Passport Demand Forecasting Study

Passport Forecast Study Questionnaire – Introductions, Screeners, and Core & Demographic Questions

INTRO

Hello. I am (FIRST NAME, LAST NAME) calling on behalf of the U.S. Department of State, Passport Services.

We are conducting interviews with Americans ages 18 and older to help the Department of State better serve the American public’s need for passport services in the coming months and years. We mailed a letter about this study to your household (a couple days ago/last week/at the beginning of the month).Do you recall seeing that letter?

IF REQUESTED: Additional Information on the study can be found by in the Federal Register under the OMB control # 1405-0177, expiration date 7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10 minutes. If you have comments regarding the interview length or content, please email [email protected]

[IF NEEDED: I am calling from STR, a public opinion research firm located in the greater Philadelphia area. We are conducting the research on behalf of

the U.S. Department of State, Passport Services.]

[IF NEEDED: Whether you/your household require passport services or not, your participation in this study can help improve customer service, allocate sufficient personnel; develop new products and plan for what citizens require. ]

[IF NEEDED: Your household was selected at random. It is important a person who is knowledgeable about the travel habits of your household to complete the interview.]

[IF NEEDED: We will not ask for your name. Your answers are anonymous and confidential and will not be linked to any personally identifying information. All answers from all participants are combined together to form statistical summaries.]

1. YES SKIP TO ADULT

2. NO

3. DON’T KNOW

OMB

Your participation, while voluntary, will be essential to the success of the study.   This interview is estimated to take less than 10 minutes to complete. We will not ask your name. Your answers will be kept private to the extent permitted by law and identifying information will not be released outside of the Department of State. All answers from all participants are combined together to form statistical summaries. If you want additional information, I can provide that to you now or at the end of the interview.

IF REQUESTED:  Additional Information on the study can be found by in the Federal Register under the OMB control # 1405-0177, expiration date 7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10 minutes. If you have comments regarding the interview length or content, please email [email protected].

[IF NEEDED: I am calling from STR, a public opinion research firm located in the greater Philadelphia area. We are conducting the research on behalf of

the U.S. Department of State, Passport Services.]

[IF NEEDED: Whether you/your household require passport services or not, your participation in this study can help improve customer service, allocate sufficient personnel; develop new products and plan for what citizens require.]

[IF NEEDED: Your household was selected at random. It is important a person who is knowledgeable about the travel habits of your household to complete the interview.]

[IF NEEDED: We will not ask for your name. Your answers are anonymous and confidential and will not be linked to any personally identifying information. All answers from all participants are combined together to form statistical summaries.]

ENTER A TO CONTINUE

ADULT

Before we continue, please confirm that you are an adult, that is, you are at least 18 years old or older?

a)YES, ADULT ON PHONE SKIP TO RESPONDENT

b)NO, ADULT COMING TO PHONE

c)NO, NO ADULT HOME NOW SKIP TO CALLBACK SCHEDULING

d)NO ADULT LIVES IN THE HOUSEHOLD CODE AS INELIGIBLE

INTRO1

Hello. I am (FIRST NAME, LAST NAME) calling on behalf of the U.S. Department of State, Passport Services.

We are conducting interviews with Americans ages 18 and older to help the Department of State better serve the American public’s need for passport services in the coming months and years. We mailed a letter about this study to your household (a couple days ago/last week/at the beginning of the month). Do you recall seeing that letter?

IF REQUESTED: Additional Information on the study can be found by in the Federal Register under the OMB control # 1405-0177, expiration date 7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10 minutes. If you have comments regarding the interview length or content, please email [email protected].

[IF NEEDED: I am calling from STR, a public opinion research firm located in the greater Philadelphia area. We are conducting the research on behalf of

the U.S. Department of State, Passport Services.

]

[IF NEEDED: Whether you/your household require passport services or not, your participation in this study can help improve customer service, allocate sufficient personnel; develop new products and plan for what citizens require.]

[IF NEEDED: Your household was selected at random. It is important a person who is knowledgeable about the travel habits of your household to complete the interview.]

[IF NEEDED: We will not ask for your name. Your answers are anonymous and confidential and will not be linked to any personally identifying information. All answers from all participants are combined together to form statistical summaries.]

a)YES SKIP TO ADULT1

b)NO

c)DON’T KNOW

OMB1

Your participation, while voluntary, will be essential to the success of the study.   This interview is estimated to take less than 10 minutes to complete. We will not ask your name. Your answers will be kept private to the extent permitted by law and identifying information will not be released outside of the Department of State. All answers from all participants are combined together to form statistical summaries. If you want additional information, I can provide that to you now or at the end of the interview.

