Annual Demographic Survey (March CPS Supplement) Questionnaire

Annual Demographic Survey (March Supplement)

Questionnaire Items

The computerized questionnaire for just the labor force portion of a CPS interview consists of more than 200 questions. However, complex skip patterns using the responses to several questions insure respondents are asked only a very small set of questions about themselves. Averaged over the 8 months of interviews, the labor force portion of the CPS interview lasts about 6 minutes per person. Obviously, larger households and households containing someone who has multiple jobs or started a new job take longer. Single-person households or households containing only retired persons who do not wish to work take less time.

Items Booklet -- March 1995

HH32b< Did (name of reference person) live at this address during the week and >SNAD1< of November 19, 1994?

<1> Yes

<2> No

===>_

>HH32d< Did any of the following household members live here during the and >SNAD2< week of November 19, 1994?

NAME NAME

(Person 1) (person 9)

(Person 2) (person 10)

(Person 3) (person 11)

(Person 4) (person 12)

(Person 5) (person 13)

(Person 6) (person 14)

(Person 7) (person 15)

(Person 8) (person 16)

<1> Yes

<2> No

===>_

>API-intro< This month, we are asking Asian and Pacific Islanders to indicate the specific Asian or Pacific Islander group from which they originate.

ENTER TO PROCEED

===>_

>API34< What is (name's/your) specific Asian or Pacific Islander group?

<A> API help

<1> Chinese

<2> Filipino

<3> Japanese

<4> Asian Indian

<5> Korean

<6> Vietnamese

<7> Laotian, Cambodian, Hmong

<8> Other Asian (For example, Thai, Pakistani,

Sri Lankan, Burmese)

<9> Hawaiian

<10> Other Pacific Islander (For example, Samoan, Guamanian, Tongan)

===>__

>API-help<

ASIAN GROUPS PACIFIC ISLANDER GROUPS

Asian Indian Japanese Carolinian Polynesian

Bangladeshi Korean Chuukese Saipanese

Bhutanese Laotian Fijian Samoan

Borneo Malayan Guamanian Tahitian

Burmese Maldivian Hawaiian Tongan

Cambodian Nepali Kosraean Yapese

Celebesian Okinawan Mariana Islander

Cernan Pakistani Marshallese

Chinese Sikkim Melanesian

Filipino Singaporean Micronesian

Hmong Sri Lankan (Ceylonese) Palauan

Indochinese Thai Papua New Guinean

Indonesian Vietnamese

Iwo-Jiman

ENTER TO PROCEED

===>_

>SSN-scrn< What is (name's/your) Social Security or Railroad Retirement number?

===>__

>FAMIN-scrn< I am going to read a list of income categories. Which category represents the total combined income of all members of this FAMILY during the past 12 months)? This includes money from jobs, net income from business, farm or rent, pensions, dividends, interest, social security payments and any other money income received by members of this FAMILY who are 15 years of age or older.

<1> Less than $5,000 <8> 25,000 to 29,999

<2> 5,000 to 7,499 <9> 30,000 to 34,999

<3> 7,500 to 9,999 <10> 35,000 to 39,999

<4> 10,000 to 12,499 <11> 40,000 to 49,999

<5> 12,500 to 14,999 <12> 50,000 to 59,999

<6> 15,000 to 19,999 <13> 60,000 to 74,999

<7> 20,000 to 24,999 <14> $75,000 or more

===>__

>Pr-incom< **WORDING OF INTRODUCTION IS OPTIONAL**

We have just completed the questions about employment and unemployment. Each March, the Census Bureau also collects information about the economic situation of Americans and their families for the previous year.

I am going to ask these questions now. We don't expect all answers to be perfect, but please think about each question and answer it the best you can.

ENTER TO PROCEED

ENTER FOR IMPORTANCE OF RESPONDING

===>_

>Q29a< Did (name/you) work at a job or business at any time during 1994?

<1> Yes goto Q33

<2> No

===>_

>Q29b< Did (you/he/she) do any temporary, part-time, or seasonal work even for a few days during 1994?

<1> Yes goto Q33

<2> No

===>_

>Q30< Even though (name/you) did not work in 1994, did (you/he/she) spend any time trying to find a job or on layoff?

<1> Yes

<2> No goto Q32

===>_

>Q31< How many different weeks (were/was) (name/you) looking for work or on layoff from a job?

<1-52>

===>__

>Q32< What was the main reason (you/he/she) did not work in 1994?

READ CATEGORIES IF NECESSARY.

<1> Ill, or disabled and unable to work

<2> Retired

<3> Taking care of home or family

<4> Going to school

<5> Could not find work

<6> Doing something else

===>_ goto Q51A1

>Q33< During 1994 in how many weeks did (name/you) work even for a few hours? Include paid vacation and sick leave as work.

