^TEMPNAME start receiving ^SSCAMT1_FIL?
Page 316 of 578
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SSC_2NDAMT
How much did ^TEMPNAME receive in Social Security before any deductions were taken out on
behalf of ^THISTHESECHILDREN ^SSCSTART1_FIL?
SSC_2NDSTART
When did ^TEMPNAME start receiving ^SSCAMT2_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
Page 317 of 578
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SSC_3RDAMT
How much did ^TEMPNAME receive in Social Security before any deductions were taken out on
behalf of ^THISTHESECHILDREN ^SSCSTART2_FIL?
SSC_3RDSTART
When did ^TEMPNAME start receiving ^SSCAMT3_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SSC_4THAMT
Page 318 of 578
How much did ^TEMPNAME receive in Social Security before any deductions were taken out on
behalf of ^THISTHESECHILDREN ^SSCSTART3_FIL?
SSC_4THSTART
When did ^TEMPNAME start receiving ^SSCAMT4_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SSC_STARTAMT
How much did ^TEMPNAME receive in Social Security before any deductions were taken out on
behalf of ^THISTHESECHILDREN ^SSCSTARTAMT_FIL?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
Page 319 of 578
SSS_ANY
? [F1]
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any Social Security income
for ^HIMHERSELF?
1. Yes
2. No
REASON_SELF
^QSTNTXT_REASONSELF What are the reasons ^HESHE received Social Security since
^MONTH1 ^CALENDAR_YRFIL?
Mark all that apply.
1. Retired
2. Disabled
3. Widowed
4. Spouse
5. Other reason
6. Did not receive Social Security
REASON_SP
What was the other reason ^TEMPNAME received Social Security?
AGEGESS
At what age did ^TEMPNAME begin receiving Social Security (for ^HIMHERSELF) because of
^HISHER disability?
Report age in years.
JOINT_SS
(Since ^MONTH1 1st ^CALENDAR_YRFIL,) Did ^TEMPNAME receive Social Security jointly with
^HISHER spouse?
1. Yes
2. No
Page 320 of 578
PWAVE_SS_NOW
PWAVE_REASONSELF
PWAVE_AGESS
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SSS_NOW
C_DODOES ^TEMPNAME receive Social Security for ^HIMHERSELF now?
1. Yes
2. No
SSS_LAST_REC
When did ^TEMPNAME last receive Social Security (for ^HIMHERSELF)?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
Page 321 of 578
SSS_START_REC
When did ^TEMPNAME start receiving Social Security (for ^HIMHERSELF)?
Enter 0 if the person started receiving Social Security prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SSS_1STAMT
How much ^DIDDO ^TEMPNAME receive in Social Security, before any deductions ^AREWERE
taken out, ^SSSCURAMT_FIL?
SSS_GUESS
What would you estimate the monthly amount to be?
Ask respondent to please report the gross amount, that is before any deductions are taken out.
SSS_1STSTART
When did ^TEMPNAME start receiving ^SSSAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
Page 322 of 578
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SSS_2NDAMT
How much did ^TEMPNAME receive in Social Security, before any deductions were taken out,
^SSSSTART1_FIL?
SSS_2NDSTART
When did ^TEMPNAME start receiving ^SSSAMT2_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
Page 323 of 578
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SSS_3RDAMT
How much ^DIDDO ^TEMPNAME receive in Social Security, before any deductions were taken
out, ^SSSSTART2_FIL?
SSS_3RDSTART
When did ^TEMPNAME start receiving ^SSSAMT3_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SSS_4THAMT
How much did ^TEMPNAME receive in Social Security, before any deductions were taken out,
^SSSSTART3_FIL?
Page 324 of 578
SSS_4THSTART
When did ^TEMPNAME start receiving ^SSSAMT4_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SSS_STARTAMT
How much did ^TEMPNAME receive in Social Security, before any deductions were taken out, in
^SSSSTARTAMT_FIL?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SSSPARB
? [F1]
Earlier ^TEMPNAME stated ^HESHE ^HAVHAS Medicare medical insurance, also called Part B.
Page 325 of 578
C_DODOES ^TEMPNAME have the premium taken out of ^HISHER Social Security benefit before
it reaches HIMHER?
1. Yes
2. No
SSPARTBAMT
How much is deducted from ^PTEMPNAME monthly Social Security benefits?
SSPARTC
? [F1]
Earlier ^TEMPNAME stated ^HESHE ^HAVHAS a Medicare Advantage Plan, also called Part C.
C_DODOES ^TEMPNAME have the premium taken out of ^HISHER Social Security benefit before
it reaches HIMHER?
1. Yes
2. No
SSPARTCAMT
How much is deducted from ^PTEMPNAME monthly Social Security benefits?
SSPARTCAMT_PD
How much did ^TEMPNAME pay per month for Medicare Part C?
SSPARTD
? [F1]
Earlier ^TEMPNAME stated ^HESHE ^HAVHAS prescription drug coverage through Medicare,
also called Medicare Part D.
C_DODOES ^TEMPNAME have the premium taken out of ^HISHER Social Security benefit before
it reaches HIMHER?
1. Yes
2. No
Page 326 of 578
SSPARTDAMT
How much is deducted from ^PTEMPNAME monthly Social Security benefits?
SSPARTDAMT_PD
How much did ^TEMPNAME pay per month for Medicare Part D?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
DISABL
C_DODOES ^TEMPNAME have a physical, mental, or other health condition that limits the kind or
amount of work ^HESHE can do at a job or business?
1. Yes
2. No
TAX_RETURNS_FLAG
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
LMPNOW
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME
receive any severance pay or lump sum payments from a pension or retirement plan?
1. Yes
2. No
Page 327 of 578
LUMPTYP
What type of payment was that?
(Anything else?)
Mark all that apply.
1. Lump sum from a pension/retirement plan
2. Severance pay
3. Deferred payment/final paycheck
4. Something else
LUMPTYP_SP
What was the other type?
LUMPAMT
What was the total amount of lump sum payments ^TEMPNAME received between ^MONTH1 1st
and the end of ^LASTMONTH ^CALENDAR_YRFIL?
Round the amount to the nearest dollar.
ROLLOVR1
Did ^HESHE re-invest or roll-over any of the money into an IRA or some other kind of retirement
plan?
1. Yes
2. No
ROLLOVR2
C_DODOES ^HESHE plan to re-invest or roll-over any of the money?
1. Yes
2. No
ROLLAMT
How much ^PLANFIL_ROLLAMT roll-over into another retirement account?
Round the amount to the nearest dollar.
Page 328 of 578
DEFERAMT
What was the amount of the deferred payment or final paycheck ^TEMPNAME received between
^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?
Round the amount to the nearest dollar.
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
DIS_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL ^OTHERTHAN_DISANY, did ^TEMPNAME receive any
income because of ^HISHER health condition?
1. Yes
2. No
DIS_TYPE
N, ? [F1]
^QSTNTXT_DISTYPE What type of disability income did ^TEMPNAME receive since ^MONTH1
^CALENDAR_YRFIL?
Mark all that apply.
1. Payments from a sickness, accident, or disability insurance policy
2. Employer disability payments
3. Pension from a company or union including income from a profit-sharing plan
4. Federal Civil Service or other Federal civilian employee pension
5. State government pension
6. Local government pension
7. U.S. Military retirement pay
8. U.S. Government Railroad Retirement
9. Black Lung benefits
10. Other disability income
Page 329 of 578
11. Did not receive disability payments
DIS_TYPETWO
Did ^TEMPNAME purchase that policy on ^HISHER own?
1. Yes
2. No
DISTYPE_SP
What was that other type of disability income?
PWAVE_DIS_NOW
**NON-DISPLAYED ITEM**
PWAVE_DIS_TYPE
PWAVE_DISTYPE_SP
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
DISABLECODE
**NON-DISPLAYED ITEM**
DIS_NOW
C_DODOES ^TEMPNAME receive ^DISABILITY_TYPE now?
1. Yes
2. No
DIS_LAST_REC
When did ^TEMPNAME last receive ^DISABILITY_TYPE?
Page 330 of 578
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
DIS_START_REC
When did ^TEMPNAME start receiving ^DISABILITY_TYPE?
Enter 0 if the person started receiving ^DISABILITY_TYPE prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
Page 331 of 578
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
DIS_1STAMT
How much ^DIDDO ^TEMPNAME receive in ^DISABILITY_TYPE ^DISCURAMT?
DIS_GUESS
What would you estimate the monthly amount to be?
DIS_1STSTART
When did ^TEMPNAME start receiving ^DISAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
DIS_2NDAMT
How much did ^TEMPNAME receive in ^DISABILITY_TYPE ^DISSTART1_FIL?
Page 332 of 578
DIS_2NDSTART
When did ^TEMPNAME start receiving ^DISAMT2_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
DIS_3RDAMT
How much did ^TEMPNAME receive in ^DISABILITY_TYPE ^DISSTART2_FIL?
DIS_3RDSTART
When did ^TEMPNAME start receiving ^DISAMT3_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
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10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
DIS_4THAMT
How much did ^TEMPNAME receive in ^DISABILITY_TYPE ^DISSTART3_FIL?
DIS_4THSTART
When did ^TEMPNAME start receiving ^DISAMT4_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
DIS_STARTAMT
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How much did ^TEMPNAME receive in ^DISABILITY_TYPE in ^DISSTARTAMT_FIL?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SUR_ANY
^OTHERTHANFIL_SURANY ^SSHLTHRETFIL_SURANY ^DIDFIL_SURANY ^TEMPNAME receive
any ^OTHERFIL_SURANY income as a result of being a ^WIDOWFIL_SURANY?
1. Yes
2. No
SUR_TYPE
N
^QSTNTXT_SURTYPE What type of survivor income did ^TEMPNAME receive since ^MONTH1
^CALENDAR_YRFIL?
Mark all that apply.
1. Pension from a company or union including income from a profit-sharing plan
2. Veterans' compensation or pension
3. Federal Civil Service or other Federal civilian employee pension
4. U.S. Government Railroad Retirement
5. State government pension
6. Local government pension
7. Income from a paid-up life insurance policy or annuity
8. Military retirement pay
9. Black Lung benefits
10. Workers' Compensation
11. Payments from an estate or trust
12. National Guard or Reserve Forces retirement
13. Other survivor income
14. Did not receive survivor income
Page 335 of 578
SURTYPE_SP
What was that other type of survivor income?
PWAVE_SUR_NOW
PWAVE_SUR_TYPE
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SURVRCODE
**NON-DISPLAYED ITEM**
SUR_NOW
C_DODOES ^TEMPNAME receive ^SURVIVOR_TYPE now?
1. Yes
2. No
SUR_LAST_REC
When did ^TEMPNAME last receive ^SURVIVOR_TYPE?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
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14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SUR_START_REC
When did ^TEMPNAME start receiving ^SURVIVOR_TYPE?
Enter 0 if the person starting receiving ^SURVIVOR_TYPE prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SUR_1STAMT
How much ^DIDDO ^TEMPNAME receive in ^SURVIVOR_TYPE ^SURCURAMT_FIL?
SUR_GUESS
What would you estimate the monthly amount to be?
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SUR_1STSTART
When did ^TEMPNAME start receiving ^SURAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SUR_2NDAMT
How much did ^TEMPNAME receive in ^SURVIVOR_TYPE ^SURSTART1_FIL?
SUR_2NDSTART
When did ^TEMPNAME start receiving ^SURAMT2_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
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10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SUR_3RDAMT
How much did ^TEMPNAME receive in ^SURVIVOR_TYPE ^SURSTART2_FIL?
SUR_3RDSTART
When did ^TEMPNAME start receiving ^SURAMT3_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SUR_4THAMT
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How much did ^TEMPNAME receive in ^SURVIVOR_TYPE ^SURSTART3_FIL?
SUR_4THSTART
When did ^TEMPNAME start receiving ^SURAMT4_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SUR_STARTAMT
How much did ^TEMPNAME receive in ^SURVIVOR_TYPE ^SURSTARTAMT_FIL?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
PWAVE_FCC_ANY
FCC_ANY
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Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any foster child care
payments?
1. Yes
2. No
CSAGREE
Have child support payments ever been court-ordered, or informally agreed to, for
name(s)?
Read
Display the first and last name of children under the age of 21 from both the
HH and T2 rosters where either one or both parents are not household members
and the child(ren) are NOT foster child(ren) and the respondent is the
'guardian' as specified by the question universe (NOTE: because of the age
range, this does not necessarily conform to usual guardianship flag; see
question universe)
1. Yes
2. No
CS_ANY
? [F1]
Fill to acknowledge what we know about pass-through child support ^MONTH1 1st
^CALENDAR_YRFIL, did ^TEMPNAME receive any child support payments or other financial help
from the ^PARFIL_CSANY of Read name(s)?
Do not include alimony.
Display the first and last name of children under the age of 21 on both the
HH and T2 rosters where either one or both parents are not household members
and the child(ren) are NOT foster child(ren) and for whom the Respondent is
the guardian as specified in question universe for CSAGREE.
1. Yes
2. No
3. No - absent parent deceased (volunteered)
PWAVE_ALI_ANY
ALI_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any payments from
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^FORMERFIL_ALI_ANY spouse, such as alimony or spousal support?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SUPPORTPMTCODE
**NON-DISPLAYED ITEM**
SUP_LAST_REC
When did ^TEMPNAME last receive ^FMLY_SUP_TYPE?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
19. ^FEEDBACKWRONG
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SUP_START_REC
When did ^TEMPNAME start receiving ^FMLY_SUP_TYPE?
Enter 0 if the person starting receiving ^FMLY_SUP_TYPE prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
SUP_OTH_REC
In which months from ^SUP_START_REC to ^SUP_LAST_REC did ^TEMPNAME
receive^FMLY_SUP_TYPE?
Enter 0 if the respondent received ^FMLY_SUP_TYPE in all months.
Mark all that apply.
0. All Months
1. MONTH1, CALENDAR_YEAR
2. MONTH2, CALENDAR_YEAR
3. MONTH3, CALENDAR_YEAR
4. MONTH4, CALENDAR_YEAR
5. MONTH5, CALENDAR_YEAR
6. MONTH6, CALENDAR_YEAR
7. MONTH7,CALENDAR_YEAR
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8. MONTH8, CALENDAR_YEAR
9. MONTH9, CALENDAR_YEAR
10. MONTH10, CALENDAR_YEAR
11. MONTH11, CALENDAR_YEAR
12. MONTH12, CALENDAR_YEAR
13. INTV_MONTH1, INTV_YEAR
14. INTV_MONTH2, INTV_YEAR
15. INTV_MONTH3, INTV_YEAR
16. INTV_MONTH4, INTV_YEAR
17. INTV_MONTH5, INTV_YEAR
18. INTV_MONTH6, INTV_YEAR
SUP_LAST_AMT
How much ^DIDDOLAST_AMT ^TEMPNAME receive in ^FMLY_SUP_TYPE ^LASTMONTH_UCCS?
SUP_GUESS
What would you estimate the monthly amount to be?
SUP_WHEN_AMT
Did ^TEMPNAME get ^SUP_LAST_AMT during all months of receipt?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
MONTHCODE
**NON-DISPLAY ITEM**
SUPPORTPMTCODE
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**NON-DISPLAYED ITEM**
sup_oth_amt
Intro fill to make FR aware of temporal switch much in ^FMLY_SUP_TYPE did ^TEMPNAME
receive in ^OTH_MONTHFIL?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
ANYKID
Did ^TEMPNAME have any children under 21 years of age who lived elsewhere with their other
parent or guardian at any time between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL?
Do not include children who were away at school and were considered part of this household. On the
other hand, if a child is away at school and was considered part of the other parent or guardian's
household, then they should be included.
1. Yes
2. No
NUMKIDS
How many children?
SUPPORTPAY
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME
make any payments for the support of ^CHILDCHILDREN_CS_SUPPORTPAY (who lived
elsewhere)?
Include any payments:
... made directly to the other parent or guardian,
... made through a court or agency, or
... withheld from this person's paycheck.
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1. Yes
2. No
AMOUNTPAID
What was the total amount of support payments ^TEMPNAME made for
^CHILDCHILDREN_CS_AMTPAY between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL?
Count all forms of child support payments, including:
... payments made directly to the other parent or guardian,
... payments made through a court or agency, or
... payments withheld from this person's paycheck.
TIMESPENT
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, about how often did
^TEMPNAME see ^CS_THISCHILDYOUNGESTCHILD (who lived elsewhere)?
0. Not at all
1. About once a year
2. Several times a year
3. One to three times a month
4. About once a week
5. Several times a week
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
OTHERSUPPORT
The following questions are about regular or lump sum support payments ^TEMPNAME might
have made between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL to people
living outside ^HISHER household.
To which people who lived outside ^HISHER household did ^TEMPNAME make support
payments: Read answer categories.
Page 346 of 578
Mark all that apply.
Payments can be either mandatory or voluntary.
Do not include people who were away at school and who were considered part of this household.
Supported parents who are not the respondent's own (i.e., in-laws) should be classified as "Someone
else not related to HIMHER".
Supported children who are not the respondent's own should be classified as either "Someone else
related to HIMHER" or "Someone else not related to HIMHER".
1. ^C_PTEMPNAME parent or parents?
2. ^C_PTEMPNAME child 21 years old or older who lived elsewhere?
3. Someone else related to ^TEMPNAME (excluding ^HISHER children under 21 living elsewhere)?
4. ^C_PTEMPNAME ex-spouse or ex-partner (Or current spouse or partner living elsewhere)?
5. Someone else not related to ^TEMPNAME?
6. Did not make support payments?
NUMPARSUP
How many parents did ^TEMPNAME make support payments for (between ^MONTH1 1st and the
end of ^LASTMONTH ^CALENDAR_YRFIL)?
PARTOTAMT
What was the total amount ^TEMPNAME paid in support for ^HISHER parent(s) between
^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?
NUMKIDSUP
How many of ^PTEMPNAME children 21 years old and older who lived elsewhere did
^TEMPNAME make support payments for (between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL)?
KIDTOTAMT
What was the total amount ^TEMPNAME paid in support for ^HISHER children 21 years old or
older who lived elsewhere between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL?
NUMORSUP
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How many relatives (other than parents and children) did ^TEMPNAME make support payments for
(between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)?
ORTOTAMT
What was the total amount ^TEMPNAME paid in support for ^THISTHESE_ORSUP between
^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?
NUMEXSUP
How many current or ex-spouses (or partners) who lived elsewhere did ^TEMPNAME make
support payments for (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)?
This support includes payments such as alimony or spousal support.
EXTOTAMT
What was the total amount ^TEMPNAME paid in support for ^HISHER current or ex-spouse(s) (or
partner(s)) between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?
NUMNRSUP
How many non-relatives did ^TEMPNAME make support payments for (between ^MONTH1 1st and
the end of ^LASTMONTH ^CALENDAR_YRFIL)?
NRTOTAMT
What was the total amount ^TEMPNAME paid in support for ^THISTHESE_NRSUP between
^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
FILING
Did ^TEMPNAME file a federal income tax return during ^CALENDAR_YEAR for tax year
^CALENDAR_YEAR-1 ?
Page 348 of 578
1. Yes
2. No
WILLFILE
C_DODOES ^TEMPNAME plan to file a federal income tax return for tax year
^CALENDAR_YEAR-1?
1. Yes
2. No
FSTATUS
What ^WASWILL ^PTEMPNAME filing status on ^HISHER tax year ^CALENDAR_YEAR-1 federal
income tax return...
Read answer categories.
Respondents should report their filing status for their ^CALENDAR_YEAR-1 tax return.
To file as a head of household, you must be unmarried and have dependents.
1. Single?
2. Married filing jointly?
3. Married filing separately?
4. Head of household?
DEPCLM
^C_FILED_WASWERE claimed as a dependent on ^PTEMPNAME parent's or someone else's
income tax return for tax year ^CALENDAR_YEAR-1?
1. Yes
2. No
EITC
^C_DIDWILL ^TEMPNAME claim an Earned Income Tax Credit (EITC) on ^HISHER tax year
^CALENDAR_YEAR-1 federal income tax return?
The EITC is a benefit for people who work and have low to moderate wage earnings. The EITC
reduces the amount of taxes you may owe and often results in an income benefit to the eligible federal
tax filer.
Page 349 of 578
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
INCOME_TYPE
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME
receive any money or income from any of the following sources...
Read answer categories.
Do not include any money or income received from the government due to the
coronavirus pandemic. Mark all that apply.
1. A community or religious charity?
2. Family or friends?
3. Roomers or boarders?
4. Estates?
5. Incidental or casual earnings?
6. Miscellaneous cash income (such as lottery winnings)?
7. National Guard or Reserve Pay?
8. Did not receive money from any of these sources?
AMOUNT_TOTAL
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL), how much did you
receive from ^THISTHESE_MISC?
Read list:
Display all selections from INCOME_TYPE.
AMOUNT_GUESS
L
Page 350 of 578
What would you estimate the annual amount to be- less than $200, $200 to $400, $400 to $600,
$600 to $800, or more than $800?
1. Less than $200
2. $200-399
3. $400-599
4. $600-799
5. $800 or more
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
FOOD_TYPE1
Do not include any assistance previously reported (such as ^FOODFIL).
Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the
following types of food assistance...
... Money, vouchers, or certificates to buy groceries or food (Other than Food Stamps) ?
(... Bags of groceries or packaged foods?)
(... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?)
(... Any other food assistance?)
1. Yes
2. No
FOOD_TYPE2
Do not include any assistance previously reported (such as ^FOODFIL).
(Between ^MONTH1 and December ^CALENDAR_YEAR, did ^TEMPNAME receive any of the following
types of food assistance...)
(... Money, vouchers, or certificates to buy groceries or food (Other than Food Stamps)?)
Page 351 of 578
... Bags of groceries or packaged foods?
(... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?)
(... Any other food assistance?)
1. Yes
2. No
FOOD_TYPE3
Do not include any assistance previously reported (such as ^FOODFIL).
(Between ^MONTH1 and December ^CALENDAR_YEAR, did ^TEMPNAME receive any of the following
types of food assistance...)
(... Money, vouchers, or certificates to buy groceries or food (Other than Food Stamps)?)
(... Bags of groceries or packaged foods?)
... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?
(... Any other food assistance?)
1. Yes
2. No
FOOD_OTH
Do not include any assistance previously reported (such as ^FOODFIL).
(Between ^MONTH1 and December ^CALENDAR_YEAR, did ^TEMPNAME receive any of the following
types of food assistance...)
(... Money, vouchers, or certificates to buy groceries or food (Other than Food Stamps)?)
(... Bags of groceries or packaged foods?)
(... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?)
... Any other food assistance?
1. Yes
2. No
FOOD_SP
What was the other type of food assistance ^TEMPNAME received?
FOOD_SOURCE
Page 352 of 578
Was this food assistance provided by...
Read answer categories.
Mark all that apply.
1. A Government agency?
2. A community or religious charity?
3. Family or friends?
4. Someplace else?
FOOD_SOURCE_SP
What was the other source of food assistance?
FOOD_WHEN
During which months did ^TEMPNAME receive food assistance?
Mark all that apply.
1. ^MONTH1 ^CALENDAR_YEAR
2. ^MONTH1 ^CALENDAR_YEAR
3. ^MONTH1 ^CALENDAR_YEAR
4. ^MONTH1 ^CALENDAR_YEAR
5. ^MONTH1 ^CALENDAR_YEAR
6. ^MONTH1 ^CALENDAR_YEAR
7. ^MONTH1 ^CALENDAR_YEAR
8. ^MONTH1 ^CALENDAR_YEAR
9. ^MONTH1 ^CALENDAR_YEAR
10. ^MONTH1 ^CALENDAR_YEAR
11. ^MONTH1 ^CALENDAR_YEAR
12. ^MONTH1 ^CALENDAR_YEAR
13. All months
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
Page 353 of 578
**NON-DISPLAYED ITEM**
TRANS_TYPE1
Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the
following types of transportation assistance...
... gas vouchers?
(... bus or subway tokens or passes?)
(... help registering, repairing, or insuring a car?)
(... rides to a doctor's office or medical appointment?)
(... some other kind of transportation assistance?)
Do not include any assistance previously reported (such as commuting expenses paid by an
employer).