IF REQUESTED:  :  Additional Information on the study can be found by in the Federal Register under the OMB control # 1405-0177, expiration date 7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10 minutes. If you have comments regarding the interview length or content, please email [email protected].

[IF NEEDED: I am calling from STR, a public opinion research firm located in the greater Philadelphia area. We are conducting the research on behalf of the U.S. Department of State, Passport Services.]

[IF NEEDED: Whether you/your household require passport services or not, your participation in this study can help improve customer service, allocate sufficient personnel; develop new products and plan for what citizens require.]

[IF NEEDED: Your household was selected at random. It is important a person who is knowledgeable about the travel habits of your household to complete the interview.]

[IF NEEDED: This data collection consists of a voluntary interview. We will not ask for your name. Your answers will be kept private to the extent permitted by law and identifying information will not be released outside the Department of State. All answers from all participants are combined together to form statistical summaries.]

ENTER A TO CONTINUE TO ADULT 1

RESPONDENT

Are you able to answer a few basic questions about the general travel habits of your household?

[IF NEEDED: It is just basic questions such as whether each person has a passport or intends to get a passport.]

[IF NEEDED: This interview takes only about 10 minutes to complete. Let’s get started.]

1. YES SKIP TO CORE Q1

2. NO

3. DON’T KNOW SKIP TO CORE Q1

4. REFUSED CODE AS REFUSAL

KNOWR

May I please speak with the adult household member who would be more knowledgeable about the general travel habits of your household?

a) YES, COMING TO PHONE

b) NO, NOT AVAILABLE NOW SKIP TO CALLBACK SCHEDULING

c) REFUSED CODE AS REFUSAL

INTRO2

Hello. I am (FIRST NAME, LAST NAME) calling on behalf of the U.S. Department of State, Passport Services.

We are conducting interviews with Americans ages 18 and older to help the Department of State better serve the American public’s need for passport services in the coming months and years. We mailed a letter about this study to your household (a couple days ago/last week/at the beginning of the month). Do you recall seeing that letter?

IF REQUESTED: Additional Information on the study can be found by in the Federal Register under the OMB control # 1405-0177, expiration date 7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10 minutes. If you have comments regarding the interview length or content, please email [email protected].

[IF NEEDED: I am calling from STR, a public opinion research firm located in the greater Philadelphia area. We are conducting the research on behalf of the U.S. Department of State, Passport Services.]

[IF NEEDED: Whether you/your household require passport services or not, your participation in this study can help improve customer service, allocate sufficient personnel; develop new products and plan for what citizens require.]

[IF NEEDED: Your household was selected at random. It is important a person who is knowledgeable about the travel habits of your household to complete the interview.]

[IF NEEDED: We will not ask for your name. Your answers are anonymous and confidential and will not be linked to any personally identifying information. All answers from all participants are combined together to form statistical summaries.]

1. YES SKIP TO ADULT2

2. NO

3. DON’T KNOW

OMB2

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

IF REQUESTED:  :  Additional Information on the study can be found by in the Federal Register under the OMB control # 1405-0177, expiration date 7/31/2017, at https://www.federalregister.gov/. The estimated burden is 10 minutes. If you have comments regarding the interview length or content, please email [email protected].

[IF NEEDED: I am calling from STR, a public opinion research firm located in the greater Philadelphia area. We are conducting the research on behalf of the U.S. Department of State, Passport Services.]

[IF NEEDED: Whether you/your household require passport services or not, your participation in this study can help the Department of State to improve customer service, allocate sufficient personnel; develop new products and plan for what citizens require. ]

[IF NEEDED: Your household was selected at random. It is important a person who is knowledgeable about the travel habits of your household complete the interview.]

[IF NEEDED: We will not ask for your name. Your answers are anonymous and confidential and will not be linked to any personally identifying information. All answers from all participants are combined together to form statistical summaries.]

ENTER A TO CONTINUE TO ADULT2

ADULT2

Before we continue, please confirm that you are an adult, that is, you are at least 18 years old or older?

1. YES, ADULT ON PHONE

2. NO, ADULT COMING TO PHONE SKIP TO INTRO2…

3. NO, NO ADULT HOME NOW SKIP TO CALLBACK SCHEDULING

4. NO ADULT LIVES IN THE HOUSEHOLD CODE AS INELIGIBLE

RESPONDENT1

Are you able to answer a few basic questions about the general travel habits of your household?