ENTER NUMBER OF WEEKS <1-52> OR <M> IF RESPONDENT CAN ONLY ANSWER IN MONTHS

===>__

>Q33-mon< ENTER NUMBER OF MONTHS WORKED

<1-12>

===>__

>Q33-ver< Then (name/you) worked about (number) weeks. Is that correct?

<1> Yes

<2> No -- back to Q33 and obtain estimate

===>_

Check Item Number of weeks in Q33 is:

1-49 goto Q36

50-51 goto Q35

52 goto Q39

>Q35< Did (name/you) lose any full weeks of work in 1994 because (you/he/she) (were/was) on layoff from a job or lost a job?

NUMBER OF WEEKS WORKED IN 1994: (number)

<1> Yes

<2> No

<M> Mistake made in number of weeks worked in 1994--Specify

===>_ goto Q39

>Q36< You said (name/you) worked about (number) (week/weeks) in 1994. How many OF THE REMAINING (number) WEEKS (were/was) (you/he/she) looking for work or on layoff from a job?

<X> None goto Q38

===>__

>Q37< Were the (number) weeks (name/you) (were/was) looking for work or on layoff all in one stretch?

<1> Yes -- one stretch

<2> No -- two stretches

<3> No -- 3 or more stretches

===>_

>Q38< What was the main reason (name/you) (were/was) not working or looking for work in the remaining weeks of 1994?

<1> Ill, or disabled and unable to work

<2> Taking care of home or family

<3> Going to school

<4> Retired

<5> No work available

<6> Other (SPECIFY)

===>_

>Q39< For how many employers did (name/you) work in 1994? If more than one at the same time, only count it as one employer.

<1> One

<2> Two

<3> Three or more

===>_

>Q41< In the (one week/weeks) that (name/you) worked, how many hours did (you/he/she) (work that week?/usually work per week?)

ENTER NUMBER OF HOURS

===>__

>Q43< During 1994, were there one or more weeks in which (name/you) worked less than 35 hours? Exclude time off with pay because of holidays, vacation, days off, or sickness.

<1> Yes

<2> No

===>_

>Q44< In the weeks that (name/you) worked, how many weeks did (name/you) work less than 35 hours in 1994?

NUMBER OF WEEKS WORKED IN 1994: (number)

(NUMBER OF WEEKS WAS REPORTED IN ITEM Q33)

<1-52>

===>__

>Q45< What was the main reason (name/you) worked less than 35 hours per week?

<1> Could not find a full time job

<2> Wanted to work part time or only able to work part time

<3> Slack work or material shortage

<4> Other reason

===>_

>Q46< What was (name's/your) longest job during 1994?

Was it:

(IO1NAM:) (name of employer)

(IO1IND:) (kind of business or industry)

(IO1OCC:) (occupation)

(IO1DT:) (duties)

(duties)

CLASS OF WORKER: (PRIVATE/FEDERAL GOVERNMENT/STATE GOVERNMENT/LOCAL GOVERNMENT/WORKING WITHOUT PAY IN FAMILY BUS./SELF EMPLOYED--INCORPORATED/SELF EMPLOYED--UNINCORPORATED)

<S> Same as listed goto Q4788

<N> Not the same job

===>_

>Q47a< For whom did (name/you) work(?/at) (blank/(your/his/her) (blank/longest job during 1994?)

NAME OF COMPANY, BUSINESS, ORGANIZATION OR OTHER EMPLOYER

(blank/ <J> REFER TO CURRENT AND LONGEST JOBS)

(((IO1NAM:) (entry))/If longest job last year is military job, enter Armed Forces)

(blank/<S> Same as IO1NAM /<N> No work done at all during 1994)

===>__________________________________________________________

>Q47b< What kind of business or industry is this?

FOR EXAMPLE: TV AND RADIO MFG., RETAIL SHOE STORE, FARM

(blank/<J> REFER TO CURRENT AND LONGEST JOBS)

(((IO1IND:) (entry))/If longest job last year is military job, enter NA)

(blank/<S> Same as IO1IND/blank)

===>__________________________________________________________

>Q47c< What kind of work (were/was) (you/he/she) doing?

FOR EXAMPLE: ELECTRICAL ENGINEER, STOCK CLERK, TYPIST

(<J> REFER TO CURRENT AND LONGEST JOBS/blank)

(((IO1OCC): entry)/If longest job last year is military job, enter Armed Forces)

(<S> Same as IO1OCC/Blank)

===>__________________________________________________________

>Q47d< What were (your/his/her) most important activities or duties?

FOR EXAMPLE: TYPES, KEEPS ACCOUNT BOOKS, FILES, SELLS CARS, OPERATES PRINTING PRESS, FINISHES CONCRETE.

(<J> REFER TO CURRENT AND LONGEST JOBS/blank)

(((IO1DT): entry)/If longest job last year is military job, enter NA) (entry 2/blank)

(<S> Same as IO1DT/Blank)

===>__________________________________________________________

>Q47E1< (ASK ONLY IF NECESSARY) (Were/Was) (you/name) employed by government, by a PRIVATE company, a non-profit organization, or (were/was) (you/name) self employed or working in a family business?