1. Yes
2. No
TRANS_TYPE2
(Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the following
types of transportation assistance...)
(... gas vouchers?)
... bus or subway tokens or passes?
(... help registering, repairing, or insuring a car?)
(... rides to a doctor's office or medical appointment?)
(... some other kind of transportation assistance?)
Do not include any assistance previously reported (such as commuting expenses paid by an
employer.)
1. Yes
2. No
TRANS_TYPE3
(Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the following
types of transportation assistance...)
(... gas vouchers?)
(... bus or subway token or passes?)
... help registering, repairing, or insuring a car?
(... rides to a doctor's office or medical appointment?)
Page 354 of 578
(... some other kind of transportation assistance?)
Do not include any assistance previously reported (such as commuting expenses paid by an
employer).
1. Yes
2. No
TRANS_TYPE4
(Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the following
types of transportation assistance...)
(... gas vouchers?)
(... bus or subway tokens or passes?)
(... help registering, repairing, or insuring a car?)
... rides to a doctor's office or medical appointment?
(... some other kind of transportation assistance?)
Do not include any assistance previously reported (such as commuting expenses paid by an
employer).
1. Yes
2. No
TRANS_OTHER
(Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the following
types of transportation assistance...)
(... gas vouchers?)
(... bus or subway tokens or passes?)
(... help registering, repairing, or insuring a car?)
(... rides to a doctor's office or medical appointment?)
... some other kind of transportation assistance?
Do not include any assistance previously reported (such as commuting expenses paid by an
employer).
1. Yes
2. No
TRANSOTH_SP
Page 355 of 578
What was the other kind of transportation assistance ^TEMPNAME received?
GAS_SOURCE
Did ^TEMPNAME receive the gas vouchers through a government social service agency?
1. Yes
2. No
GAS_SOURCE_SP
What was the source of the gas voucher?
TOKEN_SOURCE
Did ^TEMPNAME receive the bus or subway tokens or passes through a government agency?
1. Yes
2. No
TOKEN_SOURCE_SP
What was the source of the bus or subway tokens or passes?
TRANS_WHEN
During which months did ^TEMPNAME receive transportation assistance?
Mark all that apply.
1. ^MONTH1 ^CALENDAR_YEAR
2. ^MONTH1 ^CALENDAR_YEAR
3. ^MONTH1 ^CALENDAR_YEAR
4. ^MONTH1 ^CALENDAR_YEAR
5. ^MONTH1 ^CALENDAR_YEAR
6. ^MONTH1 ^CALENDAR_YEAR
7. ^MONTH1 ^CALENDAR_YEAR
8. ^MONTH1 ^CALENDAR_YEAR
9. ^MONTH1 ^CALENDAR_YEAR
10. ^MONTH1 ^CALENDAR_YEAR
11. ^MONTH1 ^CALENDAR_YEAR
12. ^MONTH1 ^CALENDAR_YEAR
Page 356 of 578
13. All months
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CLTH_TYPE
(Between ^MONTH1 and December ^CALENDAR_YRFIL,) Did ^TEMPNAME receive any of the
following types of clothing assistance...
Read answer categories.
1. Free or reduced price clothes?
2. Money or vouchers for clothes?
3. Both free or reduced price clothes and money or vouchers?
4. (Did not receive clothing assistance.)
CLTH_SOURCE
Was this clothing assistance provided by...
Read answer categories.
Mark all that apply.
1. A Government agency?
2. A community or religious charity?
3. Family or friends?
4. An employer?
5. Someplace else?
CLTH_SOURCE_SP
What was the other source of clothing assistance?
HOUSE_ANY
Page 357 of 578
(Since ^MONTH1 ^CALENDAR_YRFIL,) Did ^TEMPNAME receive any assistance to help pay for
housing^ENERGYFIL?
1. Yes
2. No
OTHASST_WHEN
During which months did ^TEMPNAME receive ^OTHASSTFIL assistance?
Mark all that apply.
1. ^MONTH1 ^CALENDAR_YEAR
2. ^MONTH1 ^CALENDAR_YEAR
3. ^MONTH1 ^CALENDAR_YEAR
4. ^MONTH1 ^CALENDAR_YEAR
5. ^MONTH1 ^CALENDAR_YEAR
6. ^MONTH1 ^CALENDAR_YEAR
7. ^MONTH1 ^CALENDAR_YEAR
8. ^MONTH1 ^CALENDAR_YEAR
9. ^MONTH1 ^CALENDAR_YEAR
10. ^MONTH1 ^CALENDAR_YEAR
11. ^MONTH1 ^CALENDAR_YEAR
12. ^MONTH1 ^CALENDAR_YEAR
13. All months
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
WELACTV1
Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME attend any of the
following types of training...
...classes to improve basic reading or math skills?
(...job readiness training to learn about resume writing, job interviewing, or building self-esteem?)
(...job search programs or job clubs, or use any job resource centers to find out about jobs, to schedule
Page 358 of 578
interviews, or to fill out applications?)
(...training to learn a specific job skill, such as computers, car repair, nursing, day care work, or some
other job skill?)
1. Yes
2. No
WELACTV2_1
(Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME attend any of the following
types of training...)
(...classes to improve basic reading or math skills?)
...job readiness training to learn about resume writing, job interviewing, or building self-esteem?
(...job search programs or job clubs, or use any job resource centers to find out about jobs, to schedule
interviews, or to fill out applications?)
(...training to learn a specific job skill, such as computers, car repair, nursing, day care work, or some
other job skill?)
1. Yes
2. No
WELACTV2_2
(Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME attend any of the following
types of training...)
(...classes to improve basic reading or math skills?)
(...job readiness training to learn about resume writing, job interviewing, or building self-esteem?)
...job search programs or job clubs, or use any job resource centers to find out about jobs, to
schedule interviews, or to fill out applications?
(...training to learn a specific job skill, such as computers, car repair, nursing, day care work, or some
other job skill?)
1. Yes
2. No
WELACTV2_3
(Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME attend any of the following
types of training...)
(...classes to improve basic reading or math skills?)
(...job readiness training to learn about resume writing, job interviewing, or building self-esteem?)
Page 359 of 578
(...job search programs or job clubs, or use any job resource centers to find out about jobs, to schedule
interviews, or to fill out applications?)
...training to learn a specific job skill, such as computers, car repair, nursing, day care work, or
some other job skill?
1. Yes
2. No
WELACTV3
Did ^TEMPNAME ^TRAINJOB_FIL because the state or local welfare office required it, or because
^HESHE chose to do it, or for both reasons?
1. Required to ^TRAINJOB_FIL
2. Chose to ^TRAINJOB_FIL2
3. Both required and chose
WELACTV4
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME participate in any work experience
programs, such as a community service job, in exchange for ^PTEMPNAME ^TANF_FIL?
1. Yes
2. No
WORKEXP1
Did ^TEMPNAME already tell me about this work when ^HESHE reported ^PTEMPNAME
^JOBS_FIL1 with Read employer name(s)?
Display the name(s) of the respondents employer(s).
1. Yes
2. No
WHICHEXP1
Which job(s)? (Which job(s) did ^HESHE have as part of a work experience program?)
Mark all that apply.
Display list of names of the respondents employers
Page 360 of 578
0. None of the employers
1. Employer name from Jobline1
2. Employer name from Jobline2
3. Employer name from Jobline3
4. Employer name from Jobline4
5. Employer name from Jobline5
6. Employer name from Jobline 6
7. Employer name from Jobline 7
WORKEXP2
Earlier ^TEMPNAME told me that ^HESHE worked for Read employer name(s). Was this also a
work experience program where ^TEMPNAME worked at Read employer name(s) in exchange for
^PTEMPNAME ^TANF_FIL?
Display list of name(s) of all of the respondents employers
1. Yes
2. No
WHICHEXP2
Which job(s)? (Which job(s) did ^HESHE have as part of a work experience program?)
Mark all that apply.
0. None of the employers
1. Employer name from Jobline1
2. Employer name from Jobline2
3. Employer name from Jobline3
4. Employer name from Jobline4
5. Employer name from Jobline5
6. Employer name from Jobline 6
7. Employer name from Jobline 7
WORKEXP3
Did ^TEMPNAME participate in a work experience program because the state or local welfare
office required it, or because ^HESHE chose to do it, or for BOTH reasons?
1. Required to do work experience program
2. Chose to do work experience program
Page 361 of 578
3. Both required and chose
TRAIN_WHEN
During which months did ^TEMPNAME attend training?
Mark all that apply.
1. ^MONTH1 ^CALENDAR_YEAR
2. ^MONTH1 ^CALENDAR_YEAR
3. ^MONTH1 ^CALENDAR_YEAR
4. ^MONTH1 ^CALENDAR_YEAR
5. ^MONTH1 ^CALENDAR_YEAR
6. ^MONTH1 ^CALENDAR_YEAR
7. ^MONTH1 ^CALENDAR_YEAR
8. ^MONTH1 ^CALENDAR_YEAR
9. ^MONTH1 ^CALENDAR_YEAR
10. ^MONTH1 ^CALENDAR_YEAR
11. ^MONTH1 ^CALENDAR_YEAR
12. ^MONTH1 ^CALENDAR_YEAR
13. All months
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
N_DEC_JOBS
**NON-DISPLAYED ITEM**
RETIRE_INTRO
Next I'll ask some questions about ^RET_INTRO_FIL
1. Enter 1 to continue
Page 362 of 578
MAIN_JOB
Which of the following did ^YOUHESHE consider to be ^YOURHISHER main employer in
December ^REFYEAR?
Respondent must select one of the options below. If respondent is unsure, choose the job where
respondent has the most earnings.
If no main job can be identified or selected, enter CTRL+D.
1. ^JOB1_FILL
2. ^JOB2_FILL
3. ^JOB3_FILL
4. ^JOB4_FILL
5. ^JOB5_FILL
6. ^JOB6_FILL
7. ^JOB7_FILL
EVERET
^C_HAVHAS ^TEMPNAME ever retired, for any reason, from a job or business?
1. Yes
2. No
PWAVE_EVERET
**NON-DISPLAYED ITEM**
NOW_RET
**NON-DISPLAYED ITEM**
ECVD_RETIRE
^COVIDRET
1. Yes
2. No
ECVD_RET_HOW
^COVIDRET_HOW
Page 363 of 578
Read answer categories
1. postpone or delay retirement?
2. plan an earlier retirement date?
3. return to work from retirement?
4. retire later than planned?
5. retire earlier than planned?
6. Retired before pandemic began - (DO NOT READ)
7. Other reason (or no change in plans) - (DO NOT READ)
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
OWN_IRAKEO
? [F1]
Next are a couple of questions about retirement accounts. At any time between ^MONTH1 1st
and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME have an Individual
Retirement Account (IRA) or a Keogh account?
1. Yes
2. No
OWN_THR401
? [F1]
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL) Did ^TEMPNAME
^ALSOFIL own a retirement plan, such as a 401k, 403b, 503b, or thrift plan?
1. Yes
2. No
OWN_PENSION
Page 364 of 578
? [F1]
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL) ^C_WASWERE
^TEMPNAME included in a plan that provides regular payments for life based on earnings or
years on the job, such as a defined-benefit pension or cash balance plan?
1. Yes
2. No
PENSION_FUP
^DODOES ^TEMPNAME have a defined-benefit pension from a current or previous job which will
provide benefits in the future?
1. Yes
2. No
MULTI_RETIRE
***Non-displayed item***
1. Yes
2. No
RETIRE_INTRO2
Next, I'll ask more detailed questions about ^PTEMPNAME ^IRA401FIL
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
IRAKEOVAL
? [F1]
Page 365 of 578
^IRA_MULT_FIL As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total
balance or market value of the account(s) ^TEMPNAME owned?
IRAVAL_RAN
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $50,000, or more than $50,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $49,999
4. $50,000 or more
IRA_INC_YN
At any time in ^CALENDAR_YRFIL, did ^TEMPNAME receive any income or withdrawals from
^HISHER IRA or Keogh account(s)?
1. Yes
2. No
IRA_INC_AMT
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how much income did
^TEMPNAME receive (from ^HISHER IRA or Keogh account)?
IRA_INC_RANGE
Was the annual amount less than $1,000, between $1,000 and $5,000, between $5,000 and
$20,000, or more than $20,000?
1. less than $1,000
2. $1,000 to $4,999
3. $5,000 to $19,999
4. $20,000 or more
MAIN_JOB_IRA
In ^CALENDAR_YRFIL, did ^TEMPNAME have an IRA or Keogh account(s) provided through
^MJBNAME_FIL?
1. Yes
Page 366 of 578
2. No
SCNTYN_IRA
In ^CALENDAR_YRFIL, did ^HESHE contribute any money to the plan with ^MJBNAME_FIL, for
example, through payroll deductions?
1. Yes
2. No
SCNTAMT_IRA
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how much did
^TEMPNAME contribute toward this plan?
Enter 0 if the respondent made no contributions.
ECNTYN_IRA
In ^CALENDAR_YRFIL, did ^MJBNAME_FIL make contributions to this plan?
1. Yes
2. No
ECNTAMT_IRA
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how much did
^MJBNAME_FIL contribute toward this plan?
Enter 0 if ^MJBNAME_FIL made no contributions.
PREV_JOB_IRA
^PREVJOBIRA_FIL
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
Page 367 of 578
LNO
**NON-DISPLAYED ITEM**
THR401VAL
? [F1]
^THR401_MULT_FIL As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total
balance or market value of the plan(s) ^TEMPNAME participated in?
THR401VAL_RAN
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $50,000, or more than $50,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $49,999
4. $50,000 or more
THR401_INC_YN
At any time in ^CALENDAR_YRFIL, did ^TEMPNAME receive any income or withdrawals from
^HISHER 401k, 403b, 503b, or thrift plan(s)^LUMP_FIL?
1. Yes
2. No
THR401_INC_AMT
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how much income did
^TEMPNAME receive (from ^HISHER 401k, 403b, 503b, or thrift plan)?
THR401_INC_RANGE
Was the annual amount less than $1,000, between $1,000 and $5,000, between $5,000 and
$20,000, or more than $20,000?
1. less than $1,000
2. $1,000 to $4,999
3. $5,000 to $19,999
4. $20,000 or more
Page 368 of 578
MAIN_JOB_THR401
In ^CALENDAR_YRFIL, did ^TEMPNAME have a 401k, 403b, 503b, or thrift plan provided through
^MJBNAME_FIL?
1. Yes
2. No
SCNTYN_401
In ^CALENDAR_YRFIL, did ^HESHE contribute any money to the plan with ^MJBNAME_FIL, for
example, through payroll deductions?
1. Yes
2. No
SCNTAMT_401
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how much did
^TEMPNAME contribute toward this plan?
Enter 0 if the respondent made no contributions.
ECNTYN_401
In ^CALENDAR_YRFIL, did ^MJBNAME_FIL make contributions to this plan?
1. Yes
2. No
ECNTAMT_401
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how much did
^MJBNAME_FIL contribute toward this plan?
Enter 0 if ^MJBNAME_FIL made no contributions.
PREV_JOB_THR401
^PREVJOB401_FIL
1. Yes
2. No
Page 369 of 578
PENSION_INC_YN
^PENS_MULT_FIL. At any time in ^CALENDAR_YEAR, did ^TEMPNAME receive any income from
^HISHER pension or cash balance plan(s)?
1. Yes
2. No
RET_ANY
^OTHERTHANFIL_RETANY ^SSHLTHFIL_RETANY ^DIDFIL_RETANY ^TEMPNAME receive any
^OTHERFIL_RETANY retirement income?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
RET_TYPE
N
^QSTNTXT_RETTYPE What type of retirement income did ^TEMPNAME receive since ^MONTH1
^CALENDAR_YRFIL?
Mark all that apply.
1. Pension from a company or union including income from a profit-sharing plan
2. Federal Civil Service or other Federal Civilian employee pension
3. State government pension
4. Local government pension
5. Military retirement pay
6. U.S. Government Railroad Retirement
7. National Guard or Reserve Forces retirement
8. Other retirement income
9. Did not receive retirement income
Page 370 of 578
RETTYPE_SP
What was that other type of retirement income?
LIFEYN
? [F1]
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME
receive any retirement income from a paid-up life insurance policy or annuity?
1. Yes
2. No
LIFEREG
Did that come as a single lump-sum?
1. Yes
2. No
LIFEWHEN
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, during which months
did ^TEMPNAME receive retirement income from a paid-up life insurance policy or annuity?
Mark all that apply.
1. ^MONTH1 ^CALENDAR_YEAR
2. ^MONTH1 ^CALENDAR_YEAR
3. ^MONTH1 ^CALENDAR_YEAR
4. ^MONTH1 ^CALENDAR_YEAR
5. ^MONTH1 ^CALENDAR_YEAR
6. ^MONTH1 ^CALENDAR_YEAR
7. ^MONTH1 ^CALENDAR_YEAR
8. ^MONTH1 ^CALENDAR_YEAR
9. ^MONTH1 ^CALENDAR_YEAR
10. ^MONTH1 ^CALENDAR_YEAR
11. ^MONTH1 ^CALENDAR_YEAR
12. ^MONTH1 ^CALENDAR_YEAR
13. All months
LIFEAMT
Page 371 of 578
What was the total amount of life insurance payments ^TEMPNAME received between ^MONTH1
1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?
PWAVE_RET_NOW
PWAVE_RET_TYPE
PWAVE_RETTYPE_SP
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
RETIRECODE
**NON-DISPLAYED ITEM**
RET_NOW
C_DODOES ^TEMPNAME receive ^RETIREMENT_TYPE now?
1. Yes
2. No
RET_LAST_REC
Whe did ^TEMPNAME last receive ^RETIREMENT_TYPE?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
Page 372 of 578
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
RET_START_REC
When did ^TEMPNAME start receiving ^RETIREMENT_TYPE?
Enter 0 if the person started receiving ^RETIREMENT_TYPE prior to the start of the reference period.
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
RET_1STAMT
How much ^DIDDO ^TEMPNAME receive in ^RETIREMENT_TYPE ^RETCURAMT_FIL?
RET_GUESS
What would you estimate the montly amount to be?
Page 373 of 578
RET_1STSTART
When did ^TEMPNAME start receiving ^RETAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
RET_2NDAMT
How much did ^TEMPNAME receive in ^RETIREMENT_TYPE ^RETSTART1_FIL?
RET_2NDSTART
When did ^TEMPNAME start receiving ^RETAMT2_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
Page 374 of 578
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
RET_3RDAMT
How much did ^TEMPNAME receive in ^RETIREMENT_TYPE ^RETSTART2_FIL?
RET_3RDSTART
When did ^TEMPNAME start receiving ^RETAMT3_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
RET_4THAMT
Page 375 of 578
How much did ^TEMPNAME receive in ^RETIREMENT_TYPE ^RETSTART3_FIL?
RET_4THSTART
When did ^TEMPNAME start receiving ^RETAMT4_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
RET_STARTAMT
How much did ^TEMPNAME receive in ^RETIREMENT_TYPE ^RETSTARTAMT_FIL?
MAIN_JOB_PENSION
In ^CALENDAR_YRFIL, did ^TEMPNAME have a pension or cash balance plan provided through
^MJBNAME_FIL?
1. Yes
2. No
CASH_BAL
Was the plan(s) through ^MJBNAME_FIL a defined-benefit pension, a cash balance plan, or both?
Page 376 of 578
1. Defined-benefit pension
2. Cash balance plan
3. Both a defined-benefit pension and cash balance plan
SCNTYN_PEN
In ^CALENDAR_YRFIL, did ^HESHE contribute any money to the ^PEN_CASH_FIL plan with
^MJBNAME_FIL, for example, through payroll deductions?
1. Yes
2. No
SCNTAMT_PEN
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how much did
^TEMPNAME contribute toward this plan?
Enter 0 if the respondent made no contributions.
PREV_JOB_PENSION
^PREVJOBPEN_FIL
1. Yes
2. No
PENSNYN
Even though ^TEMPNAME ^DODOES not have a retirement plan through ^MJBNAME_FIL, did
^MJBNAME_FIL have any kind of pension or retirement plans for anyone in ^PTEMPNAME
company or organization?
1. Yes
2. No
INCPENS
^C_WASWERE ^TEMPNAME included in such a plan?
1. Yes
2. No
Page 377 of 578
EPREVPEN
Even though ^TEMPNAME ^DODOES not have a retirement plan through a previous job,
^HAVHAS ^TEMPNAME ever been covered by a pension or retirement plan on any previous job
or business?
Examples include a 401k you cashed out or leaving a job before you were vested.
1. Yes
2. No
PENTYP
Earlier you reported that ^TEMPNAME had ^PENTYP_FIL through ^MJBNAME_FIL. Which plan is
the most important to ^TEMPNAME?
1. The IRA or Keogh plan
2. The 401k, 403b, 503b, or thrift plan
3. The defined-benefit pension
4. The cash balance plan
N_MAIN_JOB_PLANS
***Non-displayed item***
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
ASSET_INTRO
? [F1]
Next I'll ask some questions about the value of assets ^TEMPNAME ^OWNOWNSFIL_PR, income
received from those assets, and any debts ^TEMPNAME may have. This is the additional
sentence in the Assets intro to be included when someone has a spouse.
(The Census Bureau uses the data collected to create national estimates of wealth.) We know that
people aren't used to talking about their assets, but we ask these questions to get an overall
picture of your community and the nation -- NOT to find out about ^YOUANYONEFIL personally.
Page 378 of 578
The types of assets I will be asking you about include checking and savings accounts, retirement
accounts, stocks, cars, motorcycles, and real estate.
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
AST1A
O, ? [F1]
Please only include U.S. Government savings bonds or U.S. Government securities that were owned
separately from any mutual funds.
The next few questions are about assets and other investments, either individually or jointly
owned INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL, did ^TEMPNAME own, either individually or jointly...
...any U.S. Government savings bonds or U.S. Government securities?
(...a checking account?)
(...a savings account?)
(^RETIRE_FIL)
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...mutual funds?)
(...stocks?)
1. Yes
2. No
AST2A
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
Page 379 of 578
(...any U.S. Government savings bonds or U.S. Government securities?)
...a checking account?
(...a savings account?)
(^RETIRE_FIL)
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...mutual funds?)
(...stocks?)
1. Yes
2. No
AST2B
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
(...a checking account?)
...a savings account?
(^RETIRE_FIL)
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...mutual funds?)
(...stocks?)
1. Yes
2. No
AST2C
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
(...a checking account?)
Page 380 of 578
(...a savings account?)
^RETIRE_FIL
...a money market deposit account or fund?
(...any certificates of deposit (that is, CDs)?)
(...mutual funds?)
(...stocks?)
1. Yes
2. No
AST2D
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
(...a checking account?)
(...a savings account?)
^RETIRE_FIL
(...a money market deposit account or fund?)
...any certificates of deposit (that is, CDs)?
(...mutual funds?)
(...stocks?)
1. Yes
2. No
AST3A
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
(...a checking account?)
(...a savings account?)
^RETIRE_FIL
Page 381 of 578
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
...mutual funds?
(...stocks?)
1. Yes
2. No
AST3B
O, ? [F1]
(The next few questions are about assets and other investments, either individually or jointly owned
INCLCHILDFIL. Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME own, either individually or jointly...)
(...any U.S. Government savings bonds or U.S. Government securities?)
(...a checking account?)
(...a savings account?)
^RETIRE_FIL
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...mutual funds?)
...stocks?
1. Yes
2. No
AST3C
P, ? [F1]
Read (or verify) all response options.
^ASSET2_QSTNTXT
...any municipal or corporate bonds?
(...any life insurance policies (including employer-provided policies)?)
(...rental property?)
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)
Page 382 of 578
1. Yes
2. No
MUNCOR
Were these municipal or corporate bonds separate from the mutual funds you just told me
about?
Select 'Yes' if some municipal or corporate bonds are included in mutual funds, and some are not.
1. Yes
2. No
AST5A
P, ? [F1]
Read (or verify) all response options.
(^ASSET2_QSTNTXT)
(...any municipal or corporate bonds?)
...any life insurance policies (including employer-provided policies)?
(...rental property?)
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)
1. Yes
2. No
AST4A
P, ? [F1]
Read (or verify) all response options.
