Form SIPP EHC FORM Part SIPP EHC FORM Part SIPP EHC FORM Part 1

MANIPULA_SCRIPT
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

HELP_SCREEN
**Non-displayed item**

CARI_Fields
***NON-DISPLAYED ITEM***

OPT_OUT
Who is opting out?
Mark all that apply.
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
Page 1 of 372

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

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. 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 your portion of the population to
ensure each household is only eligible for one survey each decade.
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.

Page 2 of 372

1. Enter 1 to continue

H_PURPOSE3
How is my income/health/wealth/program participation relevant?
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, and 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
infromation to deport me or take away my benefits?
Your information is protected under Title 13 of the U.S. Constitution which includes all of the
following:
·
Data from individuals, households, and establishments must be kept confidential
·
Data must be used only for statistical purposes
·
Data must not be distributed in a manner that could be used to identify a respondent
·
Data provided to the Census Bureau by individuals and establishments cannot be used in a
court of law.
In addition to stripping the data of any personally identifiable information prior to dissemination,
anyone with access to the data must sign a Sworn Affidavit of Nondisclosure, which obligates
confidentiality and violation is punishable with penalties of 5 years imprisonment and a $250,000
fine. Technological safeguards are in place on this laptop, the lines through which transmissions
occur, and at the storage facility. Additionally, data access is restricted and prior to the release of
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any data, all products must meet the Disclosure Review Board standards, ensuring the protection
of your privacy. 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 jumble 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

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. Return to Previous Menu

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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 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
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are determined by the Social Security office where the food stamp representative works. Monthly
amounts vary by state, individual/familial income, and family size or number of dependents.
1. Enter 1 to continue

H_REFERENCE4
Free/Reduced-Price School Lunch
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/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
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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 and/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
administers the basic SSI program, income from SSI is NOT the same as Social Security. A
person is considered disabled if he/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,
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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.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, and/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
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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
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.
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1. Enter 1 to continue

SHOW_HH
Please display a table with 11 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 10: ^HHSTAT_FIL; labeled as "Status"
Column 11: ^STATDATE_FIL; labeled as "Date"
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 PARENT_SCRN=2 OR
DINMOM=(0,...,7,DK,R) OR DINDAD=(0,...,7,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".

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1. Enter 1 to continue

HOLIDAY_LIST
Display the attached table.
**Table needs 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

ADDRCHG
**NON-DISPLAYED ITEM**

AFCNT
**NON-DISPLAYED ITEM**

CONTACT_NUM
**NON-DISPLAYED ITEM**

FOSTER
**NON-DISPLAYED ITEM**

GOOD_EXTRA
**NON-DISPLAY ITEM**

HHRESP
Page 11 of 372

**NON-DISPLAYED ITEM**

MAILADDRCHG
**NON-DISPLAYED ITEM**

MARK
**NON-DISPLAYED ITEM**

MARKTWO
**NON-DISPLAYED ITEM**

MOVERFLG
**NON-DISPLAYED ITEM**

OUTCOME
**NON-DISPLAYED ITEM**

PCNT
**NON-DISPLAYED ITEM**

PCNTGE15
**NON-DISPLAYED ITEM**

PCNTGE17
**NON-DISPLAYED ITEM**

PEOPLE_TO_ROSTER
**NON-DISPLAY ITEM**

REF_LNO
**NON-DISPLAYED ITEM**

SKIPFLAG
Page 12 of 372

**NON-DISPLAYED 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**

START
CENSUS CATI/CAPI SYSTEM

^VERDATE
^VERSION
SIPP

SURVEY OF INCOME AND PROGRAM PARTICIPATION
^I_PANEL

^WAVE

PSU: ^I_PSU
DATE IS: ^DATE
TIME IS: ^TIME

O.M.B Number: 0607-0957
Expiration Date: December 31, 2011

CASE STATUS IS: ^CSTATUS
INTERVIEW MODE: ^I_NXTINTFLG
Page 13 of 372

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.
This outcome code is NOT transmittable.
You can request the case be re-assigned to another FR for completion or you can close the case as a
207 - Completed partial interview with Type Z lines.
1. Reassign the case to another FR
2. Closeout the case with an outcome code of 207

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

Page 14 of 372

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?
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

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
Page 15 of 372

^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?
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
Page 16 of 372

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
^I_NONCITYADD
^I_PHYSDES
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
^I_BLDGNAME

HHAPPT2
When would be a convenient time to conduct an interview with your household?

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
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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
? [F1]
Enter the correct Street Name or press ENTER for Same.

HHAPPT4_UNITDES
? [F1]
Enter the correct Unit Designation 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]
Page 18 of 372

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
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
Page 19 of 372

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

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]
Page 20 of 372

Enter the correct Building Name or press ENTER for Same.

HHAPPT5
I have listed

Read names 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.
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

INTRO_D
^NAMEFIL_INTROD
Some of the questions have already been answered. Let me see where we should begin.
Press 1 to Continue
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.
Ask the respondent if he/she received the advance letter. If no, give or read the letter to the
respondent (depending on the type of interview) before proceeding.
Page 21 of 372

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
This interview may be recorded for quality control purposes. Is that O.K.?
1. Yes
2. No

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. Other Type A

TYPEA__SP
Specify the kind of 'other' Type A noninterview.

TYPE_B
Enter Type B noninterview code.

Page 22 of 372

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
Specify the kind of 'other' Type B noninterview.

TYPE_C
Enter code for Type C noninterview/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
9. Unit already had a chance of selection
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
Page 23 of 372

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
2. ENTIRE household moved with US; 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
Page 24 of 372

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 --

1. Owned or being bought by someone in the household
2. Rented
3. Occupied without payment of rent

TYPEAD_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**

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 any other
sources of income. After that, I'll have questions about anyone else who lives here.
Enter 1 to continue.

1. Enter 1 to continue

VERIFY_ADDRESS
? [F1]
Page 25 of 372

I have your address listed as:
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
(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
Page 26 of 372

? [F1]
Enter the correct Unit Designation or press ENTER for Same.

NEW_GQUNITINFO
? [F1]
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
Page 27 of 372

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
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
Page 28 of 372

WA. Washington
WV. West Virginia
WI. Wisconsin
WY. Wyoming

NEW_ZIP5
? [F1]
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_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.

Page 29 of 372

NEW_MHNOSUF
? [F1]
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 Unit Designation of the mailing address or press ENTER for Same.

NEW_GQUNITINFO
? [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
Page 30 of 372

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 31 of 372

SD. South Dakota
TN. Tennessee
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.

YR_BUILT
If this address is a
- Group Quarters,
- Mobile Home,
- Trailer, Tent, Boat, or
- a Unit not located in a structure,
Enter 3 without asking the following question.
Was this structure originally built before April 1, 2000?
1. Yes
2. No
3. Not Asked

OTHLIVQTR
Are there other living quarters, either occupied or vacant, at this address?
Page 32 of 372

1. Yes
2. No

TABX_INTRO
You are about to begin asking questions about one or more additional living arrangements at this
location to determine if they qualify as EXTRA UNITS!!!
If you have accidentally reached this screen, PRESS "UP ARROW" to back up to the previous screen
and correct an earlier entry.
To begin collecting information for additional living arrangements at this location, press 1 to continue.
1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

XHNO
What is the exact address of this other living quarters?
Enter the House Number or press ENTER for Same.

XHNOSUF
Enter the House Number Suffix or press ENTER for Same.

XSTRNAME
Enter the Street Name or press ENTER for Same.

XUNITDES
Enter the Unit Designation or press ENTER for Same.

XGQUNITINFO
Enter the GQ Unit Information or press ENTER for Same.

Page 33 of 372

XNONCITYADD
Enter the Non-City Style Address or press ENTER for Same.

XPHYSDES
Enter the Physical Description or press ENTER for Same.

XPO
Enter the Locality or press ENTER for Same.

XST
Enter the 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
IA. Iowa
KS. Kansas
KY. Kentucky
LA. Louisiana
ME. Maine
MD. Maryland
MA. Massachusetts
MI. Michigan
MN. Minnesota
MS. Mississippi
MO. Missouri
Page 34 of 372

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

XZIP5
Enter the Zip Code or press ENTER for Same.

XZIP4
Enter the 4-Digit Zip Code or press ENTER for Same.

XBLDGNAME
Enter the Building Name or press ENTER for Same.

TABX_MORE
Are there any more (other living quarters, either occupied or vacant at this address)?
Page 35 of 372

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

TABX_A2
Is the address of the additional living quarters already listed?
^I_HNO ^I_HNOSUF ^I_STRNAME
^I_UNITDES
^I_PO, ^I_ST ^I_ZIP5-^I_ZIP4
Non-city: ^I_NONCITYADD
Building: ^I_BLDGNAME
1. Yes
2. No

TABX_B1
Are the additional living quarters within the same space occupied by the original sample unit?

1. Yes
2. No

TABX_B2
Are the additional living quarters within the basic address (house number and street name) of the
original sample unit?
1. Yes
2. No

TABX_B3
Are the additional living quarters within the same structure and within the same space as the original
sample unit?

Page 36 of 372

1. Yes
2. No

TABX_C1
Are the additional living quarters in a group quarters?
1. Yes
2. No

TABX_D
Do the occupants or intended occupants of the additional living quarters live separately from all
other persons on the property?
1. Yes
2. No

TABX_E
Do the occupants or intended occupants of the additional living quarters have direct access from
the outside or through a common hall?
1. Yes
2. No

TABXSPAWN
This additional living quarters IS an extra unit. Do NOT include members of this extra unit as members
of the current unit. They must be interviewed separately.
Add the extra unit to your listing sheet according to the instructions in your listing and coverage
manual.
***CREATE FILLS FOR EXTRA ADDRESS
XHNO XHNOSUF XSTRNAME
XUNITDES
XPO, XST XZIP5-XZIP4
Non City: XNONCITY
Building: XBLDGNAME
1. Enter 1 to continue
Page 37 of 372

TABX_NO
The other living quarters IS NOT considered to be an extra unit. Include the persons who occupy that
living arrangements as members of the assigned household.
1. Enter 1 to continue

TABX_FR
Interview the parent case.
After interviewing the parent unit, you will receive instructions from your RO on what to do with the
EXTRA_UNITS.
You have identified ^TOTSPAWN_FIL extra units.
Display the address of the extra unit in the following format:
XHNO XHNOSUF XSTRNAME
XUNITDES
XPO, XST, XZIP5-XZIP4
Non-city: XNONCITY
Buliding: XBLDGNAME
1. Enter 1 to continue

CALLRO
More than 8 EXTRA UNITS have been identified for this listed address.
1) Call your office.
2) Tell your supervisor than you have identified more than 26 EXTRA UNITS for this address.
1. Enter 1 to continue

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
Page 38 of 372

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.

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. Unoccupied 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 -Page 39 of 372

Read answer categories.

1. Owned or being bought by someone in the household
2. Rented
3. Occupied without payment of rent

CTRLNUM
**NON-DISPLAYED ITEM**

RENTSUB
^RENTSUBQTEXT
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 he/she lives AND it helps pay the rent.)
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

AGE
**NON-DISPLAYED ITEM**

AMOUNTSPELL
**NON-DISPLAYED ITEM**

ASTCODE
Page 40 of 372

**NON-DISPLAYED ITEM**

ASTCODE2
**NON-DISPLAYED**

ASTCODE_RET
**NON-DISPLAYED ITEM**

BUSINESS_CODE
**NON-DISPLAYED ITEM**

CARICONFLAG
***NON-DISPLAYED ITEM****
1. Yes
2. No

CARNO
**NON-DISPLAYED ITEM**

CHILD_LNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

DISABLECODE
**NON-DISPLAYED ITEM**

ED_RETURNING
**NON-DISPLAYED ITEM**

EHC_PGM_SCRN
Page 41 of 372

**NON-DISPLAYED ITEM**
1. Yes
2. No

FS_RETURNING
**NON-DISPLAYED ITEM**

GA_RETURNING
**NON-DISPLAYED ITEM**

HHSTAT
**NON-DISPLAYED ITEM**

INLIST
**NON-DISPLAYED ITEM**

INC_SCRN
**NON-DISPLAYED ITEM**
1. Yes
2. No

INVBUSINESS_CODE
**NON-DISPLAYED ITEM**

LNBIODAD
**NON-DISPLAYED ITEM**

LNBIOMOM
**NON-DISPLAYED ITEM**

LNDCUPT
**NON-DISPLAYED ITEM**
Page 42 of 372

LNGD
**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**

MONTHCODE
**NON-DISPLAY ITEM**

MOVER_LNO
**NON-DISPLAY ITEM**
Page 43 of 372

OSP_FLAG
***NON-DISPLAYED ITEM***

PCNTLT5T2
**NON-DISPLAYED ITEM**

PCNTFEGE15T2
**NON-DISPLAYED ITEM**

PCNTLT18T2
**NON-DISPLAYED ITEM**

PLPCNTLE18T2
**NON-DISPLAYED ITEM**

PLPCNTLT5T2
**NON-DISPLAYED ITEM**

PCNTLT22T2
**NON-DISPLAYED ITEM**

PLPCNT_TYPE2
**NON-DISPLAYED ITEM**

PELIG
**NON-DISPLAYED ITEM**

PLINTDATE
**NON-DISPLAYED ITEM**

PNUM
**NON-DISPLAYED ITEM**

Page 44 of 372

PROCEEDMONTHNUM
**NON-DISPLAYED ITEM**

PROCEEDYEAR
**NON-DISPLAYED ITEM**

PROPLOAN_CODE
**NON-DISPLAYED ITEM**

PSTATUS
**NON-DISPLAYED ITEM**

RES_RETURNING
**NON-DISPLAYED ITEM**

RETIRECODE
**NON-DISPLAYED ITEM**

SCREENER_CLUMP
**NON-DISPLAYED ITEM**
1. Yes
2. No

SLFPRX
**NON-DISPLAYED ITEM**

SSI_RETURNING
**NON-DISPLAYED ITEM**

SSCHLDFLAG
**NON-DISPLAYED ITEM**

SUPPORTPMTCODE
Page 45 of 372

**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**

NUMCLD314
**NON-DISPLAYED ITEM**

NUMCLD014
Page 46 of 372

**NON-DISPLAYED ITEM**

NUMCLD617
**NON-DISPLAYED ITEM**

NUMCLD05
**NON-DISPLAYED ITEM**

NALLKIDALLROS

NBIOKIDALLROS

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 47 of 372

**NON-DISPLAYED ITEM**

NCLD017_HH
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

PREROST
^QSTNTXT_PREROST
1. Enter 1 to continue

PERSTAT
I have listed from a year ago

Read name(s).