[IF NEEDED: It is just basic questions such as whether each person has a passport or intends to get a passport.]

[IF NEEDED: This interview takes only about 10 minutes to complete. Let’s get started.]

1. YES SKIP TO CORE Q1

2. NO SKIP TO KNOWR1…

3. DON’T KNOW SKIP TO CORE Q1

4. REFUSED CODE AS REFUSAL

Web Intro:

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

Thank you for participating in this important research!

CORE - PASSPORT FORECAST SECTION

1. Do you currently have a valid:

1. U.S. passport BOOK (valid for international air, land, or sea travel),

2. U.S. passport CARD (sized like a driver’s license and valid for land and sea travel only),

3. Both a U.S. passport book and card,

4. Or do you not currently have any valid U.S. passport?

Which of the following do you currently have?

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

2. When did you last get a new or renewed passport? Was it:

1. Within the last 12 months,

2. 1 year to less than 2 years ago,

3. 2 years to less than 3 years ago,

4. 3 years to less than 4 years ago,

5. 4 years to less than 10 years ago,

6. 10 or more years ago,

7. Or have you never had a U.S. passport?Skip to PASSPORT FORECAST Q4

8. DON’T KNOW

9. REFUSED

When did you last get a new or renewed passport? Was it:

	Within the last 12 months
	1 year to less than 2 years ago
	2 years to less than 3 years ago
	3 years to less than 4 years ago
	4 years to less than 10 years ago
	I have never had a U.S. passport.
	Don't know

3. Which of the following best describes how you applied for your most recent U.S. passport (new or renewed, book or card):

1. Filled out the forms in person at a U.S. Passport Agency location,

2. Filled out the forms in person at a Post Office,

3. Filled out the forms in person at a city hall, court house, or other government office (not a U.S. Passport Agency location or Post Office),

4. Filled out the forms myself and then mailed them in, or

5. Some other way?

6. DON’T KNOW

7. REFUSED

Which of the following best describes how you applied for your most recent U.S. passport (new or renewed, book or card)?

	Filled out the forms in person at a U.S. Passport Agency location
	Filled out the forms in person at the Post Office
	Filled out the forms in person at a city hall, court house, or other government office (not a U.S. Passport Agency location or Post Office)
	Filled out the forms myself and then mailed them in
	I applied in some other way.
	Don't know

4. Do you plan to apply for either a new, renewed or replacement U.S. passport at some point in the next three years?

1. YES

2. NO Skip to PASSPORT FORECAST Q8

3. DON’T KNOWSkip to PASSPORT FORECAST Q8

4. REFUSEDSkip to PASSPORT FORECAST Q8

Do you plan to apply for either a new, renewed or replacement U.S. passport at some point in the next three years?

	Yes
	No
	Don't know

4a. Will that be a:

1. Passport book,

2. Passport card, or  Skip to PASSPORT FORECAST 5b

3. both a passport book and card?

4. DON’T KNOW

5. REFUSED

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

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

5a. When might you apply for a new, renewed, or replacement U.S. passport book? Would you say:

1. I’ve already applied for and am waiting to receive it, IF 4a = a, Skip to PASSPORT FORECAST Q8

2. In the next 6 months, IF 4a = a, Skip to PASSPORT FORECAST Q6a

3. In the next 7-12 months, IF 4a = a, Skip to PASSPORT FORECAST Q6a

4. In more than 1 year to less than 2 years, orIF 4a = a, Skip to PASSPORT FORECAST Q6a

5. In 2 or more years? IF 4a = a, Skip to PASSPORT FORECAST Q6a

6. DON’T KNOWIF 4a = a, Skip to PASSPORT FORECAST Q8

7. REFUSEDIF 4a = a, Skip to PASSPORT FORECAST Q8

When might you apply for a new, renewed, or replacement U.S. passport book:

	I've already applied for one and am waiting to receive it
	In the next 6 months
	In the next 7 - 12 months
	In more than 1 year but less than 2 years
	In 2 or more years
	Don't know

5b. When might you apply for a new, renewed, or replacement U.S. passport card:

