Attachment D-CPS_Questionnaire_Demo

Basic CPS Items Booklet
Demographic Items

PERSTAT
(Are all of these persons still living here? / Person status)
1
2
3
4
5
9

Person deceased
Person moved out
Person left - was a URE last month
Delete person - to correct previous mistake
Person is a URE this month
Reinstate person

FNAME
(What are the names of all persons living or staying here? / What is the name of the
next person)
Enter 999 if no more persons

LNAME
Enter Last Name

S_HHMEM
Is this (name of person talking about)’s usual place of residence?
1
2
3

Yes
No
Proxy

URE
Does (name of person talking about) have a usual place of residence elsewhere?
1
2

Yes
No

SEX
Ask only if necessary
What is (name of person talking about)’s sex?
1
2

Male
Female

NROS2B
16 Persons in household roster
At this point count additional people. You will interview only those household members 15
years old or older who are listed.
Are there any other persons 15 years old or older now living or staying there? (Who
have not been listed.)
1
2

Yes
No

CNT2BG
How many other?
Enter number

MCHILD
I have listed . . . READ NAMES
Have I missed any babies or small children?
1
2

Yes
No

MAWAY
Have I missed anyone who usually lives here but is away now -traveling, at school, or
in a hospital?
1
2

Yes
No

MLODGE
Have I missed any lodgers, boarders, or persons you employ who live here?
1
2

Yes
No

MELSE
Have I missed anyone else staying here?
1
2

Yes
No

OWNREN1
What is the name of the person or one of the persons who owns or rents that home?
Enter line number (1-16) if current HH member Enter (0) if owner(s)/renter(s) not a
household member
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17

Owner/Renter not a HH member
Person 1's name
Person 2's name
Person 3's name
Person 4's name
Person 5's name
Person 6's name
Person 7's name
Person 8's name
Person 9's name
Person 10's name
Person 11's name
Person 12's name
Person 13's name
Person 14's name
Person 15's name
Person 16's name

HHRESP
Ask if necessary
With whom am I speaking?
Respondent must be a household member and 15+ or a proxy.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.

Under_15
Person 1's name
Person 2's name
Person 3's name
Person 4's name
Person 5's name
Person 6's name
Person 7's name
Person 8's name
Person 9's name
Person 10's name
Person 11's name
Person 12's name
Person 13's name
Person 14's name
Person 15's name
Person 16's name

HHRESP_VERIFY
Are all persons –
1
2

Under 15 years of age
Non-household members

S_RRP
How (are / is) (name/you) related to (reference person's name/you)?
42
43
44
45
46
47
48
49
50
51
52
53
54

Opposite-sex Spouse (Husband/Wife)
Opposite-sex Unmarried Partner
Same-sex Spouse (Husband/Wife)
Same-sex Unmarried Partner
Child
Grandchild
Parent (Mother/Father)
Brother/Sister
Other relative (Aunt, Cousin, Nephew, Mother-in-law, etc.)
Foster_Child
Housemate/Roommate
Roomer/Boarder
Other nonrelative

S_SUBFAM
Earlier you said that (name of person talking about) (was/were) not related to
(reference person's name/you). (Are / Is) (name of person talking about) related to
anyone else in this household?
1
2

Yes
No

SUBFAM_WHO
Who (are / is) (name of person talking about) related to?
PROBE: Anyone else?
Enter line number(s), separate with commas
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16

Person 1's name
Person 2's name
Person 3's name
Person 4's name
Person 5's name
Person 6's name
Person 7's name
Person 8's name
Person 9's name
Person 10's name
Person 11's name
Person 12's name
Person 13's name
Person 14's name
Person 15's name
Person 16's name

PAR1
Enter line number of parent of (name of person talking about)
Ask if necessary: Is (name's/your) parent a member of this household?
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16

No_One
Person1
Person2
Person3
Person4
Person5
Person6
Person7
Person8
Person9
Person10
Person11
Person12
Person13
Person14
Person15
Person16