<1> Government goto Q47E1a

<2> private for profit company

<3> Non-profit organization including tax exempt and charitable organizations

<4> Self employed goto Q47E1b

<5> Working in family business goto Q47E1b

>Q47E1a< Would that be the federal, state, or local government?

<1> Federal

<2> State

<3> Local (county, city, township)

>Q47E1b< Was this business incorporated?

<1> Yes

<2> No

>Q47E1c< Are you the owner of the business?

<1> Yes

<2> No

>Q4788< Counting all locations where (this employer/(name/you)) (operates/operate), what is the total number of persons who work for ((name's/your) employer)/(name/you))?

<1> under 10

<2> 10-24

<3> 25-99

<4> 100-499

<5> 500-999

<6> 1,000+

===>_

>S-Q48a< How much did (name/you) earn from this employer before taxes and other deductions during 1994?

Enter dollar amount $ Enter <X> for None

<D> or <R> goto Q49a

READ IF NECESSARY: Is this a weekly, bi-weekly, twice monthly, monthly or yearly amount?

Per <1> Weekly

<2> Every other week (bi-weekly)

<3> Twice monthly

<4> Monthly

<5> Yearly

Q48ap ==>___

<D> or <R> goto Q49a

>Q48a1< For how many (weekly/bi-weekly/twice monthly/monthly) pay periods did (name/you) earn (fill from Q48a) from this employer in 1994?

goto Q48aV

<1-52>

<D> or <R> goto Q49a

>Q48aC2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL ANNUAL EARNINGS ENTERED IS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q48a3

<2> No goto Q48a (TO CORRECT ENTRY)

>Q48aV< According to my calculations (name/you) earned (total) dollars altogether from this employer in 1994 before deductions. Does that sound about right?

<1> Yes goto Q48a3

<2> No

<D> or <R> goto Q49a

>Q48a2< What is your best estimate of (name's/your) correct total amount of earnings from this employer during 1994 before deductions?

Enter dollar amount $

Place amount in 48aT

If <D> or <R> put (total) from 48aV in 48aT

<D> or <R> goto Q48a3

>Q48a3< Does this amount include all tips, bonuses, overtime pay or commissions (name/you) may have received from this employer in 1994?

<1> Yes goto Q49a

<2> No goto Q48aad

<D> or <R> goto Q49a

Q48aad How much did (name/you) earn in tips, bonuses, overtime pay or commissions from this employer in 1994?

Enter dollar amount $ goto Q49a

Add this amount to 48aT

<D> or <R> goto Q49a

>Q48b< What were (name's/your) net earnings from this business/farm after expenses during 1994?

IF RESPONSE IS "BROKE EVEN" THEN ENTER 1.

FOR AMOUNTS $1,000,000 AND OVER, ENTER $999,999

<L> Lost Money

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q48BLO< ENTER AMOUNT OF MONEY LOST IN 1994.

FOR AMOUNTS $10,000 AND OVER, ENTER $9,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q48b-ver1< *** DO NOT READ TO RESPONDENT ***

Your entry for (name's) earnigs from this business/farm after expenses was ($ amount). Is that correct?

<1> Yes

<2> No

===> ___

>Q48c< Does this amount include all tips, bonuses, overtime pay or commissions (name/you) may have received?

<1> Yes

<2> No BACK AND CORRECT AMOUNT ENTERED

===>_

>Q49a< Did (name/you) earn money from any other work (you/he/she) did during 1994?

<1> Yes goto S-Q49B1

<2> No goto CHK50A

===>_

>S-Q49B1< How much did (name/you) earn from all other employers before taxes and other deductions during 1994?

Enter dollar amount $

<X> none goto Q49B2

<D> or <R> goto Q49B2

READ IF NECESSARY: Is this a weekly, bi-weekly, twice monthly, monthly or yearly amount?

Per <1> Weekly

<2> Every other week (bi-weekly)

<3> Twice monthly

<4> Monthly

<5> Yearly goto Q49B1C

>Q49B1p< ==>___

<D> or <R> goto Q49B2

>Q49B11< For how many (weekly/bi-weekly/twice monthly/monthly) pay periods did (name/you) earn (fill from Q49B1) from all other employers in 1994?

goto Q49B1V

<1-52>

<D> or <R> goto Q49B2

>Q49B1C< *** DO NOT READ TO THE RESPONDENT ***

THE TOTAL ANNUAL EARNINGS ENTERED FROM ALL OTHER EMPLOYERS IS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q49B13

<2> No goto Q49B1 (TO CORRECT ENTRY)

>Q49B1V< According to my calculations (name/you) earned (total) dollars altogether from all other employers in 1994. Does that sound about right?