1. I’ve already applied for one and am waiting to receive it,  Skip to PASSPORT FORECAST Q8

2. In the next 6 months,  IF 4a = b, Skip to PASSPORT FORECAST Q6b

3. In the next 7-12 months, IF 4a = b, Skip to PASSPORT FORECAST Q6b

4. In more than 1 year but less than 2 years, or  IF 4a = b, Skip to PASSPORT FORECAST Q6b

5. In 2 or more years?  IF 4a = b, Skip to PASSPORT FORECAST Q6b

6. DON’T KNOW  Skip to PASSPORT FORECAST Q8

7. REFUSED Skip to PASSPORT FORECAST Q8

When might you apply for a new, renewed, or replacement U.S. passport card:

	I've already applied for one and am waiting to receive it
	In the next 6 months
	In the next 7 - 12 months
	In more than 1 year but less than 2 years
	In 2 or more years
	Don't know

6a. How likely is it that you will apply for a U.S. passport book [INSERT ANSWER TO 5a]:

1. Not at all likely,

2. A little likely,

3. Somewhat likely,

4. Likely, or

5. Extremely likely?

6. DON’T KNOW

7. REFUSED

How likely is it that you will apply for a U.S. passport book in the next 7 - 12 months?

	Not at all likely
	A little likely
	Somewhat likely
	Likely
	Extremely likely
	Don't know

IF 4a = a, Skip to PASSPORT FORECAST Q7a

6b. How likely is it that you will apply for a U.S. passport card [INSERT ANSWER TO 5b]:

1. Not at all likely,

2. A little likely,

3. Somewhat likely,

4. Likely, or

5. Extremely likely?

6. DON’T KNOW

7. REFUSED

How likely is it that you will apply for a U.S. passport card in the next 7 - 12 months?

	Not at all likely
	A little likely
	Somewhat likely
	Likely
	Extremely likely
	Don't know

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

7am. ENTER MONTH

DON’T KNOW

REFUSED

7ay. ENTER YEAR

DON’T KNOW

REFUSED

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

If you are unsure of the exact month, indicate the earliest month and year during which you are likely to apply.

ENTER MONTH AND YEAR

IF 4a = a, Skip to PASSPORT FORECAST Q8

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

7bm. ENTER MONTH

DON’T KNOW

REFUSED

7by. ENTER YEAR

DON’T KNOW

REFUSED

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

If you are unsure of the exact month, indicate the earliest month and year during which you are likely to apply.

ENTER MONTH AND YEAR

8. Did you have prior plans to get a passport (book or card) in the past 12 months, but then decided not to apply for a passport (book or card)?

1. YES

2. NO  Skip to PASSPORT FORECAST Q10

3. DON’T KNOW  Skip to PASSPORT FORECAST Q10

4. REFUSED  Skip to PASSPORT FORECAST Q10

Did you have prior plans to get a passport (book or card) in the past 12 months, but then decided not to apply for a passport (book or card)?

	Yes
	No
	Don't know

8. What was the primary reason you changed your plans to obtain a passport (book or card):

1. Your personal travel needs changed,

2. Your business travel needs changed,

3. Your personal financial situation changed,

4. The overall economic downturn,

5. Concerns about the spread of disease while traveling,

6. Unsafe conditions in your planned international travel location,

7. The costs for planned travel were too high, or

8. Something else?

9. DON’T KNOW

10. REFUSED

What was the primary reason you changed your plans to obtain a passport (book or card)?

	My personal travel needs changed
	My business travel needs changed
	My personal financial situation changed
	The overall economic downturn
	Concerns about the spread of disease while traveling
	Unsafe conditions in my planned international travel location
	The costs for planned travel were too high
	Some other reason
	Don't know

8. How many children under the age of 18 currently live in your household?

ZERO  Skip to PASSPORT FORECAST Q11

ENTER NUMBER IN VALID RANGE OF ONE-TWENTY

DON’T KNOW  Skip to PASSPORT FORECAST Q11

REFUSED  Skip to PASSPORT FORECAST Q11

How many children under the age of 18 currently live in your household?

Enter 0 if there are no children under 18 in your household



Refused

10A.To help predict the future demand for U.S. passports, Passport Services would like to know about the passport plans for the [one child/children]under the age of 18 currently living in your household. [Let’s start with the (younger/youngest child).]

10Aa. How old is this child?