Are all of these people still living or staying here?
If 'NO', use arrow keys to move to the correct person and enter the main reason for the membership
change.
If 'YES" or when done making corrections, press End to go to ROST_FNAME.
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, parent moves into nursing home)
9. Listed in error in prior wave
10. Other
Page 48 of 372

11. Reinstate person

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/new people.
^MAX20

ROST_MNAME
^QSTNTXT_ROSTER
Enter middle name.

ROST_LNAME
^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.

ROST_ONAME
^QSTNTXT_ROSTER
Enter other/maiden name.

CM_PERSTAT
*** Non-Displayed Item ***
1. Active Household Member
3. Inactive, but may come back
Page 49 of 372

4. Deceased

HHRESP2
Ask if necessary.
With whom am I speaking?
WARNING: This person must be 15 years of age or older. If in doubt inquire as to the person's age
and, if necessary, ask to speak with someone who is at least 15 years of age.
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
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

Page 50 of 372

NOTHERE
Who doesn't live or sleep here most of the time? Anyone else?
Mark all that apply.
If there is only one person in the household, do not read the question text, select that person and
proceed with the interview.

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
21. ^LNO ^ROST_FNAME ^ROST_LNAME
22. ^LNO ^ROST_FNAME ^ROST_LNAME
23. ^LNO ^ROST_FNAME ^ROST_LNAME
24. ^LNO ^ROST_FNAME ^ROST_LNAME
25. ^LNO ^ROST_FNAME ^ROST_LNAME

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
Page 51 of 372

**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
2. No

Page 52 of 372

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

MSNGSTAY
? [F1]
Sometimes we miss people when it's not totally clear where they live or stay. Just to make sure,
^OTHERTHANFIL...
... Have I missed anyone who is staying here until they find a place to live? E
(... (Have I missed) Any lodgers, boarders or persons you employ who live here?)
(... (Have I missed) Anyone who may have another place to live, but who stays here often or has some
space or a room here?)

1. Yes
2. No

MSNGLODGE
? [F1]
(Sometimes we miss people when it's not totally clear where they live or stay. Just to make sure,
^OTHERTHANFIL...)
(... Have I missed anyone who is staying here until they find a place to live?)
... (Have I missed) Any lodgers, boarders or persons you employ who live here? E
(... (Have I missed) Anyone who may have another place to live, but who stays here often or has some
space or a room here?)

1. Yes
2. No

MSNGOTH
? [F1]
Page 53 of 372

(Sometimes we miss people when it's not totally clear where they live or stay. Just to make sure,
^OTHERTHANFIL...)
(... Have I missed anyone who is staying here until they find a place to live?)
(... (Have I missed) Any lodgers, boarders or persons you employ who live here?)
... (Have I missed) Anyone who may have another place to live, but who stays here often or has
some space or a room here? E

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 MSNGSTAY,
MSNGLODGE, and MSNGOTH
1. Yes
2. No

NOTHEREONE
Who doesn't live or sleep here most of the time? Anyone else?
Mark all that apply.

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
Page 54 of 372

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
21. ^LNO ^ROST_FNAME ^ROST_LNAME
22. ^LNO ^ROST_FNAME ^ROST_LNAME
23. ^LNO ^ROST_FNAME ^ROST_LNAME
24. ^LNO ^ROST_FNAME ^ROST_LNAME
25. ^LNO ^ROST_FNAME ^ROST_LNAME

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

URE_NUM
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

Page 55 of 372

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, display the
following text 'No one in this household is eligible to be included in this
interview'
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
Page 56 of 372

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/her usual place of residence. This designates
this address as a Type B noninterview.

0. The information about usual residence is incorrect
1. No other adult maintains this address as his/her usual residence

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

Page 57 of 372

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

OTHRRP_FIX
What information about ^HISHER residence needs to be corrected?
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**

LEAVE_MO
^INTROLEAVE_FIL When did this person ^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
Page 58 of 372

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

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ENTER_MO
^INTROLEAVE_FIL When did this person 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
Page 59 of 372

12. ^MONTH12 ^CALENDAR_YRFIL
13. ^MONTH13 ^INTYEARFIL
14. ^MONTH14 ^INTYEARFIL
15. ^MONTH15^INTYEARFIL
16. ^MONTH16 ^INTYEARFIL
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 chages (e.g., change in custody, adoption or parent/child joins the household)
5. From an institution or other group quarters (e.g., nuring 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
Page 60 of 372

11. Fill with 11th. reason selected in TRSNENT

RSNENT_SP
What is the 'other' reason FNAME LNAME joined this household?

CTRLNUM
**NON-DISPLAYED ITEM**

MOVER_LNO
**NON-DISPLAY ITEM**

WHOELSE
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
Page 61 of 372

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
1. Yes
2. No/Address not available yet

CTRLNUM
**NON-DISPLAYED ITEM**

MOVER_LNO
**NON-DISPLAY ITEM**

MOVE_HNO
? [F1]
What is the new address for ^MOVERTENSE_FIL?
Enter the House Number.

MOVE_HNOSUF
? [F1]
Page 62 of 372

(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?)
Enter the Unit Designation.

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]

Page 63 of 372

(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
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
Page 64 of 372

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
? [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_TELENO
What is the telephone number for ^MOVERTENSE_FIL?

MOVE_MO
When did ^THISTHESEPERSONSFIL move to this address?
Enter the month.

Page 65 of 372

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
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-realted 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 nuring 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-realted 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 nuring home)
Page 66 of 372

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 to the next screen.
1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**
Page 67 of 372

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/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
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 68 of 372

LNO
**NON-DISPLAYED ITEM**

RELRPEXP
A
^QSTNTXT_RELRP
Domestic partners should be classified as "Unmarried Partners"; we will ask a follow-up question later
that will capture this relationship.
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

RELRP
**NON-DISPLAYED ITEM**
1. Spouse (Husband/Wife)
2. Unmarried Partner
3. Child (Biological, Step, Adopted)
Page 69 of 372

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

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

DOB_BMONTH
^ASKORVERIFY
What ^ISWAS ^PTEMPNAME date 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

Page 70 of 372

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

AGEGES
? [F1]
How old would you say ^TEMPNAME ^AREISWAS?
Enter best estimate of age.

FRGES
Enter your best estimate of ^NAMEFIL age.

UNDERAGE
Both the household reference person and the household respondent must be 15 years of age or
Page 71 of 372

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
^ASKORVERIFY
^C_AREISWAS ^TEMPNAME Spanish, Hispanic or Latino? (Such as Mexican, Mexican-American,
Chicano, Puerto Rican, Cuban or some other Spanish, Hispanic, or Latino group.)

1. Yes
2. No

HISPAN
B
^ASKORVERIFY
^C_AREISWAS ^TEMPNAME Mexican, Mexican American, Chicano, Puerto Rican, Cuban, Cuban
American, or other Spanish, Hispanic, or Latino group?
1. Mexican
2. Mexican American
3. Chicano
4. Puerto Rican
5. Cuban
6. Cuban American
7. Other Spanish, Hispanic, or Latino group
Page 72 of 372

OROTSP
What is the name of ^PTEMPNAME other Spanish, Hispanic, or Latino group?

OROTSS
What 'other' Spanish, Hispanic or Latino group?

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.
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.
Page 73 of 372

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

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
Page 74 of 372

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
35. Samoan
36. Scotch-Irish
37. Spanish
38. Vietnamese
39. West Indian
40. White

RACEOS
What 'other' race?

CTRLNUM
**NON-DISPLAYED ITEM**

Page 75 of 372

LNO
**NON-DISPLAYED ITEM**

BORNUS
^ASKORVERIFY
^C_WASWERE ^TEMPNAME born in the United States?
1. Yes
2. No

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
17. Indiana
18. Iowa
19. Kansas
20. Kentucky
21. Louisiana
22. Maine
23. Maryland
24. Massachusetts
Page 76 of 372

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

BORNST
*** THIS IS A NON-DISPLAYED ITEM ***

Page 77 of 372

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
28. Czechoslovakia
29. Denmark
30. Dominica
31. Dominican Republic
32. Ecuador
33. Egypt
34. El Salvador
Page 78 of 372

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
67. Lithuania
68. Malaysia
69. Mexico
70. Morocco
71. Netherlands
72. New Zealand
73. Nicaragua
Page 79 of 372

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
106. Vietnam
107. Yugoslavia
108. Other Africa
109. Other Asia
110. Other Central America
111. Other Europe
112. Other Pacific Islands
Page 80 of 372

113. Other South America
114. Other

BORNCOUNTRY
CITIZEN
^ASKORVERIFY
^C_AREISWAS ^TEMPNAME a citizen of the United States?
1. Yes
2. No

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

YRENTRY
^ASKORVERIFY
What year did ^TEMPNAME first come to live in the United States?

IMSTAT
E
^ASKORVERIFY
When ^TEMPNAME first moved to the United States to live, what was ^HISHER immigration
Page 81 of 372

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

HHSPEAK1
Do not read to the respondent.
So far, has any part of this interview been conducted in a language other than English?
Do not count American Sign Language as non-English Language.

1. Yes
2. No, all in English

HHSPEAK2
? [F1]
^INTROFIL_HHSPEAK2 speak a language other than English at home?
Do not count American Sign Language as non-English Language.

1. Yes
2. No, only English

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

HHSPEAK3
Page 82 of 372

? [F1]
C_DODOES ^TEMPNAME speak a language other than English at home?
Do not count American Sign Language as non-English Language.

1. Yes
2. No

WHOSPEAK
? [F1]
Who ^OTHERTHANFIL_WHOSPEAK speaks a language other than English at home?
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

Page 83 of 372

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 French Creole, Patois, Cajun)
4. Tagalog, Filipino
5. Vietnamese
6. German
7. Korean
8. Russian
9. Italian
10. Hindi, Urdu
11. Arabic
12. Portuguese or Portuguese Creole
13. Polish
14. 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

Page 84 of 372

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

MARITAL_STATUS
? [F1]
^C_AREIS ^TEMPNAME currently married, widowed, divorced, separated or ^HAVHAS ^HESHE
never married?

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
Page 85 of 372

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**

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_SP

2. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

3. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

4. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

5. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

6. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

7. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP
Page 86 of 372

8. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

9. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

10. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

11. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

12. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

13. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

14. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

15. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

16. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

17. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

18. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

19. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

20. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

PAR1TYPE
? [F1]
^C_AREIS ^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?)
Page 87 of 372

1. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

2. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

3. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

4. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

5. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

6. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

7. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

8. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

9. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

10. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

11. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

12. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

13. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

14. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

15. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

16. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

17. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

18. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

19. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

20. Display the ^LNO ^ROST_FNAME ^ROST_MNAME ^ROST_LNAME where AGE >= 15 and not equal WHO_SP

PAR2TYPE
? [F1]
^C_AREIS ^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**

Page 88 of 372

EDUC
F, ? [F1]
What ^ISWAS_EDUC the highest level of school ^TEMPNAME had completed or the highest
degree ^HESHE had received by the end of December ^CALENDAR_YRFIL?

31. Less than 1st grade
32. 1st, 2nd, 3rd or 4th grade
33. 5th or 6th grade
34. 7th or 8th grade
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
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
Page 89 of 372

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
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

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

Page 90 of 372

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

FALLOUT
If AFCNT = PCNTGE17, then display the following text:
ALL HOUSEHOLD MEMBERS ELIGIBLE FOR INTERVIEW ARE CURRENTLY SERVING IN THE
ARMED FORCES. THIS HOUSEHOLD IS NOW CLASSIFIED AS A TYPE B NONINTERVIEW.
IF THIS INFORMATION IS INCORRECT, BACK UP TO CHANGE THE ARMED FORCES STATUS IN
THE AFNOW SCREEN; OTHERWISE, PRESS 1 TO CONTINUE.
If PCNTGE15 = 0 AND W1PERSON = 0, then display the following text:
ALL HOUSEHOLD MEMBERS ELIGIBLE FOR INTERVIEW ARE UNDER THE AGE OF 15. THIS
HOUSEHOLD IS NOW CLASSIFIED AS A TYPE C NONINTERVIEW.
IF THIS INFORMATION IS INCORRECT RESRTAT THE CASE IN CASE MANAGEMENT;
OTHERWISE, PRESS 1 TO CONTINUE.
Page 91 of 372

1. Enter 1 to continue

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 live together ^DURATION_REFPERDFIL?

Display the first and last name of all people with HHSTAT=1 on the final
household roster (excluding the HH respondent).

1. Yes
2. No

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?)

1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME
Page 92 of 372

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**

LNO
**NON-DISPLAYED ITEM**

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.
Page 93 of 372

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

T2LNO
**NON-DISPLAYED ITEM**

T2SLOT
**NON-DISPLAY 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/no more.
Display the fist and last name of the people aready entered

T2_ROST_FNAME
^T2FNAMETEXT
Enter 999 for none/no more.

T2_ROST_LNAME
Page 94 of 372

^T2LNAMETEXT
Enter 999 for none/no more.

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.

T2SLOT
**NON-DISPLAY ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

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/child, probe for biological, step or adoptive.
If the exact relationship is unknown, mark 'Other Relatives' if the person is related or mark 'Friends,
Roommates, or Other Non-Relatives' if the person is not related.

1. Opposite sex husband/wife/spouse
2. Opposite sex unmarried partner
3. Same sex husband/wife/spouse
Page 95 of 372

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

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

T2SLOT
**NON-DISPLAY ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

Page 96 of 372

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
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

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

T2_SEX
Ask if necessary.
Is ^T2_ROSTNAMEFIL male or female?
1. Male
2. Female

T2_AGE
What was ^HISHER age as of the beginning of last year (^MONTH1 1st, ^CALENDAR_YEAR)?
Page 97 of 372

(Your best guess is fine.)

T2_AGERANGE
Was ^HESHE...
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?

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?
PRECHART MONTHS LISTED IN 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.
Page 98 of 372

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.
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
Page 99 of 372

**NON-DISPLAYED ITEM**

PARFLAG
*********** NON-DISPLAYED ITEM ****************
1. Yes
2. No

PROCERT
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, or PMP certification, or an IT Certification.

1. Yes
2. No

CERT
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 also called vocational diplomas, for example, a cosmetology or
mechanics diploma, which differs from a high school diploma.

1. Yes
2. No

YR_CURR_MARR
yet another possible intro in person-level demo block

Page 100 of 372

In what year did ^TEMPNAME enter ^HISHER current marriage?

TIMES_MARRIED
How many times ^HAVEHAS ^TEMPNAME been married?
1. Once
2. Twice
3. Three times
4 or more. Four or more times

YR_FIRST_MARR
In what year did ^TEMPNAME get married ^FIRSTIMEFIL?

EVRWID
^C_HAVHAS ^TEMPNAME ever been widowed?
1. Yes
2. No

EVRDIV
? [F1]
^C_HAVHAS ^TEMPNAME ever been divorced?

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.