(^ASSET2_QSTNTXT)
(...any municipal or corporate bonds?)
(...any life insurance policies (including employer-provided policies)?)
...rental property?
Page 383 of 578
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)
1. Yes
2. No
AST5B
P, ? [F1]
Read (or verify) all response options.
Do not include right-to-use timeshares as 'other' real estate.
(^ASSET2_QSTNTXT)
(...any municipal or corporate bonds?)
(...any life insurance policies (including employer-provided policies)?)
(...rental property?)
...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)
1. Yes
2. No
AST5E
P, ? [F1]
Read (or verify) all response options.
(^ASSET2_QSTNTXT)
(...any municipal or corporate bonds?)
(...any life insurance policies (including employer-provided policies)?)
(...rental property?)
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
...annuities and trusts?
(...businesses as an investment only?)
Page 384 of 578
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)
1. Yes
2. No
AST5F
P, ? [F1]
Read (or verify) all response options.
(^ASSET2_QSTNTXT)
(...any municipal or corporate bonds?)
(...any life insurance policies (including employer-provided policies)?)
(...rental property?)
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
(...annuities and trusts?)
...businesses as an investment only?
(...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid to
HIMHER, other loans owed to HIMHER, or royalties.)
1. Yes
2. No
AST4C
P, ? [F1]
Read (or verify) all response options.
(^ASSET2_QSTNTXT)
(...any municipal or corporate bonds?)
(...any life insurance policies (including employer-provided policies)?)
(...rental property?)
(...other real estate such as a vacation home, a deeded timeshare, or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
...or any other financial investments? Examples include coins, jewelry, artwork, mortgages paid
to HIMHER, other loans owed to HIMHER, or royalties.
1. Yes
2. No
Page 385 of 578
AST4C_SP
? [F1]
What 'other' type of financial investment(s)?
Please separate individual 'other' financial investments by the use of a comma.
VERIFY_ASSETS
^QSTNTXT_VERIFYASSETS
Read list:
Display all of the assets reported by the respondent as defined in the
special instructions.
1. Yes
2. No
FIX_ASSETS
Which assets should not be included on the list?
4. U.S. Govt. savings bonds/securities
5. Checking account
7. Savings account
8. Money market deposit account
9. Certificates of deposit
11. Mutual funds
12. Stocks
13. Municipal or corporate bonds
14. Life insurance
15. Rental property
16. Real estate
17. Annuities and trusts
18. Businesses as an investment only
19. Fill with response to item AST4C_SP
EDITRESULT
WHYSUPPRESS
Page 386 of 578
QUESTIONCONTINUE
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
LSPANSWERED
LSPANSWEREDOTH
LSPCHANSWERED
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
ASTCODE
**NON-DISPLAYED ITEM**
JT
^JT_QSTNTXT
1. Yes
2. No
JTWHO1
With whom?
^JTWHOFRNOTE_FIL
Enter 50 if the person owns the asset(s) with a non-household member.
1. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
2. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
3. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
Page 387 of 578
4. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
5. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
6. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
7. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
8. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
9. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
10. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
11. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
12. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
13. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
14. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
15. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
16. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
17. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
18. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
19. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
20. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
21. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
22. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
23. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
24. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
25. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
50. Non-household member(s)
OAST1
^INADDITIONFIL_OAST1 ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME ^ALSOFIL_OAST1 own any in ^HISHER name only?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
Page 388 of 578
LSPANSWERED
LSPANSWEREDOTH
LSPCHANSWERED
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
astcode2
**NON-DISPLAYED**
ANYJNT
^ANYJNT_QSTNTXT
1. Yes
2. No
JTWHO2
With whom?
^JTWHOFRNOTE_FIL
Enter 50 if the respondent owns the mutual funds or stocks with a non-household member.
1. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
2. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
3. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
4. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
5. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
6. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
7. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
8. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
9. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
10. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
11. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
12. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
Page 389 of 578
13. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
14. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
15. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
16. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
17. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
18. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
19. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
20. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
21. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
22. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
23. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
24. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
25. Display the LNO, ^FNAME, ^LNAME (where PEOPLE_TO_ROSTER = 1 for people on the Hhld. roster)
50. Non-household member(s)
OAST2
^INADDITIONFIL_OAST2 ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME ^ALSOFIL_OAST2 ^FNDSTCK2FIL in ^HISHER name only?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
AST2F
? [F1]
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL was anyone in
^PTEMPNAME household the owner or the beneficiary of an educational or college savings
account (such as a 529 account)?
1. Yes
2. No
NUM_EDSAV
^NUMEDSAV_QSTNTXT
Page 390 of 578
Enter 0 if nobody in the household owned or was the beneficiary of the educational or college savings
account as of the last day of ^LASTMONTH, ^CALENDAR_YEAR.
If the person or household was the owner or the beneficiary of three or more educational or college
savings accounts, the person should report the accounts with the largest balance.
CTRLNUM
**NON-DISPLAYED ITEM**
EDSAVNO
**NON-DISPLAYED ITEM**
EDSAV_OWNER
Who was the owner of the (educational or college savings) account ^123_EDSAVFIL?
1. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
2. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
3. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
4. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
5. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
6. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
7. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
8. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
9. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
10. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
11. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
12. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
13. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
14. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
15. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
16. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
17. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
18. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
19. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
20. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
50. A non-household member
Page 391 of 578
EDSAV_BENEFICIARY
Who was the beneficiary of the (educational or college savings) account?
1. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
2. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
3. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
4. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
5. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
6. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
7. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
8. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
9. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
10. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
11. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
12. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
13. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
14. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
15. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
16. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
17. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
18. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
19. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
20. Display the LNO, ^FNAME, and ^LNAME where PEOPLE_TO_ROSTER = 1
21. Display the ^FNAME and ^LNAME of a Type 2 Person
22. Display the ^FNAME and ^LNAME of a Type 2 Person
23. Display the ^FNAME and ^LNAME of a Type 2 Person
24. Display the ^FNAME and ^LNAME of a Type 2 Person
25. Display the ^FNAME and ^LNAME of a Type 2 Person
50. A non-household member
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
LSPANSWERED
LSPANSWEREDOTH
Page 392 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
ANYJTRNT
^ANYJTRNT_QSTNTXT
1. Yes
2. No
JTWHO4
With whom?
^JTWHOFRNOTE_FIL
Enter 50 if the respondent owns the rental property with a non-household member.
1. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
2. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
3. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
4. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
5. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
6. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
7. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
8. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
9. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
10. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
11. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
12. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
13. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
14. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
15. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
16. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
17. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
18. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
19. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
20. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
Page 393 of 578
21. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
22. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
23. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
24. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
25. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
50. Non-household member(s)
OWNRNT
^INADDITIONFIL_OWNRNT ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did
^TEMPNAME ^ALSOFIL_OWNRNT own any rental property in ^HISHER name only?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
LSPANSWERED
LSPANSWEREDOTH
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
ANYJTPROP
^ANYJTPROP_QSTNTXT
1. Yes
2. No
Page 394 of 578
JTWHO5
With whom?
^JTWHOFRNOTE_FIL
Enter 50 if the respondent owns the non-retirement or non-rental property, such as a second home
with a non-household member.
1. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
2. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
3. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
4. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
5. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
6. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
7. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
8. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
9. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
10. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
11. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
12. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
13. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
14. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
15. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
16. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
17. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
18. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
19. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
20. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
21. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
22. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
23. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
24. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
25. Display the LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the Hh
50. Non-household member(s)
OWNPROP
^INADDITIONFIL_OWNPROP ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,
did ^TEMPNAME ^ALSOFIL_OWNPROP own any real estate (such as a vacation home, a deeded
timeshare, or an undeveloped lot) in ^HISHER name only?
1. Yes
Page 395 of 578
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
AST5C
^VEHICLE_QSTNTXT
If respondent reports later that all vehicles in the household are leased, then change this value to "No".
1. Yes
2. No
NUM_VEHICLES
^NUMVEHICLE_QSTNTXT
Enter 0 if the household no longer owned any vehicles as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Do not include leased vehicles.
CTRLNUM
**NON-DISPLAYED ITEM**
CARNUM
**NON-DISPLAYED ITEM**
MODEL_YRX
VEHICLE ^X
What is the model year of ^WHICH_VEHICLE?
^FR_VEHICLE
MAKEX
Page 396 of 578
VEHICLE ^X
What is the make of this vehicle?
Make of vehicle is its brand name (for example: Honda or Chevrolet).
MAKEX_SP
VEHICLE ^X
What is the make of this vehicle?
MODELX
VEHICLE ^X
Read if necessary:
What is the model of this vehicle?
1. CAR_MODEL1
2. CAR_MODEL2
3. CAR_MODEL3
4. CAR_MODEL4
5. CAR_MODEL5
6. CAR_MODEL6
7. CAR_MODEL7
8. CAR_MODEL8
9. CAR_MODEL9
10. CAR_MODEL10
11. CAR_MODEL11
12. CAR_MODEL12
13. CAR_MODEL13
14. CAR_MODEL14
15. CAR_MODEL15
16. CAR_MODEL16
17. CAR_MODEL17
18. CAR_MODEL18
19. CAR_MODEL19
20. CAR_MODEL20
21. CAR_MODEL21
22. CAR_MODEL22
Page 397 of 578
23. CAR_MODEL23
24. CAR_MODEL24
25. CAR_MODEL25
26. CAR_MODEL26
27. CAR_MODEL27
28. CAR_MODEL28
29. CAR_MODEL29
30. CAR_MODEL30
31. CAR_MODEL31
32. CAR_MODEL32
33. CAR_MODEL33
34. CAR_MODEL34
35. CAR_MODEL35
36. CAR_MODEL36
37. CAR_MODEL37
38. CAR_MODEL38
39. CAR_MODEL39
40. CAR_MODEL40
41. CAR_MODEL41
42. CAR_MODEL42
43. CAR_MODEL43
44. CAR_MODEL44
45. CAR_MODEL45
46. CAR_MODEL46
MODELX_SP
VEHICLE ^X
What is the model of this vehicle?
WHO_VEHICLE
Who owns this vehicle as of the last day of ^LASTMONTH, ^CALENDAR_YEAR?
Mark all that apply.
1. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
2. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
3. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
4. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
Page 398 of 578
5. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
6. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
7. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
8. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
9. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
10. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
11. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
12. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
13. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
14. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
15. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
16. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
17. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
18. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
19. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
20. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
CTRLNUM
**NON-DISPLAYED ITEM**
AST5D
? [F1]
^RV_QSTNTXT
Do not include leased vehicles.
Only include vehicles which have not been reported already.
1. Yes
2. No
TYPE_RECVEH
^TYPERV_QSTNTXT
Mark all that apply.
Do not include leased vehicles.
Page 399 of 578
Only include vehicles which have not been reported already.
1. Motorcycle
2. Boat
3. Recreational vehicle (RV)
4. Another type of vehicle
RECVEH_SP
What 'other' type of recreational vehicle?
ADINCSRCE2
The next part of the interview is about ^PTEMPNAME income and the value of ^PTEMPNAME
assets between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL. We want to be
both as accurate and efficient as we can, so it would be very helpful if you could refer to any
records you might have. (Also -- we know that people aren't used to talking about their income and the
value of their assets, but we ask these questions to get an overall picture of your community and the
nation -- NOT to find out about ^YOUANYONEFIL personally.)
At appropriate moments, encourage respondent to get records.
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
Page 400 of 578
astcode
**NON-DISPLAYED ITEM**
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
astcode
**NON-DISPLAYED ITEM**
jintsp_pd
? [F1]
^JINTSPPD_QSTNTXT
^AST3CINT_FIL
^FRAST1A_FIL
^FRAST2A_FIL
jcatsp1y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $25, between $25 and $75, between $75 and $150, or more than $150?
1. Less than $25
2. $25 to $74.99
3. $75 to $149.99
4. $150 or more
jcatsp1value
? [F1]
Page 401 of 578
ASSET TYPE: ^C_ASNAME_BANKACCT
JCATSP_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
jcatsp1range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $500, between
$500 and $1,000, between $1,000 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $999
3. $1,000 to $4,999
4. $5,000 or more
jcatsp2y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,500, or more than $1,500?
1. Less than $100
2. $100 to $499.99
3. $500 to $1,499.99
4. $1,500 or more
jcatsp2value
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^JCATSP_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Page 402 of 578
jcatsp2range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) ^RANGEAMTFIL?
1. Less than $1,000
2. $1,000 to $4,999
3. $5,000 to $9,999
4. $10,000 or more
5. Less than $5,000
6. $5,000 to $9,999
7. $10,000 to $19,999
8. $20,000 or more
jcatsp3y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $1,500, between $1,500 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
4. $5,000 or more
jcatsp3value
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^JCATSP_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
^AST3CMV_FIL
^FRAST1AMV_FIL
jcatsp3range
Page 403 of 578
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $100,000, or more than $100,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $99,999
4. $100,000 or more
spanswered
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
astcode
**NON-DISPLAYED ITEM**
jintch_pd
? [F1]
Earlier I recorded that ^TEMPNAME owned ^ASNAME_BANKACCT jointly with Read name(s).
How much INTEREST INCOME was produced (by those joint ^ASNAME_BANKACCT) between
^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL?
^AST3CINT_FIL
^FRAST1A_FIL
^FRAST2A_FIL
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO1
jcatch1y
Page 404 of 578
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $25, between $25 and $75, between $75 and $150, or more than $150?
1. Less than $25
2. $25 to $74.99
3. $75 to $149.99
4. $150 or more
jcatch1value
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL BALANCE or
MARKET VALUE (including interest earned) of the ^ASNAME_BANKACCT ^TEMPNAME owned
jointly with Read name(s)?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO1
jcatch1range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $500, between
$500 and $1,000, between $1,000 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $999
3. $1,000 to $4,999
4. $5,000 or more
jcatch2y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
Page 405 of 578
less than $100, between $100 and $500, between $500 and $1,500, or more than $1,500?
1. Less than $100
2. $100 to $499.99
3. $500 to $1,499.99
4. $1,500 or more
jcatch2value
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
As of the last day of ^LASTMONTH ^CALENDAR_YEAR, what was the TOTAL BALANCE or
MARKET VALUE (including interest earned) of the ^ASNAME_BANKACCT ^TEMPNAME owned
jointly with Read name(s)?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO1
jcatch2range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) ^RANGEAMTFIL?
1. Less than $1,000
2. $1,000 to $4,999
3. $5,000 to $9,999
4. $10,000 or more
5. Less than $5,000
6. $5,000 to $9,999
7. $10,000 to $19,999
8. $20,000 or more
jcatch3y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
Page 406 of 578
less than $500, between $500 and $1,500, between $1,500 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
4. $5,000 or more
jcatch3value
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL BALANCE or
MARKET VALUE (including interest earned) of the ^ASNAME_BANKACCT ^TEMPNAME owned
jointly with Read name(s)?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
^AST3CMV_FIL
^FRAST1AMV_FIL
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO1.
jcatch3range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $100,000, or more than $100,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $99,999
4. $100,000 or more
spchanswered
ctrlnum
Page 407 of 578
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
astcode
**NON-DISPLAYED ITEM**
jtothint_pd
? [F1]
^JTOTHINTPD_QSTNTXT
'Share' refers to share in dollars and not to percentage share.
^AST3CINT_FIL
^FRAST1A_FIL
^FRAST2A_FIL
Display the first and last name(s) of the person(s) selected in JTWHO1 (with
the exception of the person's spouse or registered domestic or civil union
partner if one exists). Star the name(s) of the child(ren) under the age of
15 who are living in the household. Display 'a Non-household member' when
JTWHO1 = 50
jcatot1y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $25, between $25 and $75, between $75 and $150, or more than $150?
1. Less than $25
2. $25 to $74.99
3. $75 to $149.99
4. $150 or more
jcatoth1value
Page 408 of 578
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^JCATOTH_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO1 (with
the exception of the person's spouse or registered domestic or civil union
partner if one exists). Star the name(s) of the child(ren) under the age of
15 who are living in the household. Display 'a Non-household member' when
JTWHO1 = 50
jcatoth1range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $500, between
$500 and $1,000, between $1,000 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $999
3. $1,000 to $4,999
4. $5,000 or more
jcatot2y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,500, or more than $1,500?
1. Less than $100
2. $100 to $499.99
3. $500 to $1,499.99
4. $1,500 or more
jcatoth2value
Page 409 of 578
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^JCATOTH_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO1 (with
the exception of the person's spouse or registered domestic or civil union
partner if one exists). Star the name(s) of the child(ren) under the age of
15 who are living in the household. Display 'a Non-household member' when
JTWHO1 = 50
jcatoth2range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) ^RANGEAMTFIL?
1. Less than $1,000
2. $1,000 to $4,999
3. $5,000 to $9,999
4. $10,000 or more
5. Less than $5,000
6. $5,000 to $9,999
7. $10,000 to $19,999
8. $20,000 or more
jcatot3y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $1,500, between $1,500 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
4. $5,000 or more
Page 410 of 578
jcatoth3value
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^JCATOTH_QSTNTXT
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
^AST3CMV_FIL
^FRAST1AMV_FIL
Display the first and last name(s) of the person(s) selected in JTWHO1 (with
the exception of the person's spouse or registered domestic or civil union
partner if one exists). Star the name(s) of the child(ren) under the age of
15 who are living in the household. Display 'a Non-household member' when
JTWHO1 = 50
jcatoth3range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $100,000, or more than $100,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $99,999
4. $100,000 or more
spanswered
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
Page 411 of 578
astcode
**NON-DISPLAYED ITEM**
excl_cd
Earlier I recorded that ^TEMPNAME ^ALSOFIL_ASSETS owned CDs^OWNNAMEFIL_EXCL Were
those CDs included in ^PTEMPNAME ^IRA401FIL_EXCL, or did ^HESHE own them separately
from any retirement account(s) -- or both?
1. All CDs are included in IRA, Keogh, 401k,403b, or thrift accounts
2. All CDs are owned separately from retirement accounts
3. Both -- some are included in retirement accounts and some are owned separately
oint_pd
? [F1]
^INCOMENOWFIL_OINT
^EARLIERFIL_OINT How much INTEREST INCOME did ^TEMPNAME earn ^OWNNAME_FIL (from
those ASNAME_BANKACCT) between ^MONTH1 1st. and the end of ^LASTMONTH
^CALENDAR_YRFIL?
^FRAST1A_FIL
^AST3CINT_FIL
^FRAST2A_FIL
ocat1y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $25, between $25 and $75, between $75 and $150, or more than $150?
1. Less than $25
2. $25 to $74.99
3. $75 to $149.99
4. $150 or more
ocat1value
? [F1]
Page 412 of 578
ASSET TYPE: ^C_ASNAME_BANKACCT
^REG_CHKFIL As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL
BALANCE or MARKET VALUE (including interest earned) of the ^ASNAME_BANKACCT
^OWNNAME_FIL?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
ocat1range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $500, between
$500 and $1,000, between $1,000 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $999
3. $1,000 to $4,999
4. $5,000 or more
ocat2y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,500, or more than $1,500?
1. Less than $100
2. $100 to $499.99
3. $500 to $1,499.99
4. $1,500 or more
ocat2value
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL BALANCE or
MARKET VALUE (including interest earned) of the ^ASNAME_BANKACCT ^OWNNAME_FIL?
Page 413 of 578
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
ocat2range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) ^RANGEAMTFIL?
1. Less than $1,000
2. $1,000 to $4,999
3. $5,000 to $9,999
4. $10,000 or more
5. Less than $5,000
6. $5,000 to $9,999
7. $10,000 to $19,999
8. $20,000 or more
ocat3y
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st. and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $1,500, between $1,500 and $5,000, or more than $5,000?
^FRAST1A_FIL
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
4. $5,000 or more
ocat3value
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL BALANCE or
MARKET VALUE (including interest earned) of the ^ASNAME_BANKACCT ^OWNNAME_FIL?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Page 414 of 578
^AST3CMV_FIL
^FRAST1AMV_FIL
ocat3range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $100,000, or more than $100,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $99,999
4. $100,000 or more
dkint
^ASIDEFRMFIL_DKINT was the total amount of INTEREST INCOME ^TEMPNAME ^HAVHAS
earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL on all
^OTHERFIL_DKINT ^ASNAME_BANKACCT ^HESHE owned?
^FRAST1A_FIL
^AST3CINT_FIL
^FRAST2A_FIL
dkint1range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $25, between $25 and $75, between $75 and $150, or more than $150?
1. Less than $25
2. $25 to $74.99
3. $75 to $149.99
4. $150 or more
dkint2range
Page 415 of 578
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,500, or more than $1,500?
1. Less than $100
2. $100 to $499.99
3. $500 to $1,499.99
4. $1,500 or more
dkint3range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $1,500, between $1,500 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
4. $5,000 or more
dkmrktval
^ASIDEFRMFIL_DKMRKTVAL was the TOTAL BALANCE or MARKET VALUE (including interest
earned) of the ^OTHERFIL_DKMRKTVAL ^ASNAME_BANKACCT ^HESHE owned as of the last
day of ^LASTMONTH, ^CALENDAR_YEAR?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
^FRAST1AMV_FIL
^AST3CMV_FIL
dkmrktval1range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $500, between
$500 and $1,000, between $1,000 and $5,000, or more than $5,000?
1. Less than $500
Page 416 of 578
2. $500 to $999
3. $1,000 to $4,999
4. $5,000 or more
dkmrktval2range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) ^RANGEAMTFIL?
1. Less than $1,000
2. $1,000 to $4,999
3. $5,000 to $9,999
4. $10,000 or more
5. Less than $5,000
6. $5,000 to $9,999
7. $10,000 to $19,999
8. $20,000 or more
dkmrktval3range
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $5,000,
between $5,000 and $25,000, between $25,000 and $100,000, or more than $100,000?
1. Less than $5,000
2. $5,000 to $24,999
3. $25,000 to $99,999
4. $100,000 or more
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
astcode2
Page 417 of 578
**NON-DISPLAYED**
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
astcode2
**NON-DISPLAYED**
jtanywsp
^EARLIERFIL_JTANYWSP What kind of dividends did ^YOUTHEYFIL_JTANYW
^BOTHALLFIL_JTANYWSP get from those joint ^ASNAME_MFS? Were the dividends
automatically reinvested or did ^YOUTHEYFIL_JTANYW get dividend checks?
1. Dividend CHECKS
2. REINVESTED dividends
3. Both
4. Neither; no dividends received
jtdivsp_pd
? [F1]
^INCLUDEFIL_JTDIVSP ^CREDITEDFIL_JTDIVSP DIVIDEND INCOME was produced by those
joint ^ASNAME_MFS (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)?
Include reinvested dividends in income.
jdivsp1y
ASSET TYPE: MUTUAL FUNDS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $250, between $250 and $1,000, between $1,000 and $2,500, or more than $2,500?
1. Less than $250
2. $250 to $999.99
Page 418 of 578
3. $1,000 to $2,499.99
4. $2,500 or more
jdivsp1value
? [F1]
ASSET TYPE: MUTUAL FUNDS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL BALANCE or
MARKET VALUE (including dividends) of the mutual funds ^WHO_JDIVSPVALUE?
Enter 0 if the person no longer owns the mutual funds as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of mutual funds held outside of any retirement
account.
Display the first and last name(s) of the children under the age of 15 living
in the household who were selected in JTWHO2
jdivsp1range
ASSET TYPE: MUTUAL FUNDS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more
jdivsp2y
ASSET TYPE: STOCKS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,000, or more than $1,000?
1. Less than $100
2. $100 to $499.99
3. $500 to $999.99
Page 419 of 578
4. $1,000 or more
jdivsp2value
? [F1]
ASSET TYPE: STOCKS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL BALANCE or
MARKET VALUE (including dividends) of the stocks ^WHO_JDIVSPVALUE?
Enter 0 if the person no longer owns the stocks as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of stocks held outside of any retirement account.
Display the first and last name(s) of the children under the age of 15 living
in the household who were selected in JTWHO2
jdivsp2range
ASSET TYPE: STOCKS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more
spanswered
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
astcode2
Page 420 of 578
**NON-DISPLAYED**
jtanywch
^EARLIERFIL_JTANYWCH What kind of dividends did those joint ^MUTFNDSTOCKOTFIL
produce? Were the dividends automatically reinvested or did ^HESHE get dividend checks?