ENTER YEARS [VALID RANGE 0-17]

IF ZERO YEARS, ENTER MONTHS [VALID RANGE 0-11]

IF ZERO MONTHS, ENTER WEEKS [VALID RANGE 0-4]

IF ZERO WEEKS, ENTERS DAYS [VALID RANGE 1-6]

 IF AGE PROVIDED SKIP TO PASSPORT FORECAST 10Ab

DON’T KNOW GO TO 10Aage

REFUSED  GO TO 10Aage

To help predict the future demand for U.S. passports, Passport Services would like to know about the passport plans for the children under the age of 18 currently living in your household.

Let's start with the younger child.

How old is this child?

Enter 0 for under 1 year old.

Refused

10Aage. Age is an important factor in understanding passport service needs. Please estimate in which of the following general categories is this child’s age as of today:

1. Newborn through 5 years old,

2. 6 through10 years old,

3. 11 through13 years old

4. 14 through 15 years old, or

5. 16 through18 years old?

6. DON’T KNOW

7. REFUSED

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

• Newborn through 5 years old

• 6 through 10 years old

• 11through 13 years old

• 14 through 15 years old

• 16 through 18 years old

• Don't Know

• Refused

10Ab. Is this child:

1. Male or

2. Female?

3. DON’T KNOW

4. REFUSED

Is this child male or female?

• Male

• Female

• Refused
  
  

10Ac.Does [he/she/this child] currently have a valid U.S. passport?

1. YES

2. NO

3. DON’T KNOW

4. REFUSED

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

• Yes

• No

• Don't know
  
  
  

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

1. YES

2. NO IF Q10=1, Skip to PASSPORT FORECAST Q11, OTHERWISE SKIP TO 10B

3. DON’T KNOW  IF Q10=1, Skip to PASSPORT FORECAST Q11, OTHERWISE SKIP TO 10B

4. REFUSED  IF Q10=1, Skip to PASSPORT FORECAST Q11, OTHERWISE SKIP TO 10B

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

• Yes

• No

• Don't know
  
  
  

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

10Aea. ENTER MONTH

DON’T KNOW

REFUSED

10Aeb. ENTER YEAR

DON’T KNOW

REFUSED

ALL  IF Q10=1, Skip to PASSPORT FORECAST Q11, OTHERWISE SKIP TO 10B

In what month and year will he be applying for a new, renewed, or replacement U.S. passport?

If unsure, mark the earliest month likely to apply.

ENTER MONTH AND YEAR

10Ba. And now for the (older/next youngest) child. How old is this child?

ENTER YEARS [VALID RANGE 0-17]

IF ZERO YEARS, ENTER MONTHS [VALID RANGE 0-11]

IF ZERO MONTHS, ENTER WEEKS [VALID RANGE 0-4]

IF ZERO WEEKS, ENTERS DAYS [VALID RANGE 1-6]

 IF AGE PROVIDED SKIP TO PASSPORT FORECAST 10Bb

DON’T KNOW GO TO 10Bage

REFUSED GO TO 10Bage

And now for the older child.

How old is this child?

Enter 0 for under 1 year old.

Refused

10Bage. Please estimate in which of the following general categories is this child’s age as of today:

1. Newborn through 5 years old,

2. 6 through10 years old,

3. 11 through13 years old,

4. 14 through 15 years old, or

5. 16 through18 years old?

6. DON’T KNOW

7. REFUSED

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

• Newborn through 5 years old

• 6 through 10 years old

• 11through 13 years old

• 14 through 15 years old

• 16 through 18 years old

• Don't Know

• Refused

10Bb. Is this child:

1. Male or

2. Female?

3. DON’T KNOW

4. REFUSED

Is this child male or female?

• Male

• Female

• Refused

10Bc.Does [he/she/this child] currently have a valid U.S. passport?

1. YES

2. NO

3. DON’T KNOW

4. REFUSED

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

• Yes

• No

• Don't know

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

1. YES

2. NO  IF Q10 >2, SKIP TO Q10Ca, OTHERWISE SKIP TO PASSPORT FORECAST Q11

3. DON’T KNOW  IF Q10 > 2, SKIP TO Q10Ca, OTHERWISE SKIP TO PASSPORT FORECAST Q11

4. REFUSED  IF Q10 > 2, SKIP TO Q10Ca, OTHERWISE SKIP TO PASSPORT FORECAST Q11

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

• Yes

• No

• Don't know

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

10Bea. ENTER MONTH

DON’T KNOW

REFUSED

10Beb. ENTER YEAR  IF Q10 > 2, SKIP TO Q10Ca, OTHERWISE SKIP TO PASSPORT FORECAST Q11

DON’T KNOW  IF Q10 > 2, SKIP TO Q10Ca, OTHERWISE SKIP TO PASSPORT FORECAST Q11

REFUSED  IF Q10 >2, SKIP TO Q10Ca, OTHERWISE SKIP TO PASSPORT FORECAST Q11

In what month and year will he be applying for a new, renewed, or replacement U.S. passport?