<1> Yes goto Q49B13

<2> No goto Q49B12

If 1, <D> or <R> put (total) amount in 49B1T

>Q49B12< What is your best estimate of (name's/your) correct total amount of earnings from all other employers during 1994?

PREVIOUS ENTRIES: Q48a: (amount)

Q48ap: (periodicity)

Q48a1: (number of pay periods)

Enter dollar amount $

Put this amount in 49B1T

If <D> or <R> put (total) from 49B1V in 49B1T

<D> or <R> goto Q49B2

>Q49B13< Does this amount include all tips, bonuses, overtime pay or commissions (name/you) may have received from all other employers in 1994?

<1> Yes goto Q49B2

<2> No goto Q49B1ad

<D> or <R> goto Q49B2

>Q49B1ad< How much did (name/you) earn in tips, bonuses, overtime pay or commissions from all other employers in 1994?

Enter dollar amount $ goto Q49B2

<D> or <R> goto Q49B2

Add this amount to 49B1T

>Q49B2< How much did (name/you) earn from (his/her/your) own business after expenses?

(IF RESPONSE IS "BROKE EVEN" THEN ENTER 1.)

FOR AMOUNTS $1,000,000 AND OVER, ENTER $999,999

<X> None <L> Lost money

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

FOR AMOUNTS $10,000 AND OVER, ENTER $9,999

===>$___,___ .00 ENTER ANNUAL AMOUNT LOST ONLY

>Q49B3< How much did (name/you) earn from (his/her/your) farm after expenses?

(IF RESPONSE IS "BROKE EVEN" THEN ENTER 1.)

FOR AMOUNTS $1,000,000 AND OVER, ENTER $999,999

<X> None <L> Lost money

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

FOR AMOUNTS $10,000 AND OVER, ENTER $9,999

===>$___,___ .00 ENTER ANNUAL AMOUNT LOST ONLY

>CHK50A< CHECK ITEM --*DO NOT READ*

IS THE LONGEST JOB ENTERED FOR THIS PERSON "FARMER"?

LONGEST JOB RECORDED FOR (name) IS:

WORKING FOR: (entry in Q47a)

BUSINESS: (entry in Q47b)

KIND OF WORK: (entry in Q47c)

DUTIES: (entry in Q47D1)

(entry in Q47D2)

<1> YES

<2> NO goto Q51A1

===>_

>Q50b< Other than the farm income we have already talked about, did (name/you) receive any income from agricultural work done for others, recreational services, or government farm programs other than loans?

AMOUNTS PREVIOUSLY ENTERED--

Q48B, LONGEST JOB: $(entry in Q48b/DOES NOT APPLY/REFUSED/DON'T KNOW/ Q48BLO -LOST)

Q49B3, OTHER FARM INCOME: $(entry in Q49b3/REFUSED/NONE/Q49B3 -LOST)

<1> Yes

<2> No goto Q51A1

===>_

>Q50b-add< ENTER ADDITIONAL AMOUNT OF FARM INCOME NOT PREVIOUSLY REPORTED

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q51A1< At any time during 1994 did (name/you) receive any State or Federal unemployment compensation?

<1> Yes goto Q51A1p

<2> No goto Q51A2

===>_

>Q51A1p< What is the easiest way for you to report (name's/your) State or Federal unemployment compensation; weekly, bi-weekly, twice monthly, monthly, or yearly?

<1> Weekly

<2> Every other week (bi-weekly)

<3> twice monthly

<4> Monthly

<5> Yearly

==>___

<D> or <R> goto Q51A2

>Q51A11< How much did (name\you) receive

(weekly/ bi-weekly/twice monthly/monthly/ ) in State or Federal unemployment compensation during 1994?

Enter dollar amount $ If <5> in Q51A1p enter amount in 51A1T and

goto Q51A1c1, else goto Q51A12

<D> or <R> goto Q51A2

>Q51A1C2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL STATE OR FEDERAL UNEMPLOYMENT COMPENSATION RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q51A2

<2> No goto Q51A11 (TO CORRECT ENTRY)

>Q51A12< How many (weekly/ bi-weekly/twice monthly/monthly) payments did (name/you) receive from State or Federal unemployment compensation during 1994?

<1-52>

<D> or <R> goto Q51A2

>Q51A13< According to my calculations (name/you) received (total) dollars altogether from State or Federal unemployment compensation during 1994. Does that sound about right?

<1> Yes goto Q51A2

<2> No goto Q51A14

If 1, <D> or <R> put (total) amount in 51A1T

<D> or <R> goto Q51A2

>Q51A14< What is your best estimate of the correct total amount (name/you) received from State or Federal unemployment compensation during 1994?