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO2
1. Dividend CHECKS
2. REINVESTED dividends
3. Both
4. Neither; no dividends received
jtdivch_pd
? [F1]
^INCLUDEFIL_JTDIVCH ^CREDITEDFIL_JTDIVCH DIVIDEND INCOME was produced by those
joint ^ASNAME_MFS (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)?
Include reinvested dividends in income.
jdivch1y
ASSET TYPE: MUTUAL FUNDS
Wass the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $250, between $250 and $1,000, between $1,000 and $2,500, or more than $2,500?
1. Less than $250
2. $250 to $999.99
3. $1,000 to $2,499.99
4. $2,500 or more
jdivch1value
? [F1]
ASSET TYPE: MUTUAL FUNDS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL BALANCE or
Page 421 of 578
MARKET VALUE (including dividends) of the mutual funds ^TEMPNAME owned jointly with
name(s)?
Read
Enter 0 if the person no longer owns the mutual funds as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of mutual funds held outside of any retirement
account.
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO2
jdivch1range
ASSET TYPE: MUTUAL FUNDS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more
jdivch2y
ASSET TYPE: STOCKS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1,000, or more than $1,000?
1. Less than $100
2. $100 to $499.99
3. $500 to $999.99
4. $1,000 or more
jdivch2value
? [F1]
ASSET TYPE: STOCKS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL BALANCE or
Page 422 of 578
MARKET VALUE (including dividends) of the stocks ^TEMPNAME owned jointly with
name(s)?
Read
Enter 0 if the person no longer owns the stocks as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of stocks held outside of any retirement account.
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO2
jdivch2range
ASSET TYPE: STOCKS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more
spchanswered
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
astcode2
**NON-DISPLAYED**
jtothany
^EARLIERFIL_JTOTHANY What kind of dividends did those joint ^MUTFNDSTOCKOTFIL
produce? Were the dividends automatically reinvested or did ^YOUTHEYFIL_JTANYW get
dividend checks?
Page 423 of 578
Display the first and last name(s) of the person(s) selected in JTWHO2 (with
the exception of the person's spouse or registered domestic or civil union
parter if one exists). Star the name(s) of the child(ren) under the age of 15
who are living in the household. Display 'a non-household member(s)' when
JTWHO1 = 50
1. Dividend CHECKS
2. REINVESTED dividends
3. Both
4. Neither; no dividends received
jtothdiv_pd
? [F1]
^INCLUDEFIL_JTOTHDIV was ^PTEMPNAME^ANDWHO_JTOTHDIV share, in dollars, of the
^CREDITEDFIL_JTOTHDIV DIVIDEND INCOME that was produced by those joint
^MUTFNDSTOCKOTFIL (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)?
'Share' refers to share in dollars and not to percentage share.
Include reinvested dividends in income.
Display the first and last name(s) of the person(s) selected in JTWHO2 (with
the exception of the person's spouse or registered domestic or civil union
parter if one exists). Star the name(s) of the child(ren) under the age of 15
who are living in the household. Display 'a non-household member(s)' when
JTWHO1 = 50
jdivot1y
ASSET TYPE: MUTUAL FUNDS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $250, between $250 and $1,000, between $1,000 and $2,500, or more than $2,500?
1. Less than $250
2. $250 to $999.99
3. $1,000 to $2,499.99
4. $2,500 or more
jdivot1value
Page 424 of 578
? [F1]
ASSET TYPE: MUTUAL FUNDS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was
^PTEMPNAME^ANDWHO_JTOTHDIV share, in dollars, of the TOTAL BALANCE or MARKET
VALUE (including dividends) of the mutual funds ^TEMPNAME owned jointly?
Enter 0 if the person no longer owns the mutual funds as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of mutual funds held outside of any retirement
account.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO2 (with
the exception of the person's spouse or registered domestic or civil union
parter if one exists). Star the name(s) of the child(ren) under the age of 15
who are living in the household. Display 'a non-household member(s)' when
JTWHO1 = 50
jdivot1range
ASSET TYPE: MUTUAL FUNDS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more
jdivot2y
ASSET TYPE: STOCKS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $100, between $100 and $500, between $500 and $1000, or more than $1,000?
1. Less than $100
2. $100 to $499.99
3. $500 to $999.99
Page 425 of 578
4. $1,000 or more
jdivot2value
? [F1]
ASSET TYPE: STOCKS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was
^PTEMPNAME^ANDWHO_JTOTHDIV share, in dollars, of the TOTAL BALANCE or MARKET
VALUE (including dividends) of the stocks ^TEMPNAME owned jointly?
Enter 0 if the person no longer owns the stocks as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of stocks held outside of any retirement account.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO2 (with
the exception of the person's spouse or registered domestic or civil union
parter if one exists). Star the name(s) of the child(ren) under the age of 15
who are living in the household. Display 'a non-household member(s)' when
JTWHO1 = 50
jdivot2range
ASSET TYPE: STOCKS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more
spanswered
ctrlnum
**NON-DISPLAYED ITEM**
Page 426 of 578
lno
**NON-DISPLAYED ITEM**
astcode2
**NON-DISPLAYED**
exclude
Earlier I recorded that ^TEMPNAME ^ALSOFIL_EXCLUDE owned ^SOMEFIL ^MUTFNDSTOCKFIL
^OWNNAMEFIL_EXCLUDE Were those ^MUTFNDSTOCKFIL included in ^PTEMPNAME
^IRA401FIL_EXCL, or did ^HESHE own them separately from any retirement account(s) -- or
both?
1. All shares are included in IRA/Keogh/401k/403b/thrift accounts
2. All shares are owned separately from retirement accounts
3. Both -- some are included in retirement accounts and some are owned separately
owntype
^INCOMENOWFIL_OWNTYPE
^EARLIERFIL_OWNTYPE What kind of dividends did ^TEMPNAME get from those
^MUTFNDSTOCKFIL? Were the dividends automatically reinvested or did ^HESHE get dividend
checks?
1. Dividend CHECKS
2. REINVESTED dividends
3. Both
4. Neither; no dividends received
owndiv_pd
? [F1]
^INCOMENOWFIL_OWNDIV
^INCLUDEFIL_OWNDIV ^CREDITEDFIL_OWNDIV DIVIDEND INCOME did ^TEMPNAME receive
^OWNNAME_FIL from those ^ASNAME_MFS (between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL)?
Include reinvested dividends in income.
Page 427 of 578
odiv1y
ASSET TYPE: MUTUAL FUNDS
Was the annual amount (earned between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL) less than $250, between $250 and $1,000, between $1,000 and $2,500, or
more than $2,500?
1. Less than $250
2. $250 to $999.99
3. $1,000 to $2,499.99
4. $2,500 or more
odiv1value
? [F1]
ASSET TYPE: MUTUAL FUNDS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR , what was the TOTAL BALANCE or
MARKET VALUE (including dividends) of the mutual funds ^OWNNAME_FIL?
Enter 0 if the person no longer owns the mutual funds as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of mutual funds held outside of any retirement
account.
odiv1range
ASSET TYPE: MUTUAL FUNDS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more
odiv2y
ASSET TYPE: STOCKS
Was the annual amount (earned between ^MONTH1 1st and the end of ^LASTMONTH
Page 428 of 578
^CALENDAR_YRFIL) less than $100, between $100 and $500, between $500 and $1000, or more
than $1,000 dollars?
1. Less than $100
2. $100 to $499.99
3. $500 to $999.99
4. $1,000 or more
odiv2value
? [F1]
ASSET TYPE: STOCKS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR , what was the TOTAL BALANCE or
MARKET VALUE (including dividends) of the stocks ^OWNNAME_FIL?
Enter 0 if the person no longer owns the stocks as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Please remind the person to only report the value of stocks held outside of any retirement account.
odiv2range
ASSET TYPE: STOCKS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more
dkanyw
Earlier I recorded that ^TEMPNAME owned some ^ASNAME_MFS. ^DKANYW_OWNNAMEFIL
kind of dividends did ^HESHE get from those ^ASNAME_MFS? Were the dividends automatically
reinvested or did ^HESHE get dividend checks?
1. Dividend CHECKS
2. REINVESTED dividends
3. Both
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4. Neither; no dividends received
dkdiv
^ASIDEFRMFIL_DKDIV was the total amount of dividend income ^TEMPNAME ^HAVHAS earned
between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL on all
^OTHERFIL_DKDIV ^ASNAME_MFS ^HESHE owned?
Include reinvested dividends in income.
dkdiv1range
ASSET TYPE: MUTUAL FUNDS
Was the amount (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL) less
than $250, between $250 and $1,000, between $1,000 and $2,500, or more than $2,500?
1. Less than $250
2. $250 to $999.99
3. $1,000 to $2,499.99
4. $2,500 or more
dkdiv2range
ASSET TYPE: STOCKS
Was the amount (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL) less
than $100, between $100 and $500, between $500 and $1,000, or more than $1,000?
1. Less than $100
2. $100 to $499.99
3. $500 to $999.99
4. $1,000 or more
dkdivvalue
^ASIDEFRMFIL_DKDIVVALUE was the TOTAL BALANCE or MARKET VALUE (including dividends)
of the ^OTHERFIL_DKDIVVALUE ^ASNAME_MFS ^HESHE owned as of the last day of
^LASTMONTH, ^CALENDAR_YEAR?
Enter 0 if the person no longer owns the ^ASNAME_MFS as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
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dkdivvalue1range
ASSET TYPE: MUTUAL FUNDS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more
dkdivvalue2range
ASSET TYPE: STOCKS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $1,000,
between $1,000 and $10,000, between $10,000 and $25,000, or more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more
ctrlnum
**NON-DISPLAYED ITEM**
ctrlnum
**NON-DISPLAYED ITEM**
mobile_value
(Earlier I recorded that ^TEMPNAME ^OWNOWNSFIL_PR or AREIS in the process of buying
^PTEMPNAME primary residence.) As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what
was the value of ^PTEMPNAME mobile home; that is, how much ^DODOES ^TEMPNAME think it
would have sold for if it were for sale?
Enter 0 if the household did not own their mobile home as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Page 431 of 578
mobile_debt
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, was there a mortgage, installment loan,
contract to purchase, or other debt on this mobile home or site?
Reverse mortgages are included as debts against this home.
Enter "Yes" if the household has a reverse mortgage or a home equity loan.
1. Yes
2. No
mobile_loans
Altogether, how many mortgages, contracts, or other types of loans were there on this mobile
home as of the last day of ^LASTMONTH, ^CALENDAR_YEAR?
ctrlnum
**NON-DISPLAYED ITEM**
mhloan_code
**NON-DISPLAYED ITEM**
mobile_amt
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much principal was owed on
^PTEMPNAME 123_FILL mortgage or loan on this mobile home?
If the household has a reverse mortgage or a home equity loan, the principal owed is the total amount
received to date.
mhsite_debt
Was this mortgage, contract, or other debt for just the site, just the mobile home, or did it apply
to both the mobile home and the site as of the last day of ^LASTMONTH, ^CALENDAR_YEAR?
1. Just the site
2. Just the mobile home
Page 432 of 578
3. Both the mobile home and the site
ctrlnum
**NON-DISPLAYED ITEM**
property_value
(Earlier I recorded that ^TEMPNAME ^OWNOWNSFIL_PR, or AREIS in the process of buying,
^PTEMPNAME primary residence.) As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what
was the value of ^PTEMPNAME property; that is, how much ^DODOES ^TEMPNAME think it
would have sold for if it were for sale?
Enter 0 if the household did not own their primary residence as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
property_debt
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, were there any mortgages, home equity
loans, or other debt on this home?
Reverse mortgages are included as debts against this home.
Enter "Yes" if the household has a reverse mortrgage or a home equity loan.
1. Yes
2. No
property_loans
Altogether, how many mortgages or other types of loans were there on this home as of the last
day of ^LASTMONTH, ^CALENDAR_YEAR?
ctrlnum
**NON-DISPLAYED ITEM**
Page 433 of 578
proploan_code
**NON-DISPLAYED ITEM**
property_amt
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much principal was owed on
^PTEMPNAME 123_FILL mortgage or loan on this home?
If the household has a reverse mortgage or a home equity loan, the principal owed is the total amount
received to date.
yrs_debt
For the ^123_FILL mortgage or loan, what is the total number of years over which payments are
to be made?
The respondent should provide the full span of the mortgages, not the years remaining at the time of
interview.
property_rate
What was the annual interest rate on this ^123_FILL mortgage or loan as of the last day of
^LASTMONTH, ^CALENDAR_YEAR?
Enter both a whole number and a decimal.
Respondents' usually report mortgage interest rates as whole numbers followed by fractions. For
example: '5 and 3/8ths %'.
Here is a 'Fraction to Decimal Converstion Chart' to help convert the second part, the fraction, of the
respondent's answer:
1/8 = .125
1/4 = .25
3/8 = .375
1/2 = .5
5/8 = .625
3/4 = .75
7/8 = .875
Examples of complete mortgage interest rates, that is whole numbers followed by a fraction, converted
to decimal form are listed below. Remember, respondents may give any whole number or a whole
number and a fraction response, not just the below examples:
If rate is 3 and 1/8%, then enter 3.125
If rate is 4 and 1/4%, then enter 4.25
If rate is 5 and 3/8%, then enter 5.375
If rate is 6 and 1/2%, then enter 6.5
Page 434 of 578
If rate is 7 and 5/8%, then enter 7.625
If rate is 8 and 3/4%, then enter 8.75
If rate is 7 and 7/8%, then enter 7.875
If rate is 7%, then enter 7.0
If rate is 11%, then enter 11.0
ratetype_debt
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, was the interest rate ^TEMPNAME
^PAY_FIL on this ^123_FILL mortgage or loan fixed, variable, or a combination of the two?
1. Fixed
2. Variable
3. Combination of fixed and variable
type_debt
? [F1]
Did ^TEMPNAME obtain this 123_FILL mortgage or loan through an FHA, VA, or other mortgage
program...
Read answer categories.
1. FHA?
2. VA?
3. Other mortgage program?
4. None of these?
rentmort_pay
How much was this household's ^RENTMORT payment in December ^CALENDAR_YEAR,
including any condominium or association fees?
Include amounts paid for property taxes, property insurance, mortgage insurance, and any other fees
included in a typical monthly payment.
rentmort_range
Was the amount (as of December, ^CALENDAR_YEAR) less than $400, between $400 and $750,
between $750 and $1,200, or more than $1,200?
Page 435 of 578
1. Less than $400
2. $400 to $749
3. $750 to $1,199
4. $1,200 or more
ctrlnum
**NON-DISPLAYED ITEM**
utilities_expense
How much did this household pay for electricity, gas, basic telephone service, and other utilities
in December ^CALENDAR_YEAR?
Other common examples of utilities include water, heating oil and wood, trash or recycling, and mobile
telephone service (excluding data plans, applications, games, and ringtones.) Do not include cable TV
or internet.
utilities_range
Was the amount (as of December, ^CALENDAR_YEAR) less than $100, between $100 and $200,
between $200 and $300, or more than $300?
1. Less than $100
2. $100 to $199
3. $200 to $299
4. $300 or more
whopay
Starting with the person who paid the most, who paid for ^MOTRNTUTL_FILL in ^LASTMONTH
^CALENDAR_YEAR?
Mark all that apply.
1. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
2. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
3. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
4. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
5. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
6. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
7. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
Page 436 of 578
8. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
9. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
10. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
11. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
12. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
13. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
14. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
15. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
16. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
17. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
18. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
19. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
20. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
21. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
22. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
23. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
24. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
25. LNO ROST_FNAME ROST_LNAME of all people AGE >= 15 either on the T2 roster or where PEOPLE_TO_RO
50. a non-household member
utilities_amt
How much did ^NAME_WHOPAY pay in December ^CALENDAR_YEAR?
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
facelife
? [F1]
(Earlier ^TEMPNAME said ^HESHE owned life insurance policies.) As of the last day of
^LASTMONTH, ^CALENDAR_YEAR, what was the FACE VALUE of all life insurance policies that
^TEMPNAME ^HAVHAS? By face value, we mean the amount stated on an insurance policy, to
Page 437 of 578
be paid upon death or maturity.
Enter 0 if the person no longer owns the life insurance policies as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
type_lifeinsur
? [F1]
Did ^TEMPNAME have any policies that build up a cash value or that ^TEMPNAME could borrow
on? These are sometimes called 'whole life', 'straight life', or 'universal life' policies.
1. Yes
2. No
cashlife
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the CASH VALUE of all life
insurance policies that ^TEMPNAME ^HAVHAS? The cash value is NOT the same as the face
value. By cash value, we mean the amount an insurance company will pay to the policyholder in
the event his or her policy is voluntarily terminated before its maturity; the cash value is the
savings component of most whole life and universal life insurance policies.
Enter 0 if the person no longer owns the life insurance policies as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
EDUCSAV_CODE
**NON-DISPLAYED ITEM**
educ_value
? [F1]
Page 438 of 578
^EDSAV_QSTNTXTFIL
If the person or household owned three or more educational or college savings accounts, the person
should report the accounts with the largest balance.
educ_range
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $10,000,
between $10,000 and $75,000, between $75,000 and $150,000, or more than $150,000?
1. Less than $10,000
2. $10,000 to $74,999
3. $75,000 to $149,999
4. $150,000 or more
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
jtrntsp_pd
? [F1]
^JTRNTSPPD_QSTNTXT
jtnetsp_pd
? [F1]
Page 439 of 578
^JTNETSPPD_QSTNTXT
Enter a net loss as a negative amount.
spnet1y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $2,500, between $2,500 and $5,000, or more than $5,000?
Enter a net loss in the first response category.
1. Less than $500
2. $500 to $2,499.99
3. $2,500 to $4,999.99
4. $5,000 or more
jtspmrkvalue
? [F1]
^JTSPMRKVALUE_QSTNTXT
Enter 0 if the person no longer owns the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Enter 0 if the rental property is attached to or located in this residence.
spmrkvalue1y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
Page 440 of 578
jtspdebt
? [F1]
^JTSPDEBT_QSTNTXT
Enter 0 if the person owed no debt on the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Enter 0 if the rental property is attached to or located in this residence.
spdebt1y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YRFIL) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
spanswered
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
jtothrnt_pd
? [F1]
^JTOTHRNTPD_QSTNTXT
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO4 (with
the exception of the person's spouse or registered domestic or civil union
partner if one exists). Display 'a Non-household member' when JTWHO4 = 50
Page 441 of 578
jtothnet_pd
? [F1]
^JTOTHNETPD_QSTNTXT
Enter a net loss as a negative amount.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO4 (with
the exception of the person's spouse or registered domestic or civil union
partner if one exists). Display 'a Non-household member' when JTWHO4 = 50
othnet1y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $2,500, between $2,500 and $5,000, or more than $5,000?
Enter a net loss in the first response category.
1. Less than $500
2. $500 to $2,499.99
3. $2,500 to $4,999.99
4. $5,000 or more
jtothmrkvalue
? [F1]
^JTOTHMRKVALUE_QSTNTXT
Enter 0 if the person no longer owns the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
Enter 0 if the rental property is attached to or located in this residence.
Display the first and last name(s) of the person(s) selected in JTWHO4 (with
the exception of the person's spouse or registered domestic or civil union
partner if one exists). Display 'a Non-household member' when JTWHO4 = 50
Page 442 of 578
othmrkvalue1y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
jtothdebt
? [F1]
^JTOTHDEBT_QSTNTXT
Enter 0 if the person owed no debt on the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
???Enter 0 if the rental property is attached to or located in this residence.
Display the first and last name(s) of the person(s) selected in JTWHO4 (with
the exception of the person's spouse or registered domestic or civil union
partner if one exists). Display 'a Non-household member' when JTWHO4 = 50
othdebt1y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YRFIL) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
spanswered
Page 443 of 578
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
ownrent_pd
? [F1]
Earlier I recorded that ^TEMPNAME ^ALSOFIL_OWNRENT owned rental property
^OWNNAMEFIL_OWNRENT. How much GROSS rent did ^TEMPNAME receive from all rental
property owned ^OWNNAME_FIL between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL?
ownnet_pd
? [F1]
What was the NET income or NET loss after expenses (from all of those rental properies
^TEMPNAME owned ^OWNNAME_FIL between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL) ?
Enter a net loss as a negative amount.
ownnet1y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $2,500, between $2,500 and $5,000, or more than $5,000?
Enter a net loss in the first response category.
1. Less than $500
2. $500 to $2,499.99
3. $2,500 to $4,999.99
4. $5,000 or more
ownmrkvalue
? [F1]
Page 444 of 578
Excluding properties attached to or located on ^PTEMPNAME own residence, and as of the last
day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total market value of all of those rental
properties ^OWNNAME_FIL?
Enter 0 if the person no longer owns the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Enter 0 if the rental property is attached to or located in this residence.
ownmrkvalue1y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
owndebt
? [F1]
Excluding properties attached to or located on ^PTEMPNAME own residence, and as of the last
day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total value of any debt (such as
mortgages, deeds of trust, or other debt) owed on all of those rental properties (^TEMPNAME owned
^OWNNAME_FIL)?
Enter 0 if the person owed no debt on the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Enter 0 if the rental property is attached to or located in this residence.
owndebt1y
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YRFIL) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
Page 445 of 578
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
dkrnt
^ASIDEFRMFIL_DKRNT was the total amount of GROSS rent ^TEMPNAME received between
^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL from all ^OTHERFIL_DKRNT
rental property ^HESHE owned?
dkrntrange
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
dknet
(^ASIDEFRMFIL_DKRNT) was the NET income or NET loss after expenses (from all of those rental
properties between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL) ?
Enter a net loss as a negative amount.
dknetrange
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $500, between $500 and $2,500, between $2,500 and $5,000, or more than $5,000?
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
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4. $5,000 or more
dkvalue
^ASIDEFRMFIL_DKVALUE was the TOTAL MARKET VALUE from all ^OTHERFIL_DKVALUE
rental property ^HESHE owned as of the last day of ^LASTMONTH, ^CALENDAR_YEAR?
Enter 0 if the person no longer owns the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Enter 0 if the rental property is attached to or located in this residence.
dkdebt
? [F1]
^ASIDEFRMFIL_DKDEBT properties attached to or located on ^PTEMPNAME own residence and
as of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total value of any debt
(such as mortgages, deeds of trust, or other debt) owed on all ^OTHERFIL_DKDEBT rental
properties?
Enter 0 if the person owed no debt on the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Enter 0 if the rental property is attached to or located in this residence.
dkdebtrange
ASSET TYPE: RENTAL PROPERTY
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YRFIL) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
ctrlnum
Page 447 of 578
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
jtspouse_mrkvalue
? [F1]
^SPMRKVALUE_QSTNTXT
Enter 0 if the person no longer owned the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
If respondent is unsure of the value, then ask them "For example, about how much money would
^HESHE have received if ^HESHE tried to sell this property or timeshare"?
spmrkvalue2y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
jtspredebt
^JTSPREDEBT_QSTNTXT
Page 448 of 578
Enter 0 if the person owed no debt on the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
spdebt2y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
spanswered
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
jtother_mrkvalue
? [F1]
^OTMRKVALUE_QSTNTXT
Enter 0 if the person no longer owned the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
If respondent is unsure of the value, then ask them "For example, about how much money would
^HESHE have received if ^HESHE tried to sell this property or timeshare"?
Display the first and last name(s) of the person(s) selected in JTWHO5 (with
the exception of the person's spouse or registered domestic or civil union
partner if one exists). Display 'a Non-household member' when JTWHO5 = 50
Page 449 of 578
otmrkvalue2y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
jtotredebt
^JTOTREDEBT_QSTNTXT
Enter 0 if the person owed no debt on the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
Display the first and last name(s) of the person(s) selected in JTWHO5 (with
the exception of the person's spouse or registered domestic or civil union
partner if one exists). Display 'a Non-household member' when JTWHO5 = 50
otdebt2y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
spanswered
ctrlnum
**NON-DISPLAYED ITEM**
lno
Page 450 of 578
**NON-DISPLAYED ITEM**
self_mrkvalue
? [F1]
Earlier I recorded that ^TEMPNAME ^ALSOFIL_OWNREAL owned real estate (such as a vacation
home, a deeded timeshare, or an undeveloped lot) ^OWNNAME_FIL. As of the last day of
^LASTMONTH, ^CALENDAR_YEAR, what was the total market value of all of those properties?
