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Sp eas
en ur
di ing
ng A
Si m
nc er
e ica
18 ’s
88
OMB No. 1220-0050
U.S. DEPARTMENT OF COMMERCE
ENT OF C
TM
OM
AR
R
EA
EN
UO
F TH E C
S
BU
US
CE
ER
M
U.S.
DE
P
U.S. CENSUS BUREAU
Acting as a collecting agent for
U.S. Department of Labor
Bureau of Labor Statistics
Your Daily Expenses
Help us learn about the buying habits of people in the United States
Lady holding
credit card
jpg file
Currency_2
curled $1 jpg file
internet
shopping
man_jpeg file
dinner party
jpg file
receipts
jpg file
couple
shopping
jpg file
mug
credit card
phone_jpg file
couple_gift
jpg file
family unpacking
groceries jpg file
daughter_dad
pet shop jpg file
When you write down what you purchase in this diary, you will help
provide a bigger picture of how U.S. consumers spend their money.
By law (Title 13, U.S. Code), we must keep your information confidential;
we use it for statistical purposes only.
If you have comments regarding this survey, please email [email protected].
Please record your expenses and purchases
for the following period
Day
Date
1
2
3
4
5
6
7
I will return on: _______________________________________
If you have any questions, please call:
Field representative’s name:
Telephone:
Field representative supervisor’s name:
Telephone:
FORM CE-801 (7-2022)
Black (40% and 100%); Pantone Green at 30% and 100% -- Green(344), White(600),
General Instructions
■
Fill out this diary for an entire week, writing
down everything you and the people on
your list spend money on each day – the
products you buy, the services you use, the
household expenses you have during the
week – no matter how large or small they
are.
■
We recommend that you record your
expenses each day. Think about where you
went and what you did.
■
Talk to the people on your list every day
to find out how they spent their money.
■
Include payments by
Cash
Check
SNAP Card
Credit/Debit Card
Money Order
Venmo
Paypal
WIC Voucher
Automatic Withdrawal
Payroll Deduction
Store Charge Card
Gift Card
Cashapp
Keep receipts and other records so that you
will remember to record what you bought
or paid for. Use the pocket at the back of the
diary to store them.
■
Some record types include:
Receipts
Bills
Pay Stubs
Bank Statements
Internet/Catalog Purchases
Credit Card Statements
■
Include items that you bought for people
who are not on your list, such as gifts.
Do NOT record
■
Expenses of people on your list while
they were away from home overnight
■
Business or farm operating expenses
■
Sales tax, except for Meals, Snacks, and
Drinks Away from Home
FORM CE-801 (7-2022)
FRONT OF FRONT FLAP-ATTACH TO COVER/TITLE PAGE,
Black Ink (40%, & 100%)
FOLD IN
How to Fill Out
Your Diary
The diary is divided into 7 days and each
day is divided into 4 parts.
Enter each item in the appropriate part
for each day.
1. Food and Drinks for Home Consumption
■ Describe the item.
■
Mark whether the item was fresh, frozen,
bottled/canned, or other.
■
Enter the cost without tax and deduct any
discounts or coupons.
■
Enter the name of the store, business, or
website where the item was purchased.
2. Meals, Snacks, and Drinks Away from
Home
■ Enter the name of the restaurant, vendor, or
cafeteria. Do not include the name of the
delivery service.
■ Mark one of the four choices that best
describes where you made the purchase.
■
Enter the total cost with tax and tip. Include
any delivery fees in the total cost.
■
Check whether alcoholic beverages were
included or not, and if yes, enter the cost of
the alcoholic beverages.
3. Clothing, Shoes, Jewelry, and Accessories
■ Describe the item and enter the cost without
tax.
■
Mark the appropriate sex and age range of
the person for whom the item was bought.
■
Enter the name of the store, business, or
website where the item was purchased.
4. All Other Products, Services, and
Expenses
■
Describe the item and enter the total cost
without tax.
■
Enter the name of the store, business, or
website where the item was purchased.
See back fiap for answers to
Frequently Asked Questions
There is an Additional Pages section
on pages 18–23 in case you run out of
lines on any particular day.