CTRLNUM
Page 101 of 372

**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 total annual income below $^INCYR_FILL?
1. Yes
2. No

HHINCSCR_MTH
During any month in ^CALENDAR_YEAR, was ^PINCPER_FILL total 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 any assistance from any federal, state, or local agency, such as
from Food Stamps/SNAP or WIC, Medicaid, TANF FIL1, TANF FILL, TANF FILL (PACASH1,
PATANF), or General Assistance?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

STATE_EXC
Page 102 of 372

**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

EXCHANGE
Did ^TEMPNAME get any of ^HISHER health coverage through the Fill for state-based health
exchange during ^CALENDAR_YEAR?
1. Yes
2. No

EXCHTYPE
Which exchange plan were you covered by?
Read answer categories
1. Commonwealth Care
2. Commonwealth Choice

EMPNOESI
Page 103 of 372

During ^CALENDAR_YEAR, there was a period of at least one month when ^TEMPNAME
^WEREWAS employed, but did not have health insurance through ^HISHER job. During this
time, did an employer offer ^TEMPNAME health insurance?
1. Yes
2. No

WHYNOESI
X, ? [F1]
Why didn't ^TEMPNAME sign up for the health insurance offered through this employer?
Mark all that apply

1. ^EXPENSIVE
2. ^ELIGIBLE
3. Healthy (haven't needed health insurance)
4. Able to get care elsewhere (such as VA, church, etc.)
5. ^OTHERPLN
6. Dissatisfied with or don't believe in insurance
7. ^WAITING
8. ^CONFUSE
9. Other

NOESIOTH
You said ^TEMPNAME had some other reason for not accepting employer-sponsored health
insurance. What was that reason?

WHYNOPRI
Y
^WHYNOPRIFILL. What were the reasons ^TEMPNAME did not obtain private health insurance
such as this during this time?
Mark all that apply.

1. ^EXPENSIVE
2. ^ELIGIBLE
3. Healthy (haven't needed health insurance)
Page 104 of 372

4. Able to get care elsewhere (such as VA, church, etc.)
5. ^OTHERPLN
6. Dissatisfied with or don't believe in insurance
7. ^WAITING
8. ^CONFUSE
9. Other

NOPRIOTH
You said ^TEMPNAME had some other reason for not being covered by private health insurance.
What was that reason?

WHYNOPUB
Z
I see that for at least one month in ^CALENDAR_YEAR ^TEMPNAME did not have any kind of
health insurance, including public health insurance. What were the reasons that ^TEMPNAME
did not obtain public insurance coverage (such as Medicaid, Medicare or medical assistance)
during this time?
Mark all that apply.

1. ^EXPENSIVE
2. ^ELIGIBLE
3. Healthy (haven't needed health insurance)
4. Able to get care elsewhere (such as VA, church, etc.)
5. ^OTHERPLN
6. Dissatisfied with or don't believe in insurance
7. ^WAITING
8. ^CONFUSE
9. Other

NOPUBOTH
You said ^TEMPNAME had some other reason for not being covered by public health insurance.
What was that reason?

Page 105 of 372

PROGINCOME_INTRO
? [F1]
In this next section of the interview, 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 aboutThis 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

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

Page 106 of 372

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

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

Page 107 of 372

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
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

VABENEFITCODE
***NON-DISPLAYED ITEM***

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

VA_NOW
C_DODOES ^TEMPNAME receive ^TYPEVAPMTFIL now?
1. Yes
2. No

Page 108 of 372

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
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
Page 109 of 372

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_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
Page 110 of 372

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
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
Page 111 of 372

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_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
Page 112 of 372

VA_STARTAMT
How much did ^TEMPNAME receive in ^TYPEVAPMTFIL in ^VASTARTAMT_FIL?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

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 is the reason ^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
Page 113 of 372

REASON_SP
What was the other reason ^TEMPNAME received Social Security?

AGESS
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

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
Page 114 of 372

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_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
Page 115 of 372

SSS_1STAMT
How much ^DIDDO ^TEMPNAME receive in Social Security ^SSSCURAMT_FIL?

SSS_GUESS
What would you estimate the monthly amount to be?

SSS_1STSTART
When did ^TEMPNAME start receiving ^SSSAMT1_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_2NDAMT
How much did ^TEMPNAME receive in Social Security ^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
Page 116 of 372

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_3RDAMT
How much did ^TEMPNAME receive in Social Security ^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
Page 117 of 372

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 ^SSSSTART3_FIL?

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 in ^SSSSTARTAMT_FIL?

CTRLNUM
**NON-DISPLAYED ITEM**
Page 118 of 372

LNO
**NON-DISPLAYED ITEM**

SSPARTB
? [F1]
Earlier ^TEMPNAME stated ^HESHE ^HAVHAS Medicare medical insurance, also called Part B.
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 prescritpion drug coverage through Medicare,
Page 119 of 372

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

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**

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.

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
Page 120 of 372

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

Read Names ?

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

CTRLNUM
Page 121 of 372

**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SSC_NOW
C_DODOES ^TEMPNAME receive Social Security on behalf of

Read Names 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

SSC_START_REC
Page 122 of 372

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 on behalf of ^THISTHESECHILDREN
^SSCCURAMT_FIL?

SSC_GUESS
What would you estimate the monthly amount to be?

SSC_1STSTART
When did ^TEMPNAME start receiving ^SSCAMT1_FIL?
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
Page 123 of 372

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 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
11. ^MONTH11, ^CALENDAR_YEAR
12. ^MONTH12, ^CALENDAR_YEAR
13. ^INTV_MONTH1, ^INTV_YEAR
Page 124 of 372

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 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
How much did ^TEMPNAME receive in Social Security on behalf of ^THISTHESECHILDREN
^SSCSTART3_FIL?

Page 125 of 372

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 on behalf of ^THISTHESECHILDREN
^SSCSTARTAMT_FIL?

CTRLNUM
**NON-DISPLAYED ITEM**

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?

Page 126 of 372

1. Yes
2. No

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
Page 127 of 372

17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR
19. ^FEEDBACKWRONG

WC_START_REC
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
Page 128 of 372

When did ^TEMPNAME start receiving ^WCAMT1_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_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
Page 129 of 372

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_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
Page 130 of 372

How much did ^TEMPNAME receive ^WCSTART3_FIL?

WC_4THSTART
When did ^TEMPNAME start receiving ^WCAMT4_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_STARTAMT
How much did ^TEMPNAME receive ^WCSTARTAMT_FIL?

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
Page 131 of 372

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

UEMP_COMP_CODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

UC_NOW
C_DODOES ^TEMPNAME receive ^TYPEUCFIL now?
1. Yes
2. No

UC_LAST_REC
When did ^TEMPNAME last receive ^TYPEUCFIL?
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 132 of 372

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
15. ^INTV_MONTH3, ^INTV_YEAR
16. ^INTV_MONTH4, ^INTV_YEAR
17. ^INTV_MONTH5, ^INTV_YEAR
18. ^INTV_MONTH6, ^INTV_YEAR

UC_1STAMT
How much ^DIDDO ^TEMPNAME receive in ^TYPEUCFIL ^UCCURAMT_FIL?

Page 133 of 372

UC_GUESS
What would you estimate the monthly amount to be?

UC_1STSTART
When did ^TEMPNAME start receiving ^UCAMT1_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

UC_2NDAMT
How much did ^TEMPNAME receive in ^TYPEUCFIL ^UCSTART1_FIL?

UC_2NDOTH
Did ^TEMPNAME receive ^TYPEUCFIL at any other time between ^UCBMONTH_FIL and
^UCEMONTH_FIL?
1. Yes
2. No

UC_2NDSTART
^QSTNTXT_UC2NDSTART
Page 134 of 372

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

UC_3RDAMT
How much did ^TEMPNAME receive ^UCSTART2_FIL?

UC_3RDOTH
Did ^TEMPNAME receive ^TYPEUCFIL at any other time between ^UCBMONTH_FIL and
^UCEMONTH_FIL?
1. Yes
2. No

UC_3RDSTART
^QSTNTXT_UC3RDSTART
0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
Page 135 of 372

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_4THAMT
How much did ^TEMPNAME receive in ^TYPEUCFIL ^UCSTART3_FIL?

UC_4THOTH
Did ^TEMPNAME receive ^TYPEUCFIL at any other time between ^UCBMONTH_FIL and
^UCEMONTH_FIL?
1. Yes
2. No

UC_4THSTART
^QSTNTXT_UC4THSTART
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 136 of 372

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_STARTAMT
How much did ^TEMPNAME receive in ^TYPEUCFIL in ^UCBMONTH_FIL?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

UTILITIES
^DIDFIL_UTILYN pay ^SEPARATE_UTILYN for water, electricity, gas, or oil?
1. Yes
2. No

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

Page 137 of 372

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?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**
Page 138 of 372

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?

1. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

2. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

3. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

4. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

5. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

6. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

7. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

8. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

9. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

10. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

11. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

12. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

13. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

14. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

15. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

16. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

17. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

18. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

19. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO
Page 139 of 372

20. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

21. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

22. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

23. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

24. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

25. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO
26. Child not listed

FREE_LUNCH
? [F1]
Were these lunches free or reduced-price because ^CHILDFIL_SCHOOLMEALS qualified for the
School Lunch Program, or full-price because ^CHILDFIL_SCHOOLMEALS did not qualify for the
School Lunch Program?

1. Free lunch
2. Reduced-price lunch
3. 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

WHO_BREAKFAST
? [F1]
Which children usually got the school breakfast?

1. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

2. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO
Page 140 of 372

3. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

4. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

5. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

6. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

7. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

8. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

9. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

10. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

11. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

12. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

13. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

14. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

15. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

16. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

17. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

18. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

19. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

20. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

21. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

22. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

23. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

24. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO

25. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 5 and AGE <= 18 and EDUC <= 38 (and PEOPLE_TO_RO
26. Child not listed

FREE_BREAKFAST
? [F1]
Were these breakfasts free or reduced-price because ^CHILDFIL_SCHOOLMEALS qualified for
the School Breakfast Program, or full-price because ^CHILDFIL_SCHOOLMEALS did not qualify
for the School Breakfast Program?

1. Free breakfast
2. Reduced-price breakfast
3. Did not qualify

CTRLNUM
Page 141 of 372

**NON-DISPLAYED ITEM**

LNO
**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

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
Page 142 of 372

and the end of ^LASTMONTH ^CALENDAR_YRFIL?
Round the amount to the nearest dollar.

ROLLOVR1
Earlier you said that ^TEMPNAME received a lump sum payment from
^LUMPFIL_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.

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.

DISABL
C_DODOES ^TEMPNAME have a physical, mental or other health condition that limits the kind or
amount of work he/she can do at a job or business?
1. Yes
2. No
Page 143 of 372

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

DIS_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any income
^OTHERTHAN_DISANY 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
11. Did not receive disability payments

DIS_TYPETWO
Did ^TEMPNAME purchase that policy on ^HISHER own?
1. Yes
2. No

Page 144 of 372

DISTYPE_SP
What was that other type of disability income?

DISABLECODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**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?

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 145 of 372

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
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
Page 146 of 372

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?

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
Page 147 of 372

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
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
Page 148 of 372

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
How much did ^TEMPNAME receive in ^DISABILITY_TYPE in ^DISSTARTAMT_FIL?

EVERET
^C_HAVHAS ^TEMPNAME ever retired, for any reason, from a job or business?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**
Page 149 of 372

LNO
**NON-DISPLAYED ITEM**

RET_ANY
^RETINTRO_FIL
^OTHERTHANFIL_RETANY ^SSHLTHFIL_RETANY ^DIDFIL_RETANY ^TEMPNAME receive any
^OTHERFIL_RETANY retirement income?

1. Yes
2. No

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

RETTYPE_SP
What was that other type of retirement income?

RETIRECODE
**NON-DISPLAYED ITEM**

CTRLNUM
Page 150 of 372

**NON-DISPLAYED ITEM**

LNO
**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
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?
Page 151 of 372

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?

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
Page 152 of 372

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
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
Page 153 of 372

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
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
Page 154 of 372

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?

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
Page 155 of 372

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
What was the total amount of life insurance payments ^TEMPNAME received between ^MONTH1
1st to the end of ^LASTMONTH ^CALENDAR_YRFIL?

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

Page 156 of 372

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

SURTYPE_SP
What was that other type of survivor income?

SURVRCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SUR_NOW
C_DODOES ^TEMPNAME receive ^SURVIVOR_TYPE now?
Page 157 of 372

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
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
Page 158 of 372

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?

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
Page 159 of 372

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
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
Page 160 of 372

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
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
Page 161 of 372

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**

FCC_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any foster child care
payments?
1. Yes
2. No

ALI_ANY
Since ^MONTH1 1st ^CALENDAR_YRFIL, did ^TEMPNAME receive any payments from
^FORMERFIL_ALI_ANY spouse, such as alimony or spousal support?
1. Yes
2. No

SUPPORTPMTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
Page 162 of 372

**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

SUP_NOW
Introductory text in cases of feedback of receipt in reference year
C_DODOES ^TEMPNAME receive ^FMLY_SUP_TYPE now?
1. Yes
2. No

SUR_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

SUP_START_REC
When did ^TEMPNAME start receiving ^FMLY_SUP_TYPE?

Page 163 of 372

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_1STAMT
How much ^DIDDO ^TEMPNAME receive in ^FMLY_SUP_TYPE ^SUPCURAMT_FIL?

SUP_GUESS
What would you estimate the monthly amount to be?

SUP_1STSTART
When did ^TEMPNAME start receiving ^SUPAMT1_FIL?

0. Receipt started prior to ^MONTH1, ^CALENDAR_YEAR
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
Page 164 of 372

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_2NDAMT
How much did ^TEMPNAME receive in ^FMLY_SUP_TYPE ^SUPSTART1_FIL?

SUP_2NDSTART
When did ^TEMPNAME start receiving ^SUPAMT2_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
Page 165 of 372

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_3RDAMT
How much did ^TEMPNAME receive in ^FMLY_SUP_TYPE ^SUPSTART2_FIL?

SUP_3RDSTART
When did ^TEMPNAME start receiving ^SUPAMT3_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

SUP_4THAMT
How much did ^TEMPNAME receive in ^FMLY_SUP_TYPE ^SUPSTART3_FIL?

Page 166 of 372

SUP_4THSTART
When did ^TEMPNAME start receiving ^SUPAMT4_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

SUP_STARTAMT
How much did ^TEMPNAME receive in ^FMLY_SUP_TYPE ^SUPSTARTAMT_FIL?

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
Page 167 of 372

2. No

CS_ANY
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)

CS_NOW
C_DODOES ^TEMPNAME receive child support now?

1. Yes
2. No

CS_LAST_REC
When did ^TEMPNAME last receive child support?