Enter 0 if the person no longer owned the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
If respondent is unsure of the value, then ask them "For example, about how much money would
^HESHE have received if ^HESHE tried to sell this property or timeshare"?
selfmrkvalue2y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
selfdebt
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total value of any debt
(such as mortgages, deeds of trust, or other debt) owed on all of those properties (^TEMPNAME
owned in ^HISHER own name)?
Enter 0 if the person owed no debt on the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
selfdebt2y
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
Page 451 of 578
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
spanswered
dkrevalue
^ASIDEFRMFIL_DKREVALUE was the TOTAL MARKET VALUE from all ^OTHERFIL_DKREVALUE
real estate (such as a vacation home, a deeded timeshare, or an undeveloped lot) ^HESHE owned as
of the last day of ^LASTMONTH, ^CALENDAR_YEAR?
Enter 0 if the person no longer owned the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
If respondent is unsure of the value, then ask them "For example, about how much money would
^HESHE have received if ^HESHE tried to sell this property or timeshare"?
dkrevaluerange
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
dkredebt
? [F1]
^ASIDEFRMFIL_DKREDEBT of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the
total value of any debt (such as mortgages, deeds of trust, or other debt) owed on all of those
^OTHERFIL_DKREDEBT properties?
Enter 0 if the person owed no debt on the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Page 452 of 578
dkredebtrange
ASSET TYPE: REAL ESTATE
Was the amount (as of the last day of ^LASTMONTH ^CALENDAR_YEAR) less than $50,000,
between $50,000 and $150,000, between $150,000 and $250,000, or more than $250,000?
1. Less than $50,000
2. $50,000 to $149,999
3. $150,000 to $249,999
4. $250,000 or more
ctrlnum
**NON-DISPLAYED ITEM**
carno
**NON-DISPLAYED ITEM**
carfree
^QSTN_TYPECARFIL
1. Yes
2. No
carowed
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much was owed on that vehicle?
primary_use
Was this vehicle used primarily either for business purposes or for the transportation of a
disabled person?
Please do not consider a vehicle to be used primarily for business purposes if that vehicle was used
primarily for transportation to and from work.
1. Yes
2. No
Page 453 of 578
ctrlnum
**NON-DISPLAYED ITEM**
type_recveh_num
**NON-DISPLAYED ITEM**
who_recveh
^RECVEH_INTRO Who owned the ^TYPE_RECVEH as of the last day of ^LASTMONTH,
^CALENDAR_YEAR?
Mark all that apply.
1. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
2. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
3. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
4. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
5. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
6. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
7. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
8. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
9. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
10. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
11. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
12. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
13. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
14. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
15. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
16. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
17. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
18. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
19. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
20. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
rec_vehicle
If that ^TYPE_RECVEH were sold, as of the last day of ^LASTMONTH, ^CALENDAR_YEAR what
would it sell for?
Enter 0 if the household no longer owns the vehicle as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Page 454 of 578
recvehicfree
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, did ^HESHE owe money on that
^TYPE_RECVEH?
1. Yes
2. No
recvehicowed
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much was owed on that
^TYPE_RECVEH?
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
annuity_trust
? [F1]
(Earlier I recorded that ^TEMPNAME owned an annuity or a trust or managed investment account.) As
of the last day of ^LASTMONTH, CALENDARY_YEAR, did ^HESHE have just an annuity, just a
trust or managed investment account, both, or no longer own either?
1. Annuities
2. Trusts
3. Both
4. No longer owns either an annuity or trust/managed investment account
annuity_inc
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how much annuity
income did ^TEMPNAME receive?
If annuity income is shared, count only ^HISHER share.
annuity_inc_range
Page 455 of 578
ASSET TYPE: ANNUITIES
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $2,500, between $2,500 and $5,000, between $5,000 and $10,000 or more than $10,000?
1. Less than $2,500
2. $2,500 to $4,999
3. $5,000 to $9,999
4. More than $10,000
annuity_self
? [F1]
Did ^TEMPNAME have annuities in which some or all of the equity belonged to HIMHER?
1. Yes
2. No
annuity_value
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was ^PTEMPNAME share, in
dollars, of the total value of those annuities (in which ^TEMPNAME
^OWNOWNSFIL_ANNUITYTRUST some or all of the equity)?
annuity_range
ASSET TYPE: ANNUITIES
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $25,000,
between $25,000 and $50,000, between 50,000 and 100,000, or more than $100,000?
1. Less than $25,000
2. $25,000 to $49,999
3. $50,000 to $99,999
4. $100,000 or more
trust_inc
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how much trust or
Page 456 of 578
managed investment account income did ^TEMPNAME receive?
If trust or managed investment account income in shared, count only ^HISHER share.
trust_inc_range
ASSET TYPE: TRUSTS OR MANAGED INVESTMENT ACCOUNTS
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
less than $2,500, between $2,500 and $5,000, between $5,000 and $10,000 or more than $10,000?
1. Less than $2,500
2. $2,500 to $4,999
3. $5,000 to $9,999
4. More than $10,000
trust_self
? [F1]
Did ^TEMPNAME have trusts or managed investment accounts in which some or all of the equity
belong to HIMHER?
1. Yes
2. No
trust_value
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was ^PTEMPNAME share, in
dollars, of the total value of those trusts or managed investment accounts (in which ^TEMPNAME
^OWNOWNSFIL_ANNUITYTRUST some or all of the equity)?
trust_range
ASSET TYPE: TRUSTS OR MANAGED INVESTMENT ACCOUNTS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $25,000,
between $25,000 and $50,000, between $50,000 and $100,000, or more than $100,000?
1. Less than $25,000
2. $25,000 to $49,999
Page 457 of 578
3. $50,000 to $99,999
4. $100,000 or more
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
business_inv_num
(Earlier I recorded that ^TEMPNAME owned a business(es) as an investment only.) As of the last day
of ^LASTMONTH, ^CALENDAR_YEAR, how many businesses as an investment only did ^HESHE
own?
Enter 0 for none.
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
invbusiness_code
**NON-DISPLAYED ITEM**
business_inv_name
What was the name ^NAME_BUSFIL
While respondents are allowed to report that they own up to 10 businesses as an investment only, we
are only asking the detailed questions for up to 3 businesses as an investment only.
ctrlnum
**NON-DISPLAYED ITEM**
Page 458 of 578
lno
**NON-DISPLAYED ITEM**
invbusiness_code
**NON-DISPLAYED ITEM**
business_code
**NON-DISPLAYED ITEM**
percent_owned
^SELF_EMPFIL As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what percent of
^BUSINESS_NAMES did ^TEMPNAME own?
^ENTER0_FIL
Please enter all ownership percentages as WHOLE numbers. For any NON-WHOLE number
ownership percentages, please round up or down accordingly. For example, for 50 percent, please enter
'50'; for 9.7 percent, please enter '10'; for 25.2 percent, please enter '25'.
business_value
? [F1]
(As of the last day of ^LASTMONTH, ^CALENDAR_YEAR) What was the total value of
^BUSINESS_NAMES before figuring in any debts that might be owed against it?
If respondent is unsure of the value, then ask them, "For example, about how much money would
^HESHE have received if ^HESHE sold all property and equipment associated with the business?"
business_range
ASSET TYPE: BUSINESS(ES) OWNED
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $10,000,
between $10,000 and $50,000, between $50,000 and $150,000, or more than $150,000?
1. Less than $10,000
2. $10,000 to $49,999
3. $50,000 to $149,999
4. $150,000 or more
Page 459 of 578
business_debt
? [F1]
(As of the last day of ^LASTMONTH, ^CALENDAR_YEAR) What was the total debt owed against
^BUSINESS_NAMES?
Enter 0 for none.
Please include all outstanding debts even if they may be forgiven at a future date.
Please do not include fully forgiven loans as part of the businesses debt.
business_debt_range
ASSET TYPE: BUSINESS(ES) OWNED
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $10,000,
between $10,000 and $50,000, between $50,000 and $150,000, or more than $150,000?
1. Less than $10,000
2. $10,000 to $49,999
3. $50,000 to $149,999
4. $150,000 or more
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
rndup2_income
? [F1]
(Earlier I recorded that ^TEMPNAME had Read investments.) Between ^MONTH1 1st and the end
of ^LASTMONTH ^CALENDAR_YRFIL, what was ^HISHER share of income from Read
investments ^INTOTAL_FIL? (If the income is shared, count only ^HISHER ^CHILDFIL)
Enter a net loss as a negative amount.
'Share' refers to share in dollars and not to percentage share.
Enter 0 if the asset generates no income.
Page 460 of 578
Display the 'other' investments reported in AST4C_SP:
Financial Investments
Heading:
Other
rndup2_inc_range
ASSET TYPE: OTHER INVESTMENTS
Was the amount less than $25, between $25 and $100, between $100 and $500, or more than
$500?
1. Less than $25
2. $25 to $99.99
3. $100 to $499.99
4. $500 or more
rndup2_value
? [F1]
ASSET TYPE: OTHER INVESTMENTS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was ^HISHER share of the total
balance or market value of the Read investments ^TEMPNAME owned ^ALLTOG_FIL?
Enter 0 if the person no longer owns the 'other' investments as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
'Share' refers to share in dollars and not to percentage share.
If respondent is unsure of the value, then ask them "For example, about how much money would
^HESHE have received if ^HESHE tried to sell the assets"?
Display the list of 'other financial investment' reported in AST4C_SP
Heading: Other Financial Investments
rndup2_val_range
ASSET TYPE: OTHER INVESTMENTS
Was the amount less than $1,000, between $1,000 and $10,000, between $10,000 and $25,000, or
more than $25,000?
1. Less than $1,000
2. $1,000 to $9,999
Page 461 of 578
3. $10,000 to $24,999
4. $25,000 or more
ctrlnum
**NON-DISPLAYED ITEM**
lno
**NON-DISPLAYED ITEM**
credit_cards
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME owe
any money for...
...store bills or credit card bills?
(...educational or education-related expenses?)
(...medical bills ^YOUHESHE WASWERE unable to pay in full?)
(...any other debt we have not yet mentioned, including loans obtained through a bank or credit union,
money owed to private individuals, debt held against mutual funds or stocks (margin accounts), or any
other debt not covered?)
Please exclude store bills or credit card debt for business expenses that will be paid or reimbursed by
an employer or business.
1. Yes
2. No
educ_loans
? [F1]
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME owe any
money for)
(...store bills or credit card bills?)
...educational or education-related expenses?
(...medical bills ^YOUHESHE WASWERE unable to pay in full?)
(...any other debt we have not yet mentioned, including loans obtained through a bank or credit union,
money owed to private individuals, debt held against mutual funds or stocks (margin accounts), or any
other debt not covered?)
Page 462 of 578
Examples include loans to students (such as Stafford Loans and Perkins loans), loans to parents (such
as PLUS loans), as well as other loans obtained for the purpose of financing education.
Please exclude any home equity loans taken out to pay for education.
1. Yes
2. No
med_debt
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME owe any
money for)
(...store bills or credit card bills?)
(...educational or education-related expenses?)
...medical bills ^YOUHESHE WASWERE unable to pay in full?
(...any other debt we have not yet mentioned, including loans obtained through a bank or credit union,
money owed to private individuals, debt held against mutual funds or stocks (margin accounts), or any
other debt not covered?)
Include bills for doctors, dentists, hospitals, therapists, medication, equipment, nursing home or home
care.
Include any bills of the respondent's children that have not already been reported.
1. Yes
2. No
other_debt
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME owe any
money for)
(...store bills or credit card bills?)
(...educational or education-related expenses?)
(...medical bills ^YOUHESHE WASWERE unable to pay in full?)
...any other debt we have not yet mentioned, including loans obtained through a bank or credit
union, money owed to private individuals, debt held against mutual funds or stocks (margin
accounts), or any other debt not covered?
Please exclude any debt that the respondent has already reported.
1. Yes
2. No
Page 463 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
JTCC_DEBT
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did ^TEMPNAME owe
money for store bills or credit card bills jointly with ^HISHER ^SPOUSEPARTNER_FIL?
Please exclude store bills or credit card debt for business expenses that will be paid or reimbursed by
an employer or business.
1. Yes
2. No
JTCC_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME and
^HISHER ^SPOUSEPARTNER_FIL jointly owe for store bills or credit card bills?
Please exclude store bills or credit card debt for business expenses that will be paid or reimbursed by
an employer or business.
Enter 0 if the store bills or credit card debt have been paid in full.
spanswered
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SELFCC_DEBT
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did ^TEMPNAME owe
money for store bills or credit card bills in ^HISHER own name only?
Please exclude store bills or credit card debt for business expenses that will be paid or reimbursed by
an employer or business.
Page 464 of 578
1. Yes
2. No
SELFCC_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME owe for
store bills or credit card bills (in ^HISHER name only)?
Please exclude store bills or credit card debt for business expenses that will be paid or reimbursed by
an employer or business.
Enter 0 if the store bills or credit card debt have been paid in full.
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
JTEDUC_DEBT
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did ^TEMPNAME have
any loans for educational or education-related expenses jointly with ^HISHER
^SPOUSEPARTNER_FIL?
Please exclude any home equity loans taken out to pay for education.
1. Yes
2. No
JTEDUC_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME and
^HISHER ^SPOUSEPARTNER_FIL jointly owe in loans for educational or education-related
expenses?
Enter 0 if the loans have been paid in full.
spanswered
Page 465 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SELFEDUC_DEBT
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did ^TEMPNAME have
any loans for educational or education-related expenses in ^HISHER own name only?
Please exclude any home equity loans taken out to pay for education.
1. Yes
2. No
SELFEDUC_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME owe in
loans for educational or education-related expenses (in ^HISHER name only)?
Enter 0 if the loans have been paid in full.
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
med_amt
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME owe for
medical bills ^YOUHESHE WASWERE unable to pay in full?
Exclude bills that will likely be paid by the insurance company.
Enter 0 if the medical bills have been paid in full.
med_range
Was the amount less than $1,000, between $1,000 and $2,500, between $2,500 and $5,000, or
Page 466 of 578
more than $5,000?
1. less than $1,000
2. $1,000 to $2,500
3. $2,501 to $5,000
4. greater than $5,000
ctrlnum
lno
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
JTOTH_DEBT
Did ^TEMPNAME have other debt (including money owed to private individuals, debts held agains
mutual funds or stocks (margin accounts), or any other debt not covered) jointly with ^HISHER
SPOUSEPARTNER_FIL (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)?
Please exclude any debt that the respondent has already reported.
1. Yes
2. No
JTOTH_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME and
^HISHER ^SPOUSEPARTNER_FIL jointly owe in other debt (including money owed to private
individuals, debts held against mutual funds or stocks (margin accounts), or any other debt not covered)
?
Please exclude any debt that the respondent has already reported.
Enter 0 if the 'other' debt has been paid in full.
spanswered
Page 467 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
SELFOTH_DEBT
Did ^TEMPNAME have other debt (including money owed to private individuals, debts held against
mutual funds or stocks (margin accounts), or any other debt not covered) in ^HISHER own name only
(between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)?
Please exclude any debt that the respondent has already reported.
1. Yes
2. No
SELFOTH_AMT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME owe in
other debt (including money owed to private individuals, debts held against mutual funds or stocks
(margin accounts), or any other debt not covered)?
Please exclude any debt that the respondent has already reported.
Enter 0 if the 'other' debt has been paid in full.
ASTRECUSE
Did the respondent use any records to answer any asset questions?
If this is a telephone interview, please record whether you can tell if the respondent used any records.
Has the respondent mentioned anything in passing (for example, "Hold on, let me check that.")? Has the
respondent reported exact amounts (for example, $1,234.56)? Could you hear papers shuffling? If yes,
or if you could tell in some other way that the respondent used records, enter 1. If you cannot tell
whether the respondent used records, enter CTRL+D.
1. Yes
2. No
CTRLNUM
Page 468 of 578
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
UTILZ_INTRO
? [F1]
Next I'll ask some questions about doctor visits, (such as how often ^TEMPNAME visited a doctor or
dentist,) ^UTILZ_INTRO_FIL
1. Enter 1 to continue
HLTHSTS
Would you say ^HISHER health in general is...
(These questions apply to both physical and mental health.)
Read answer categories.
1. Excellent?
2. Very good?
3. Good?
4. Fair?
5. Poor?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
HOSPNGHT
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, ^WEREWAS
^TEMPNAME a patient in a hospital overnight or longer?
Page 469 of 578
1. Yes
2. No
HOSPNMNGT
? [F1]
How many nights in total did ^HESHE spend in a hospital of any type (between ^MONTH1 1st and
the end of ^LASTMONTH ^CALENDAR_YRFIL)?
HOSPRNNGT
Which of the following describes why ^HESHE entered the hospital ^RECENT_STAYFIL
Read answer categories.
Mark all that apply.
1. For a diagnostic test to determine what was wrong?
2. For a birth (either to be born, or to give birth, including C-section)?
3. To have an operation or surgery?
4. For some other treatment or therapy not including surgery?
5. To be treated for Covid-19 (suspected or diagnosed), or complications from Covid-19?
6. For any other reason?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
PRESCRIPYR
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME take
any prescription medications?
1. Yes
2. No
Page 470 of 578
PRESCRIP
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL did ^HESHE take
prescription medicines on a daily basis for a month or more?
^BIRTHCONTROL_FIL
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
DENTALVIS
Q
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, how many visits did
^TEMPNAME make to a dentist or other dental professional?
Enter 0 for none.
DENTTHLS
^C_HAVHAS ^TEMPNAME lost any of ^HISHER permanent adult teeth?
Exclude the removal of wisdom teeth.
1. Yes
2. No
DENTALTH
^C_HAVHAS ^HESHE lost ALL of ^HISHER permanent adult teeth?
1. Yes
2. No
Page 471 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
HLTHPRVD
R
^HLTHPROV_QSTNTXTFIL
Enter 0 for none.
Exclude email contacts.
HLTHDR
Did that visit or call include contact with a physician?
1. Yes
2. No
HLTHDR_NO
How many of the ^NUM_VISITFIL visits or calls included contact with a physician?
DAYSICK
^DAYSICK_QSTNTXTFIL
Enter 0 for none.
If the person can't provide the exact number of days, ask for an estimate.
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
Page 472 of 578
**NON-DISPLAYED ITEM**
MEDCRPAYC
CC
Next I will ask about out-of-pocket medical expenses between ^MONTH1 1st and the end of
^LASTMONTH ^CALENDAR_YRFIL.
^MOOP_INTRO
^MOOP_QSTNTXT
^MOOP_NOTE
^MOOP_FRNOTE
MEDCRPAYC_RANGE
CC
Was it ...
Read answer categories.
Enter 0 for none.
0. $0?
1. $1 to $300?
2. $301 to $500?
3. $501 to $1,000?
4. $1,001 to $2,000?
5. $2,001 to $3,000?
6. $3,001 to $4,000?
7. $4,001 to $7,000?
8. $7,001 to $11,000?
9. $11,001 or more?
WMEDCRPAYC
Who in the household did ^TEMPNAME pay for?
Page 473 of 578
Mark all that apply.
1. Display the LNO ROST_FNAME ROST_LNAME
2. Display the LNO ROST_FNAME ROST_LNAME
3. Display the LNO ROST_FNAME ROST_LNAME
4. Display the LNO ROST_FNAME ROST_LNAME
5. Display the LNO ROST_FNAME ROST_LNAME
6. Display the LNO ROST_FNAME ROST_LNAME
7. Display the LNO ROST_FNAME ROST_LNAME
8. Display the LNO ROST_FNAME ROST_LNAME
9. Display the LNO ROST_FNAME ROST_LNAME
10. Display the LNO ROST_FNAME ROST_LNAME
11. Display the LNO ROST_FNAME ROST_LNAME
12. Display the LNO ROST_FNAME ROST_LNAME
13. Display the LNO ROST_FNAME ROST_LNAME
14. Display the LNO ROST_FNAME ROST_LNAME
15. Display the LNO ROST_FNAME ROST_LNAME
16. Display the LNO ROST_FNAME ROST_LNAME
17. Display the LNO ROST_FNAME ROST_LNAME
18. Display the LNO ROST_FNAME ROST_LNAME
19. Display the LNO ROST_FNAME ROST_LNAME
20. Display the LNO ROST_FNAME ROST_LNAME
MEDCRPAYS
^MOOPS_QSTNTXT
MEDCRPAYS_RANGE
CC
Was it ...
Read answer categories.
Enter 0 for none.
0. $0?
1. $1 to $50?
2. $51 to $100?
3. $101 to $300?
Page 474 of 578
4. $301 to $500?
5. $501 to $800?
6. $801 to $1,000?
7. $1,001 to $3,000?
8. $3,001 to $6,000?
9. $6,001 or more?
WMEDCRPAYS
Who in the household did ^TEMPNAME pay for?
Mark all that apply.
1. Display the LNO ROST_FNAME ROST_LNAME
2. Display the LNO ROST_FNAME ROST_LNAME
3. Display the LNO ROST_FNAME ROST_LNAME
4. Display the LNO ROST_FNAME ROST_LNAME
5. Display the LNO ROST_FNAME ROST_LNAME
6. Display the LNO ROST_FNAME ROST_LNAME
7. Display the LNO ROST_FNAME ROST_LNAME
8. Display the LNO ROST_FNAME ROST_LNAME
9. Display the LNO ROST_FNAME ROST_LNAME
10. Display the LNO ROST_FNAME ROST_LNAME
11. Display the LNO ROST_FNAME ROST_LNAME
12. Display the LNO ROST_FNAME ROST_LNAME
13. Display the LNO ROST_FNAME ROST_LNAME
14. Display the LNO ROST_FNAME ROST_LNAME
15. Display the LNO ROST_FNAME ROST_LNAME
16. Display the LNO ROST_FNAME ROST_LNAME
17. Display the LNO ROST_FNAME ROST_LNAME
18. Display the LNO ROST_FNAME ROST_LNAME
19. Display the LNO ROST_FNAME ROST_LNAME
20. Display the LNO ROST_FNAME ROST_LNAME
MDPAY
CC, ? [F1]
^MDPAY_QSTNTXT
Page 475 of 578
MDPAY_RANGE
CC
Was it ...
Read answer categories.
Enter 0 for none.
0. $0?
1. $1 to $50?
2. $51 to 100?
3. $101 to $300?
4. $301 to $500?
5. $501 to $800?
6. $801 to $1,000?
7. $1,001 to $3,000?
8. $3,001 to $6,000?
9. $6,001 or more?
WMDPAY
Who in the household did ^TEMPNAME pay for?
Mark all that apply.
1. Display the LNO ROST_FNAME ROST_LNAME
2. Display the LNO ROST_FNAME ROST_LNAME
3. Display the LNO ROST_FNAME ROST_LNAME
4. Display the LNO ROST_FNAME ROST_LNAME
5. Display the LNO ROST_FNAME ROST_LNAME
6. Display the LNO ROST_FNAME ROST_LNAME
7. Display the LNO ROST_FNAME ROST_LNAME
8. Display the LNO ROST_FNAME ROST_LNAME
9. Display the LNO ROST_FNAME ROST_LNAME
10. Display the LNO ROST_FNAME ROST_LNAME
11. Display the LNO ROST_FNAME ROST_LNAME
12. Display the LNO ROST_FNAME ROST_LNAME
13. Display the LNO ROST_FNAME ROST_LNAME
14. Display the LNO ROST_FNAME ROST_LNAME
15. Display the LNO ROST_FNAME ROST_LNAME
16. Display the LNO ROST_FNAME ROST_LNAME
Page 476 of 578
17. Display the LNO ROST_FNAME ROST_LNAME
18. Display the LNO ROST_FNAME ROST_LNAME
19. Display the LNO ROST_FNAME ROST_LNAME
20. Display the LNO ROST_FNAME ROST_LNAME
OTCMDPAY
CC
^OTCMDPAY_QSTNTXT
OTCMDPAY_RANGE
CC
Was it ...
Read answer categories.
Enter 0 for none.
0. $0?
1. $1 to $10?
2. $11 to $50?