If you are unsure about whether to
include an item or where to record an
item, write it down wherever it seems
best or make a note and ask your field
representative.
FORM CE-801 (7-2022)
BACK SIDE OF FRONT FLAP, ATTACH TO RECORD DAILY EXPENSES PAGE
Black Ink (40%, & 100%)
Record Your Daily Expenses
The people on your list:
Record the purchases and expenses made by ALL of these people.
Notes
FORM CE-801 (7-2022)
CE-801 Black Ink (40% & 100%)
Thank you for agreeing to fill out this diary.
We understand that this task takes time; however, your information is
very important to us and will be used for many purposes that affect all
households in the U.S. Among the most important, it is used to help
calculate the Consumer Price Index, or CPI. The CPI is one of the most
important tools used to measure how fast consumer prices are rising
or declining.
Here are some of the uses of the Consumer Price Index:
♦ Provide cost-of-living wage adjustments for millions of American workers
♦ Adjust Social Security payments
♦ Adjust Federal income-tax brackets
For more information about the survey, visit: www.bls.gov/cex and www.census.gov/programs-surveys/ce.html
Office Use: Place the barcode label here
Questions?
Some Frequently Asked Questions are answered on the fiap attached to the back cover.
If you still have questions after reviewing these, please call your field representative.
1
FORM CE-801 (7-2022)
§)""¤
080101
Black Ink (40%, & 100%)
Examples
Food and Drinks for Home Consumption
Is this item:
Mark (X) one
What did you buy or pay for?
fresh
bread
101
eggs
102
chicken wings
103
apples
104
beer
105
milk
106
orange juice
107
candy
108
vegetable oil
109
baby food
110
potato chips
111
frozen meals
112
ketchup
113
soup
114
soda
115
pork chops
116
shrimp
117
cookies
118
ground beef
119
carbonated water
120
apple pie
121
ground coffee
122
bagels
123
wine
124
juice boxes
125
1
bottled/
canned
other
2
3
4
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
1
2
3
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
dog food
126
frozen
Cost
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
4
X
4
4
without tax
1
49
1
50
6
78
2
80
4
29
2
99
3
99
2
50
2
99
4
95
2
79
8
97
1
59
4
96
1
98
6
36
Name of
Store or Website
where purchased
Foodway Grocery Store
11 20
X
3
50
5
87
89
4
99
2
79
NY Bagel Bakery
5
25
"
42
00
Total Wine
X
20
85
Amazon.com
X
21
45
Pets&More.com
X
127
128
2 of the
3
4
Use the pocket on the1 inside
back
cover to store your receipts
1
2 until 3you’re
4
ready to record your purchases.
129
130
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
131
132
133
134
135
136
2
FORM CE-801 (7-2022)
§)"#¤
080102
CE-801, Pantone Green 344 (20% 40% 70% & 100%) Pantone Yellow 101 (70%), Black (30% and 100%)
Examples
Meals, Snacks, and Drinks Away from Home
Mark (X) one that best describes
where you made this purchase
Name of
Restaurant or Vendor
201
202
203
204
205
206
McDonald’s
Lupo Verde Italian restaurant
Fast Food
Take-out
Delivery
Concession
Full
Service
Places
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
X
Mister Days sports bar
YMCA vending machine
Vending
Employer
Machines
or School
or Mobile
Cafeteria
Vendors /
Food Trucks
X
Total Cost
with tax & tip
Yes
62
1
2
1
2
X
23
X
1
X
15 00
X
1
X
00
1
2
15
00
1
2
1
2
X
X
00
2 09
X
12
2
50
45
X
Enter the
total cost of
the alcohol
No
7 25
Millbrook school cafeteria
Starbucks
Were
alcoholic
beverages
included?
X
Clothing, Shoes, Jewelry, and Accessories
What did you buy or pay for?