PAR1TYP
(Are / Is) (name of person talking about) (your / mother's name) biological, step, or
adopted child?
1
2
3

Biological
Step
Adopted

PAR2
Enter line number of other parent of (name of person talking about)
Ask if necessary: Is (name's/your) other parent a member of this household?
0
1
2
3
4
5
6
7
8

No_One
Person1
Person2
Person3
Person4
Person5
Person6
Person7
Person8

9
10
11
12
13
14
15
16

Person9
Person10
Person11
Person12
Person13
Person14
Person15
Person16

PAR2TYP
(Are / Is) (name of person talking about) (your / father's name) biological, step, or
adopted child?
1
2
3

Biological
Step
Adopted

PARENT2
(REF_FNAME ^REF_LNAME’s) parent is also (name of person talking about)’s
parent, is that correct?
1
2

Yes
No

BIRTHM
What is (name's/your) date of birth?
Enter Birth Month
1
2
3
4
5
6
7
8
9
10
11
12

Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec

BIRTHD
What is (name's/your) date of birth?
Enter Birth Day

BIRTHY
What is (name's/your) date of birth?
Enter Birth Year (Enter 4 digit year - ex: 1964)

VERIFY_AGE
As of last week, that would make (name/you) (approximately (AGE)/ less than 1 / over
98 / AGE) years old. Is that correct?
1.
2.

Yes
No

AGEGSS
Even though you don’t know (name's/your) exact birthdate, what is your best guess as
to how old (you/he/she) (was/were) on (your/his/her) last birthday?
99
00 – 98

99 years or older
0 to 98 years old

AGE2
Ask if necessary
(Are / Is) (you/he/she) under 15?
1
2

Yes
No

PREMARTL
Since our last interview, has any household member had any changes in his or her
Marital Status?
1
2

Yes
No

MARITL
(Are / Is) (name/you) now married, widowed, divorced, separated or never married?
1
2
3
4
5
6

Married - Spouse PRESENT
Married - Spouse ABSENT
Widowed
Divorced
Separated
Never married

SPOUSE

0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16

Enter line number of spouse of (name of person talking about)
-Ask if necessary

No_One
Person1
Person2
Person3
Person4
Person5
Person6
Person7
Person8
Person9
Person10
Person11
Person12
Person13
Person14
Person15
Person16

COHAB
Do you have a boyfriend, girlfriend or partner in this household?
If Yes, probe WHO and enter line number
If No, enter "0"
0
1
2
3
4
5

No
Person 1's name
Person 2's name
Person 3's name
Person 4's name
Person 5's name

6
7
8
9
10
11
12
13
14
15
16

Person 6's name
Person 7's name
Person 8's name
Person 9's name
Person 10's name
Person 11's name
Person 12's name
Person 13's name
Person 14's name
Person 15's name
Person 16's name

AFEVER
Did (name/you) ever serve on active duty in the U. S. Armed Forces?
1
2

Yes
No

AFWHEN
IF NECESSARY: Previously I was told that (name/you) served on active duty in the U. S.
Armed Forces.
When did (you/he/she) serve?
Enter all that apply, separate with commas Mark up to 4 that apply
1
2
3
4
5
6
7
8
9

September 2001 or later
August 1990 to August 2001
May 1975 to July 1990
Vietnam Era (August 1964 to April 1975)
February 1955 to July 1964
Korean War (July 1950 to January 1955)
January 1947 to June 1950
World War II (December 1941 to December 1946)
November 1941 or earlier

AFNOW
(Are / Is) (name/you) (now/still) in the Armed Forces?
1
2

Yes
No

EDUCA
What is the highest level of school (name/you) (have/has) completed or the highest
degree (name/you) (have/has) received?
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46