If unsure, mark the earliest month likely to apply.

ENTER MONTH AND YEAR

10Ca. How old is the next oldest child?

ENTER YEARS [VALID RANGE 0-17]

IF ZERO YEARS, ENTER MONTHS [VALID RANGE 0-11]

IF ZERO MONTHS, ENTER WEEKS [VALID RANGE 0-4]

IF ZERO WEEKS, ENTERS DAYS [VALID RANGE 1-6]

 IF AGE PROVIDED SKIP TO PASSPORT FORECAST 10Cb

DON’T KNOW GO TO 10Cage

REFUSED GO TO 10Cage

How old is this child?

Enter 0 for under 1 year old.

Refused

And now for the next oldest child.

10Cage. Please estimate in which of the following general categories is this child’s age as of today:

1. Newborn through 5 years old,

2. 6 through 10 years old,

3. 11 through 13 years old,

4. 14 through 15 years old, or

5. 16 through 18 years old?

6. DON’T KNOW

7. REFUSED

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

• Newborn through 5 years old

• 6 through 10 years old

• 11 through 13 years old

• 14 through 15 years old

• 16 through 18 years old

• Don't Know

• Refused
  
  
  

10Cb. Is this child:

1. Male or

2. Female?

3. DON’T KNOW

4. REFUSED

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

• Yes

• No

• Don't know

10Cc.Does [he/she/this child] currently have a valid U.S. passport?

1. YES

2. NO

3. DON’T KNOW

4. REFUSED

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

• Yes

• No

• Don't know

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

1. YES

2. NO IF Q10 < 4, SKIP TOPASSPORT FORECAST 11, OTHERWISE SKIP TO Q10Da

3. DON’T KNOW  IF Q10 < 4, SKIP TO PASSPORT FORECAST 11, OTHERWISE SKIP TO Q10Da

4. REFUSED  IF Q10 < 4, SKIP TO PASSPORT FORECAST 11, OTHERWISE SKIP TO Q10Da

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

• Yes

• No

• Don't know
  
  
  

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

10Cea. ENTER MONTH

DON’T KNOW

REFUSED

10Ceb. ENTER YEAR  IF Q108 < 4, SKIP TO PASSPORT FORECAST 11, OTHERWISE SKIP TO Q10Da

DON’T KNOW  IF Q10 < 4, SKIP TO PASSPORT FORECAST 11, OTHERWISE SKIP TO Q10Da

REFUSED  IF Q10 < 4, SKIP TO PASSPORT FORECAST 11, OTHERWISE SKIP TO Q10Da

In what month and year will he be applying for a new, renewed, or replacement U.S. passport?

If unsure, mark the earliest month likely to apply.

ENTER MONTH AND YEAR

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

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

ZERO  Skip to Q12

ENTER NUMBER IN VALID RANGE OF ONE-TWENTY

DON’T KNOW  Skip to Q12

REFUSED  Skip to Q12

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

Enter 0 if there are no OTHER adults over 18 in your household

Refused

11Aa. (Let’s start with the oldest other adult living in your household.) How old is this adult?

ENTER YEARS [VALID RANGE 18-99]  Skip to 11Ab

DON’T KNOW

REFUSED

How old is this adult?

ENTER YEARS [VALID RANGE 18-99]

Refused

11Aage. Age is an important factor in understanding passport service needs. Please estimate in which of the following general categories is this other adult’s age as of today:

1. Age 18 through 24,

2. 25 through 34,

3. 35 through 44,

4. 45 through 54,

5. 55 through 64, or

6. Age 65 or older?

7. DON’T KNOW

8. REFUSED

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

Age 18 through 24
25 through 34
35 through 44
45 through 54
55 through 64
Age 65 or older
Refused

11Ab. Is this adult:

1. Male or

2. Female?

3. DON’T KNOW

4. REFUSED

Is this adult a male or female?

Male
Female
Refuse

11Ac.Does [he/she/this adult] currently have a valid U.S. passport?

1. YES

2. NO

3. DON’T KNOW

4. REFUSED

Does he currently have a valid U.S. passport?