301
302
303
304
305
306
307
308
dress shirts
running shoes
wallet
baseball cap
bib
Cost
without tax
non-prescription sunglasses
child’s costume (returned for refund)
Boy
2-15
Girl
2-15
Man
16 &
over
Woman
16 &
over
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
3
4
5
2
3
4
5
1
2
3
4
5
1
2
3
4
5
75 00
69 00
29 00
14 99
3
necklace
Was the item for:
Child
Under 2
50
250 00
59 00
15 00
Name of
Store or Website
where purchased
Dillards.com
X
1
1
2
X
X
X
X
X
5
Target
Sweet Dreams
boutique
X
Olde Towne jewelry
X
Walmart.com
Partysupply.com
All Other Products, Services, and Expenses
What did you buy or pay for?
Name of
Store or Website
Cost
without tax
where purchased
6
95
Walmart
12
86
Liberty
highway tolls
2
00
Tri-River bridge
digital music
10
99
Spotify
8
99
Jim’s Mart
15
50
Green cleaners
401
cold medicine (non-prescription)
402
gasoline
403
404
406
cigarettes
dry cleaning (clothes)
407
lottery tickets
1
00
Jim’s Mart
408
bus fare
1
50
MetroCounty transit
409
piano lessons
410
electric drill
411
Netfiix subscription
412
veterinarian fees
405
150 00
Private Individual
65
00
Village Hardware
9
99
Netfiix
85
00
Bay County Vets
3
FORM CE-801 (7-2022)
§)"$¤
080103
CE-801, Pantone Green 344 (20%, 40%, 70% & 100%), Black (30%, & 100%)
ENTER
DAY AND
DATE
DAY 1
See pages 2-3 for examples. If you need additional space, use pages 18-23.
Food and Drinks for Home Consumption
Is this item:
Mark (X) one
What did you buy or pay for?
fresh
frozen
Cost
bottled/
canned
other
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
without tax
Name of
Store or Website
where purchased
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
4
FORM CE-801 (7-2022)
§)"%¤
080104
Black Ink (30%, & 100%), Pantone Green 344 (20% 40%, and 100%)
FR USE:
DAY 1
None
VC
Meals, Snacks, and Drinks Away from Home
Mark (X) one that best describes
where you made this purchase
Name of
Restaurant or Vendor
Fast Food
Take-out
Delivery
Concession
Full
Service
Places
Vending
Machines
or Mobile
Vendors /
Food Trucks
Employer
or School
Cafeteria
Were
alcoholic
beverages
included?
Total Cost
with tax & tip
Yes
Enter the
total cost of
the alcohol
No
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
201
202
203
204
205
206
Clothing, Shoes, Jewelry, and Accessories
What did you buy or pay for?
Cost
without tax
Was the item for:
Child
Under 2
Boy
2-15
Girl
2-15
Man
16 &
over
Woman
16 &
over
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Name of
Store or Website
where purchased
301
302
303
304
305
306
307
308
All Other Products, Services, and Expenses
What did you buy or pay for?
Cost
without tax
Name of
Store or Website
where purchased
401
402
403
404
405
406
407
408
409
410
411
412
413
FORM CE-801 (7-2022)
§)"&¤
080105
Black Ink (40%, & 100%), Pantone Green 344 (20% 40%, and 100%)
5
ENTER
DAY AND
DATE
DAY 2
See pages 2-3 for examples. If you need additional space, use pages 18-23.
Food and Drinks for Home Consumption
Is this item:
Mark (X) one
What did you buy or pay for?
fresh
frozen
Cost
bottled/
canned
other
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
without tax
Name of
Store or Website
where purchased
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
6
FORM CE-801 (7-2022)
§)"’¤
080106
Black Ink (30%, & 100%), Pantone Green 344 (20% 40%, and 100%)
FR USE:
DAY 2
None
VC
Meals, Snacks, and Drinks Away from Home
Mark (X) one that best describes
where you made this purchase
Name of
Restaurant or Vendor
Fast Food
Take-out
Delivery
Concession
Full
Service
Places
Vending
Employer
Machines
or School
or Mobile
Cafeteria
Vendors /
Food Trucks
Were
alcoholic
beverages
included?
Total Cost
with tax & tip
Yes
Enter the
total cost of
the alcohol
No
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
201
202
203
204
205
206
Clothing, Shoes, Jewelry, and Accessories
What did you buy or pay for?