PREVIOUS ENTRIES: Q51A11: (amount)

Q51A1p: (periodicity)

Q51A12: (number of pay periods)

Enter dollar amount $ goto Q51A2

Put this amount in 51A1T

If <D> or <R> put (total) from 51A13 in 51A1T

<D> or <R> goto Q51A2

>Q51A2< At any time during 1994 did (name/you) receive any Supplemental Unemployment Benefits?

<1> Yes

<2> No goto Q51A3

===>_

>Q51A2p< What is the easiest way for you to report (name's/your) Supplemental Unemployment Benefits; weekly, bi-weekly, twice monthly, monthly, or yearly?

<1> Weekly

<2> Every other week (bi-weekly)

<3> twice monthly

<4> Monthly

<5> Yearly

==>___

<D> or <R> goto Q51A3

>Q51A21< How much did (name\you) receive

(weekly/ bi-weekly/twice monthly/monthly/ ) in Supplemental Unemployment Benefits during 1994?

Enter dollar amount $ If <5> in Q51A2p enter amount in 51A2T and

goto Q51A2C1, else goto Q51A22

<D> or <R> goto Q51A3

>Q51A2C2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL SUPPLEMENTAL UNEMPLOYMENT BENEFITS RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q51A3

<2> No goto Q51A21 (TO CORRECT ENTRY)

>Q51A22< How many (weekly/ bi-weekly/twice monthly/monthly) payments did (name/you) receive from Supplemental Unemployment Benefits during 1994?

<1-52>

<D> or <R> goto Q51A3

>Q51A23< According to my calculations (name/you) received (total) dollars altogether from Supplemental Unemployment Benefits during 1994. Does that sound about right?

<1> Yes goto Q51A3

<2> No goto Q51A24

If 1, <D> or <R> put (total) amount in 51A2T

<D> or <R> goto Q51A3

>Q51A24< What is your best estimate of the correct total amount (name/you) received from Supplemental Unemployment Benefits during 1994?

PREVIOUS ENTRIES: Q51A21: (amount)

Q51A2p: (periodicity)

Q51A22: (number of pay periods)

Enter dollar amount $ goto Q51A3

Put this amount in 51A2T

If <D> or <R> put (total) from 51A23 in 51A2T

<D> or <R> goto Q51A3

>Q51A3< At any time during 1994 did (name/you) receive any Union Unemployment or Strike Benefits?

<1> Yes goto Q51A3p

<2> No goto Q52a

===>_

>Q51A3p< What is the easiest way for you to report (name's/your) Union Unemployment or Strike Benefits; weekly, bi-weekly, twice monthly, monthly, or yearly?

<1> Weekly

<2> Every other week (bi-weekly)

<3> twice monthly

<4> Monthly

<5> Yearly

==>___

<D> or <R> goto Q52a

>Q51A31< How much did (name\you) receive (weekly/bi-weekly/twice monthly/monthly/ ) in Union Unemployment or Strike Benefits during 1994?

Enter dollar amount $ If <5> in Q51A3p enter amount in Q51A3T and

goto Q51A3C1, else goto Q51A32

<D> or <R> goto Q52a

>Q51A3C2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL UNION UNEMPLOYMENT OR STRIKE BENEFITS RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q52a

<2> No goto Q51A31 (TO CORRECT ENTRY)

>Q51A32< How many (weekly/bi-weekly/twice monthly/monthly) payments did (name/you) receive from Union Unemployment or Strike Benefits during 1994?

<1-52>

<D> or <R> goto Q52a

>Q51A33< According to my calculations (name/you) received (total) dollars altogether from Union Unemployment or Strike Benefits during 1994. Does that sound about right?

<1> Yes goto Q52a

<2> No goto Q51A34

If 1, <D> or <R> put (total) amount in 51A3T

<D> or <R> goto Q52a

>Q51A34< What is your best estimate of the correct total amount (name/you) received from Union Unemployment or Strike Benefits during 1994?

PREVIOUS ENTRIES: Q51A31: (amount)

Q51A3p: (periodicity)

Q51A32: (number of pay periods)

Enter dollar amount $ goto Q52a

Put this amount in 51A3T

If <D> or <R> put (total) from 51A33 in 51A3T

<D> or <R> goto Q52a

>Q52a< During 1994 did (name/you) receive any Worker's Compensation payments or other payments as a result of a job related injury or illness?

EXCLUDE SICK PAY AND DISABILITY RETIREMENT.

<1> Yes

<2> No goto Q29a for next person or Q56a

===>_

>Q52b< What was the source of these payments?

<1> State Worker's Compensation

<2> Employer or employer's insurance

<3> Own insurance

<4> Other

===>_

>Q52cp< What is the easiest way for you to report (name's/your) Worker's Compensation; weekly, bi-weekly, twice monthly, monthly, or yearly?

<1> Weekly

<2> Every other week (bi-weekly)

<3> twice monthly

<4> Monthly

<5> Yearly

==>___

<D> or <R> goto Q56a

>Q52c1< How much did (name\you) receive (weekly/bi-weekly/twice monthly/monthly/ ) in Worker's Compensation during 1994?