3. $51 to $100?
4. $101 to $200?
5. $201 to $300?
6. $301 to $500?
7. $501 to $1,000?
8. $1,001 to $5,000?
9. $5,001 or more?
WOTCMDPAY
Who in the household did ^TEMPNAME pay for?
Mark all that apply.
1. Display the LNO ROST_FNAME ROST_LNAME
2. Display the LNO ROST_FNAME ROST_LNAME
3. Display the LNO ROST_FNAME ROST_LNAME
Page 477 of 578
4. Display the LNO ROST_FNAME ROST_LNAME
5. Display the LNO ROST_FNAME ROST_LNAME
6. Display the LNO ROST_FNAME ROST_LNAME
7. Display the LNO ROST_FNAME ROST_LNAME
8. Display the LNO ROST_FNAME ROST_LNAME
9. Display the LNO ROST_FNAME ROST_LNAME
10. Display the LNO ROST_FNAME ROST_LNAME
11. Display the LNO ROST_FNAME ROST_LNAME
12. Display the LNO ROST_FNAME ROST_LNAME
13. Display the LNO ROST_FNAME ROST_LNAME
14. Display the LNO ROST_FNAME ROST_LNAME
15. Display the LNO ROST_FNAME ROST_LNAME
16. Display the LNO ROST_FNAME ROST_LNAME
17. Display the LNO ROST_FNAME ROST_LNAME
18. Display the LNO ROST_FNAME ROST_LNAME
19. Display the LNO ROST_FNAME ROST_LNAME
20. Display the LNO ROST_FNAME ROST_LNAME
FLEXSPND
? [F1]
^INTRO_HSA, did ^TEMPNAME have a Flexible Spending Account for health expenses?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
ANYHICOV
**NON-DISPLAYED ITEM**
Page 478 of 578
NOINDNT
Earlier ^TEMPNAME said that ^HESHE ^WEREWAS not covered by any health insurance in
Read month(s). During ^THATTHOSE_MOFIL did ^TEMPNAME go to a dentist or other dental
professional?
Display the name of the months of no health insurance coverage as reported in
the EHC (include ONLY reference months).
1. Yes
2. No
NOINDOC
(Earlier ^TEMPNAME said that ^HESHE ^WEREWAS not covered by any health insurance in Read
month(s).) During ^THATTHOSE_MOFIL did ^TEMPNAME go to a doctor, nurse, or other medical
provider?
Display the name of the months of no health insurance coverage as reported in
the EHC (include ONLY reference months).
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
NOINCLN
Where did ^TEMPNAME go to get those health care services...
Read answer categories.
Mark all that apply.
1. Clinic or Public Health Department?
2. Emergency room?
3. Hospital, excluding emergency room?
4. VA Hospital?
Page 479 of 578
5. Doctor's office?
6. Dentist's office?
7. Someplace else?
NOININC
Did anyone ask what ^PTEMPNAME income was before they set a price for the services?
1. Yes
2. No
NOINTRT
Did ^TEMPNAME receive treatment for an illness or injury?
1. Yes
2. No
NOINCHK
Did ^TEMPNAME receive any routine or preventative care, ^TYPECAREFIL?
1. Yes
2. No
ANYHICOV
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
ADULT_DISABLE
**NON-DISPLAYED ITEM**
Page 480 of 578
HEARING
Now we want to learn about people who have difficulties doing certain activities because of
physical, mental, or emotional health problems.
^C_AREIS ^TEMPNAME deaf or ^DODOES ^HESHE have serious difficulty hearing?
1. Yes
2. No
SEEING
^C_AREIS ^TEMPNAME blind or ^DODOES ^HESHE have serious difficulty seeing even when
wearing glasses or contacts?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
COGNIT_AD
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME experience any of
the following...
...serious difficulty concentrating, remembering, or making decisions?
(...serious difficulty walking or climbing stairs?)
(...difficulty dressing or bathing?)
(...difficulty doing errands alone such as visiting a doctor's office or shopping?)
1. Yes
2. No
AMBULAT_AD
(Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME experience any of the
following...)
Page 481 of 578
(...serious difficulty concentrating, remembering, or making decisions?)
...serious difficulty walking or climbing stairs?
(...difficulty dressing or bathing?)
(...difficulty doing errands alone such as visiting a doctor's office or shopping?)
1. Yes
2. No
SELFCARE_AD
(Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME experience any of the
following...)
(...serious difficulty concentrating, remembering, or making decisions?)
(...serious difficulty walking or climbing stairs?)
...difficulty dressing or bathing?
(...difficulty doing errands alone such as visiting a doctor's office or shopping?)
1. Yes
2. No
ERRANDS
(Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME experience any of the
following...)
(...serious difficulty concentrating, remembering, or making decisions?)
(...serious difficulty walking or climbing stairs?)
(...difficulty dressing or bathing?)
...difficulty doing errands alone such as visiting a doctor's office or shopping?
1. Yes
2. No
SIT_DIF
C_DODOES ^TEMPNAME have any difficulty:
... sitting for one hour?
(... lifting or carrying something as heavy as 10 pounds (such as a bag of groceries)?)
(... using ^YOURHISHER hands and fingers to do things such as picking up a glass or grasping a
pencil?)
Page 482 of 578
1. Yes
2. No
LIFT10_DIF
(C_DODOES ^TEMPNAME have any difficulty:)
... sitting for one hour?
... lifting or carrying something as heavy as 10 pounds (such as a bag of groceries)?
(... using ^YOURHISHER hands and fingers to do things such as picking up a glass or grasping a
pencil?)
1. Yes
2. No
GRASP_DIF
(C_DODOES ^TEMPNAME have any difficulty:)
(... sitting for one hour?)
(... lifting or carrying something as heavy as 10 pounds (such as a bag of groceries)?)
... using ^YOURHISHER hands and fingers to do things such as picking up a glass or grasping a
pencil?
1. Yes
2. No
LRN_DIS_AD
C_DODOES ^TEMPNAME have a learning or developmental disability? (This could include
conditions such as dyslexia, ADHD, autism, Down Syndrome, or some other learning or developmental
disability.)
1. Yes
2. No
MENT_DIS_AD
C_DODOES ^TEMPNAME have a mental or emotional condition? (This could include conditions
such as depression, anxiety, or some other psychological condition.)
Page 483 of 578
1. Yes
2. No
FINDJOB
Because of a physical, mental, or emotional problem...
...^DODOES ^TEMPNAME have difficulty finding a job or remaining employed?
(...AREIS ^TEMPNAME prevented from working?)
1. Yes
2. No
JOBCANT
(Because of a physical, mental, or emotional problem...)
(...^DODOES ^TEMPNAME have difficulty finding a job or remaining employed?)
...AREIS ^TEMPNAME prevented from working?
1. Yes
2. No
HLTHCOND_AD
C_DODOES ^TEMPNAME have any physical, mental, or emotional health conditions lasting 12
months or longer that limit ^YOURHISHER daily activities?
1. Yes
2. No
COND1_AD
^WORKDIS_FIL What condition or conditions limit ^YOURHISHER ^ACTIVITY_FIL?
Enter at least the first 3 letters of the condition to display the answer list.
Enter "None" for no conditions.
Enter "Other" for a condition not on the answer list.
COND1CODE_AD
Page 484 of 578
OTHADCOND_SP
Enter the respondent's "Other" condition that could not be found on the answer list.
If you do not recall the person's "Other" condition, read the optional question text below.
(Could you please repeat the name of the condition that limits ^YOURHISHER ^ACTIVITY_FIL?)
COND2_AD
Any other conditions?
Enter at least the first 3 letters of the condition to display the answer list.
Enter "None" for no conditions.
Enter "Other" for a condition not on the answer list.
COND2CODE_AD
COND3_AD
Any other condition?
Enter at least the first 3 letters of the condition to display the answer list.
Enter "None" for no conditions.
Enter "Other" for a condition not on the answer list.
COND3CODE_AD
AGE_5TO14
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
COGNIT
Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME...
Page 485 of 578
...experience serious difficulty concentrating, remembering, or making decisions?
(...experience serious difficulty walking or climbing stairs?)
(...experience difficulty dressing or bathing?)
(...have limited ability to play with other children of the same age?)
(...have limitations in ^HISHER ability to do regular school work?)
1. Yes
2. No
AMBULAT
(Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME...)
(...experience serious difficulty concentrating, remembering, or making decisions?)
...experience serious difficulty walking or climbing stairs?
(...experience difficulty dressing or bathing?)
(...have limited ability to play with other children of the same age?)
(...have limitations in ^HISHER ability to do regular school work?)
1. Yes
2. No
SELFCARE
(Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME...)
(...experience serious difficulty concentrating, remembering, or making decisions?)
(...experience serious difficulty walking or climbign stairs?)
...experience difficulty dressing or bathing?
(...have limited ability to play with other children of the same age?)
(...have limitations in ^HISHER ability to do regular school work?)
1. Yes
2. No
PLAYDIF
(Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME...)
(...experience serious difficulty concentrating, remembering, or making decisions?)
(...experience serious difficulty walking or climbign stairs?)
(...experience difficulty dressing or bathing?)
...have limited ability to play with other children of the same age?
Page 486 of 578
(...have limitations in ^HISHER ability to do regular school work?)
1. Yes
2. No
SKOOLWK
(Because of a physical, mental, or emotional problem ^DODOES ^TEMPNAME...)
(...experience serious difficulty concentrating, remembering, or making decisions?)
(...experience serious difficulty walking or climbign stairs?)
(...experience difficulty dressing or bathing?)
(...have limited ability to play with other children of the same age?)
...have limitations in ^HISHER ability to do regular school work?
1. Yes
2. No
LRN_DIS
C_DODOES ^TEMPNAME have a learning or developmental disability? (This could include
conditions such as dyslexia, ADHD, autism, Down Syndrome, or some other learning or developmental
disability.)
1. Yes
2. No
MENT_DIS
C_DODOES ^TEMPNAME have a mental or emotional condition? (This could include conditions
such as depression, anxiety, or some other psychological condition.)
1. Yes
2. No
HLTHCOND
C_DODOES ^TEMPNAME have any physical, mental, or emotional health conditions lasting 12
months or longer that limit ^YOURHISHER ordinary activities?
1. Yes
2. No
Page 487 of 578
COND1
What condition or conditions limit ^YOURHISHER ordinary activities?
Enter at least the first 3 letters of the condition to display the answer list.
Enter "None" for no conditions.
Enter "Other" for a condition not on the answer list.
COND1CODE
OTHCHCOND_SP
Enter the child's "Other" condition that could not be found on the answer list.
If you do not recall the child's "Other" condition, read the optional question text below.
(Could you please repeat the name of the condition that limits ^YOURHISHER ordinary activity?)
COND2
Any other conditions?
Enter at least the first 3 letters of the condition to display the answer list.
Enter "None" for no conditions.
Enter "Other" for a condition not on the answer list.
COND2CODE
COND3
Any other condition?
Enter at least the first 3 letters of the condition to display the answer list.
Enter "None" for no conditions.
Enter "Other" for a condition not on the answer list.
COND3CODE
AGE_LESSTHAN5
**NON-DISPLAYED ITEM**
Page 488 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
DDELAY
C_DODOES ^TEMPNAME have a developmental condition or delay that limits ordinary activities?
1. Yes
2. No
FERT_INTRO
? [F1]
Next I'll ask some questions about Text to appear on introductory screen of Fertility/Parent
mortality/natality depending on subsequent content.
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
I_PWCEB
**NON-DISPLAYED ITEM**
NEWCHILD_FLAG
**NON-DISPLAYED ITEM**
COPYSOURCEFLAG
GRNDPR_FLG
Page 489 of 578
**NON-DISPLAYED ITEM**
GRNDPR
Ask or verify.
^C_AREIS ^TEMPNAME a grandparent - that is, ^ANYCHILDFIL have any biological or adopted
children of their own who are currently living?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CEB_FLAG
**NON-DISPLAYED ITEM**
REV_KIDLIST
PARCHL_COUNT
**NON-DISPLAYED ITEM**
PARCHL
^ALTOGETHERFIL many children ^HAVHAS ^HESHE ever ^BIRTHFATHERFIL?
Count all biological children of this person, regardless of whether they were born within or outside of
any marriage. Include those who don't live with this person now, or if they died or were adopted by
someone else.
Do not count children adopted by this person, foster children, or stepchildren. Do not count stillbirths
and do not count children not yet born.
Enter 0 for none.
Page 490 of 578
KIDLISTCHK
I am showing that
that correct?
Read name(s) ^FERT_AREIS ^PTEMPNAME biological ^CHILDFERTFIL. Is
Display the first names and ages of the children in ^BIOCHILDLIST.
1. Yes
2. No
KIDLIST_REV
^PCHK_Q
Read answer categories.
Mark all that apply.
Enter 95 if all of the children are biological children.
Enter 96 if none of these children are biological children.
1. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
2. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
3. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
4. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
5. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
6. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
7. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
8. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
9. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
10. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
11. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
12. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
13. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
14. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
15. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
16. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
17. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
18. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
19. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
20. Fill with LNO, ^FNAME, ^LNAME from BIOCHILDLIST?
95. All of the children are ^HISHER biological children?
Page 491 of 578
96. None of the children are ^HISHER biological children?
SAMEPAR
? [F1]
Ask or verify:
Do ^ALLBOTH of ^PTEMPNAME biological children have the same biological Mother/Father fill
for fertility section?
1. Yes
2. No
FERT_CONF
You have keyed:
NUMBER OF CHILDREN:
LIST OF KNOWN CHILDREN: ^FERT_BIOCHILDLIST
WARNING: Once you enter 1 to continue, you cannot make changes to the information above.
Enter 1 to continue.
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
NUMKIDS
CTRLNUM
**NON-DISPLAYED ITEM**
Page 492 of 578
LNO
**NON-DISPLAYED ITEM**
HVARKID_F
**NON-DISPLAY ITEM**
CHL_BDAY
KIDLNO
CHLNAME
Child roster name intro
^CHLNAMEFIL
NEWKID
KIDAGE
COPIED
CHL_BMON
What is this child's month and year of birth?
Enter month.
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
CHL_BYR
(What is this child's month and year of birth?)
Page 493 of 578
Enter year.
CHL_AGEGS
? [F1]
How old would you say this child is?
Enter best estimate of age.
OTHERPARENT
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
HVAR_CLST
**NON-DISPLAY ITEM**
CLUSTER
? [F1]
^CLUSTERFIL
Mark all that apply.
1. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
2. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
3. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
4. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
5. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
6. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
7. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
8. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
Page 494 of 578
9. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
10. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
11. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
12. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
13. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
14. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
15. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
16. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
17. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
18. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
19. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
20. Display the LNO CHL_NAME, CHL_AGE of each child from BKIDS
95. All of these children have the same biological Mother/Father fill for fertility section
OP_LIVHH
Does
Read name(s)'s biological Mother/Father fill for fertility section live here?
Display the names and ages of children from ^CHL_CLUSTERFIL.
1. Yes
2. No
WHOBIOP
Ask or verify:
Who is
Read name(s)'s biological Mother/Father fill for fertility section?
Display the names and ages from ^CHL_CLUSTERFIL.
1. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
2. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
3. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
4. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
5. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
6. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
7. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
8. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
9. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
10. LNO, ^FNAME ^LNAME from TLNMOM/TLNDAD
Page 495 of 578
11. Someone not listed.
CLUSTER_DONE
Enter 1 to continue.
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
PREGWORK
Now I'm going to ask about leave from work ^TEMPNAME may have taken leading up to or right
after the birth of ^HISHER first child. Did ^HESHE work for pay at a job or business at any time
during that pregnancy?
1. Yes
2. No
PREGSTOP
Did ^TEMPNAME continue working right up to the birth of the child?
1. Yes
2. No
PREGMO
In what month and year did ^TEMPNAME stop working before the child was born?
Enter month.
1. January
2. February
Page 496 of 578
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
PREGYR
(In what month and year did ^TEMPNAME stop working before the child was born?)
Enter year.
PREGRSN
DD
In order for ^TEMPNAME to stop working before the child was born, what type of leave, if any, did
^HESHE use...
Read answer categories.
Mark all that apply.
1. Quit?
2. Let go from the job?
3. Paid maternity or paternity leave?
4. Unpaid maternity or paternity leave?
5. Paid sick leave?
6. Unpaid sick leave?
7. Disability leave?
8. Paid vacation leave?
9. Some other kind of leave?
10. Did not take leave DO NOT READ
BIRTHRSN
DD
Page 497 of 578
After the baby was born, and up to the time the baby was 12 weeks old, what type of leave, if any,
did ^TEMPNAME use...
Read answer categories.
Mark all that apply.
1. Quit?
2. Let go from the job?
3. Paid maternity or paternity leave?
4. Unpaid maternity or paternity leave?
5. Paid sick leave?
6. Unpaid sick leave?
7. Disability leave?
8. Paid vacation leave?
9. Some other kind of leave?
10. Did not take leave DO NOT READ
BIRTHWORK
Did ^TEMPNAME work for pay at any time after the birth of the child?
1. Yes
2. No
BIRTHSTMO
In what month and year did ^TEMPNAME start to work after the birth of the child?
Enter month.
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
Page 498 of 578
11. November
12. December
BIRTHSTYR
(In what month and year did ^TEMPNAME start to work after the birth of the child?)
Enter year.
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
BIOMOM
The intent of these questions is to collect information about the respondent's biological parents, even if
the respondent is adopted or has a step-parent.
Is ^PTEMPNAME biological mother (still) alive?
1. Yes
2. No
BIOMOMDEATH_RESPAGE
How old ^WEREWAS ^TEMPNAME when ^HISHER (biological) mother passed away?
BIOMOMDEATH_RESPUNDR19
^C_WASWERE ^TEMPNAME younger than 19 years old when ^HISHER (biological) mother passed
away?
1. Yes
2. No
BIOMOMDOB_M
In what month and year was ^PTEMPNAME (biological) mother born?
Page 499 of 578
Enter month
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
BIOMOMDOB_Y
(In what month and year was ^PTEMPNAME biological mother born?)
Enter year
BIOMOMUS
? [F1]
Was ^PTEMPNAME (biological) mother born in the United States?
1. Yes
2. No
BIOMOMCOUNTRY
? [F1]
In what country was ^PTEMPNAME (biological) mother born?
1. United States (US, USA)
2. Afghanistan
3. American Samoa
4. Argentina
Page 500 of 578
5. Armenia
6. Australia
7. Austria
8. Azores
9. Bahamas
10. Bangladesh
11. Barbados
12. Belgium
13. Belize
14. Bermuda
15. Bolivia
16. Bosnia and Herzegovina
17. Brazil
18. Burma/Myanmar
19. Cambodia
20. Canada
21. Caribbean
22. Chile
23. China
24. Colombia
25. Costa Rica
26. Cuba
27. Czech Republic
28. Czechoslovakia
29. Denmark
30. Dominica
31. Dominican Republic
32. Ecuador
33. Egypt
34. El Salvador
35. England
36. Ethiopia
37. Fiji
38. Finland
39. France
40. Germany
41. Ghana
42. Great Britain
43. Greece
Page 501 of 578
44. Grenada
45. Guam
46. Guatemala
47. Guyana
48. Haiti
49. Honduras
50. Hong Kong
51. Hungary
52. India
53. Indonesia
54. Iran
55. Iraq
56. Ireland
57. Israel
58. Italy
59. Jamaica
60. Japan
61. Jordan
62. Kenya
63. Korea
64. Laos
65. Latvia
66. Lebanon
67. Lithuania
68. Malaysia
69. Mexico
70. Morocco
71. Netherlands
72. New Zealand
73. Nicaragua
74. Nigeria
75. Northern Marianas
76. Norway
77. Pakistan
78. Palestine
79. Panama
80. Peru
81. Philippines
82. Poland
Page 502 of 578
83. Portugal
84. Puerto Rico
85. Romania
86. Russia
87. Scotland
88. Slovakia
89. South Africa
90. South Korea
91. Spain
92. Sweden
93. Switzerland
94. Syria
95. Taiwan
96. Thailand
97. Trinidad and Tobago
98. Turkey
99. U.S. Virgin Islands
100. Ukraine
101. United Kingdom
102. United States (US, USA)
103. Uruguay
104. USSR
105. Venezuela
106. Vietnam
107. Yugoslavia
108. Other Africa
109. Other Asia
110. Other Central America
111. Other Europe
112. Other Pacific Islands
113. Other South America
114. Other
BIOMOMNAT
? [F1]
In what country was ^PTEMPNAME (biological) mother born?
1. United States (US, USA)
Page 503 of 578
2. Afghanistan
3. American Samoa
4. Argentina
5. Armenia
6. Australia
7. Austria
8. Azores
9. Bahamas
10. Bangladesh
11. Barbados
12. Belgium
13. Belize
14. Bermuda
15. Bolivia
16. Bosnia and Herzegovina
17. Brazil
18. Burma/Myanmar
19. Cambodia
20. Canada
21. Caribbean
22. Chile
23. China
24. Colombia
25. Costa Rica
26. Cuba
27. Czech Republic
28. Czechoslovakia
29. Denmark
30. Dominica
31. Dominican Republic
32. Ecuador
33. Egypt
34. El Salvador
35. England
36. Ethiopia
37. Fiji
38. Finland
39. France
40. Germany
Page 504 of 578
41. Ghana
42. Great Britain
43. Greece
44. Grenada
45. Guam
46. Guatemala
47. Guyana
48. Haiti
49. Honduras
50. Hong Kong
51. Hungary
52. India
53. Indonesia
54. Iran
55. Iraq
56. Ireland
57. Israel
58. Italy
59. Jamaica
60. Japan
61. Jordan
62. Kenya
63. Korea
64. Laos
65. Latvia
66. Lebanon
67. Lithuania
68. Malaysia
69. Mexico
70. Morocco
71. Netherlands
72. New Zealand
73. Nicaragua
74. Nigeria
75. Northern Marianas
76. Norway
77. Pakistan
78. Palestine
79. Panama
Page 505 of 578
80. Peru
81. Philippines
82. Poland
83. Portugal
84. Puerto Rico
85. Romania
86. Russia
87. Scotland
88. Slovakia
89. South Africa
90. South Korea
91. Spain
92. Sweden
93. Switzerland
94. Syria
95. Taiwan
96. Thailand
97. Trinidad and Tobago
98. Turkey
99. U.S. Virgin Islands
100. Ukraine
101. United Kingdom
102. United States (US, USA)
103. Uruguay
104. USSR
105. Venezuela
106. Vietnam
107. Yugoslavia
108. Other Africa
109. Other Asia
110. Other Central America
111. Other Europe
112. Other Pacific Islands
113. Other South America
114. Other
BIODAD
The intent of these questions is to collect information about the respondent's biological parents, even if
the respondent is adopted or has a step-parent.
Page 506 of 578
Is ^PTEMPNAME biological father (still) alive?
1. Yes
2. No
BIODADDEATH_RESPAGE
How old ^WEREWAS ^TEMPNAME when ^HISHER (biological) father passed away?
BIODADDEATH_RESPUNDR19
^C_WASWERE ^TEMPNAME younger than 19 years old when ^HISHER (biological) father passed
away?
1. Yes
2. No
BIODADDOB_M
In what month and year was ^PTEMPNAME (biological) father born?
Enter month
1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
BIODADDOB_Y
(In what month and year was ^PTEMPNAME biological father born?)
Enter year
Page 507 of 578
BIODADUS
? [F1]
Was ^PTEMPNAME (biological) father born in the United States?
1. Yes
2. No
BIODADCOUNTRY
? [F1]
In what country was ^PTEMPNAME (biological) father born?