Cost
without tax
Was the item for:
Child
Under 2
Boy
2-15
Girl
2-15
Man
16 &
over
Woman
16 &
over
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Name of
Store or Website
where purchased
301
302
303
304
305
306
307
308
All Other Products, Services, and Expenses
What did you buy or pay for?
Cost
without tax
Name of
Store or Website
where purchased
401
402
403
404
405
406
407
408
409
410
411
412
413
FORM CE-801 (7-2022)
§)"(¤
080107
Black Ink (40%, & 100%), Pantone Green 344 (20% 40%, and 100%)
7
ENTER
DAY AND
DATE
DAY 3
See pages 2-3 for examples. If you need additional space, use pages 18-23.
Food and Drinks for Home Consumption
Is this item:
Mark (X) one
What did you buy or pay for?
fresh
frozen
Cost
bottled/
canned
other
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
without tax
Name of
Store or Website
where purchased
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
8
FORM CE-801 (7-2022)
§)")¤
080108
Black Ink (30%, & 100%), Pantone Green 344 (20% 40%, and 100%)
FR USE:
DAY 3
None
VC
Meals, Snacks, and Drinks Away from Home
Mark (X) one that best describes
where you made this purchase
Name of
Restaurant or Vendor
Fast Food
Take-out
Delivery
Concession
Full
Service
Places
Vending
Machines
or Mobile
Vendors /
Food Trucks
Employer
or School
Cafeteria
Were
alcoholic
beverages
included?
Total Cost
with tax & tip
Yes
Enter the
total cost of
the alcohol
No
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
201
202
203
204
205
206
Clothing, Shoes, Jewelry, and Accessories
What did you buy or pay for?
Cost
without tax
Was the item for:
Child
Under 2
Boy
2-15
Girl
2-15
Man
16 &
over
Woman
16 &
over
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Name of
Store or Website
where purchased
301
302
303
304
305
306
307
308
All Other Products, Services, and Expenses
What did you buy or pay for?
Cost
without tax
Name of
Store or Website
where purchased
401
402
403
404
405
406
407
408
409
410
411
412
413
FORM CE-801 (7-2022)
§)"*¤
080109
Black Ink (40%, & 100%), Pantone Green 344 (20% 40%, and 100%)
9
ENTER
DAY AND
DATE
DAY 4
See pages 2-3 for examples. If you need additional space, use pages 18-23.
Food and Drinks for Home Consumption
Is this item:
Mark (X) one
What did you buy or pay for?
fresh
frozen
Cost
bottled/
canned
other
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
without tax
Name of
Store or Website
where purchased
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
10
FORM CE-801 (7-2022)
§)"+¤
080110
Black Ink (30%, & 100%), Pantone Green 344 (20% 40%, and 100%)
FR USE:
DAY 4
None
VC
Meals, Snacks, and Drinks Away from Home
Mark (X) one that best describes
where you made this purchase
Name of
Restaurant or Vendor
Fast Food
Take-out
Delivery
Concession
Full
Service
Places
Vending
Employer
Machines
or School
or Mobile
Cafeteria
Vendors /
Food Trucks
Were
alcoholic
beverages
included?
Total Cost
with tax & tip
Yes
Enter the
total cost of
the alcohol
No
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
201
202
203
204
205
206
Clothing, Shoes, Jewelry, and Accessories
What did you buy or pay for?
Cost
without tax
Was the item for:
Child
Under 2
Boy
2-15
Girl
2-15
Man
16 &
over
Woman
16 &
over
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Name of
Store or Website
where purchased
301
302
303
304
305
306
307
308
All Other Products, Services, and Expenses
What did you buy or pay for?
Cost
without tax
Name of
Store or Website
where purchased
401
402
403
404
405
406
407
408
409
410
411
412
413
FORM CE-801 (7-2022)
§)",¤
080111
Black Ink (40% & 100%), Pantone Green 344 (20% 40%, and 100%)
11
ENTER
DAY AND
DATE
DAY 5
See pages 2-3 for examples. If you need additional space, use pages 18-23.