Enter dollar amount $ If <5> in Q52cp enter amount in 52cT and

goto Q52cC1, else goto Q52c2

<D> or <R> goto Q56a

>Q52cC2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL WORKER'S COMPENSATION RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q56a

<2> No goto Q52c1 (TO CORRECT ENTRY)

>Q52c2< How many (weekly/bi-weekly/twice monthly/monthly) payments did (name/you) receive from Worker's Compensation during 1994?

<1-52>

<D> or <R> goto Q56a

>Q52c3< Then (name/you) received (total) dollars altogether from Worker's Compensation during 1994. Does that sound about right?

<1> Yes goto Q56a

<2> No goto Q52c4

If 1, <D> or <R> put (total) amount in 52cT

<D> or <R> goto Q56a

Q52c4 What is your best estimate of the correct total amount (name/you) received from Worker's Compensation during 1994?

PREVIOUS ENTRIES: Q52c1: (amount)

Q52cp: (periodicity)

Q52c2: (number of pay periods)

Enter dollar amount $ goto Q56a

Put this amount in 52cT

If <D> or <R> put (total) from 52c3 in 52cT

<D> or <R> goto Q56a

>Q56a< During 1994 did (anyone in this household/you) receive any Social Security payments from the U.S. Government?

<1> Yes

<2> No goto Q56f

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q56b< **READ ONLY IF NECESSARY**

Who received Social Security payments either for themselves or as combined payments with other family members?

ENTER LINE NUMBER OF GUARDIAN FOR PAYMENTS MADE TO CHILDREN UNDER 15.

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q56dp< What is the easiest way for you to report (name's/your) Social Security payment; monthly, quarterly or yearly?

<1> monthly

<2> quarterly

<3> yearly

==>___ goto Q56d

<D> goto Q56d1

<R> goto Q56f

>Q56d< How much did (name/you) receive (monthly/quarterly/ ) in Social Security payments in 1994?

( \<A> already included) If A goto Q56f

Enter dollar amount $ goto Q56d2

<D> goto Q56d1

<R> goto Q56f

>Q56d1< What is the amount of the Social Security payment (name/you) received last month?

Enter dollar amount $

<D> or <R> goto Q56f

>Q56d2< For how many (months/quarters) did (name/you) receive Social Security in 1994?

goto Q56d3

<1-12>

<D> or <R> goto Q56f

>Q56d3< Is this (amount from Q56d/amount from Q56d1) before or after the (41.10/xx.xx) per month medicare deduction?

<1> After add the (41.10/xx.xx) per month

<2> Before

If 1, <D> or <R> add the (41.10/xx.xx)

>Q56d4< Was the cost of living increase the only change which occurred in monthly payments?

<1> Yes goto Q56d5

<2> No goto Q56d6

If 1, <D> or <R> goto Q56d5

>Q56dC2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL SOCIAL SECURITY RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q56f

<2> No goto Q56d (TO CORRECT ENTRY)

>Q56d5< According to my calculations (name/you) received (total) dollars altogether from Social Security in 1994. Does that sound about right?

<1> Yes goto Q56f

<2> No goto Q56d6

If 1, <D> or <R> put (total) amount in 56dT

<D> or <R> goto Q56f

>Q56d6< What is your best estimate of the correct amount (name\you) received in Social Security during 1994?

PREVIOUS ENTRIES: Q56d1: (amount)

Q56dp: (periodicity)

Q56d2: (number of pay periods)

Q56d3: (amount added per month)

Q56d4: (cost of living subtracted per month)

Enter dollar amount goto Q56f

Put this amount in 56dT

If <D> or <R> put (total) from 56d5 in 56dT, else

If <D> or <R> and no entry in 56d5, then enter D or R in 56dT

<D> or <R> goto Q56f

>Q56f< Did anyone in this household receive any separate Social Security payments which we have not talked about for the children in this household?

INCLUDES ALL CHILDREN UNDER 23 YEARS OF AGE

<1> Yes

<2> No goto Q57a

<H> (Help) Social Security income previously reported

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q56g< **READ ONLY IF NECESSARY**

Who received these Social Security payments?

ENTER LINE NUMBER OF GUARDIAN

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

<H> (Help) Social Security income previously reported

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q56ip< What is the easiest way for you to report (name's/your) Social Security payment for children in this household; monthly, quarterly or yearly?

<1> monthly

<2> quarterly

<3> yearly

==>___ goto Q56i

<D> goto Q56i1

<R> goto Q57a

>Q56i< How much did (name/you) receive (monthly/quarterly/ ) in Social Security payments for children in this household in 1994?

( \<A> already included) If A goto Q57a

Enter dollar amount $ goto Q56i2

<D> goto Q56i1

<R> goto Q57a

>Q56i1< What is the amount of the Social Security payment (name/you) received for children in this household last month?