Yes
No
Don't know

11Ad. Will this adult be applying for a new, renewed, or replacement U.S. passport in the next 12 months?

1. YES

2. NO  IF Q11=1, SKIP TO Q12, OTHERWISE SKIP TO 11Ba

3. DON’T KNOW  IF Q11=1, SKIP TO Q12, OTHERWISE SKIP TO 11Ba

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

Will this adult be applying for a new, renewed, or replacement U.S. passport in the next 12 months?

Yes
No
Don't know

11Ae. In what month and year will [he/she] be applying for a new, renewed, or replacement U.S. passport?

11Aea. ENTER MONTH

DON’T KNOW

REFUSED

11Aeb. ENTER YEAR

DON’T KNOW

REFUSED

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

In what month and year will he be applying for a new, renewed, or replacement U.S. passport?

If unsure, mark the earliest month likely to apply.

ENTER MONTH AND YEAR

11Ba. And now for the (younger/next youngest) adult. How old is this person?

ENTER YEARS [VALID RANGE 18-99]  Skip to 11Bb

DON’T KNOW

And now for the younger adult.

REFUSED

How old is this adult?

ENTER YEARS [VALID RANGE 18-99]

Refused

11Bage. Age is an import factor in understanding passport service needs. Please estimate in which of the following general categories is this other adult’s age as of today:

1. Age 18 through 24,

2. 25 through 34,

3. 35 through 44,

4. 45 through 54,

5. 55 through 64, or

6. Age 65 or older?

7. DON’T KNOW

8. REFUSED

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

Age 18 through 24
25 through 34
35 through 44
45 through 54
55 through 64
Age 65 or older
Refused

11Bb. Is this adult:

1. Male or

2. Female?

3. DON’T KNOW

4. REFUSED

Is this adult a male or female?

Male
Female
Refused

11Bc.Does [he/she/this adult] currently have a valid U.S. passport?

1. YES

2. NO

3. DON’T KNOW

4. REFUSED

Does she currently have a valid U.S. passport?

Yes
No
Don't know

11Bd. Will this adult be applying for a new, renewed, or replacement U.S. passport in the next 12 months?

1. YES

2. NO  IF Q11 > 2, SKIP TO Q11Ca, OTHERWISE SKIP TO Q12

3. DON’T KNOW  IF Q11 > 2, SKIP TO Q11Ca, OTHERWISE SKIP TO Q12

4. REFUSED  IF Q11 > 2, SKIP TO Q11Ca, OTHERWISE SKIP TO Q12

Will this adult be applying for a new, renewed, or replacement U.S. passport in the next 12 months?

Yes
No
Don't know

11Be. In what month and year will [he/she] be applying for a new, renewed, or replacement U.S. passport?

11Bea. ENTER MONTH

DON’T KNOW

REFUSED

11Beb. ENTER YEAR  IF Q11 > 2, SKIP TO Q11Ca, OTHERWISE SKIP Q12

DON’T KNOW  IF Q11 > 2, SKIP TO Q11Ca, OTHERWISE SKIP TO Q12

REFUSED  IF Q11 >2, SKIP TO Q11Ca, OTHERWISE SKIP TO Q12

In what month and year will she be applying for a new, renewed, or replacement U.S. passport?

If unsure, mark the earliest month likely to apply.

ENTER MONTH AND YEAR

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

DEMOGRAPHICS

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

11. [ASK IF NECESSARY] Are you:

1. Male or

2. Female?

3. DON’T KNOW

4. REFUSED

As a reminder, the following questions are used for statistical purposes only. No personal information is ever identified or shared.

Are you male or female?

	Male
	Female
	Refused

11. In what year were you born?

ENTER NUMBER [valid range 1900 - 1994]  SKIP TO PASSPORT FORECAST Q14

DON’T KNOW

REFUSED

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

Refused

13A. Age is an important factor in understanding passport service needs as well as in creating statistical summaries of the data we are collecting for this study. Please estimate in which of the following general categories is your age as of today:

1. Age 18 through 24,

2. 25 through 34,

3. 35 through 44,

4. 45 through 54,

5. 55 through 64, or

6. Age 65 or older?

7. DON’T KNOW

8. REFUSED

Age is an important factor in understanding passport service needs as well as in creating statistical summaries of the data we are collecting for this study. Please estimate in which of the following general categories is your age as of today:

	Age 18 through 24
	25 through 34
	35 through 44
	45 through 54
	55 through 64
	Age 65 or older
	Refused

11. Are you of Hispanic, Latino, or Spanish origin?

1. YES

2. NO

3. DON’T KNOW

4. REFUSED

Are you of Hispanic, Latino, or Spanish origin?