Food and Drinks for Home Consumption
Is this item:
Mark (X) one
What did you buy or pay for?
fresh
frozen
Cost
bottled/
canned
other
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
without tax
Name of
Store or Website
where purchased
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
12
FORM CE-801 (7-2022)
§)"-¤
080112
Black Ink (30%, & 100%), Pantone Green 344 (20% 40%, and 100%)
FR USE:
DAY 5
None
VC
Meals, Snacks, and Drinks Away from Home
Mark (X) one that best describes
where you made this purchase
Name of
Restaurant or Vendor
Fast Food
Take-out
Delivery
Concession
Full
Service
Places
Vending
Employer
Machines
or School
or Mobile
Cafeteria
Vendors /
Food Trucks
Were
alcoholic
beverages
included?
Total Cost
with tax & tip
Yes
Enter the
total cost of
the alcohol
No
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
201
202
203
204
205
206
Clothing, Shoes, Jewelry, and Accessories
What did you buy or pay for?
Cost
without tax
Was the item for:
Child
Under 2
Boy
2-15
Girl
2-15
Man
16 &
over
Woman
16 &
over
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Name of
Store or Website
where purchased
301
302
303
304
305
306
307
308
All Other Products, Services, and Expenses
What did you buy or pay for?
Cost
without tax
Name of
Store or Website
where purchased
401
402
403
404
405
406
407
408
409
410
411
412
413
FORM CE-801 (7-2022)
§)".¤
080113
Black Ink (40%, & 100%), Pantone Green 344 (20% 40%, and 100%)
13
ENTER
DAY AND
DATE
DAY 6
See pages 2-3 for examples. If you need additional space, use pages 18-23.
Food and Drinks for Home Consumption
Is this item:
Mark (X) one
What did you buy or pay for?
fresh
frozen
Cost
bottled/
canned
other
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
without tax
tax
without
Name of
Storeor
orWebsite
Website
Store
wherepurchased
purchased
where
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
14
FORM CE-801 (7-2022)
§)"/¤
080114
Black Ink (30%, & 100%), Pantone Green 344 (20% 40%, and 100%)
FR USE:
DAY 6
None
VC
Meals, Snacks, and Drinks Away from Home
Mark (X) one that best describes
where you made this purchase
Name of
Restaurant or Vendor
Fast Food
Take-out
Delivery
Concession
Full
Service
Places
Vending
Employer
Machines
or School
or Mobile
Cafeteria
Vendors /
Food Trucks
Were
alcoholic
beverages
included?
Total Cost
with tax & tip
Yes
Enter the
total cost of
the alcohol
No
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
201
202
203
204
205
206
Clothing, Shoes, Jewelry, and Accessories
What did you buy or pay for?
Cost
without tax
Was the item for:
Child
Under 2
Boy
2-15
Girl
2-15
Man
16 &
over
Woman
16 &
over
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Name of
Store or Website
where purchased
301
302
303
304
305
306
307
308
All Other Products, Services, and Expenses
What did you buy or pay for?
Cost
without tax
Name of
Store or Website
where purchased
401
402
403
404
405
406
407
408
409
410
411
412
413
FORM CE-801 (7-2022)
§)"0¤
080115
Black Ink (40%, & 100%), Pantone Green 344 (20% 40%, and 100%)
15
ENTER
DAY AND
DATE
DAY 7
See pages 2-3 for examples. If you need additional space, use pages 18-23.
Food and Drinks for Home Consumption
Is this item:
Mark (X) one
What did you buy or pay for?
fresh
frozen
Cost
bottled/
canned
other
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
without tax
Name of
Store or Website
where purchased
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
16
FORM CE-801 (7-2022)
§)"1¤
080116
Black Ink (30%, & 100%), Pantone Green 344 (20% 40%, and 100%)
FR USE:
DAY 7
None
VC
Meals, Snacks, and Drinks Away from Home
Mark (X) one that best describes
where you made this purchase
Name of
Restaurant or Vendor
Fast Food
Take-out
Delivery
Concession
Full
Service
Places
Vending
Employer
Machines
or School
or Mobile
Cafeteria
Vendors /
Food Trucks
Were
alcoholic
beverages
included?