Enter dollar amount $

<D> or <R> goto Q57a

>Q56i2< For how many (months/quarters) did (name/you) receive Social Security in 1994?

<1-12>

If amount in Q56i1 goto Q56i3, else

If Q56ip = 1 or 2 and amount in Q56k and Q56i2 goto Q56i4, else

If Q56ip = 2, then limit = 4

<D> or <R> goto Q57a

>Q56i3< Was the cost of living increase the only change which occurred in monthly payments for children in this household?

<1> Yes goto Q56i4

<2> No goto Q56i5

If 1, <D> or <R> goto 56i4

>Q56iC2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL SOCIAL SECURITY RECEIVED FOR CHILDREN IN THIS HOUSEHOLD IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q57a

<2> No goto Q56i (TO CORRECT ENTRY)

>Q56i4< According to my calculations (name/you) received (total) dollars altogether for children in this household from Social Security in 1994? Does that sound about right?

<1> Yes goto Q57a

<2> No goto Q56i5

If 1, <D> or <R> put (total) amount in 56iT

<D> or <R> goto Q57a

>Q56i5< What is your best estimate of the correct amount (name\you) received in Social Security for children in this household during 1994?

PREVIOUS ENTRIES: Q56i1: (amount)

Q56ip: (periodicity)

Q56i2: (number of pay periods)

Q56i3: (cost of living subtracted per month)

Enter dollar amount goto Q57a

Put this amount in 56iT

If <D> or <R> put (total) from 56i4 in 56iT

If <D> or <R> and no entry in 56i4, then enter D or R in 56iT

<D> or <R> goto Q57a

>Q57a< During 1994 did (anyone in this household receive:/you receive:)

Any SSI payments, that is, Supplemental Security Income?

NOTE: SSI ARE ASSISTANCE PAYMENTS TO LOW-INCOME AGED, BLIND AND DISABLED PERSONS AND COME FROM STATE OR LOCAL WELFARE OFFICES, THE FEDERAL GOVERNMENT, OR BOTH.

<1> Yes

<2> No goto Q59A88

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q57b< **READ ONLY IF NECESSARY**

Who received SSI? SUPPLEMENTAL SECURITY INCOME

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q57cp< What is the easiest way for you to report (name's/your) Supplemental Security Income payment; monthly, quarterly or yearly?

<1> monthly

<2> quarterly

<3> yearly

==>___ goto Q57c

<D> goto Q57c1

<R> goto Q59A88

>Q57c< How much did (name/you) receive (monthly/quarterly/ ) in Supplemental Security Income payments in 1994?

Enter dollar amount $ goto Q57c2

<D> goto Q57c1

<R> goto Q59A88

If <3> in Q57cp and amount in Q57c goto Q57cC1

If <1> or <2> in Q57cp and amount in Q57c goto Q57c2

>Q57c1< What is the amount of the Supplemental Security Income payment (name/you) received last month?

Enter dollar amount $

<D> or <R> goto Q59A88

>Q57c2< For how many (months/quarters) did (name/you) receive Supplemental Security Income in 1994?

<1-12>

<D> or <R> goto Q59A88

If amount in Q57c1 goto Q57c3

If Q57cp = 1 or 2, and amount in Q57c, then goto Q57c4

>Q57c3< Was the cost of living increase the only change which occurred in monthly payments?

<1> Yes goto Q57c4

<2> No goto Q57c5

<D> or <R> goto Q57c4

>Q57cC2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL SUPPLEMENTAL SECURITY INCOME RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q59A88

<2> No goto Q57c (TO CORRECT ENTRY)

>Q57c4< According to my calculations (name/you) received (total) dollars altogether from Supplemental Security Income in 1994? Does that sound about right?

<1> Yes goto Q59A88

<2> No goto Q57c5

If 1, <D> or <R> put (total) amount in 57cT

<D> or <R> goto Q59A88

>Q57c5< What is your best estimate of the correct amount (name\you) received in Supplemental Security Income during 1994?

PREVIOUS ENTRIES: Q56d1: (amount)

Q57cp: (periodicity)

Q57c2: (number of pay periods)

Q57c3: (amount subtracted per month)

Enter dollar amount goto Q59A88

Put this amount in 57cT

If <D> or <R> put (total) from 57c4 in 57cT

If <D> or <R> and no entry in 57c4, then enter d or R in 57cT

<D> or <R> goto Q59A88

>Q59A88< At any time during 1994, even for one month, did (anyone in this household/you) receive any public assistance or welfare payments from the state or local welfare office?

INCLUDE SUCH PAYMENTS AS AID TO FAMILIES WITH DEPENDENT CHILDREN, AID TO DEPENDENT CHILDREN, GENERAL ASSISTANCE PROGRAM, EMERGENCY ASSISTANCE, CUBAN/HAITIAN REFUGEE, OR INDIAN ASSISTANCE.