1. United States (US, USA)
2. Afghanistan
3. American Samoa
4. Argentina
5. Armenia
6. Australia
7. Austria
8. Azores
9. Bahamas
10. Bangladesh
11. Barbados
12. Belgium
13. Belize
14. Bermuda
15. Bolivia
16. Bosnia and Herzegovina
17. Brazil
18. Burma/Myanmar
19. Cambodia
20. Canada
21. Caribbean
22. Chile
23. China
24. Colombia
25. Costa Rica
26. Cuba
27. Czech Republic
Page 508 of 578
28. Czechoslovakia
29. Denmark
30. Dominica
31. Dominican Republic
32. Ecuador
33. Egypt
34. El Salvador
35. England
36. Ethiopia
37. Fiji
38. Finland
39. France
40. Germany
41. Ghana
42. Great Britain
43. Greece
44. Grenada
45. Guam
46. Guatemala
47. Guyana
48. Haiti
49. Honduras
50. Hong Kong
51. Hungary
52. India
53. Indonesia
54. Iran
55. Iraq
56. Ireland
57. Israel
58. Italy
59. Jamaica
60. Japan
61. Jordan
62. Kenya
63. Korea
64. Laos
65. Latvia
66. Lebanon
Page 509 of 578
67. Lithuania
68. Malaysia
69. Mexico
70. Morocco
71. Netherlands
72. New Zealand
73. Nicaragua
74. Nigeria
75. Northern Marianas
76. Norway
77. Pakistan
78. Palestine
79. Panama
80. Peru
81. Philippines
82. Poland
83. Portugal
84. Puerto Rico
85. Romania
86. Russia
87. Scotland
88. Slovakia
89. South Africa
90. South Korea
91. Spain
92. Sweden
93. Switzerland
94. Syria
95. Taiwan
96. Thailand
97. Trinidad and Tobago
98. Turkey
99. U.S. Virgin Islands
100. Ukraine
101. United Kingdom
102. United States (US, USA)
103. Uruguay
104. USSR
105. Venezuela
Page 510 of 578
106. Vietnam
107. Yugoslavia
108. Other Africa
109. Other Asia
110. Other Central America
111. Other Europe
112. Other Pacific Islands
113. Other South America
114. Other
BIODADNAT
? [F1]
In what country was ^PTEMPNAME (biological) father born?
1. United States (US, USA)
2. Afghanistan
3. American Samoa
4. Argentina
5. Armenia
6. Australia
7. Austria
8. Azores
9. Bahamas
10. Bangladesh
11. Barbados
12. Belgium
13. Belize
14. Bermuda
15. Bolivia
16. Bosnia and Herzegovina
17. Brazil
18. Burma/Myanmar
19. Cambodia
20. Canada
21. Caribbean
22. Chile
23. China
24. Colombia
Page 511 of 578
25. Costa Rica
26. Cuba
27. Czech Republic
28. Czechoslovakia
29. Denmark
30. Dominica
31. Dominican Republic
32. Ecuador
33. Egypt
34. El Salvador
35. England
36. Ethiopia
37. Fiji
38. Finland
39. France
40. Germany
41. Ghana
42. Great Britain
43. Greece
44. Grenada
45. Guam
46. Guatemala
47. Guyana
48. Haiti
49. Honduras
50. Hong Kong
51. Hungary
52. India
53. Indonesia
54. Iran
55. Iraq
56. Ireland
57. Israel
58. Italy
59. Jamaica
60. Japan
61. Jordan
62. Kenya
63. Korea
Page 512 of 578
64. Laos
65. Latvia
66. Lebanon
67. Lithuania
68. Malaysia
69. Mexico
70. Morocco
71. Netherlands
72. New Zealand
73. Nicaragua
74. Nigeria
75. Northern Marianas
76. Norway
77. Pakistan
78. Palestine
79. Panama
80. Peru
81. Philippines
82. Poland
83. Portugal
84. Puerto Rico
85. Romania
86. Russia
87. Scotland
88. Slovakia
89. South Africa
90. South Korea
91. Spain
92. Sweden
93. Switzerland
94. Syria
95. Taiwan
96. Thailand
97. Trinidad and Tobago
98. Turkey
99. U.S. Virgin Islands
100. Ukraine
101. United Kingdom
102. United States (US, USA)
Page 513 of 578
103. Uruguay
104. USSR
105. Venezuela
106. Vietnam
107. Yugoslavia
108. Other Africa
109. Other Asia
110. Other Central America
111. Other Europe
112. Other Pacific Islands
113. Other South America
114. Other
I_BIOMOM
I_BIOMOMDOB_M
I_BIOMOMDOB_Y
I_BIOMOMUS
I_BIOMOMCOUNTRY
I_BIODAD
I_BIODADDOB_M
I_BIODADDOB_Y
I_BIODADUS
I_BIODADCOUNTY
CHILD_INTRO
? [F1]
Next I'll ask some questions about children in the household. I will ask aboutChild care fill
children's attitude towards school and homework, children's interaction with both parents or
caregivers, and about activities children participate in both inside and outside of school.
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
Page 514 of 578
LNO
**NON-DISPLAYED ITEM**
PAR
During a typical week in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care Read name(s) while
^TEMPNAME ^WEREWAS working (or in school).
Child's other parent or stepparent?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD.
1. Yes
2. No
PARWHCH
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.
Child's other parent or stepparent?)
Which child or children?
Mark all that apply.
1. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
Page 515 of 578
14. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.
CSELF
(During a typical week in fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) while ^TEMPNAME
^WEREWAS working (or in school).
Did ^TEMPNAME care forChild/children for Child Care
working/in school suffix fill?
Read name(s) Designated parent
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD.
1. Yes
2. No
SELFWHCH
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if you used any of the following
arrangements to look afterChild/children for Child Care Read name(s) while you were working.
Did ^TEMPNAME care forChild/children for Child Care
^WEREWAS working (or in school))
Read name(s) while ^TEMPNAME
Which child or children?
Mark all that apply.
Page 516 of 578
1. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.
SIB15
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.)
Brother or sister age 15 or older?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD.
1. Yes
Page 517 of 578
2. No
SIB15WHCH
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.
Brother or sister age 15 or older?)
Which child or children?
Mark all that apply.
1. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.
Page 518 of 578
GRAN
^CC_NONWORKINTROFIL
Grandparent?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
If the respondent is the grandparent of the children in question, then ask about "other grandparents."
CHILDREN:
List names of all children under 15 for whom respondent is LNGD.
1. Yes
2. No
GRANWHCH
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look after Child/children for Child Care Read name(s) Designated parent
working/not working suffix fill.
Grandparent?)
Which child or children?
Mark all that apply.
1. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
Page 519 of 578
17. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.
OTHR
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.)
Any other relative?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD.
1. Yes
2. No
OTHRWHCH
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.
Any other relative?)
Which child or children?
Mark all that apply.
1. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
Page 520 of 578
5. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.
FAM
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.)
Family day care provider caring for two or more children outside of ^PTEMPNAME home?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD.
1. Yes
2. No
FAMWHC
Page 521 of 578
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.
Family day care provider caring for two or more children outside of ^PTEMPNAME home?)
Which child or children?
Mark all that apply.
1. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.
NREL
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.)
Page 522 of 578
A non-relative such as a friend, neighbor, sitter, nanny, or au pair?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD.
1. Yes
2. No
NRELWHCH
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.
A non-relative such as a friend, neighbor, sitter, nanny, or au pair?)
Which child or children?
Mark all that apply.
1. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
Page 523 of 578
20. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.
DAYCARE
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if you used any of the following
arrangements to look afterChild/children for Child Care Read name(s) Designated parent working/not
working suffix fill.)
A child care or day care center?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD.
1. Yes
2. No
DAYWHCH
(During a typical week in the fall ^CALENDAR_YRFIL, please tell me if you used any of the following
arrangements to look afterChild/children for Child Care Read name(s) Designated parent working/not
working suffix fill.
A child care or day care center?)
Which child or children?
Mark all that apply.
1. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
Page 524 of 578
8. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.
DAYSH
ISTHISCC child care or day care CENTER a Head Start program?
Head Start is a federally sponsored preschool program primarily for children from low-income families.
1. Yes
2. No
DAYHSWHCH
(ISTHISCC child care or day care CENTER a Head Start program?)
Which child or children are in a Head Start program?
Mark all that apply.
1. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
2. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
3. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
4. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
Page 525 of 578
5. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
6. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
7. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
8. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
9. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
10. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
11. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
12. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
13. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
14. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
15. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
16. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
17. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
18. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
19. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
20. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
21. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
22. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
23. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
24. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
25. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
26. Someone not listed.
NUR
(During a typical WEEK in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.)
A nursery or preschool?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
CHILDREN:
LNGD.
List the names of all children ages 2-7 for whom the respondent is
1. Yes
2. No
NURWHCH
Page 526 of 578
(During a typical WEEK in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.
A nursery or preschool?)
Which child or children?
Mark all that apply.
CHILDREN:
LNGD.
List the names of all children 2-7 for whom the respondent is
1. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
2. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
3. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
4. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
5. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
6. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
7. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
8. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
9. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
10. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
11. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
12. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
13. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
14. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
15. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
16. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
17. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
18. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
19. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
20. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
21. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
22. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
23. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
24. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
25. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
26. Someone not listed.
NURHS
Page 527 of 578
ISTHISCC nursery School/Schools for Child Care or preSchool/Schools for Child Care a Head
Start program?
Head Start is a federally sponsored preschool program primarily for children from low-income families.
1. Yes
2. No
NURHSWHCH
(ISTHISCC nursery or preSchool/Schools for Child Care a Head Start program?)
Which child or children are in a Head Start program?
Mark all that apply.
1. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
2. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
3. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
4. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
5. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
6. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
7. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
8. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
9. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
10. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
11. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
12. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
13. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
14. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
15. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
16. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
17. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
18. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
19. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
20. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
21. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
22. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
23. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
24. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
25. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
Page 528 of 578
26. Someone not listed.
HEADSTART
(During a typical WEEK in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.)
A Head Start program?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
Head Start is a federally sponsored preschool program primarily for children from low-income families.
CHILDREN:
LNGD.
List the names of all children ages 2-7 for whom the respondent is
1. Yes
2. No
HEADSTWHCH
(During a typical WEEK in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look after Child/children for Child Care Read name(s) Designated parent
working/not working suffix fill.
A Head Start program?)
Which child or children?
Mark all that apply.
1. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
2. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
3. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
4. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
5. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
6. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
7. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
8. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
9. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
10. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
Page 529 of 578
11. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
12. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
13. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
14. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
15. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
16. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
17. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
18. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
19. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
20. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
21. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
22. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
23. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
24. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
25. LNO, ^FNAME where AGE >1 and AGE < 8, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER=
26. Someone not listed.
PROG
(During a typical WEEK in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.)
Before or after school care programs?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
CHILDREN:
LNGD.
List names of all children ages 3-14 for whom the respondent is
1. Yes
2. No
PROGWHCH
(During a typical WEEK in the fall ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care Read name(s) Designated parent
working/not working suffix fill.
Before or after school care programs?)
Which child or children?
Page 530 of 578
Mark all that apply.
1. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
2. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
3. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
4. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
5. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
6. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
7. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
8. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
9. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
10. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
11. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
12. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
13. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
14. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
15. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
16. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
17. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
18. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
19. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
20. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
21. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
22. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
23. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
24. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
25. LNO, ^FNAME where AGE >2 and AGE < 15, (LNMOM or LNDAD or LNGRD = LNO) & PEOPLE_TO_ROSTER
26. Someone not listed.
KIDSELF
Sometimes it is difficult to make arrangements to look after children all of the time. During a
typical week in the fall ^CALENDAR_YRFIL, did Child/children for Child Care Read name(s) care
for ^HIMHERSELFFIL_CC for even a small amount of time when ^TEMPNAME ^WEREWAS not
there?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in a
typical week in October ^CALENDAR_YRFIL?)
1. Yes
Page 531 of 578
2. No
KSELFWHCH
(Sometimes it is difficult to make arrangements to look after children all of the time. During a typical
week in the fall ^CALENDAR_YRFIL, did Child/children for Child Care Read name(s) care for
^HIMHERSELFFIL_CC for even a small amount of time?)
Which child or children?
Mark all that apply.
1. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
2. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
3. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
4. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
5. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
6. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
7. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
8. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
9. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
10. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
11. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
12. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
13. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
14. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
15. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
16. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
17. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
18. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
19. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
20. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
21. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
22. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
23. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
24. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
25. LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.
WORKSCHOOLDEC
Page 532 of 578
WORKREFYEAR
PAYREFYR
Did ^TEMPNAME or ^HISHER family pay for child care at any time while ^TEMPNAME
^WEREWAS working during ^REFYEAR?
Include cost of preschool and nursery school, but do not include tuition costs for kindergarten or grade
school.
1. Yes
2. No
PAYWKREFYR
In a typical week in ^REFYEAR when ^TEMPNAME ^WEREWAS working, how much did
^TEMPNAME or ^HISHER family pay for child care?
Include cost of preschool and nursery school, but do not include tuition costs for kindergarten or grade
school.
If the respondent has trouble reporting the amount for a typical week, then ask: (How much did
^TEMPNAME or ^PTEMPNAME family pay for child care in the last week where child care was used?)
PAY
I'd like you to think about all the child care arrangements used for
^CALENDAR_YRFIL.
Read name(s) in the fall
Did ^TEMPNAME or ^HISHER family usually pay for any of these arrangements for
name(s)?
Read
Include cost of preschool and nursery school, but do not include tuition costs for kindergarten or grade
school.
Child/children for Child Care: List the names of all children on TCHILD_CC014
answer list, excluding 'someone not listed'.
1. Yes
2. No
3. Did not use any arrrangements
PAYWK
Intro CAREPAY text if speaking to the reference person a typical WEEK in the fall
^CALENDAR_YRFIL, how much did ^TEMPNAME or ^HISHER family pay for all of these
arrangements for Read name(s)?
Page 533 of 578
Include cost of preschool and nursery school, but do not include tuition costs for kindergarten or grade
school.
Do not include money paid to household members for care arrangements such as babysitting.
If the respondent has trouble reporting the amount for a typical week, then ask: (How much did
^TEMPNAME or ^PTEMPNAME family pay any of these arrangements in a typical week in October
^CALENDAR_YRFIL?)
Child/children for Child Care: List the names of all children on TCHILD_CC014
answer list, excluding 'someone not listed'.
PAYHELP
Sometimes a parent may pay less than the total cost of a child care arrangement because some
other person or agency pays part of the cost. By this I mean a government agency,
^PTEMPNAME employer, or someone else outside of ^HISHER household.
Did any person or agency help pay for ^PAYFILL care in the fall ^CALENDAR_YRFIL?
Remind the respondent to include all children under 15: (Please include all of ^PTEMPNAME children
under 15 who were living with ^TEMPNAME in December ^CALENDAR_YRFIL.)
1. Yes
2. No
WHOPAID
What persons or agencies helped to pay for part or all of ^PTEMPNAME ^PCHILD care in the fall
^CALENDAR_YRFIL?
Mark all that apply.
Remind the respondent to include all children under 15: (Please include all of ^PTEMPNAME children
under 15 who were living with ^TEMPNAME in December ^CALENDAR_YRFIL.)
1. Welfare or Social Services
2. Employer
3. Non-resident parent
4. Relative or friend
5. Other
LIST
Page 534 of 578
^C_WASWERE ^TEMPNAME on a waiting list for a child care arrangement in the fall
^CALENDAR_YRFIL?
Remind the respondent to include all children under 15: (Please include all of ^PTEMPNAME children
under 15 who were living with ^TEMPNAME in the fall ^CALENDAR_YRFIL.)
1. Yes
2. No
WORKMORE
Did ^TEMPNAME have any problems in obtaining child care that prevented ^TEMPNAME from
^WRK_WRKM in the fall ^CALENDAR_YRFIL?
Remind the respondent to include all children under 15: (Please include all of ^PTEMPNAME children
under 15 who were living with ^TEMPNAME in the fall ^CALENDAR_YRFIL.)
1. Yes
2. No
TIMELOST
^TIMELOSTINTRO much time, if any, did ^TEMPNAME lose in the fall ^CALENDAR_YRFIL from
work or school either because of failures in child care arrangements or because ^TEMPNAME
could not find a child care provider?
Enter number. The next screen captures whether this is reported as hours, days, or weeks.
TIMELOST_TYPE
(^TIMELOSTINTRO much time, if any, was lost in the fall ^CALENDAR_YRFIL from work or school
either because of failures in child care arrangements or because ^TEMPNAME could not find a child
care provider?)
Read if necessary:
Is that hours, days, or weeks?
1. Hours
2. Days
3. Weeks
CTRLNUM
Page 535 of 578
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CHLD_ANY
(People in need don't always receive unrestricted cash payments from the government - they may
receive money for specific activities or other kinds of help.)
Thinking now about all months since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME ever
receive any child care services or assistance so ^HESHE could go to work or school or training?
1. Yes
2. No
CHLD_OTH_REC
question text fill
Mark all that apply.
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
Page 536 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
DINLNGD
Now I would like to ask you some (additional) questions about
Read name(s).
In a typical week, how many days ^DODOES ^TEMPNAME eat dinner with them?
CHILDREN: List the names of all children for whom respondent is the LNGD.
0. None
1. One day
2. Two days
3. Three days
4. Four days
5. Five days
6. Six days
7. Seven days
DINOP
In a typical week, how many days does question text for DINOP eat dinner with
FR Help screen for single parents
0. None
1. One day
2. Two days
3. Three days
Page 537 of 578
Read name(s)?
4. Four days
5. Five days
6. Six days
7. Seven days
READCWB
In a typical week , about how many days ^DODOES ^TEMPNAME or any family member read
stories to: Read name(s)?
Children: Please list all children under 6 for whom the respondent is the
LNGD.
0. None
1. One day
2. Two days
3. Three days
4. Four days
5. Five days
6. Six days
7. Seven days
OUTINGSLNGD
In a typical week, about how many days ^DODOES ^TEMPNAME take Read name(s) on any kind
of outing, such as to the park, library, zoo, a store, church, a restaurant, or a family gathering?
Children: Please list all children under 6 for whom the respondent is the
LNGD.
0. None
1. One day
2. Two days
3. Three days
4. Four days
5. Five days
6. Six days
7. Seven days
OUTINGSOP
In a typical week, about how many days does question text for DINOP take
Page 538 of 578
Read name(s) on any
kind of outing, such as to the park, library, zoo, a store, church, a restaurant, or a family
gathering?
FR Help screen for single parents
0. None
1. One day
2. Two days
3. Three days
4. Four days
5. Five days
6. Six days
7. Seven days
REPGRD
C_HAVEHASCWB this/these for 6-17
any reason?
Read name(s) ever repeated a grade, or been held back for
Children: Please list all children ages 6-17 for whom the respondent is the
LNGD.
1. Yes
2. No
REPGRDWHCH
(C_HAVEHASCWB this/these for 6-17
reason?)
Read name(s) ever repeated a grade, or been held back for any
Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
Page 539 of 578
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed
EXPSCH
C_HAVEHASCWB this/these for 6-17
from school?
Read name(s) ever been suspended, excluded, or expelled
Children: Please list all children ages 6-17 for whom the respondent is the
LNGD.
1. Yes
2. No
EXPSCHWHCH
(C_HAVEHASCWB this/these for 6-17
from school?)
Read name(s) ever been suspended, excluded, or expelled
Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
Page 540 of 578
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed
GIFTED
C_HAVEHASCWB this/these for 6-17 Read name(s) ever gone to any special classes for gifted
students, or done advanced work in any subject?
Children: Please list all children ages 6-17 for whom the respondent is the
LNGD.
1. Yes
2. No
GIFTDWHCH
(C_HAVEHASCWB this/these for 6-17 Read name(s) ever gone to any special classes for gifted
students, or done advanced work in any subject?)
Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
Page 541 of 578
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed
SPORT
In ^CALENDAR_YEAR, did this/these for 6-17
Read name(s) play on a sports team?
Either in or out of school.
Children: List all children ages 6-17 for whom the respondent is LNGD.
1. Yes
2. No
SPORTWHCH
(In ^CALENDAR_YEAR, did this/these for 6-17
school?)
Read name(s) play on a sports team, either in or out of
Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
Page 542 of 578
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed
LESSON
In ^CALENDAR_YEAR, did this/these for 6-17 Read name(s) take lessons after school or on
weekends in subjects like music, dance, language, computers, or religion?
Children: Please list all children ages 6-17 for whom the respondent is the
LNGD.
1. Yes
2. No
LESSONWHCH
(In ^CALENDAR_YEAR, did this/these for 6-17 Read name(s) take lessons after school or on
weekends in subjects like music, dance, language, computers, or religion?)
Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
Page 543 of 578
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed
CLUB
In ^CALENDAR_YEAR, did this/these for 6-17 Read name(s) participate in any clubs or
organizations after school or on weekends, such as Scouts, a religious group, or a Girls' or Boys'
club?
Children: List all children age 6-17 for whom the respondent is the LNGD.
1. Yes
2. No
CLUBWHCH
(In ^CALENDAR_YEAR, did this/these for 6-17 Read name(s) participate in any clubs or organizations
after school or on weekends, such as Scouts, a religious group, or a Girls' or Boys' club?)
Which child or children?
Mark all that apply.
1. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
2. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
3. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
4. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
5. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
6. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
7. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
8. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
Page 544 of 578
9. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
10. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
11. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
12. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
13. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
14. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
15. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
16. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
17. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
18. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
19. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
20. LNO, FNAME LNAME where AGE > 5 and AGE < 18 and the respondent is the child's guardian
26. Someone not listed
RELIG
In the past year, how often did Read name(s) go to a religious service, a religious social event,
or to religious education such as Sunday school?
If designated parent has more than one child and has trouble determining how often, then ask, (In the
past year, how often did ^HISHER OLDEST child go to a religious service, a religious social event, or to
a religious education such as Sunday school?)
CHILDREN: List all children ages 6-17 for whom the respondent is LNGD.
1. Never
2. Several times a year
3. About once a month
4. About once a week
5. Every day or almost every day
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
KIDLNO
Page 545 of 578
**NON-DISPLAY ITEM**
HVARKID
**NON-DISPLAY ITEM**
CARES
^SCHCARE
1. All of the time?
2. Most of the time?
3. Some of the time?
4. None of the time?
6. Not enrolled?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
KIDLNO
**NON-DISPLAYED ITEM**
HVARKID
**NON-DISPLAY ITEM**
WORKS
^SCHWORK
1. All of the time?
2. Most of the time?
3. Some of the time?
4 . None of the time?
Page 546 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
KIDLNO
**NON-DISPLAYED ITETM**
HVARKID
**NON-DISPLAY ITEM**
GETBY
^SCHGETBY
1. All of the time?
2. Most of the time?
3. Some of the time?
4 . None of the time?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
KIDLNO
**NON-DISPLAYED ITEM**
HVARKID
**NON-DISPLAY ITEM**
HMWRK
Page 547 of 578
^SCHHMWK
1. All of the time?
2. Most of the time?
3. Some of the time?
4 . None of the time?
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
AWB_INTRO
? [F1]
Next I'll ask some questions about conditions in your home, the safety of your neighborhood,
and questions about whether or not ^TEMPNAME had problems obtaining the kinds or amount of
food ^TEMPNAME needed.
1. Enter 1 to continue
AWBCRACK
I have some questions about the place where ^TEMPNAME ^WEREWAS living in ^YEAR. Were
the following conditions present...
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.
...holes in the walls or ceiling, or cracks wider than the edge of a dime?
(...holes in the floor big enough to catch your foot on?)
(...problems with pests such as rats, mice, roaches, or other insects?)
(...a toilet, hot water heater, or other plumbing that didn't work?)
1. Yes
2. No
Page 548 of 578
AWBHOLES
(I have some questions about the place where ^TEMPNAME ^WEREWAS living in ^YEAR. Were the
following conditions present...)
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.
(...holes in the walls or ceiling, or cracks wider than the edge of a dime?)
...holes in the floor big enough to catch your foot on?
(...problems with pests such as rats, mice, roaches, or other insects?)
(...a toilet, hot water heater, or other plumbing that didn't work?)
1. Yes
2. No
AWBPESTS
(I have some questions about the place where ^TEMPNAME ^WEREWAS living in ^YEAR. Were the
following conditions present...)
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.
(...holes in the walls or ceiling, or cracks wider than the edge of a dime?)
(...holes in the floor big enough to catch your foot on?)
...problems with pests such as rats, mice, roaches, or other insects?
(...a toilet, hot water heater, or other plumbing that didn't work?)
1. Yes
2. No
AWBPLUMB
(I have some questions about the place where ^TEMPNAME ^WEREWAS living in ^YEAR. Were the
following conditions present...)
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.