Total Cost
with tax & tip
Yes
Enter the
total cost of
the alcohol
No
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
201
202
203
204
205
206
Clothing, Shoes, Jewelry, and Accessories
What did you buy or pay for?
Cost
without tax
Was the item for:
Child
Under 2
Boy
2-15
Girl
2-15
Man
16 &
over
Woman
16 &
over
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Name of
Store or Website
where purchased
301
302
303
304
305
306
307
308
All Other Products, Services, and Expenses
What did you buy or pay for?
Cost
without tax
Name of
Store or Website
where purchased
401
402
403
404
405
406
407
408
409
410
411
412
413
FORM CE-801 (7-2022)
§)"2¤
080117
Black Ink (100%), Pantone Green 344 (20% 40%, and 100%)
17
Additional Pages
Food and Drinks for Home Consumption
Is this item:
Mark (X) one
What did you buy or pay for?
fresh
frozen
Cost
bottled/
canned
other
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
without tax
Name of
Store or Website
where purchased
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
18
FORM CE-801 (7-2022)
§)"3¤
080118
Black Ink (100%), Pantone Green 344 (20%, 40% and 70%)
Additional Pages
Meals, Snacks, and Drinks Away from Home
Mark (X) one that best describes
where you made this purchase
Name of
Restaurant or Vendor
Fast Food
Take-out
Delivery
Concession
Full
Service
Places
Vending
Employer
Machines
or School
or Mobile
Cafeteria
Vendors /
Food Trucks
Were
alcoholic
beverages
included?
Total Cost
with tax & tip
Yes
Enter the
total cost of
the alcohol
No
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
201
202
203
204
205
206
Clothing, Shoes, Jewelry, and Accessories
What did you buy or pay for?
Cost
without tax
Was the item for:
Child
Under 2
Boy
2-15
Girl
2-15
Man
16 &
over
Woman
16 &
over
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Name of
Store or Website
where purchased
301
302
303
304
305
306
307
308
All Other Products, Services, and Expenses
What did you buy or pay for?
Cost
without tax
Name of
Store or Website
where purchased
401
402
403
404
405
406
407
408
409
410
411
412
413
19
FORM CE-801 (7-2022)
§)"4¤
080119
Black Ink (40% & 100%), Pantone Green 344 (20%, 40%, 70% and 100%)
Additional Pages
Food and Drinks for Home Consumption
Is this item:
Mark (X) one
What did you buy or pay for?
fresh
frozen
Cost
bottled/
canned
other
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
without tax
Name of
Store or Website
where purchased
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
20
FORM CE-801 (7-2022)
§)"5¤
080120
Black Ink (100%), Pantone Green 344 (20%, 40% and 70%)
Additional Pages
Meals, Snacks, and Drinks Away from Home
Mark (X) one that best describes
where you made this purchase
Name of
Restaurant or Vendor
Fast Food
Take-out
Delivery
Concession
Full
Service
Places
Vending
Employer
Machines
or School
or Mobile
Cafeteria
Vendors /
Food Trucks
Were
alcoholic
beverages
included?
Total Cost
with tax & tip
Yes
Enter the
total cost of
the alcohol
No
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
207
208
209
210
211
212
Clothing, Shoes, Jewelry, and Accessories
What did you buy or pay for?
Cost
without tax
Was the item for:
Child
Under 2
Boy
2-15
Girl
2-15
Man
16 &
over
Woman
16 &
over
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Name of
Store or Website
where purchased
309
310
311
312
313
314
315
316
All Other Products, Services, and Expenses
What did you buy or pay for?