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 168 of 372

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

CS_START_REC
When did ^TEMPNAME start receiving child support?
Enter 0 if the person started receiving child support 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

CTRLNUM
**NON-DISPLAYED ITEM**
Page 169 of 372

LNO
**NON-DISPLAYED ITEM**

CS_OTH_REC
In which months ^CSSPELL_FIL did ^TEMPNAME receive child support?
Enter 0 if the respondent received child support in all months OR 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

CS_LAST_AMT
How much ^DIDDO ^TEMPNAME get in child support ^LASTMONTH_UCCS?

CS_WHEN_AMT
When did ^TEMPNAME start receiving ^THISAMT?
1. ^MONTH1, ^CALENDAR_YEAR
2. ^MONTH2, ^CALENDAR_YEAR
3. ^MONTH3, ^CALENDAR_YEAR
4. ^MONTH4, ^CALENDAR_YEAR
5. ^MONTH5, ^CALENDAR_YEAR
Page 170 of 372

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

AMOUNTSPELL
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CS_WHEN_AMT
When did ^TEMPNAME start receiving ^THISAMT?
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 171 of 372

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

CS_NEW_AMT
How much did ^TEMPNAME get in child support before ^LASTCHANGE?

MONTHCODE
**NON-DISPLAY ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CS_OTH_AMT
How much child support 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
Page 172 of 372

^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/guardian,
... made through a court or agency, or
... withheld from this person's paycheck.
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/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)?

Page 173 of 372

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 of the following people who lived outside ^HISHER household did ^TEMPNAME make
support payments: READ ANSWER LIST?
Mark all that apply
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 "Other
non-relatives"
Supported children who are not the respondent's own should be classified as either "Other relatives" or
"Other non-relatives"

1. ^C_PTEMPNAME parent or parents
2. ^C_PTEMPNAME child 21 years old or older who lived elsewhere
3. Someone else related to ^TEMPNAME
4. ^C_PTEMPNAME ex-spouse or ex-partner (OPTIONAL TEXT: Or current spouse or partner living elsewhere)
5. Someone else not related to ^TEMPNAME
6. Did not make support payments
Page 174 of 372

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
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
Page 175 of 372

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 for ^CALENDAR_YEAR?

1. Yes
2. No

WILLFILE
C_DODOES ^TEMPNAME plan to file a federal income tax return for ^CALENDAR_YEAR?
1. Yes
2. No

FSTATUS
What ^WASWILL ^PTEMPNAME filing status on ^HISHER ^CALENDAR_YEAR federal income tax
return?
Read answer categories.
Page 176 of 372

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. Yes
2. No

EITC
^C_DIDWILL ^TEMPNAME claim an Earned Income Tax Credit (EITC) on ^HISHER
^CALENDAR_YEAR 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.
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**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?)
Page 177 of 372

(... some other kind of transportation assistance?)
Do not include any assistance previously reported (e.g. 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 (e.g. 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?)
(... some other kind of transportation assistance?)
Do not include any assistance previously reported (e.g. 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...)

Page 178 of 372

(... 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 (e.g. commuting expenses paid by an employer).
1. Yes
2. No

TRANS_OTH
(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?
1. Yes
2. No

TRANSOTH_SP
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 social
Page 179 of 372

service 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
13. All months

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

FOOD_TYPE1
Between ^MONTH1 and December ^CALENDAR_YRFIL, did ^TEMPNAME receive any of the
Page 180 of 372

following types of food assistance...
... Money, vouchers, or certificates to buy groceries or food?
(... Bags of groceries or packaged foods?)
(... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?)
(... Any other food assistance?)
Do not include any assistance previously reported (e.g. ^FOODFIL).
1. Yes
2. No

FOOD_TYPE2
(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?)
... Bags of groceries or packaged foods?
(... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?)
(... Any other food assistance?)
Do not include any assistance previously reported (e.g. ^FOODFIL).
1. Yes
2. No

FOOD_TYPE3
(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?)
(... Bags of groceries or packaged foods?)
... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?
(... Any other food assistance?)
Do not include any assistance previously reported (e.g. ^FOODFIL).
1. Yes
2. No

FOOD_OTH
Page 181 of 372

(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?)
(... Bags of groceries or packaged foods?)
(... Any meals from a shelter, soup kitchen, Meals-on-Wheels, or other charity?)
... Any other food assistance?
Do not include any assistance previously reported (e.g. ^FOODFIL).
1. Yes
2. No

FOODOTH_SP
What was the other type of food assistance ^TEMPNAME received?

FOOD_SOURCE
Was this food assistance provided by

Read answer categories?

Mark all that apply.
1. Government agency
2. 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?
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
Page 182 of 372

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**

CLTH_TYPE
(Since ^MONTH1 ^CALENDAR_YRFIL,) Did ^TEMPNAME receive

Read answer categories?

1. Clothes
2. Money or vouchers
3. Both 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. Government agency
2. Community or religious charity
3. Family or friends
4. Employer
5. Someplace else

CLTH_SOURCE_SP
What was the other source of clothing assistance?

Page 183 of 372

HOUSE_ANY
(Since ^MONTH1 ^CALENDAR_YRFIL,) Did ^TEMPNAME receive any assistance to help pay for
housing^ENERGYFIL?
1. Yes
2. No

CASHASST_ANY
(Since ^MONTH1 1st ^CALENDAR_YRFIL,) Did ^TEMPNAME receive any other type of state
or local assistance ^CHILDASST_FIL
Do not record medical assistance here.
Display the first and last name of all children under the age of 18 living in
the household where the respondent is the mother, father, or guardian.
1. Yes
2. No

CASHASST_SOURCE
Was this assistance provided by

Read answer categories?

Mark all that apply.
1. Government agency
2. Community or religious charity
3. Family or friends
4. Someplace else

CASHASST_GVT
Was that through the federal, state, or local government?
1. Federal
2. State
3. Local

CASHASST_SOURCE_SP
What was the other source of cash assistance?

Page 184 of 372

OTHASST_WHEN
During which months did ^TEMPNAME receive these other types of 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
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

Page 185 of 372

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?)
(...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

Page 186 of 372

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
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
Page 187 of 372

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
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
Page 188 of 372

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**

ASSET_INTRO
? [F1]
In this next section of the interview, I will ask you 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.
The types of assets I will be asking you about include checking and savings accounts, retirement
accounts, stocks, cars, motorcycles, and real estate.
In order to be as accurate and efficient as we can, it would be very helpful if you could refer to
any records you might have.
1. Enter 1 to continue

CTRLNUM
Page 189 of 372

**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

AST1B
? [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

AST1C
? [F1]
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did
^TEMPNAME ^ALSOFIL participate in a 401k, 403b, or thrift plan?

1. Yes
2. No

AST1D
? [F1]
(Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,) Did ^TEMPNAME
participate in a defined-benefit pension or cash balance plan?

1. Yes
2. No

ASSETDRAW
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME
receive any lump sum or regular distribution payments from ^ANYOFFIL ^HISHER ^IRA401FIL?
Page 190 of 372

1. Yes, lump sum
2. Yes, regular distribution
3. Yes, both
4. No, no payments received

AST1A
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?
(...an interest-earning checking account?)
(...a regular (non-interest earning) checking account?)
(...a savings account?)
(^RETIRE_FIL)
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...an educational or college savings account (such as, a 529 account)?)
(...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...)
(...any U.S. Government savings bonds or U.S. Government securities?)
...an interest-earning checking account?
(...a regular (non-interest earning) checking account?)
(...a savings account?)
(^RETIRE_FIL)
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
Page 191 of 372

(...an educational or college savings account (such as, a 529 account)?)
(...mutual funds?)
(...stocks?)

1. Yes
2. No

AST2E
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?)
(...an interest-earning checking account?)
...a regular (non-interest earning) checking account?
(...a savings account?)
(^RETIRE_FIL)
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...an educational or college savings account (such as, a 529 account)?)
(...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?)
(...an interest-earning checking account?)
(...a regular (non-interest earning) checking account?)
...a savings account?
(^RETIRE_FIL)
Page 192 of 372

(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...an educational or college savings account (such as, a 529 account)?)
(...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?)
(...an interest-earning checking account?)
(...a regular (non-interest earning) checking account?)
(...a savings account?)
^RETIRE_FIL
...a money market deposit account or fund?
(...any certificates of deposit (that is, CDs)?)
(...an educational or college savings account (such as, a 529 account)?)
(...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?)
(...an interest-earning checking account?)
(...a regular (non-interest earning) checking account?)
Page 193 of 372

(...a savings account?)
^RETIRE_FIL
(...a money market deposit account or fund?)
...any certificates of deposit (that is, CDs)?
(...an educational or college savings account (such as, a 529 account)?)
(...mutual funds?)
(...stocks?)

1. Yes
2. No

AST2F
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?)
(...an interest-earning checking account?)
(...a regular (non-interest earning) checking account?)
(...a savings account?)
^RETIRE_FIL
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
...an educational or college savings account (such as, a 529 account)?
(...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?)
Page 194 of 372

(...an interest-earning checking account?)
(...a regular (non-interest earning) checking account?)
(...a savings account?)
^RETIRE_FIL
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...an educational or college savings account (such as, a 529 account)?)
...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?)
(...an interest-earning checking account?)
(...a regular (non-interest earning) checking account?)
(...a savings account?)
^RETIRE_FIL
(...a money market deposit account or fund?)
(...any certificates of deposit (that is, CDs)?)
(...an educational or college savings account (such as, a 529 account)?)
(...mutual funds?)
...stocks?

1. Yes
2. No

AST3C
P, ? [F1]
Read (or verify) all response options.

Page 195 of 372

^ASSET2_QSTNTXT
...any municipal or corporate bonds?
(...any life insurance policies?)
(...rental property?)
(...other real estate such as a vacation home or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include mortgages paid to HIMHER, other loans owed
to HIMHER, or royalties.)
1. Yes
2. No

MUNCOR
Were these municipal/corporate bonds separate from the mutual funds you just told me about?
1. Yes
2. No

AST5A
P, ? [F1]
Read (or verify) all response options.
^ASSET2_QSTNTXT
(...any municipal or corporate bonds?)
...any life insurance policies?
(...rental property?)
(...other real estate such as a vacation home or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include mortgages paid to HIMHER, other loans owed
to HIMHER, or royalties.)

1. Yes
2. No

AST4A
Page 196 of 372

P, ? [F1]
Read (or verify) all response options.
^ASSET2_QSTNTXT
(...any municipal or corporate bonds?)
(...any life insurance policies?)
...rental property?
(...other real estate such as a vacation home or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include mortgages paid to HIMHER, other loans owed
to HIMHER, or royalties.)

1. Yes
2. No

AST5B
P, ? [F1]
Read (or verify) all response options.
^ASSET2_QSTNTXT
(...any municipal or corporate bonds?)
(...any life insurance policies?)
(...rental property?)
...other real estate such as a vacation home or an undeveloped lot?
(...annuities and trusts?)
(...businesses as an investment only?)
(...or any other financial investments? Examples include mortgages paid to HIMHER, other loans owed
to HIMHER, or royalties.)

1. Yes
2. No

AST5E
P, ? [F1]
Read (or verify) all response options.
Page 197 of 372

^ASSET2_QSTNTXT
(...any municipal or corporate bonds?)
(...any life insurance policies?)
(...rental property?)
(...other real estate such as a vacation home or an undeveloped lot?)
...annuities and trusts?
(...businesses as an investment only?)
(...or any other financial investments? Examples include 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?)
(...rental property?)
(...other real estate such as a vacation home or an undeveloped lot?)
(...annuities and trusts?)
...businesses as an investment only?
(...or any other financial investments? Examples include 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?)
Page 198 of 372

(...any life insurance policies?)
(...rental property?)
(...other real estate such as a vacation home or an undeveloped lot?)
(...annuities and trusts?)
(...businesses as an investment only?)
...or any other financial investments? Examples include mortgages paid to HIMHER, other loans
owed to HIMHER, or royalties.
1. Yes
2. No

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?
1. IRA or Keogh account
2. 401k, 403b, or thrift plan
3. Defined benefit pension or cash balance plan
4. U.S. Govt. savings bonds/securities
5. Interest-earning checking account
6. Regular (non-interest earning) checking account
7. Savings account
Page 199 of 372

8. Money market deposit account
9. Certificates of deposit
10. Educational or college savings account
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

ASTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JT
^JT_QSTNTXT
1. Yes
2. No

JTWHO1
With whom?
Mark all that apply.
Enter 50 if the person owns the asset(s) with a non-household member.

Page 200 of 372

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)
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

ASTCODE2
**NON-DISPLAYED**
Page 201 of 372

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ANYJNT
^ANYJNT_QSTNTXT

1. Yes
2. No

JTWHO2
With whom?
Mark all that apply.
Enter 50 if the respondent owns the mutual funds and/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)
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)
Page 202 of 372

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**

LNO
**NON-DISPLAYED ITEM**

TYPE_LIFEINSUR
? [F1]
(You said that between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,
^TEMPNAME owned life insurance.) Was that policy Read answer categories or did ^HESHE own
both of these types (term and whole life/universal life)?
1. Term insurance
2. Whole life/Universal life insurance
3. Both

CTRLNUM
**NON-DISPLAYED ITEM**
Page 203 of 372

LNO
**NON-DISPLAYED ITEM**

ANYJTRNT
^ANYJTRNT_QSTNTXT
1. Yes
2. No

JTWHO4
With whom?
Mark all that apply.
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 H

2. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

3. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

4. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

5. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

6. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

7. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

8. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

9. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

10. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

11. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

12. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

13. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

14. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

15. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

16. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

17. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

18. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

19. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

20. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

21. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

22. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

23. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

24. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H
Page 204 of 372

25. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H
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**

ANYJTPROP
(You said that between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL,
^TEMPNAME owned some real estate such as a vacation home or an undeveloped lot). Did
^TEMPNAME own this real estate jointly with someone else ^OTHSPOUSE_ANYJTPROP?
1. Yes
2. No

JTWHO5
^OTHSPOUSE_JTWHO5 did ^TEMPNAME own the real estate jointly with?
Mark all that apply.
Enter 50 if the respondent owns the non-retirement/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 H

2. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H
Page 205 of 372

3. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

4. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

5. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

6. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

7. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

8. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

9. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

10. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

11. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

12. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

13. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

14. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

15. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

16. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

17. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

18. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

19. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

20. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

21. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

22. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

23. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

24. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H

25. Display the ^LNO, ^FNAME, ^LNAME where AGE >= 15 (where PEOPLE_TO_ROSTER = 1 for people on the H
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 or an
undeveloped lot) in ^HISHER name only?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
Page 206 of 372

**NON-DISPLAYED ITEM**

AST5C
^VEHICLE_QSTNTXT
1. Yes
2. No

NUM_VEHICLE
^NUMVEHICLE_QSTNTXT

CARNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

MODEL_YRX
VEHICLE ^X
What is the model year of ^WHICH_VEHICLE?
^FR_VEHICLE

MAKEX
VEHICLE ^X
What is the make of this vehicle?
Make of vehicle is its brand name (for example: Honda or Chevrolet).
If there is a "TRUCK" listed for a vehicle make, use trucks as the make for SUVs, vans, and minivans
Page 207 of 372

(for example, enter "Caravan" under "Dodge Truck").
Otherwise, cars, trucks, SUVs, vans, and minivans are listed together (for example, enter "Tracker"
under "Geo").