(...holes in the walls or ceiling, or cracks wider than the edge of a dime?)
(...holes in the floor big enough to catch your foot on?)
(...problems with pests such as rats, mice, roaches, or other insects?)
...a toilet, hot water heater, or other plumbing that didn't work?
Page 549 of 578
1. Yes
2. No
AWBTRAFF
Do you think any of the following conditions were problems in the neighborhood where
^TEMPNAME lived in ^YEAR...
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.
...street noise or heavy street traffic?
(...trash, litter, or garbage in the streets or lots?)
1. Yes
2. No
AWBTRASH
(Do you think any of the following conditions were problems in the neighborhood where ^TEMPNAME
lived in ^YEAR...)
If the respondent lived in more than one place, ask about where the respondent lived the longest or
spent the most time during the year. Record persistent conditions, or conditions that were present for
the majority of the time.
(...street noise or heavy street traffic?)
...trash, litter, or garbage in the streets or lots?
1. Yes
2. No
AWBSTAY
Did ^TEMPNAME stay in ^PTEMPNAME home at certain times during ^YEAR because ^HESHE
thought ^HESHE might be unsafe?
If the respondent lived in more than one place, ask for the place where he or she lived the longest or
spent the most time. Record persistent conditions, or conditions that were present for the majority of the
time.
1. Yes
2. No
Page 550 of 578
AWBSAFE
Was ^PTEMPNAME neighborhood in ^YEAR...
Read answer categories.
1. Very safe?
2. Somewhat safe?
3. Somewhat unsafe?
4. Very unsafe?
AWBMORT
Next are questions about difficulties people sometimes have in meeting their essential household
expenses.
During ^YEAR, was there ANY time when ^YOUYOURHOUSEHOLD_ADULT_WB...
...did not pay the full amount of the rent or mortgage?
(...did not pay the full amount of the gas, oil, or electricity bill?)
If respondent owns the residence free and clear, enter '2' and continue.
1. Yes
2. No
AWBGAS
(Next are questions about difficulties people sometimes have in meeting their essential household
expenses.
During ^YEAR, was there ANY time when ^YOUYOURHOUSEHOLD_ADULT_WB...)
(...did not pay the full amount of the rent or mortgage?
...did not pay the full amount of the gas, oil, or electricity bill?
1. Yes
2. No
ECVD_RENT
Would you say that not paying the full rent or mortgage was due to events related to the
coronavirus pandemic?
1. Yes
Page 551 of 578
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
FOODF1
These next questions are about whether ^TEMPNAME could afford the food ^HESHE needed
during ^CALENDAR_YEAR. I'm going to read you some statements that people have made about
their food situations.
The first statement is, "The food that ^IWE_FOOD bought just didn't last, and ^IWE_FOOD didn't
have money to get more." Was that often, sometimes, or never true for
^YOUYOURHOUSEHOLD_ADULT_WB in ^CALENDAR_YRFIL?
1. Often true
2. Sometimes true
3. Never true
FOODF2
^C_IWE_FOOD couldn't afford to eat balanced meals." Was that often, sometimes, or never true
for ^YOUYOURHOUSEHOLD_ADULT_WB in ^YEAR?
1. Often true
2. Sometimes true
3. Never true
FOODF3
In ^YEAR, did ^YOUOTHERADULTS_FOOD ever cut the size of meals or skip meals because
there wasn't enough money for food?
1. Yes
2. No
Page 552 of 578
FOODF4
How often did this happen...
Read answer categories.
1. Almost every month?
2. Some months but not every month?
3. Only 1 or 2 months?
FOODF5
In ^YEAR, did ^TEMPNAME ever eat less than ^HESHE felt you should because there wasn't
enough money for food?
1. Yes
2. No
FOODF6
In ^YEAR, ^WEREWAS ^TEMPNAME ever hungry but didn't eat because there wasn't enough
money for food?
1. Yes
2. No
CTRLNUM
**NON-DISPLAYED ITEM**
FIN
^FINQ_FIL
1. Enter 1 to continue
CTRLNUM
ULTADDR
UPHONE_INT
UWHOSPEAK
WHO_SPEAK_WITH
Page 553 of 578
Do not read to the respondent.
Select the person (based on his or her line number) with whom you are speaking right now.
1. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
2. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
3. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
4. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
5. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
6. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
7. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
8. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
9. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
10. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
11. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
12. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
13. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
14. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
15. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
16. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
17. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
18. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
19. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
20. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
CTRLNUM
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
TELEPHONE_NO
Ask or verify.
Page 554 of 578
What is the telephone number where ^TEMPNAME would like to be called?
TELEPHONE_TYPE
What type of telephone is it?
1. Home
2. Work
3. Cellular or digital
4. Beeper/Pager/Answering service
5. Public (pay phone)
6. Toll free
7. Phone outside the household (relative, friend, etc.)
8. Other
SEC_TELEPHONE_NO
Ask or verify.
What is the second telephone number where ^TEMPNAME would like to be called?
SEC_TELEPHONE_TYPE
What type of telephone is it?
1. Home
2. Work
3. Cellular or digital
4. Beeper/Pager/Answering service
5. Public (pay phone)
6. Toll free
7. Phone outside the household (relative, friend, etc.)
8. Other
BEST_TIME_CONTACT
Ask or verify.
When is the best time to contact ^TEMPNAME?
Page 555 of 578
Do not read answer categories.
1. Morning (9am - 12 noon)
2. Noon/lunchtime (11:00am - 1pm)
3. Afternoon (12 noon - 4pm)
4. Suppertime/early evening/dinner time (4pm - 7pm)
5. Evening (6pm - 9pm)
6. Anytime (9am - 9pm)
7. Late evening/night (7pm - 9pm)
8. Daytime (9am - 4pm)
9. After 5pm
10. Other
CONT_PSN1_FNAME
Ask or verify.
What is the first name of a close relative or friend, not currently living at this address, who would
know how to reach ^TEMPNAME if we are unable to do so?
CONT_PSN1_LNAME
Ask or verify.
What is this person's last name?
CONT_PSN1_REL
Ask or verify.
What is Fill for contact person's name's relationship to ^TEMPNAME?
CONT_PSN1_TELENO
What is Fill for contact person's name's telephone number?
Include the area code, prefix, suffix, and the extension (if one exists).
CONT_PSN1_PO
Ask or verify.
Page 556 of 578
In what city does Fill for contact person's name live?
CONT_PSN1_STATE_CODE
CONT_PSN1_ST
Ask or verify.
In what state does Fill for contact person's name live?
1. Alabama
2. Alaska
3. American Samoa
4. Arizona
5. Arkansas
6. California
7. Colorado
8. Connecticut
9. Delaware
10. District of Columbia
11. Florida
12. Georgia
13. Guam
14. Hawaii
15. Idaho
16. Illinois
17. Indiana
18. Iowa
19. Kansas
20. Kentucky
21. Louisiana
22. Maine
23. Maryland
24. Massachusetts
25. Michigan
26. Minnesota
27. Mississippi
28. Missouri
29. Montana
30. Nebraska
31. Nevada
Page 557 of 578
32. New Hampshire
33. New Jersey
34. New Mexico
35. New York
36. North Carolina
37. North Dakota
38. Northern Marianas
39. Ohio
40. Oklahoma
41. Oregon
42. Other place
43. Pennsylvania
44. Puerto Rico
45. Rhode Island
46. South Carolina
47. South Dakota
48. Tennessee
49. Texas
50. U.S. Virgin Islands
51. Utah
52. Vermont
53. Virginia
54. Washington
55. West Virginia
56. Wisconsin
57. Wyoming
MOVING_INTENT
^DODOES ^TEMPNAME have any plans to move in the next year?
1. Yes
2. No
LNO
**NON-DISPLAYED ITEM**
LTRADDR
Page 558 of 578
To whom should future correspondence be addressed?
You may only select original sample people to receive future correspondence.
Read name(s) if necessary.
1. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
2. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
3. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
4. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
5. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
6. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
7. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
8. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
9. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
10. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
11. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
12. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
13. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
14. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
15. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
16. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
17. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
18. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
19. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
20. Display the LNO, ^FNAME, ^LNAME, where AGE >= 15
99. No one
CTRLNUM
**NON-DISPLAYED ITEM**
LNO
**NON-DISPLAYED ITEM**
CTRLNUM
**NON-DISPLAYED ITEM**
Page 559 of 578
LN0
**NON-DISPLAYED ITEM**
MOVING_STATE_CODE
MOVING_ST
What is the new state going to be?
1. Alabama
2. Alaska
3. American Samoa
4. Arizona
5. Arkansas
6. California
7. Colorado
8. Connecticut
9. Delaware
10. District of Columbia
11. Florida
12. Georgia
13. Guam
14. Hawaii
15. Idaho
16. Illinois
17. Indiana
18. Iowa
19. Kansas
20. Kentucky
21. Louisiana
22. Maine
23. Maryland
24. Massachusetts
25. Michigan
26. Minnesota
27. Mississippi
28. Missouri
29. Montana
30. Nebraska
31. Nevada
32. New Hampshire
Page 560 of 578
33. New Jersey
34. New Mexico
35. New York
36. North Carolina
37. North Dakota
38. Northern Marianas
39. Ohio
40. Oklahoma
41. Oregon
42. Other place
43. Pennsylvania
44. Puerto Rico
45. Rhode Island
46. South Carolina
47. South Dakota
48. Tennessee
49. Texas
50. U.S. Virgin Islands
51. Utah
52. Vermont
53. Virginia
54. Washington
55. West Virginia
56. Wisconsin
57. Wyoming
MOVING_PO
What is the new city going to be?
MOVING_REASON
Does the respondent plan to move...
Read answer categories.
1. Outside the U.S.?
2. Inside the U.S., to an unknown state?
3. Inside the U.S., to an institution?
Page 561 of 578
CTRLNUM
**NON-DISPLAYED ITEM**
BCINFO
Was the noninterview status determined by observation only or did someone provide you with
information about the housing unit?
1. By observation only
2. Information provided by someone else
BCINFO2_MONTH
Enter the month in which the household left the sample.
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
6. ^MONTH6, ^CALENDAR_YEAR
7. ^MONTH7, ^CALENDAR_YEAR
8. ^MONTH8, ^CALENDAR_YEAR
9. ^MONTH9, ^CALENDAR_YEAR
10. ^MONTH10, ^CALENDAR_YEAR
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
14. ^INTV_MONTH2, ^INTV_YEAR
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
BCINFO2_DAY
Enter the day in which the household left the sample.
BCINFO2_FN
Enter the first name of the person providing the noninterview status.
Page 562 of 578
BCINFO2_LN
Enter the last name of the person providing the noninterview status.
BCINFO2_CPREL
Enter the title of the contact person (relative, neighbor, etc.).
BCINFO2_STRNUM
Enter the street number (including any unit designation) of the contact person's address.
BCINFO2_STRNME
Enter the street name of the contact person's address.
BCINFO2_PO
Enter the city of the contact person's address.
bcinfo2_st
Enter the state of the contact person's address.
AL. Alabama
AK. Alaska
AZ. Arizona
AR. Arkansas
CA. California
CO. Colorado
CT. Connecticut
DC. District of Columbia
DE. Delaware
FL. Florida
GA. Georgia
HI. Hawaii
ID. Idaho
IL. Illinois
IN. Indiana
IA. Iowa
KS. Kansas
KY. Kentucky
LA. Louisiana
Page 563 of 578
ME. Maine
MD. Maryland
MA. Massachusetts
MI. Michigan
MN. Minnesota
MS. Mississippi
MO. Missouri
MT. Montana
NE. Nebraska
NV. Nevada
NH. New Hampshire
NJ. New Jersey
NM. New Mexico
NY. New York
NC. North Carolina
ND. North Dakota
OH. Ohio
OK. Oklahoma
OR. Oregon
PA. Pennsylvania
RI. Rhode Island
SC. South Carolina
SD. South Dakota
TN. Tennessee
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
WA. Washington
WV. West Virginia
WI. Wisconsin
WY. Wyoming
bcinfo2_zip
Enter the zip code of the contact person's address.
BCINFO2_ZIP4
Enter the 4-digit zip code of the contact person's address.
Page 564 of 578
bcinfo2_phone
BCINFO2_AR
Enter the area code of the contact person's telephone number.
BCINFO2_NO
Enter the contact person's telephone number.
BCINFO2_EXT
Enter any extension to the contact person's telephone number (if applicable).
ctrlnum
**NON-DISPLAYED ITEM**
TRANSMIT
Do not read to the respondent.
Are you ready to transmit the case?
1. Yes
2. No
ctrlnum
**NON-DISPLAYED ITEM**
lno
why_typez_hhld
^TYPEZHHLDQSTNTXTFIL
1. Person was ill or in the hospital
2. Person was temporarily away from home
3. Other
typez_specify
Page 565 of 578
What is the other reason?
ctrlnum
**NON-DISPLAYED ITEM**
visit_count
How many times have you attempted personal contact (actually visited the address)?
int_mode
Was ^MAJORITY_FIL this interview done by telephone interview or by personal interview?
1. Telephone interview
2. Personal interview
THANKYOU
Thank you for your participation. Since this is a survey that measures economic change over
time, we recontact respondents annually to update their information. Also, as part of our quality
assurance program, my office may contact you in the next several weeks to verify the quality of
my work. Thank you again.
Enter 1 to continue.
1. Enter 1 to continue
other_name
Do not read to the respondent.
Identify the person who responded to the majority of this interview.
1. Display the LNO ROST_FNAME ROST_LNAME
2. Display the LNO ROST_FNAME ROST_LNAME
3. Display the LNO ROST_FNAME ROST_LNAME
4. Display the LNO ROST_FNAME ROST_LNAME
5. Display the LNO ROST_FNAME ROST_LNAME
Page 566 of 578
6. Display the LNO ROST_FNAME ROST_LNAME
7. Display the LNO ROST_FNAME ROST_LNAME
8. Display the LNO ROST_FNAME ROST_LNAME
9. Display the LNO ROST_FNAME ROST_LNAME
10. Display the LNO ROST_FNAME ROST_LNAME
11. Display the LNO ROST_FNAME ROST_LNAME
12. Display the LNO ROST_FNAME ROST_LNAME
13. Display the LNO ROST_FNAME ROST_LNAME
14. Display the LNO ROST_FNAME ROST_LNAME
15. Display the LNO ROST_FNAME ROST_LNAME
16. Display the LNO ROST_FNAME ROST_LNAME
17. Display the LNO ROST_FNAME ROST_LNAME
18. Display the LNO ROST_FNAME ROST_LNAME
19. Display the LNO ROST_FNAME ROST_LNAME
20. Display the LNO ROST_FNAME ROST_LNAME
spanish_int
Did you conduct any of this household's interview in Spanish?
1. Yes
2. No
CHECKOUT
**NON-DISPLAYED ITEM**
language_int
What language is spoken in this household that prevented you from conducting the interview?
1. Spanish or Spanish Creole
2. Chinese
3. French (including Patois, Cajun)
4. French Creole
5. Tagalog, Filipino
6. Vietnamese
7. German
8. Korean
Page 567 of 578
9. Russian
10. Italian
11. Hindi, Urdu
12. Arabic
13. Portuguese or Portuguese Creole
14. Polish
15. Persian
16. Gujarati
17. Other
SHOWFINAL
MODE: ^INT_MODEFIL
OUTCOME: ^OUTCOMEFIL
MARK: ^MARKFIL
MARKTWO: ^MARKTWOFIL
Enter 1 to continue.
1. Enter 1 to continue
CTRLNUM
**NON-DISPLAYED ITEM**
CALLBACK_TODAY
I'd like to schedule a return visit to finish conducting the interview. When should I come back to
complete the interview?
Enter 1 if the respondent gives you a time for later today.
Enter 2 if the respondent gives you a day in the future.
1. Enter a time (for later today)
2. Enter a date (for a later date)
TODAY_TIME
Page 568 of 578
What time today?
CALLBACK_DATE
What DATE and TIME would be best to visit again to conduct the interview?
Enter the date (MM/DD/YYYY).
CALLBACK_TIME
(What DATE and TIME would be best to visit again to conduct the inteview?)
Enter the time (hour, minutes, and am or pm).
THANKYOU_CALLBACK
Thank you for your help. I will come back at the time suggested.
^CALLBACKAPPTFIL
Enter 1 to continue.
1. Enter 1 to continue
ctrlnum
**NON-DISPLAYED ITEM**
ctrlnum
**NON-DISPLAYED ITEM**
alreadyspawned
movercounter
mover_lno
**NON-DISPLAY ITEM**
whoelse
Page 569 of 578
Ask if necessary:
Did any of the following people
address?
Read name(s) move with ^MOVERNAME_FIL to the same
Mark all that apply.
If none of the people listed below moved together, then mark 0.
If the person doesn't know (or refuses to answer) who moved with ^MOVERNAME_FIL to the same
address, then select all the names listed below.
0. No one else moved to same new address
1. See Special Instructions
2. See Special Instructions
3. See Special Instructions
4. See Special Instructions
5. See Special Instructions
6. See Special Instructions
7. See Special Instructions
8. See Special Instructions
9. See Special Instructions
10. See Special Instructions
11. See Special Instructions
12. See Special Instructions
13. See Special Instructions
14. See Special Instructions
15. See Special Instructions
16. See Special Instructions
17. See Special Instructions
18. See Special Instructions
19. See Special Instructions
20. See Special Instructions
21. See Special Instructions
22. See Special Instructions
23. See Special Instructions
24. See Special Instructions
25. See Special Instructions
move_addr_yn
^QSTNTXT_MOVERADDR
Page 570 of 578
1. Enter new address
2. Don't know/Address not available yet
ctrlnum
**NON-DISPLAYED ITEM**
move_zip
mover_lno
**NON-DISPLAY ITEM**
move_hno
? [F1]
What is the new address for ^MOVERTENSE_FIL?
Enter the House Number.
move_hnosuf
? [F1]
(What is the new address for ^MOVERTENSE_FIL?)
Enter the House Number Suffix.
move_strname
? [F1]
(What is the new address for ^MOVERTENSE_FIL?)
Enter the Street Name.
move_unitdes
? [F1]
(What is the new address for ^MOVERTENSE_FIL?)
Page 571 of 578
Enter the Apartment or Unit Number.
move_county
? [F1]
(What is the new address for ^MOVERTENSE_FIL?)
Enter the County.
move_po
? [F1]
(What is the new address for ^MOVERTENSE_FIL?)
Enter the City.
move_st
? [F1]
(What is the new address for ^MOVERTENSE_FIL?)
Enter the State.
AL. Alabama
AK. Alaska
AZ. Arizona
AR. Arkansas
CA. California
CO. Colorado
CT. Connecticut
DC. District of Columbia
DE. Delaware
FL. Florida
GA. Georgia
HI. Hawaii
ID. Idaho
IL. Illinois
Page 572 of 578
IN. Indiana
IA. Iowa
KS. Kansas
KY. Kentucky
LA. Louisiana
ME. Maine
MD. Maryland
MA. Massachusetts
MI. Michigan
MN. Minnesota
MS. Mississippi
MO. Missouri
MT. Montana
NE. Nebraska
NV. Nevada
NH. New Hampshire
NJ. New Jersey
NM. New Mexico
NY. New York
NC. North Carolina
ND. North Dakota
OH. Ohio
OK. Oklahoma
OR. Oregon
PA. Pennsylvania
RI. Rhode Island
SC. South Carolina
SD. South Dakota
TN. Tennessee
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
WA. Washington
WV. West Virginia
WI. Wisconsin
WY. Wyoming
MOVE_ZIP5
Page 573 of 578
? [F1]
(What is the new address for ^MOVERTENSE_FIL?)
Enter the Zip Code.
MOVE_ZIP4
? [F1]
(What is the new address for ^MOVERTENSE_FIL?)
Enter the 4-Digit Zip Code.
move_mo
When did ^THISTHESEPERSONSFIL move to this address?
Enter the month.
0. Before ^MONTH1 ^CALENDAR_YRFIL
1. ^MONTH1 ^CALENDAR_YRFIL
2. ^MONTH2 ^CALENDAR_YRFIL
3. ^MONTH3 ^CALENDAR_YRFIL
4. ^MONTH4 ^CALENDAR_YRFIL
5. ^MONTH5 ^CALENDAR_YRFIL
6. ^MONTH6 ^CALENDAR_YRFIL
7. ^MONTH7 ^CALENDAR_YRFIL
8. ^MONTH8 ^CALENDAR_YRFIL
9. ^MONTH9 ^CALENDAR_YRFIL
10. ^MONTH10 ^CALENDAR_YRFIL
11. ^MONTH11 ^CALENDAR_YRFIL
12. ^MONTH12 ^CALENDAR_YRFIL
13. ^MONTH13 ^INTYEARFIL
14. ^MONTH14 ^INTYEARFIL
15. ^MONTH15^INTYEARFIL
16. ^MONTH16 ^INTYEARFIL
17. ^MONTH17 ^INTYEARFIL
18. ^MONTH18 ^INTYEARFIL
move_reason
Page 574 of 578
Why did ^THISTHESEPERSONSFIL leave the household?
Mark all that apply.
5. Marital-status reasons (e.g., marriage, civil union, partnership, cohabitation, separation or divorce)
6. Job-related reasons
7. Attending college or boarding school, or other educational reason
8. Other family changes (e.g., change in custody, child moves out on his own, parent moved into nursing home)
10. Other
move_main_reason
What is the main reason ^THISTHESEPERSONSFIL left the household?
5. Marital-status reasons (e.g., marriage, civil union, partnership, cohabitation, separation or divorce)
6. Job-related reasons
7. Attending college or boarding school, or other educational reason
8. Other family changes (e.g., change in custody, child moves out on his own, parent moved into nursing home)
10. Other
in_fr_area
Is this address within your assignment area?
1. Yes
2. No
MOVER_WARNING
WARNING: A mover will be spawned from this case.
Enter 1 to continue.
1. Enter 1 to continue
no_spwan_warning
No spawn will be created because this is a 'grandchild' case. Please contact your supervisor for further
instructions.
Enter 1 to continue.
Page 575 of 578
1. Enter 1 to continue
NEXT_ADULT_INT
^QSTNTXT_NEXTADLTINT
1. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
2. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
3. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
4. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
5. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
6. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
7. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
8. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
9. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
10. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
11. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
12. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
13. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
14. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
15. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
16. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
17. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
18. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
19. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
20. Display the LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER = 1
99. No more people with an incomplete interview
INT_TYPE
^QSTNTXT_INTTYPE
1. Self
2. Proxy - Other household member is able to conduct interview
3. TYPE Z - Not available during the entire interview period
PROXY_INT
Ask if necessary:
Page 576 of 578
Who will be answering for ^PROXY_INT_NAMEFIL?
1. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
2. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
3. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
4. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
5. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
6. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
7. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
8. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
9. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
10. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
11. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
12. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
13. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
14. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
15. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
16. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
17. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
18. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
19. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
20. Display the LNO ROST_FNAME ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1
WHY_TYPEZ
Why is ^INT_PERSON_NAMEFIL not available to be interviewed? Is ^HESHE ill or in the hospital,
temporarily away from home, or is there some other reason?
1. Person was ill or in the hospital
2. Person was temporarily away from home
3. Other
TYPEZ_SPECIFY
What is the other reason?
Feedback Change Control
**NON-DISPLAYED ITEM**
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Item Name within Spider (MANDATORY)
? [F1] << NOTE: This is how you indicate a help screen
Question text, with fills indicated by a leading carat (i.e., ^TEMPNAME) go here; words are
EMPHASIZED by putting them in all capital letters. (Optional text appears in parentheses and is
greyed out.)
FR instructions should appear in bold blue, and are preceded by a blue diamond.
If you need to list some context specific information on screen (i.e., people
in the HH), you do it via a pre-chart below the question text. This
pre-chart appears in a lighter blue.
1. Includes edited variable values 1 & 2
2. Original edited variable is value 2, but as a result of collapsing or editing, you may renumber - NOT ADVISED - B
RETURNING
^RETURN_TEXT
Press '1' to continue.
1. Continue
EHC_EMONTH
**NON-DISPLAYED FIELD**
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| File Type | application/pdf |
| File Modified | 2020-09-29 |
| File Created | 2020-07-20 |