Cost
without tax
Name of
Store or Website
where purchased
414
415
416
417
418
419
420
421
422
423
424
425
426
21
FORM CE-801 (7-2022)
§)"6¤
080121
Black Ink (40% & 100%), Pantone Green 344 (20%, 40%, 70% and 100%)
Additional Pages
Food and Drinks for Home Consumption
Is this item:
Mark (X) one
What did you buy or pay for?
fresh
frozen
Cost
bottled/
canned
other
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
without tax
Name of
Store or Website
where purchased
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
FORM CE-801 (7-2022)
22
§)"7¤
080122
Black Ink (100%), Pantone Green 344 (20%, 40%, 70% and 100%)
Additional Pages
Meals, Snacks, and Drinks Away from Home
Mark (X) one that best describes
where you made this purchase
Name of
Restaurant or Vendor
Fast Food
Take-out
Delivery
Concession
Full
Service
Places
Vending
Employer
Machines
or School
or Mobile
Cafeteria
Vendors /
Food Trucks
Were
alcoholic
beverages
included?
Total Cost
with tax & tip
Yes
Enter the
total cost of
the alcohol
No
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
1
2
3
4
1
2
213
214
215
216
217
218
Clothing, Shoes, Jewelry, and Accessories
What did you buy or pay for?
Cost
without tax
Was the item for:
Child
Under 2
Boy
2-15
Girl
2-15
Man
16 &
over
Woman
16 &
over
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Name of
Store or Website
where purchased
317
318
319
320
321
322
323
324
All Other Products, Services, and Expenses
What did you buy or pay for?
Cost
without tax
Name of
Store or Website
where purchased
427
428
429
430
431
432
433
434
435
436
437
438
439
23
FORM CE-801 (7-2022)
§)"8¤
080123
Black Ink (40% & 100%), Pantone Green 344 (20%, 40%, 70% and 100%)
Keep your records in this pocket.
(These records are only for your reference; we will not keep them.)
■
■
■
■
■
■
FORM CE-801 (7-2022)
Receipts
Bills
Pay Stubs
Bank Statements
Catalog/Internet Purchases
Credit Card Statements
Frequently Asked Questions
(continued on other side)
11. What about gift cards or gift
certificates?
If you buy a gift card or gift certificate to give to
someone, write down its cost under the
appropriate section (e.g., a gift card to a
clothing store would go under Clothing, Shoes,
Jewelry, and Accessories and a gift card to a
department store would go under All Other
Products, Services, and Expenses). If you use a
gift card, write down the full amount for your
purchase as if paid with cash.
12. What do I do about returns & exchanges?
If an item is bought and returned during the
diary week, it can be erased or crossed out. If
it was bought outside the week and returned
during the week, do not make an entry. If an
item is exchanged during the week, erase or
cross out the item that was returned and enter
the new item and its cost on the day the
exchange was made.
13. How do I categorize the establishment
for Meals, Snacks, and Drinks Away from
Home?
■
Fast Food, Take-out, Delivery, Concession
You pay BEFORE you eat/drink
■
Full Service Places
You pay AFTER you eat/drink if you eat/drink
at the establishment
■ Vending Machines or Mobile Vendors /
Food Trucks
Include vending machines, carts, and
food trucks that move from place to place.
■ Employer and School Cafeterias
Include school meal plans and pre-payments,
and school lunch bills
14. What’s the difference between a
concession stand and a mobile vendor?
A concession stand has to stay in a permanent
location and a mobile vendor does not. Some
mobile vendors may seem permanent because
they are usually in the same location, but they
are still considered mobile vendors because
they have the option to change locations.
15. Should I record subsidized/reimbursed
expenses?
Yes, but only record the portion that you or
someone on your list has paid.
16. What should I do about shipping &
handling costs?
Include the shipping & handling cost in the total
price of the item. If the shipping & handling
covered multiple items, include the shipping &
handling in the total price of one item from the
order.
FORM CE-801 (7-2022)
ATTACH THIS FLAP TO POCKET PAGE (FOLD IN, BACK OF FAQ 1-10)
Black Ink (40% and 100%), Pantone Green 344 (20% and 100%)
Frequently Asked Questions
(continued on other side)
1. How detailed should my descriptions be?
Refer to pages 2–3 for examples of the level of
detail needed in each part. Do not rely solely
on brand names.
2. How should I record multiple quantities?
You may group identical items on the same line
and enter a total cost of all the items, or you
may write each item on a separate line with the
individual cost.
3. How should I record pre-payments such
as a subway fare card?