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
23. ^CAR_MODEL23
Page 208 of 372

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

MODELX_SP
VEHICLE ^X
What is the model of this vehicle?

WHO_VEHICLE
Who owns this vehicle?
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
Page 209 of 372

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**

LNO
**NON-DISPLAYED ITEM**

AST5D
^RV_QSTNTXT
1. Yes
2. No

TYPE_RECVEH
^TYPERV_QSTNTXT
Mark all that apply.
1. Motorcycle
2. Boat
3. Recreational vehicle (RV)
4. Another type of vehicle

RECVEH_SP
What 'other' type of recreational vehicle?

ADINCSRCE2
Page 210 of 372

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**

ASTCODE_RET
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

RETIRE_VALUE
? [F1]
(Earlier I recorded that ^TEMPNAME ^OWNPARTICIPATEFIL ^TYPERETACCT.) As of the last day of
^LASTMONTH, ^CALENDAR_YEAR, what was the total balance or market value of the
^RETIREACCTFIL ^TEMPNAME ^OWNPARTICIPATEFIL?
Enter 0 if the person no longer ^OWNSPARTICIPATESFIL ^TYPERETACCT as of the last day of
^LASTMONTH, ^CALENDAR_YEAR.

Page 211 of 372

RETIRE_RANGE
ASSET TYPE: ^C_RETIREMENT
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

ASTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ASTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JINTSP_PD
? [F1]
^JINTSPPD_QSTNTXT

JCATSP1Y
Page 212 of 372

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]
ASSET TYPE: ^C_ASNAME_BANKACCT
^REG_CHKFIL ^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
Page 213 of 372

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.

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

Page 214 of 372

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.

JCATSP3RANGE
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

ASTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**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?
Display the first and last name(s) of the child(ren) under the age of 15 who
Page 215 of 372

were selected in JTWHO1

JCATCH1Y
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
^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 ^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

Page 216 of 372

JCATCH2Y
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

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
Page 217 of 372

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

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.
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

ASTCODE
**NON-DISPLAYED ITEM**

Page 218 of 372

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTOTHINT_PD
? [F1]
^JTOTHINTPD_QSTNTXT
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/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
? [F1]
ASSET TYPE: ^C_ASNAME_BANKACCT
^REG_CHKOTHFIL ^JCATOTH_QSTNTXT
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 person(s) selected in JTWHO1 (with
the exception of the person's spouse or registered domestic/civil union
partner if one exists). Star the name(s) of the child(ren) under the age of
Page 219 of 372

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
? [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.
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/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
Page 220 of 372

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

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.
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/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

Page 221 of 372

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

ASTCODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**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 (from those
ASNAME_BANKACCT) between ^MONTH1 1st. and the end of ^LASTMONTH
^CALENDAR_YRFIL?

Page 222 of 372

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]
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 in
^PTEMPNAME own name?
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
Page 223 of 372

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 in
^PTEMPNAME own name?
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?
1. Less than $500
2. $500 to $1,499.99
3. $1,500 to $4,999.99
Page 224 of 372

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 in
^PTEMPNAME own name?
Enter 0 if the person no longer owns the ^ASNAME_BANKACCT as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

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?

DKINT1RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) 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
Page 225 of 372

4. $150 or more

DKINT2RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) 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 (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) 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.

DKMRKTVAL1RANGE
ASSET TYPE: ^C_ASNAME_BANKACCT
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) less than $500, between
Page 226 of 372

$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

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
Page 227 of 372

**NON-DISPLAYED ITEM**

EDUC_VALUE
? [F1]
(Earlier I recorded that ^TEMPNAME owned an educational or college savings account.) As of the last
day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total balance or market value
of ^PTEMPNAME educational or college savings account?
Enter 0 if the person no longer owns the educational or college savings account as of the last day of
^LASTMONTH, ^CALENDAR_YEAR.

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

ASTCODE2
**NON-DISPLAYED**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

ASTCODE2
**NON-DISPLAYED**

CTRLNUM
**NON-DISPLAYED ITEM**
Page 228 of 372

LNO
**NON-DISPLAYED ITEM**

EXCLUDE_SP
^EXCLUDESP_QSTNTXT

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

JTANYWSP
^EARLIERFIL_JTANYWSP What kind of dividends
did ^YOUTHEYFIL_JTANYW ^BOTHALLFIL_JTANYWSP get from those joint ^ASNAME_MFS?
Were the dividends credited against a margin account or automatically reinvested or did
^YOUTHEYFIL_JTANYW get dividend checks?

1. Dividend CHECKS
2. CREDITED or AUTOMATICALLY REINVESTED dividends
3. Both
4. Neither; no dividends received

NODIVSP
Ask if necessary.
Just to be sure, ^TEMPNAME^SPOUSEFIL_NODIVSP did not receive any dividends of any
kind from those joint ^ASNAME_MFS between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL. Is that correct?
Display the first and last name(s) of the children under the age of 15 living
in the household who were selected in JTWHO2.
1. Yes, correct; no dividends received
2. No, incorrect; DID RECEIVE dividends

JTDIVSP_PD
? [F1]
^INCLUDEFIL_JTDIVSP ^CREDITEDFIL_JTDIVSP DIVIDEND INCOME was produced by those
Page 229 of 372

joint ^ASNAME_MFS (between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)?

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
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 and less any debt or margin account held against those mutual
funds) 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
Page 230 of 372

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
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 and less any debt or margin account held against
those stocks) 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

ASTCODE2
Page 231 of 372

**NON-DISPLAYED**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

EXCLUDE_CH
Earlier I recorded that ^TEMPNAME ^ALSOFIL_EXCLUDE owned ^SOMEFIL ^MUTFNDSTOCKFIL
jointly with Read name(s). Were those ^MUTFNDSTOCKFIL included in
^PTEMPNAME ^IRA401FIL_EXCL, or did ^HESHE own them separately from any retirement
account(s) -- or both?
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO2
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

JTANYWCH
^EARLIERFIL_JTANYWCH What kind of dividends did ^YOUTHEYFIL_JTANYW
^BOTHALLFIL_JTANYWCH get from those joint ^ASNAME_MFS? Were the dividends credited
against a margin account or automatically reinvested or did ^YOUTHEYFIL_JTANYW 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. CREDITED or AUTOMATICALLY REINVESTED dividends
3. Both
4. Neither; no dividends received

NODIVCH
Ask if necessary.
Just to be sure, ^TEMPNAME and

Read name(s) did not receive any dividends of any kind from
Page 232 of 372

those joint ^ASNAME_MFS between ^MONTH1 1st and the end of ^LASTMONTH
^CALENDAR_YRFIL. Is that correct?
Display the first and last name(s) of the child(ren) under the age of 15 who
were selected in JTWHO2
1. Yes, correct; no dividends received
2. No, incorrect; DID RECEIVE dividends

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)?

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
ASSET TYPE: MUTUAL FUNDS
? [F1]
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the TOTAL
BALANCE or MARKET VALUE (including dividends and less any debt or margin account held against
those mutual funds) of the mutual funds ^TEMPNAME owned jointly with Read name(s)?
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.
Page 233 of 372

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 MARKET VALUE (including dividends and less any debt or margin account held against
those stocks) of the stocks ^TEMPNAME owned jointly with Read name(s)?
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
Page 234 of 372

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

ASTCODE2
**NON-DISPLAYED**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

EXCLUDE_OT
^EXCLUDEOT_QSTNTXT
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/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. 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

JTOTHANY
Page 235 of 372

^EARLIERFIL_JTOTHANY What kind of dividends did those joint ^MUTFNDSTOCKOTFIL
produce? Were the dividends credited against a margin account or automatically reinvested or
did ^YOUTHEYFIL_JTANYW get dividend checks?
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/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. CREDITED or AUTOMATICALLY REINVESTED dividends
3. Both
4. Neither; no dividends received

NODIVOTH
Ask if necessary.
Just to be sure, those joint ^MUTFNDSTOCKOTFIL produced no dividends of any kind
between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL. Is that correct?
1. Yes, correct; no dividends received
2. No, incorrect; DID RECEIVE dividends

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)?
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/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)
Page 236 of 372

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
? [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 and less any debt or margin account held against those mutual
funds) of the mutual funds ^TEMPNAME owned jointly with ^THATTHOSEPEOPLE_ANYJTOTH?
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 person(s) selected in JTWHO2 (with
the exception of the person's spouse or registered domestic/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
Page 237 of 372

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
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 and less any debt or margin account held against those stocks) of the
stocks ^TEMPNAME owned jointly with ^THATTHOSEPEOPLE_ANYJTOTH?
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 person(s) selected in JTWHO2 (with
the exception of the person's spouse or registered domestic/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

Page 238 of 372

ASTCODE2
**NON-DISPLAYED**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

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 credited against a margin account or automatically
reinvested or did ^HESHE get dividend checks?
1. Dividend CHECKS
2. CREDITED or AUTOMATICALLY REINVESTED dividends
3. Both
4. Neither; no dividends received

NODIVOWN
Ask if necessary.
Just to be sure, ^TEMPNAME did not receive any dividends of any kind from those
^ASNAME_MFS between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL. Is
that correct?
1. Yes, correct; no dividends received
Page 239 of 372

2. No, incorrect; DID RECEIVE dividends

OWNDIV_PD
? [F1]
^INCOMENOWFIL_OWNDIV
^INCLUDEFIL_OWNDIV ^CREDITEDFIL_OWNDIV DIVIDEND INCOME did ^TEMPNAME receive
from those ^ASNAME_MFS ^HESHE owned in ^HISHER own name (between ^MONTH1 1st and the
end of ^LASTMONTH ^CALENDAR_YRFIL)?

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 and less any debt or margin account held against those mutual
funds) of the mutual funds in ^PTEMPNAME own name?
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
Page 240 of 372

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
^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 and less any debt or margin account held against
those stocks) of the stocks in ^PTEMPNAME own name?
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?
Page 241 of 372

1. Less than $1,000
2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

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?

DKDIV1RANGE
ASSET TYPE: MUTUAL FUNDS
Was the amount (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) 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 (as of the last day of ^LASTMONTH, ^CALENDAR_YEAR) 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 and less any debt or margin account held against those assets) 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,
Page 242 of 372

^CALENDAR_YEAR.

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**

LNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**
Page 243 of 372

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 this mobile home; that is, how much ^DODOES ^TEMPNAME think it would have
sold for if it were for sale?

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.

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?

MHLOAN_CODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**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 and/or loan on this mobile home?

Page 244 of 372

MHSITE_DEBT
Is this mortgage, contract, or other debt for just the site, just the mobile home, or does it apply to
both the mobile home and the site?
1. Just the site
2. Just the mobile home
3. Both the mobile home and the site

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**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 this property; that is, how much ^DODOES ^TEMPNAME think it would have
sold for if it were for sale?

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.
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?

PROPLOAN_CODE
Page 245 of 372

**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**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/loan on this home?

YRS_DEBT
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was the total number of years over
which ^PTEMPNAME ^123_FILL mortgage or loan 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:
Page 246 of 372

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%
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?

RENTMORT_RANGE
Was the amount (as of December, ^CALENDAR_YEAR) less than $400, between $400 and $750,
Page 247 of 372

between $750 and $1,200, or more than $1,200?
1. Less than $400
2. $400 to $749
3. $750 to $1,199
4. $1,200 or more

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

UTILITIES_EXPENSE
How much did this household pay for electricity, gas, basic telephone service, and other utilities
in December ^CALENDAR_YEAR?

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

UTILITIES_PAYERS
Did more than one of the persons living here pay the ^MOTRNTUTL_FILL in December
^CALENDAR_YEAR?
1. Yes
2. No

WHOPAY
Which person(s) paid?
Page 248 of 372

Mark all that apply.

1. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

2. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

3. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

4. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

5. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

6. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

7. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

8. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

9. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

10. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

11. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

12. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

13. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

14. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

15. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

16. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

17. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

18. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

19. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

21. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

22. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

23. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

24. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

25. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 (and PEOPLE_TO_ROSTER = 1 for peop

UTILITIES_AMT
How much did ^NAME_WHOPAY pay in December ^CALENDAR_YEAR?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**
Page 249 of 372

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
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.

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**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTRNTSP_PD
? [F1]
Page 250 of 372

^JTRNTSPPD_QSTNTXT

JTNETSP_PD
? [F1]
^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.

SPMRKVALUE1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end 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
Page 251 of 372

4. $250,000 or more

JTSPDEBT
? [F1]
^JTSPDEBT_QSTNTXT

SPDEBT1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end 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
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTOTHRNT_PD
? [F1]
^JTOTHRNTPD_QSTNTXT
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/civil union
partner if one exists). Display 'a Non-household member' when JTWHO4 = 50

JTOTHNET_PD
? [F1]
Page 252 of 372

^JTOTHNETPD_QSTNTXT
Enter a net loss as a negative amount.
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/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.
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/civil union
partner if one exists). Display 'a Non-household member' when JTWHO4 = 50

OTHMRKVALUE1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end 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?

Page 253 of 372

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 no longer owns the rental property.
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/civil union
partner if one exists). Display 'a Non-household member' when JTWHO4 = 50

OTHDEBT1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end 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
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

OWNRENT_PD
? [F1]
Earlier I recorded that ^TEMPNAME ^ALSOFIL_OWNRENT owned rental
Page 254 of 372

property ^OWNNAMEFIL_OWNRENT. How much GROSS rent did ^TEMPNAME receive from all
rental property owned in ^HISHER own name 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 in ^HISHER own name 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]
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 (^TEMPNAME owned in ^HISHER own name)?
Enter 0 if the person no longer owns the rental property as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

OWNMRKVALUE1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL)
Page 255 of 372

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
in ^HISHER own name)?

OWNDEBT1Y
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end 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

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?

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.

Page 256 of 372

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
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.

DKRNTRANGE
ASSET TYPE: RENTAL PROPERTY
Was the amount (earned between ^MONTH1 1st and the end 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

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?