• Yes
  
  

• No
  
  

• Refused

11. I am going to read you a list of six race categories. Please choose one or more races that you consider yourself to be:

MULTIPLE RESPONSES ALLOWED

1. White or Caucasian,

2. Black or African American,

3. American Indian or Alaska Native,

4. Asian,

5. Native Hawaiian or Other Pacific Islander, or

6. Some other race?

7. DON’T KNOW

8. REFUSED

Please choose one or more races that you consider yourself to be:

MULTIPLE RESPONSES ALLOWED

• White or Caucasian

• Black or African American

• American Indian or Alaska Native

• Asian

• Native Hawaiian or Other Pacific Islander

• Some other race

• Refused

11. What is the highest level of school you have completed or the highest degree you have received?

If currently enrolled, please choose the previous grade or highest degree you have already received.

1. LESS THAN HIGH SCHOOL DIPLOMA

2. HIGH SCHOOL DIPLOMA

3. SOME COLLEGE OR TECHNICAL SCHOOL

4. COLLEGE GRADUATE (2-YEAR PROGRAM)

5. UNIVERSITY GRADUATE (4-YEAR PROGRAM)

6. MASTER’S DEGREE

7. BEYOND MASTER’S DEGREE

8. DON’T KNOW

9. REFUSED

11. Approximately what was your household’s total income, before taxes, last year for all members of your household, including yourself? Please include wages and salaries, remittances from family members living elsewhere, farming, and all other sources. Would you say your approximate household’s pre-tax income was:

1. Under $50,000,

2. At least $50,000 but less than $100,000, or  SKIP TO PASSPORT FORECAST Q17b

3. $100,000 or more last year?  SKIP TO PASSPORT FORECAST Q17c

4. DON’T KNOW  SKIP TO CLOSING

5. REFUSED  SKIP TO CLOSING

What was your household's approximate total income, before taxes, last year for all members of your household, including yourself? Please include wages and salaries, remittances from family members living elsewhere, farming, and all other sources.

Which of the following best represents your household's pre-tax income?

• Under $50,000

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

• $100,000 or more last year

• Refused

17a. And would you say it was:

1. Under $15,000,

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

3. At least $25,000 but less than $35,000, or

4. At least $35,000 but less than $50,000?

5. DON’T KNOW

6. REFUSED

 ALL SKIP TO CLOSING

And would you say it was:

• Under $15,000

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

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

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

• Refused

17b. And would you say it was:

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

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

3. At least $75,000 but less than $87,500, or

4. At least $87,500 but less than $100,000?

5. DON’T KNOW

6. REFUSED

 ALL SKIP TO CLOSING

And would you say it was:

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

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

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

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

• Refused

17c. And would you say it was:

1. At least $100,000 but less than $125,000,

2. At least $125,00 but less than $150,000,

3. At least $150,000 but less than $175,000,

4. At least $175,000 but less than$200,000, or

5. $200,000 or more?

6. DON’T KNOW

7. REFUSED

And would you say it was:

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

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

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

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

• Refused

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

ENTER MINTUES TO COMPLETE

EXIT

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

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

QUESTIONS

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

1. YES

2. NO

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

• Yes

• No

IF YES:

CLOSING OMB INFORMATION

OMB Public Reporting Burden Notification

Your participation, while voluntary, will be essential to the success of the study. This interview is estimated to take less than 10 minutes to complete. Your answers will be kept private to the extent permitted by law and identifying information will not be released outside of the Department of State. Additional information on the study can be found in the Federal Register under the OMB control # 1405-0177, expiration date XX-XX-XXXX, at https://www.federalregister.gov/. The estimated burden is 10 minutes. If you have comments regarding the interview length or content, please email [email protected].

The public reporting burden for this collection of information is estimated to average 10 minutes per response.  You do not have to supply this information unless this collection displays a currently valid OMB control number.  If you have comments on the accuracy of this burden estimate and/or recommendations for reducing it, please send them to: A/GIS/DIR, Room 2400 SA-22, US Department of State, Washington, DC 20520-2202.Additional Information on the study can be found in the Federal Register under the OMB control # 1405-0177,expiration date XX/XX/XXX at https://www.federalregister.gov/.  If you have any additional questions or issues concerning the content of this research, please email [email protected].

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