Record the expense when you pay for it, not
when you use it.
4. How should I record credit card
purchases?
Record the purchase on the day that you use
your credit card to pay for it, not on the day you
receive or pay your credit card bill.
5. Should I record automatic deductions
taken from my paycheck or bank
account?
Yes, record automatic deductions (such as
health insurance premiums taken out of your
account or paycheck) only if they are deducted
that week. Write them in the section called All
Other Products, Services, and Expenses.
6. Should I record typical monthly bills?
Yes, record typical monthly bills only if you pay
them during the week that you have the diary.
Write them in the section called All Other
Products, Services, and Expenses.
7. What should I do when I use coupons,
discount cards, or loyalty cards?
Subtract the discount from the original price
and write the amount that you paid.
8. Can I just give you receipts instead of
writing the information down?
No, we need you to write the information in the
diary. We encourage you to save your receipts
to review them with your field representative
at the end of the week. You can use the pocket
on the inside of the back cover to store your
receipts until you’re ready to record your
purchases.
9. How should I record an item if I don’t
know if it includes tax?
Write down the amount paid.
10. What if I make a contribution or
charitable donation?
Record money contributions or donations in
the section called All Other Products, Services,
and Expenses.
(continued on other side)
FORM CE-801 (7-2022)
FINAL FLAP - ATTACH TO BACK COVER (SEE DUMMY)
Black Ink (40% and 100%), Pantone Green 344 (20% and 100%)
couple
shopping.jpg
mug_credit card
phone.jpg
family_
groceries.jpg
phone_Ipad.jpg
currency 2_
curled $.jpg
dinner party.jpg
Daily Reminder List
Please review the list of expenses below with the people on your list at the end of each day.
If you have forgotten to record any expense, please do so on the appropriate page.
Did you or anyone on your list pay for . . .
■ meals, drinks, or snacks from restaurants, fast
food, cafeterias, vending machines, concession
stands, etc.?
■ medicine or medical/dental services?
■ entertainment or recreational activities?
■ catered events or meal plans?
■ food & drinks from a grocery store or other
speciality food store such as a bakery, candy shop,
or liquor store?
■ typical bills such as utility bills, cable bills,
telephone bills, etc.?
■ clothing, shoes, jewelry, accessories or clothing
services such as dry cleaning?
■ automatic deductions from a paycheck
such as insurance premiums?
■ personal care items or services such as cosmetics,
soaps, haircuts, etc.?
■ bank/ATM service fees?
■ housekeeping supplies or services for home
decoration/maintenance?
■ credit card interest or finance charges?
■ toys, books, electronics, hobby supplies, etc.?
■ internet or catalog orders?
■ cigarettes, tobacco, or other smoking supplies?
■ fees for lessons or instructions?
■ commuting costs such as public transportation,
parking fees, gasoline, or tolls?
■ gifts, contributions, or donations?
FR USE: Use the example below to transcribe the Control Number:
RO
code
Control Number
Week
Example
21
RO
code
Survey
code
(1-2)
PSU
state
(3-4)
PSU
county
(5-7)
Frame
Sample
Designation
Sequence
#1
Sequence
#2
(16-17)
HH
No.
(18)
CU
No.
(19-20)
Spinoff
Indicator
(21-22)
(8)
(9-11)
(12-15)
04
26
999
U
D15
0001
01
1
01
00
Survey
code
(1-2)
PSU
state
(3-4)
PSU
county
(5-7)
Frame
Sample
Designation
Sequence
#1
Sequence
#2
(12-15)
(16-17)
HH
No.
(18)
CU
No.
(19-20)
(8)
(9-11)
Control Number
daughter_dad_
pet shop.jpg
internet shopping
man.jpg
receipts.jpg
FORM CE-801 (7-2022)
Black 100 % -- Pantone Green 344 (30%) White (600)
1
2
Week
lady holding
credit card.jpg
currency 1.jpg
Spinoff
Indicator
(21-22)
1
2
couple_gift.jpg
| File Type | application/pdf |
| Author | OneFormUser |
| File Modified | 2022-03-24 |
| File Created | 2022-03-21 |