DKDEBTRANGE
ASSET TYPE: RENTAL PROPERTY

Page 257 of 372

Was the amount (earned between ^MONTH1 1st and the end 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
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

JTSPOUSE_EQUITY
? [F1]
Earlier I recorded that ^TEMPNAME owned real estate (such as a vacation home or an undeveloped
lot) jointly with Read name. As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what was
the total value of the equity in all of those properties? (By equity, we mean the amount that could be
obtained by selling the property and paying off any debts.)
Enter 0 if the person no longer owns the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
Display the first and last name of the person selected in JTWHO5

JTOTHER_EQUITY
? [F1]
Earlier I recorded that ^TEMPNAME owned real estate (such as a vacation home or an undeveloped
lot) jointly with Read name(s). As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what
was ^PTEMPNAME^ANDWHO_JTOTHREALEST share, in dollars, of the total value of the equity
in all of those properties? (By equity, we mean the amount that could be obtained by selling the
property and paying off any debts.)
Enter 0 if the person no longer owns the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

Page 258 of 372

Display the first and last name(s) of the person(s) selected in JTWHO5.
Display 'Non-household member(s) when JTWHO5 = 50

SELF_EQUITY
? [F1]
Earlier I recorded that ^TEMPNAME ^ALSOFIL_OWNREAL owned real estate (such as a vacation
home or an undeveloped lot) ^OWNNAMEFIL_OWNREAL. As of the last day of ^LASTMONTH,
^CALENDAR_YEAR, what was the total value of the equity in all of those properties? (By equity,
we mean the amount that could be obtained by selling the property and paying off any debts.)
Enter 0 if the person no longer owns the real estate as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

CARNO
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CARFREE
^QSTN_TYPECARFIL
Enter 0 if the person no longer owns the vehicle as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
0. Person no longer owns the vehicle
1. Free and clear
2. Money owed

CAROWED
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much was owed on that vehicle?

PRIMARY_USE
Page 259 of 372

Was this vehicle used primarily either for business purposes or for the transportation of a
disabled person?
1. Yes
2. No

TYPE_RECVEH_NUM
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

WHO_RECVEH
Who owns the ^TYPE_RECVEH?
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
Page 260 of 372

20. Display the ^LNO ^ROST_FNAME ^ROST_LNAME where AGE >= 15 and PEOPLE_TO_ROSTER = 1

REC_VEHICLE
^RECVEH_QSTNTXT
Enter 0 if the person no longer owns the vehicle as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.

RECVEHICFREE
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, was that ^TYPE_RECVEH owned free
and clear, or was there still money owed on it?
0. Person no longer owns the vehicle
1. Free and clear
2. Money owed

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 trust/managed investment account.) As of
the last day of ^LASTMONTH, CALENDARY_YEAR, did ^HESHE have just an annuity, just a
trust/managed investment account, both, or no longer own either?
1. Annuities
2. Trusts
3. Both
Page 261 of 372

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
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 belong 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)?
Round the amount to the nearest dollar.

ANNUITY_RANGE
ASSET TYPE: ANNUITIES
Page 262 of 372

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
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/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/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
Page 263 of 372

dollars, of the total value of those trusts/managed investment accounts (in which ^TEMPNAME
^OWNOWNSFIL_ANNUITYTRUST some or all of the equity)?
Round the amount to the nearest dollar.

TRUST_RANGE
ASSET TYPE: TRUSTS/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
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.

INVBUSINESS_CODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
Page 264 of 372

**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.

INVBUSINESS_CODE
**NON-DISPLAYED ITEM**

BUSINESS_CODE
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

PERCENT_OWNED
^SELF_EMPFIL As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, what percent of
^BUSINESS_NAMES did ^TEMPNAME own?
Enter 0 if the person no longer owns the business as of the last day of ^LASTMONTH,
^CALENDAR_YEAR.
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?
Page 265 of 372

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

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.

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]
Page 266 of 372

(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.
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 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.
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
Page 267 of 372

2. $1,000 to $9,999
3. $10,000 to $24,999
4. $25,000 or more

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

CREDIT_CARDS
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR,
did ^TEMPNAME^SPOUSEFIL_UNSECLIAB owe any money for
...store bills or credit card bills?
(...loans obtained through a bank or credit union, other than car loans, home equity loans or student
loans?)
(...any other debt we have not yet mentioned, including student loans, medical bills not covered by
insurance, money owed to private individuals, or any other debt not covered?)

1. Yes
2. No

ANY_LOANS
(As of the last day of ^LASTMONTH, ^CALENDAR_YEAR,
did ^TEMPNAME^SPOUSEFIL_UNSECLIAB owe any money for)
(...store bills or credit card bills?)
...loans obtained through a bank or credit union, other than car loans, home equity loans or
student loans?
(...any other debt we have not yet mentioned, including student loans, medical bills not covered by
insurance, money owed to private individuals, or any other debt not covered?)
1. Yes
2. No

OTHER_DEBT
Page 268 of 372

(As of the last day of ^LASTMONTH, ^CALENDAR_YEAR,
did ^TEMPNAME^SPOUSEFIL_UNSECLIAB owe any money for)
(...store bills or credit card bills?)
(...loans obtained through a bank or credit union, other than car loans, home equity loans or student
loans?)
...any other debt we have not yet mentioned, including student loans, medical bills not covered
by insurance, money owed to private individuals, or any other debt not covered?)
Exclude mortgages, home equity loans, and car loans.

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

WHO_CC_DEBT
Did ^TEMPNAME owe money for store bills or credit card bills jointly with ^HISHER
^SPOUSEPARTNER_FIL, in ^HISHER own name, or both?
1. Jointly with ^HISHER spouse
2. Jointly with ^HISHER partner
3. Individually in ^HISHER own name
4. Both jointly with ^HISHER ^SPOUSEPARTNER_FIL and individually

CC_DEBT_JOINTSP
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?

CC_DEBT_INDV
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME owe for
store bills or credit card bills (in ^PTEMPNAME name only)?

Page 269 of 372

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

WHO_LOAN_DEBT
Did ^TEMPNAME have the loans (obtained through a bank or credit union, other than car loans or
home equity loans) jointly with ^HISHER ^SPOUSEPARTNER_FIL, in ^HISHER own name, or both?
1. Jointly with ^HISHER spouse
2. Jointly with ^HISHER partner
3. Individually in ^HISHER own name
4. Both jointly with ^HISHER ^SPOUSEPARTNER_FIL and individually

LOAN_DEBT_JOINTSP
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME and
^HISHER ^SPOUSEPARTNER_fIL jointly owe in loans (obtained through a bank or credit union, other
than car loans or home equity loans)?

LOAN_DEBT_INDV
As of the last day of ^LASTMONTH, ^CALENDAR_YEAR, how much did ^TEMPNAME owe in
loans (obtained through a bank or credit union, other than car loans or home equity loans in
^PTEMPNAME name only)?

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

WHO_OTHER_DEBT
(Excluding mortgages, home equity loans, and car loans,) Did ^TEMPNAME have other debt (including
student loans, medical bills not covered by insurance, money owed to private individuals, or any other
debt not covered) jointly with ^HISHER ^SPOUSEPARTNER_FIL, in ^HISHER own name, or both?

Page 270 of 372

1. Jointly with ^HISHER spouse
2. Jointly with ^HISHER partner
3. Individually in ^HISHER own name
4. Both jointly with ^HISHER ^SPOUSEPARTNER_FIL and individually

OTHER_DEBT_JOINTSP
(Excluding mortgages, home equity loans, and car loans,) As of the last day of ^LASTMONTH,
^CALENDAR_YEAR, how much did ^TEMPNAME and ^HISHER ^SPOUSEPARTNER_FIL jointly
owe in other debt (including student loans, medical bills not covered by insurance, money owed to
private individuals, or any other debt not covered)?

OTHER_DEBT_INDV
(Excluding mortgages, home equity loans, and car loans) As of the last day of ^LASTMONTH,
^CALENDAR_YEAR, how much did ^TEMPNAME owe in other debt (including student loans,
medical bills not covered by insurance, money owed to private individuals, or any other debt not covered)
?

ASTRECUSE
Did the respondent use any records to answer any asset questions?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

UTILZ_INTRO
? [F1]
In this next section of the interview, I will ask questions about doctor visits, such as how often
^TEMPNAME visited a doctor or dentist, as well as ^PTEMPNAME medical expenses during the
year. I'll complete the section by asking about any disabilities or limitations ^TEMPNAME may
have because of ^HISHER health.
Page 271 of 372

1. Enter 1 to continue

HLTHSTS
These next few questions are about ^PTEMPNAME health. Would you say ^HISHER health in
general is-Read answer categoires
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?
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)?

HOSPRSNNGT
Which of the following describes why ^HESHE entered the hospital ^RECENT_STAYFIL
Page 272 of 372

Read answer categories.
Mark all that apply.

1. for 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. 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

PRESCRIP
Between ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL ^DODOES ^HESHE
take prescription medicines on a daily basis for a month or more?
^BIRTHCONTROL_FIL
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**
Page 273 of 372

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

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

HLTHPRVD
R
^HLTHPROV_QSTNTXTFIL

Page 274 of 372

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
**NON-DISPLAYED ITEM**

MEDCRPAY
Next I will ask about actual medical expenditures paid, and not those that have been or will be
returned in the form of a 'reimbursement.'
^MOOP_INTRO
^MOOP_QSTNTXT

Page 275 of 372

^MOOP_NOTE
^MOOP_FRNOTE

MEDCRPAY_RANGE
Was it ...
Enter 0 for none.
Read answer categories.

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

OTCMDPAY
^OTCMDPAY_QSTNTXT

OTCMDPAY_RANGE
Was it ...
Enter 0 for none.
Read answer categories.
0. $0
1. $1 to $10
2. $11 to $50
3. $51 to $100
4. $101 to $200
Page 276 of 372

5. $201 to $300
6. $301 to $500
7. $501 to $1,000
8. $1,001 to $5,000
9. $5,001 or more

MDPAY
^MDPAY_QSTNTXT

MDPAY_RANGE
Was it ...
Enter 0 for none.
Read answer categories.

0. $0
1. $1 to $50
2. $50 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

FLEXSPND
? [F1]
^INTRO_HSA ^MONTH1 1st and the end of ^LASTMONTH ^CALENDAR_YRFIL, did ^TEMPNAME
have a Flexible Spending Account for health expenses?
1. Yes
2. No

Page 277 of 372

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

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?

Page 278 of 372

Read answer categories.
Mark all that apply.

1. Clinic or Public Health Department
2. Emergency room
3. Hospital, excluding emergency room
4. VA Hospital
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

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
Page 279 of 372

**NON-DISPLAYED ITEM**

INTRO
The next few questions help us learn about people who have physical, mental, or emotional
conditions that cause serious difficulty with their daily activities.
1. Enter 1 to continue

HEARING
^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?
...difficulty finding a job or remaining employed?
...prevented from working?
Page 280 of 372

1. Yes
2. No

AMBULAT_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?
...difficulty finding a job or remaining employed?
...prevented from working?

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?
...difficulty finding a job or remaining employed?
...prevented from working?

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?
Page 281 of 372

...difficulty finding a job or remaining employed?
...prevented from working?

1. Yes
2. No

FINDJOB
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?
...difficulty finding a job or remaining employed?
...prevented from working?

1. Yes
2. No

JOBCANT
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?
...difficulty finding a job or remaining employed?
...prevented from working?

1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

Page 282 of 372

LNO
**NON-DISPLAYED ITEM**

COGNIT
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

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

Page 283 of 372

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?
...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

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

DDELAY
C_DODOES ^TEMPNAME have a developmental condition or delay that limits ordinary activity?
1. Yes
2. No

Page 284 of 372

FERT_INTRO
? [F1]
Now I have 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**

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.

KIDLISTCHK
I am showing that ^PTEMPNAME biological ^CHILDFERTFIL ^FERT_AREIS Read Name(s). Is
that correct?
Display the first names and ages of the children in ^BIOCHILDLIST.

1. Yes
2. No

KIDLIST_REV
question text fill for PARCHK
Page 285 of 372

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 her biological children
96. None of the children are her biological children

FERT_CONF
You have keyed:
NUMBER OF CHILDREN: (fill with answer to PARCHL)
LIST OF KNOWN CHILDREN: (fill with list of first names of children confirmed so far, separated
by commas - leave blank if none)

WARNING: Once you enter 1 to continue, you cannot make changes to the information above.
Page 286 of 372

Enter 1 to Continue
1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

KIDLNO

HVARKID_F
**NON-DISPLAY ITEM**

CHLNAME
Child roster name intro
^CHLNAMEFIL
Enter 999 if no more children.

CHL_BMON
What is this child's date of birth?
Enter month.
1. January
2. February
3. March
4. April
5. May
6. June
Page 287 of 372

7. July
8. August
9. September
10. October
11. November
12. December

CHL_BDAY
(What is this child's date of birth?)
Enter day.

CHL_BYR
(What is this child's date of birth?)
Enter year.

CHL_AGEGS
? [F1]
How old would you say this child is?
Enter best estimate of age.

SAMEPAR
[F1]
Ask or verify:
Do ^ALLBOTH of ^PTEMPNAME biological children have the same biological Mother/Father fill
for fertility section?

CTRLNUM
Page 288 of 372

**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

HVAR_CLST
**NON-DISPLAY ITEM**

CLUSTER
CLUSTERFIL

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
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 ^MOTHFATH

OP_LIVHH
Does READ NAME's biological Mother/Father fill for fertility section live here?

Page 289 of 372

List names, ages of children from ^CHL_CLUSTERFIL.
1. Yes
2. No

WHOBIOP
Ask or verify:
Who is READ NAMES's biological Mother/Father fill for fertility section?
List 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
11. Someone not listed.

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
Page 290 of 372

**NON-DISPLAYED ITEM**

BIOMOMDOB_M
Parent questions intro sentence what month and year was ^PTEMPNAME biological mother
born?
Enter month
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.

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

Page 291 of 372

BIOMOMNAT
? [F1]
In what country was ^PTEMPNAME (biological) mother 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
28. Czechoslovakia
29. Denmark
30. Dominica
31. Dominican Republic
32. Ecuador
33. Egypt
34. El Salvador
35. England
36. Ethiopia
Page 292 of 372

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
67. Lithuania
68. Malaysia
69. Mexico
70. Morocco
71. Netherlands
72. New Zealand
73. Nicaragua
74. Nigeria
75. Northern Marianas
Page 293 of 372

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
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
Page 294 of 372

BIOMOMCOUNTRY
*** THIS IS A NON-DISPLAYED ITEM ***

BIOMOM
Is ^TEMPNAME biological mother (still) alive?

BIOMOMDOD_M
In what month and year did ^PTEMPNAME biological mother die?
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

BIOMOMDOD_Y
(In what month and year did ^PTEMPNAME biological mother die?)
Enter year

BIOMOMDOD_DKR1
How old ^WEREWAS ^TEMPNAME when ^HISHER biological mother passed away?

BIOMOMDOD_DKR2
^C_WASWERE ^TEMPNAME younger than 19 years old when ^HISHER biological mother passed
away?