Less than 1st grade
1st, 2nd, 3rd or 4th grade
5th or 6th grade
7th or 8th grade
9th grade
10th grade
11th grade
12th grade NO DIPLOMA
HIGH SCHOOL GRADUATE- high school DIPLOMA or the equivalent (For
example: GED)
Some college but no degree
Associate degree in college - Occupational/vocational program
Associate degree in college -- Academic program
Bachelor's degree (For example: BA, AB, BS)
Master's degree (For example: MA, MS, MEng, MEd, MSW, MBA)
Professional School Degree (For example: MD,DDS,DVM,LLB,JD)
Doctorate degree (For example: PhD, EdD)

DIPGED
People can get a High School diploma in a variety of ways, such as graduating from
High School or by getting a GED or other equivalent. How did (name/you) get
(your/his/her) High School diploma?
1
2

Graduation from High School
GED or other equivalent

HGCOMP
What was the highest grade of regular school (name/you) completed before receiving
(your/his/her) GED?
1
2
3
4
5
6
7
8

Less than 1st grade
1st, 2nd, 3rd or 4th grade
5th or 6th grade
7th or 8th grade
9th grade
10th grade
11th grade
12th grade NO DIPLOMA

CYC
(Including any time that may have been spent getting as Associate's Degree,/ )
(How/how) many years of college CREDIT (have/has) (name/you) completed?
(Have / Has) (you/he/she) COMPLETED...
1
2
3
4
5

Less than 1 year (include 0 years completed)?
The first, or FRESHMAN year?
The second, or SOPHOMORE year?
The third, or JUNIOR year?
Four or more years?

CERT1
(Does/do) (name/you) have a currently active professional certification or a state or
industry license? Do not include business license, such as a liquor license or vending
license.
(Read if necessary: a professional certification or license shows you are qualified to
perform a specific job. Examples include a real estate license, a medical assistant
certification, a Teacher License or an IT certification. Only include certifications or
licenses obtained by an individual.)
1. Yes
2. No
CERT2
Were any of (your/his/her) certifications or licenses issued by the federal, state, or local
government?
1. Yes
2. No

HSPNON
(Are / Is) (name/you) of Hispanic, Latino, or Spanish origin?
1
2

Yes
No

ORISPN
(Are / Is) (name/you) Mexican, Mexican American, or Chicano, Puerto Rican, Cuban,
Cuban American, or another Hispanic, Latino, or Spanish origin; for example,
Argentinean, Columbian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on?
If multiple answer, Probe: Which group (do/does) (you/he/she) most closely identify

with?
1
2
3
4
5
6
7

Mexican
Mexican American
Chicano
Puerto Rican
Cuban
Cuban-American
Other Spanish, Hispanic, or Latino group

S_OROTSP
What is the name of (your/his/her) other Spanish, Hispanic, or Latino group?

OROTSS
Specify "Other" Spanish, Hispanic, or Latino group

RACE
I am going to read you a list of five race categories. You may choose one or more
races. For this survey, Hispanic origin is not a race. (Are/Is) (NAME/you) White;
Black or African American; American Indian or Alaska Native; Asian; OR Native
Hawaiian or Other Pacific Islander?
Do not probe unless response is Hispanic or a Hispanic origin
Enter all that apply, separate with commas

1
2
3
4
5
6

White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Other - DO NOT READ

RACEAS
Which of the following Asian groups (are/is) (you/he/she)? Asian Indian, Chinese,
Filipino, Japanese, Korean, Vietnamese, or another Asian group?
Read each item
Enter all that apply, separate with commas
1
2

Asian Indian
Chinese

3
4
5
6
7

Filipino
Japanese
Korean
Vietnamese
Other Asian

RACEPI
Which of the following Native Hawaiian or Other Pacific Islander groups (are/is)
(you/he/she)? Native Hawaiian; Guamanian or Chamorro; Samoan; or another Pacific
Islander group?
Read each item
Enter all that apply, separate with commas
1
2
3
4

Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander

S_RACEOT
Read only if necessary: What is (your/his/her) race?

RACEOS
Specify Other race