BIODADDOB_M
Page 295 of 372

Intro to Parent mortality/natality for SSA what month and year was ^PTEMPNAME biological
father born?
Enter month
conditional FR note on Parent mortality/natality/nativity
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

BIODADUS
? [F1]
Was ^PTEMPNAME (biological) father born in the United States?
1. Yes
2. No

BIODADNAT
? [F1]
In what country was ^PTEMPNAME (biological) father born?
1. United States (US, USA)
Page 296 of 372

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 297 of 372

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 298 of 372

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

BIODADCOUNTRY
*** THIS IS A NON-DISPLAYED ITEM ***
Page 299 of 372

BIODAD
Is ^TEMPNAME biological father (still) alive?

BIODADDOD_M
In what month and year did ^PTEMPNAME biological father die?
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

BIODADDOD_Y
(In what month and year did ^PTEMPNAME biological father die?)
Enter year

BIODADDOD_DKR1
How old ^WEREWAS ^TEMPNAME when ^HISHER biological father passed away?

BIODADDOD_DKR2
^C_WASWERE ^TEMPNAME younger than 19 years old when ^HISHER biological father passed
away?

CHILD_INTRO
? [F1]
In this section of the interview, I will ask questions specifically about children in the household. I
Page 300 of 372

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**

LNO
**NON-DISPLAYED ITEM**

PAR
During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any
of the following arrangements to look afterChild/children for Child Care READ NAMES 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 the
first week of December ^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 December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.
Child's other parent or stepparent?)
Which child or children?

Page 301 of 372

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.

SELF
During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES while ^TEMPNAME
^WEREWAS working (or in school).
Did ^TEMPNAME care forChild/children for Child Care READ NAMES while ^TEMPNAME
^WEREWAS working (or in school)?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
Page 302 of 372

List names of all children under 15 for whom respondent is LNGD

1. Yes
2. No

SELFWHCH
(During a typical week in September ^CALENDAR_YRFIL, please tell me if you used any of the following
arrangements to look afterChild/children for Child Care READ NAMES while you were working.
Did ^TEMPNAME care forChild/children for Child Care READ NAMES while ^TEMPNAME
^WEREWAS working (or in school))
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
Page 303 of 372

25. ^LNO, ^FNAME where AGE >= 0 and AGE < 15, (LNGD = LNO) & PEOPLE_TO_ROSTER=1
26. Someone not listed.

GRAN
^CC_NONWORKINTROFIL
Grandparent?
If the respondent has trouble identifying a "typical week", then ask: (What did ^TEMPNAME use in the
first week of December ^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 December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES 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
Page 304 of 372

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 December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES 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 the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD

1. Yes
2. No

SIB15WHCH
(During a typical week in September ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES Designated
parent working/not working suffix fill.
Brother or sister age 15 or older?)
Which child or children?
Page 305 of 372

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.

OTHR
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES 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 the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
Page 306 of 372

List names of all children under 15 for whom respondent is LNGD

1. Yes
2. No

OTHRWHCH
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES 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
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
Page 307 of 372

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 December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.)
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 the
first week of December ^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 December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES 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
Page 308 of 372

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.

DAYCARE
(During a typical week in December ^CALENDAR_YRFIL, please tell me if you used any of the following
arrangements to look afterChild/children for Child Care READ NAMES 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 the
first week of December ^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 December ^CALENDAR_YRFIL, please tell me if you used any of the following
arrangements to look afterChild/children for Child Care READ NAMES Designated parent working/not
working suffix fill.
Page 309 of 372

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
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.

DAYHS
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.

DAYHSWHCH
Page 310 of 372

(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

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 December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES 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 the
Page 311 of 372

first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List the names of all children ages 2-7 for whom the respondent is LNGD

1. Yes
2. No

NURWHCH
(During a typical WEEK in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.
A nursery or preschool?)
Which child or children?
Mark all that apply.
CHILDREN:
List the names of all children 2-7 for whom the respondent is LNGD

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
Page 312 of 372

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
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.

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
Page 313 of 372

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.

HEADSTART
(During a typical WEEK in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES 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 the
first week of December ^CALENDAR_YRFIL?)
Head Start is a federally sponsored preschool program primarily for children from low-income families.
CHILDREN:
List the names of all children ages 2-7 for whom the respondent is LNGD
1. Yes
2. No

HEADSTWHCH
(During a typical WEEK in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES 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
Page 314 of 372

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.

FAM
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES 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 the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children under 15 for whom respondent is LNGD

1. Yes
Page 315 of 372

2. No

FAMWHCH
(During a typical week in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of the
following arrangements to look afterChild/children for Child Care READ NAMES 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.

Page 316 of 372

PROG
(During a typical WEEK in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES 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 the
first week of December ^CALENDAR_YRFIL?)
CHILDREN:
List names of all children ages 3-14 for whom the respondent is LNGD
1. Yes
2. No

PROGWHCH
(During a typical WEEK in December ^CALENDAR_YRFIL, please tell me if ^TEMPNAME used any of
the following arrangements to look afterChild/children for Child Care READ NAMES Designated parent
working/not working suffix fill.
Before or after school care programs?)
Which child or children?
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
Page 317 of 372

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 December ^CALENDAR_YRFIL, did Child/children for Child Care READ NAMES
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 the
first week of December ^CALENDAR_YRFIL?)
1. Yes
2. No

KSELFWHCH
(Sometimes it is difficult to make arrangements to look after children all of the time. During a typical
week in December ^CALENDAR_YRFIL, did Child/children for Child Care READ NAMES 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
Page 318 of 372

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.

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.

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 READ NAMES in December
^CALENDAR_YRFIL.
Page 319 of 372

Did ^TEMPNAME or ^HISHER family usually pay for any of these arrangements for
NAMES?

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 ref person a typical WEEK in December ^CALENDAR_YRFIL,
how much did ^TEMPNAME or ^HISHER family pay for all of these arrangements for READ
NAMES?
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 any of these arrangements in the the first week of December
^CALENDAR_YRFIL?)
Child/children for Child Care:
List the names of all of the children on the TCHILD_CC answer list (exclude answer category of
"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 December ^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.)

Page 320 of 372

1. Yes
2. No

WHOPAID
What persons or agencies helped to pay for part or all of ^PTEMPNAME ^PCHILD care in
December ^CALENDAR_YRFIL?
Check 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
^C_WASWERE ^TEMPNAME on a waiting list for a child care arrangement in December
^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

WORKMORE
Did ^TEMPNAME have any problems in obtaining child care that prevented ^TEMPNAME from
^WRK_WRKM in December ^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
Page 321 of 372

TIMELOST
^TIMELOSTINTRO much time, if any, did ^TEMPNAME lose in December ^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 December ^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
**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
Page 322 of 372

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

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

DINLNGD
Now I would like to ask you some questions about

READ NAMES.

In a typical week, how many days ^DODOES ^TEMPNAME eat dinner with
CHILDREN:
List the names of all children for whom respondent is the LNGD

0. None
Page 323 of 372

READ NAMES?

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 READ NAMES?
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

READCWB
In a typical week , about how many days ^DODOES ^TEMPNAME or any family member read
stories to: READ NAMES?
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
Page 324 of 372

OUTINGLNGD
In a typical week, about how many days ^DODOES ^TEMPNAME take READ NAMES 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

OUTINGSOP
In a typical week, about how many days does question text for DINOP take READ NAMES 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

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

KIDLNO
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
Page 325 of 372

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

KIDLNO
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
6. Not Enrolled

CTRLNUM
**NON-DISPLAYED ITEM**

LNO
**NON-DISPLAYED ITEM**

KIDLNO
HVARKID
**NON-DISPLAY ITEM**

GETBY
^SCHGETBY

1. All of the time
Page 326 of 372

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
HVARKID
**NON-DISPLAY ITEM**

HMWRK
^SCHHMWK

1. All of the time
2. Most of the time
3. Some of the time
4. None of the time
6. Not Enrolled

REPGRD
C_HAVEHASCWB this/these for 6-17
any reason?

READ NAMES 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

Page 327 of 372

REPGRDWHCH
(C_HAVEHASCWB this/these for 6-17
any reason?)

READ NAMES ever repeated a grade, or been held back for

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
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 NAMES 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

Page 328 of 372

EXPSCHWHCH
(C_HAVEHASCWB this/these for 6-17
from school?)

READ NAMES 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
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 NAMES 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

Page 329 of 372

GIFTDWHCH
(C_HAVEHASCWB this/these for 6-17 READ NAMES 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
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
out of school?

READ NAMES play on a sports team, either in or

Children:
Please list all children ages 6-17 for whom the respondent is the LNGD

1. Yes
2. No

Page 330 of 372

SPORTWHCH
(In ^CALENDAR_YEAR, did this/these for 6-17
school?)

READ NAMES 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
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 NAMES 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
Page 331 of 372

LESSONWHCH
(In ^CALENDAR_YEAR, did this/these for 6-17 READ NAMES 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
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 NAMES participate in any clubs or
organizations after school or on weekends, such as Scouts, a religious group, or a Girls' or Boys'
club?
Children:
Please list all children ages 6-17 for whom the respondent is the LNGD

1. Yes
2. No
Page 332 of 372

CLUBWHCH
(In ^CALENDAR_YEAR, did this/these for 6-17 READ NAMES 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
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 NAMES 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

Page 333 of 372

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**

AWB_INTRO
? [F1]
In this final section of your interview, I will ask 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

AWBHOLES
Page 334 of 372

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 335 of 372

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 they lived the longest or spent
the most time. Record persistent conditions, or conditions that were present for the majority of the time.

Page 336 of 372

1. Yes
2. No

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?

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

CTRLNUM
Page 337 of 372

**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

FOODF4
How often did this happen

Read answer categories?

1. Almost every month
Page 338 of 372

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

CANTRIL
I have one more question for you, this one about your current life satisfaction.
Please imagine a ladder with steps numbered from zero at the bottom to ten at the top. The top
of the ladder represents the best possible life for you and the bottom of the ladder represents the
worst possible life for you. If the top step is 10 and the bottom step is 0, on which step of the
ladder do you feel you personally stand at the present time?

RIP
We will recontact this household in ^REFERENCE_PERIOD to update information. If we talk to
someone else in your household next time, instead of you, is it OK if we use your answers as a
starting point?

1. Yes
2. No

NEXT_ADULT_INT
^QSTNTXT_NEXTADLTINT
1. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
Page 339 of 372

2. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
3. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
4. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
5. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
6. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
7. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
8. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
9. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
10. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
11. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
12. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
13. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
14. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
15. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
16. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
17. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
18. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
19. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
20. Display the ^LNO, ^FNAME, and ^LNAME where PSTATUS(INT_STATUS) = <> and PEOPLE_TO_ROSTER =
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.
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
Page 340 of 372

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

CARICON2
This interview may be recorded for quality control purposes. Is that O.K.?
1. Yes
2. No

EHC_INTRO
Enter 1 to continue.
1. Enter 1 to continue

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?
Page 341 of 372

CTRLNUM
**NON-DISPLAYED ITEM**

WHO_SPEAK_WITH
Do not read to the respondent.
Select the person (based on his/her line number) you are speaking with 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**

LNO
**NON-DISPLAYED ITEM**

CELL_PHONE
Page 342 of 372

^CELLINTRO_FIL
What is ^PTEMPNAME cell phone number?
If the respondent does not have a cell phone, enter Ctrl D as the response.

MOVING_INTENT
^DODOES ^TEMPNAME have any plans to move in the next year?
1. Yes
2. No

MOVING_ADDR
Do you know the new address?
1. Yes
2. No

MOVING_HNO
What is the new address going to be?
Enter the House Number.
If a street address is not provided, press ENTER and collect the Non-City Style Mailing Address under
"Non-City" if available.

MOVING_HNOSUF
(What is the new address going to be?)
Enter the House Number Suffix.

MOVING_STRNAME
(What is the new address going to be?)
Enter the Street Name.

MOVING_UNITDES
Page 343 of 372

(What is the new address going to be?)
Enter the Unit Designation.

MOVING_NONCITYADD
? [F1]
(What is the new address going to be?)
Enter the correct Non-City Style Mailing Address or press ENTER for Same.

MOVING_COUNTY
(What is the new address going to be?)
Enter the County.

MOVING_PO
(What is the new address going to be?)
Enter the Locality.

MOVING_ST
(What is the new address going to be?)
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
Page 344 of 372

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
TX. Texas
UT. Utah
VT. Vermont
VA. Virginia
WA. Washington
WV. West Virginia
WI. Wisconsin
Page 345 of 372

WY. Wyoming

MOVING_ZIP5
(What is the new address going to be?)
Enter the Zip Code.

MOVING_ZIP4
(What is the new address going to be?)
Enter the 4-Digit Zip Code.

MOVING_TELENO
What is the telephone number going to be?

FR_AREA
Is this address within your assignment area?

1. Yes
2. No

LTRADDR
To whom should future correspondence be addressed?
You may only select original sample people to receive future correspondence.
Read names 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
Page 346 of 372

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

VERIFY_TELE_NO
During our last visit, I recorded that the telephone number for reaching this household is:
^TELEPHONENOFIL ^TYPETELEPHONE
Is this still correct?

1. Yes
2. No

TELEPHONE_HHLD
Since households included in this survey are interviewed again, we may attempt to conduct the
followup interview by telephone. Other than the numbers already provided, is there a telephone
in this house/apartment?
1. Yes
2. No

TELEPHONE_AVAIL
Is there a telephone elsewhere on which people in this household can be contacted?
1. Yes
2. No

Page 347 of 372

TELEPHONE_WHERE
Where is this telephone located?

TELEPHONE_NO
What is the telephone number where you 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. Other

TEL_TYPE_SPECIFY
What other type of telephone?

VERIFY_2NDTELE_NO
I also recorded that the second telephone number where you would like to be called is:
^2NDTELEPHONENOFIL ^TYPETELEPHONE
Is this still correct?
1. Yes
2. No

2ND_TELEPHONE
Is there another telephone number where you can be contacted?

1. Yes
2. No

Page 348 of 372

2ND_TELEPHONE_NO
What is the second telephone number where you would like to be called?

2ND_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. Other

2NDTEL_TYPE_SPECIFY
What other type of telephone?

VERIFY_BEST_TIME
During our last visit, I recorded that ^BESTTIMEFIL was the best time to contact this
household. Is that still correct?
1. Yes
2. No

BEST_TIME_CONTACT
When is the best time to contact you?
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)
Page 349 of 372

8. Daytime (9am - 4pm)
9. After 5pm
10. Other

CONTACT_SPECIFY
What other time?

PHONE_INT
Is a telephone interview acceptable?
1. Yes
2. No

CONT_PSN1_VERIFY
During our last visit, we recorded the following information about some to contact if we couldn't
reach.^YOUREFPERFIL. We were told to contact:
Display CONT_PSN1_NAME, CONT_PSN1_ADDR, CONT_PSN1_PO, CONT_PSN1_ST,
CONT_PSN1_ZIP, CONT_PSN1_TELENO
Is this still correct?

1. Yes
2. No

CONT_PSN1_YN
Is there a close relative or friend, not currently living at this address, who would know how to
reach ^YOUREFPERFIL if we are unable to contact HIMHER?
1. Yes
2. No

CONTACT_NUM
**NON-DISPLAYED ITEM**

Page 350 of 372

CTRLNUM
**NON-DISPLAYED ITEM**

CONT_PSN1_FNAME
What is this person's first name?

CONT_PSN1_LNAME
What is this person's last name?

CONT_PSN1_REL
What is ^PSN1NAMEFIL relationship to ^YOUREFPERFIL ?

CONT_PSN1_HNO
What is ^PSN1NAMEFIL street address?
Enter the house number of the street address. If a street address is not provided, collect the Non-City
Style Mailing Address (e.g. P.O Box).

CONT_PSN1_STREET
What is ^PSN1NAMEFIL street address?
Enter the street name. If a street address is not provided, collect the Non-City Style Mailing Address
(e.g. P.O Box).

CONT_PSN1_PO
In what city is this?

CONT_PSN1_ST
What state is this in?

1. Alabama
2. Alaska
3. American Samoa
4. Arizona
5. Arkansas
Page 351 of 372

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
41. Oregon
42. Other place
43. Pennsylvania
44. Puerto Rico
Page 352 of 372

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

CONT_PSN1_ZIP
What is the zip code?
Prompt the person to provide both the 5- and 4-digit zip codes if necessary.

CONT_PSN1_TELENO
What is ^PSN1NAMEFIL telephone number?
Include the area code, prefix, suffix, and the extension (if one exists).

CONT_PSN1_TELETYP
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. Other

PSN1_TELETYP_SPECIFY
Page 353 of 372

What other type of telephone?

CONT_PSN2_VERIFY
I also recorded the following information about a second close relative or friend to be contacted
if we couldn't reach ^YOUREFPERFIL. We were told to contact:
Display CONT_PSN2_NAME, CONT_PSN2_ADDR, CONT_PSN2_PO, CONT_PSN2_ST,
CONT_PSN2_ZIP, CONT_PSN2_TELENO
Is this still correct?

1. Yes
2. No

CONT_PSN2_YN
Is there another person, not currently living at this address, who would know how to reach
^YOUREFPERFIL?
Add an interviewer instruction to the question text that displays the following when PCNT>1:
" Collect primary contact information for a different adult household member if possible."
1. Yes
2. No

CONTACT_NUM
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

EMAIL
In case we cannot reach anyone by phone, ^DODOES LTRADDR_FILL have an email address we
can use to contact HIMHER?
1. Yes
Page 354 of 372

2. No

EMAIL_ADDR
What is PLTRADDR_FILL email address?

CTRLNUM
**NON-DISPLAYED ITEM**

FIN
This case is not completed.
Enter 1 to continue.
1. Enter 1 to continue

CALLBACK_TODAY
I'd like to schedule a return visit to finish conducting the interview. May I come back later today?

1. Yes
2. No

TODAY_TIME
What time today?

CALLBACK_DATE
What DATE and TIME would be best to visit again to conduct the interview?
Enter the date (month, day, and year).

CALLBACK_TIME
(What DATE and TIME would be best to visit again to conduct the inteview?)
Enter the time (hour, minutes, and am/pm).
Page 355 of 372

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**

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
Page 356 of 372

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.

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
Page 357 of 372

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 358 of 372

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.

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
Page 359 of 372

NOW_TYPEA
Do not read to the respondent.
This is now a Type A noninterview for ^REASONFIL.
Enter 1 to continue.

1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

WHY_TYPEZ_HHLD
^TYPEZHHLDQSTNTXTFIL

1. Person was ill or in the hospital
2. Person was temporarily away from home
3. Other

TYPEZ_SPECIFY
What is the other reason?

CTRLNUM
**NON-DISPLAYED ITEM**

OTHER_NAME
Do no 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
Page 360 of 372

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**

RESPAVAIL
I have a few more questions I would like to ask ^RESPONDENT_NAMEFIL. Is ^HESHE available?
If ^RESPONDENT_NAMEFIL is available, wait for him/her to return for the remaining questions. If
^HESHE is not available continue with current respondent.
1. Yes
2. No

INTRO
We are always looking for ways to improve our surveys. I would like to ask you some additional
questions about the interview we just completed. The information you provide in this section will
be used to improve the survey's efficiency, so your opinion is very important.
Enter 1 to continue.
1. Enter 1 to continue

Page 361 of 372

ADV_LTTR
Please describe any information that would have been beneficial to know in advance, or made
participation in this survey more appealing to you.

BROCHURE
Please describe any materials or information that would have made the survey seem more
important or relevant to you.

FEEDBACK
Is there anything about this interview--positive or negative--that stands out to you? Please be as
specific as possible, including things that were done well, as well as areas that could be
improved.

THANKYOU
Thank you for your cooperation. Since this is a suvey that measures the economic changes of
people over time, we recontact respondents periodically. Also, my office may check to see if I
have done my job properly. Therefore, you may receive a call in the next several weeks checking
on my work. Thank you again.
Enter 1 to continue.

1. Enter 1 to continue

CHECKOUT
**NON-DISPLAYED ITEM**

VISIT_COUNT
Do not read to the respondent.
How many times have you attempted personal contact (actually visited the address)?

INT_MODE
Do not read to the respondent.
Was ^MAJORITY_FIL this interview done by telephone interview or by personal interview?

Page 362 of 372

1. Telephone interview
2. Personal interview

SPANISH_INT
Do not read to the respondent.
Did you conduct any of this household's interview in Spanish?

1. Yes
2. No

LANGUAGE
Do not read to the respondent.
What language is spoken in this household that prevented you from conducting the interview?
1. Spanish or Spanish Creole
2. Chinese
3. French (including French Creole, Patois, Cajun)
4. Tagalog, Filipino
5. Vietnamese
6. German
7. Korean
8. Russian
9. Italian
10. Hindi, Urdu
11. Arabic
12. Portuguese or Portuguese Creole
13. Polish
14. Other

SHOWFINAL
MODE: ^INT_MODEFIL
OUTCOME: ^OUTCOMEFIL
MARK: ^MARKFIL
MARKTWO: ^MARKTWOFIL
Page 363 of 372

Enter 1 to continue.
1. Enter 1 to continue

CTRLNUM
**NON-DISPLAYED ITEM**

DIFF_LOCATE
Did you have difficulty finding this address?
1. No, I found it on the first attempt
2. Somewhat difficult to locate
3. Difficult to locate--it took multiple attmepts or required outside assistance
4. Interview or all interview attempts were done over the phone

ADDR_CONDITION
How would you describe the condition of the sample address?
1. Very poor
2. Poor
3. Fair
4. Very good
5. Excellent

WHERE_INT
Where did you conduct the interview?
If multiple locations, or multiple interview attempts, chose the location where the majority of the interview
was done.
1. Outside--porch, driveway, stoop, etc.
2. Living room
3. Dining room--some place with a table
4. Other

WHERE_SPECIFY
Page 364 of 372

Please specify where the interview was conducted.

LITTER
Were any of the following conditions present in the neighborhood:
...Litter or overflowing trash bins?
...Houses with boarded up or missing windows or doors?
...Abandoned vehicles?
...Damaged playground equipment?
...Playground equipment in good condition?
...Well-tended yards or gardens?
...Bus stop or other access to public transportation?
...Presence of gangs, prostitutes, or illegal activity?
...Security fences (designed to keep people out--not decorative)?
...Graffiti on buildings?
1. Yes
2. No

WINDOWS
Were any of the following conditions present in the neighborhood:
...Litter or overflowing trash bins?
...Houses with boarded up or missing windows or doors?
...Abandoned vehicles?
...Damaged playground equipment?
...Playground equipment in good condition?
...Well-tended yards or gardens?
...Bus stop or other access to public transportation?
...Presence of gangs, prostitutes, or illegal activity?
...Security fences (designed to keep people out--not decorative)?
...Graffiti on buildings?
1. Yes
2. No

A_VEHICLES
Were any of the following conditions present in the neighborhood:
...Litter or overflowing trash bins?
...Houses with boarded up or missing windows or doors?
...Abandoned vehicles?
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...Damaged playground equipment?
...Playground equipment in good condition?
...Well-tended yards or gardens?
...Bus stop or other access to public transportation?
...Presence of gangs, prostitutes, or illegal activity?
...Security fences (designed to keep people out--not decorative)?
...Graffiti on buildings?
1. Yes
2. No

DAMG_PLGD
Were any of the following conditions present in the neighborhood:
...Litter or overflowing trash bins?
...Houses with boarded up or missing windows or doors?
...Abandoned vehicles?
...Damaged playground equipment?
...Playground equipment in good condition?
...Well-tended yards or gardens?
...Bus stop or other access to public transportation?
...Presence of gangs, prostitutes, or illegal activity?
...Security fences (designed to keep people out--not decorative)?
...Graffiti on buildings?
1. Yes
2. No

GOOD_PLGD
Were any of the following conditions present in the neighborhood:
...Litter or overflowing trash bins?
...Houses with boarded up or missing windows or doors?
...Abandoned vehicles?
...Damaged playground equipment?
...Playground equipment in good condition?
...Well-tended yards or gardens?
...Bus stop or other access to public transportation?
...Presence of gangs, prostitutes, or illegal activity?
...Security fences (designed to keep people out--not decorative)?
...Graffiti on buildings?
1. Yes
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2. No

YARDS
Were any of the following conditions present in the neighborhood:
...Litter or overflowing trash bins?
...Houses with boarded up or missing windows or doors?
...Abandoned vehicles?
...Damaged playground equipment?
...Playground equipment in good condition?
...Well-tended yards or gardens?
...Bus stop or other access to public transportation?
...Presence of gangs, prostitutes, or illegal activity?
...Security fences (designed to keep people out--not decorative)?
...Graffiti on buildings?
1. Yes
2. No

BUS_STOP
Were any of the following conditions present in the neighborhood:
...Litter or overflowing trash bins?
...Houses with boarded up or missing windows or doors?
...Abandoned vehicles?
...Damaged playground equipment?
...Playground equipment in good condition?
...Well-tended yards or gardens?
...Bus stop or other access to public transportation?
...Presence of gangs, prostitutes, or illegal activity?
...Security fences (designed to keep people out--not decorative)?
...Graffiti on buildings?
1. Yes
2. No

GANGS
Were any of the following conditions present in the neighborhood:
...Litter or overflowing trash bins?
...Houses with boarded up or missing windows or doors?
...Abandoned vehicles?
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...Damaged playground equipment?
...Playground equipment in good condition?
...Well-tended yards or gardens?
...Bus stop or other access to public transportation?
...Presence of gangs, prostitutes, or illegal activity?
...Security fences (designed to keep people out--not decorative)?
...Graffiti on buildings?
1. Yes
2. No

FENCE
Were any of the following conditions present in the neighborhood:
...Litter or overflowing trash bins?
...Houses with boarded up or missing windows or doors?
...Abandoned vehicles?
...Damaged playground equipment?
...Playground equipment in good condition?
...Well-tended yards or gardens?
...Bus stop or other access to public transportation?
...Presence of gangs, prostitutes, or illegal activity?
...Security fences (designed to keep people out--not decorative)?
...Graffiti on buildings?
1. Yes
2. No

GRAFFITI
Were any of the following conditions present in the neighborhood:
...Litter or overflowing trash bins?
...Houses with boarded up or missing windows or doors?
...Abandoned vehicles?
...Damaged playground equipment?
...Playground equipment in good condition?
...Well-tended yards or gardens?
...Bus stop or other access to public transportation?
...Presence of gangs, prostitutes, or illegal activity?
...Security fences (designed to keep people out--not decorative)?
...Graffiti on buildings?
1. Yes
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2. No

GATE
Were any of the following present:
...Security gate or door (requires a special key or a code that blocks access of unauthorized
persons)?
...Any indication of the presence of dogs?
...Any indication of the presence of a security system or service?
...Police officers?
...Private security guards?
1. Yes
2. No

DOGS
Were any of the following present:
...Security gate or door (requires a special key or a code that blocks access of unauthorized persons)?
...Any indication of the presence of dogs?
...Any indication of the presence of a security system or service?
...Police officers?
...Private security guards?
1. Yes
2. No

SECURITY
Were any of the following present:
...Security gate or door (requires a special key or a code that blocks access of unauthorized persons)?
...Any indication of the presence of dogs?
...Any indication of the presence of a security system or service?
...Police officers?
...Private security guards?
1. Yes
2. No

POLICE
Page 369 of 372

Were any of the following present:
...Security gate or door (requires a special key or a code that blocks access of unauthorized persons)?
...Any indication of the presence of dogs?
...Any indication fo the presence of a security system or service?
...Police officers?
...Private security guards?
1. Yes
2. No

GUARDS
Were any of the following present:
...Security gate or door (requires a special key or a code that blocks access of unauthorized persons)?
...Any indication of the presence of dogs?
...Any indication of the presence of a security system or service?
...Police officers?
...Private security guards?
1. Yes
2. No

CTRLNUM
**NON-DISPLAYED ITEM**

CTRLNUM
**NON-DISPLAYED ITEM**

PROBING
Help improve SIPP by giving us your feedback about each interview you complete. Please complete this
feedback section as soon as possible, while the interview is still fresh in your mind.
What probing techniques seemed the most effective during this interview?

BUG
Aside from any instrument bugs that you reported using the F7 notes, please describe any instrument
issues you encountered during this interview. Be as specific as possible.
Page 370 of 372

IMPROV
We would like your feedback to improve training- Did anything happen during this interview that you were
NOT sufficiently prepared for, or not prepared for at all?
(NOTE: Please let us know what you did not learn in training that would have benefitted you in this
interview. For example, were there any topics you were unprepared for or had not seen in training or the
self-study, or any topics you feel should have been given more attention in training.)
1. Yes
2. No

DIMPROV
Please describe what happened during the interview that your training did NOT sufficiently prepare you
for, or any recommendations you have to improve training.

HQFEED
Is there anything else about this interview that headquarters should know about - anything that would
help improve the instrument, training, or any other aspect of the new survey?
1. Yes
2. No

DHQFEED
Please describe anything else about this interview that might help to improve the instrument, training, or
any other aspect of the new survey.

Feedback Change Control
**NON-DISPLAYED ITEM**

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
Page 371 of 372

in the HH), you do it via a pre-chart below the question text.
pre-chart appears in a lighter blue.

Page 372 of 372

This