DO NOT INCLUDE FOOD STAMPS OR SSI PAYMENTS.

<1> Yes

<2> No goto Q60A88

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q59b-88< Who received these payments?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q59C88< Did (name/you) receive Aid to Families With Dependent Children (AFDC)/Aid to Dependent Children (ADC) or some other type of assistance payments?

<1> Aid to Families With Dependent Children (AFDC)/Aid to Dependent Children (ADC)

<2> Other Assistance

<3> Both

===>_

>Q59ep< What is the easiest way for you to report (name's/your) Public Assistance or Welfare Payments; weekly, bi-weekly, twice monthly, monthly or yearly?

<1> Weekly

<2> Every other week (bi-weekly)

<3> Twice monthly

<4> Monthly

<5> Yearly

==>___ goto Q59e

<D> or <R> goto Q60A88

>Q59e< How much did (name/you) receive

(weekly/bi-weekly/twice monthly/monthly/ ) in Public Assistance or Welfare Payments in 1994?

Enter dollar amount $ If Q59ep is <5> enter amount in 59eT and

goto 59eC1, else goto Q59e2

<D> or <R> goto Q60A88

>Q59e2< How many (weekly/bi-weekly/twice monthly/monthly) payments did (name/you) receive from Public Assistance or Welfare Payments in 1994?

goto Q59e3

<1-52>

<D> or <R> goto Q60A88

>Q59eC2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL PUBLIC ASSISTANCE OR WELFARE PAYMENTS RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q60A88

<2> No goto Q59e (TO CORRECT ENTRY)

>Q59e3< According to my calculations (name/you) received (total) dollars altogether from Public Assistance or Welfare Payments in 1994? Does that sound about right?

<1> Yes goto Q60A88

<2> No goto Q59e4

If 1, D or R put (total) amount in 59eT

<D> or <R> goto Q60A88

>Q59e4< What is your best estimate of the correct amount (name\you) received in Public Assistance or Welfare Payments during 1994?

PREVIOUS ENTRIES: Q59e: (amount)

Q59ep: (periodicity)

Q59e2: (number of pay periods)

Enter dollar amount goto Q60A88

Put this amount in 59eT

If <D> or <R> put (total) from 59e3 in 59eT

<D> or <R> goto Q60A88

>Q60A88< At any time during 1994 did (anyone in this household receive:/you receive:) Any Veterans' (VA) payments?

<1> Yes

<2> No goto Q58a

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q60b-88< **READ ONLY IF NECESSARY**

Who received Veterans' (VA) payments?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q60c-88< What type of Veterans' payments did (name/you) receive?

<1> Service-connected disability compensation

<2> Survivor Benefits

<3> Veterans' pension

<4> Educational assistance

<5> Other Veterans' payments

<N> No more

PROBE: Anything else?

===>__ ===>__ ===>__ ===>__ ===>__

>Q60D88< (Are/Is) (name/you) required to fill out an annual income questionnaire for

the Department of Veterans' Affairs?

<1> Yes

<2> No

===>_

>Q60e-88< How much did (you/he/she) receive in Veterans' (VA) payments during 1994?

INCLUDE ENTIRE AMOUNT RECEIVED FROM ALL SOURCES.

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

(blank/<C> Calculate total from all sources)

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q60e-88cal< ENTER PAYMENT RECEIVED FROM EACH SOURCE.

(SOURCES RECEIVED ARE: (answers to Q60c-88)

(blank/**ENTER N FOR ALL OTHER SOURCES**)

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

<X> None

Service-connected disability ===>$__,___ ENTER ANNUAL AMOUNT ONLY

Survivor Benefits ===>$__,___ ENTER ANNUAL AMOUNT ONLY

Veterans' pension ===>$__,___ ENTER ANNUAL AMOUNT ONLY

Educational assistance ===>$__,___ ENTER ANNUAL AMOUNT ONLY

Other ===>$__,___ ENTER ANNUAL AMOUNT ONLY

>Q58a< Did (you/anyone in this household) receive any survivor benefits in 1994 such as widow's pensions, estates, trusts, annuities, or any other survivor benefits, (other than Social Security/other than VA benefits/other than Social Security or VA benefits)?

<1> Yes

<2> No goto Q59a

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q58b< **ASK ONLY IF NECESSARY**

Who received this income?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q58c< What was the source of this income?

ASKING ABOUT: (name) (blank/--CURRENT RESPONDENT)

<2> Company or union survivor pension (INCLUDE PROFIT SHARING)

<3> Federal Government (CIVIL SERVICE) pension

<4> U.S. Military retirement survivor pension

<5> State or Local government survivor pension

<6> U.S. Railroad retirement survivor pension

<7> Worker's compensation survivor pension

<8> Black Lung survivor pension

<9> Regular payments from estates or trusts

<10> Regular payments from annuities or paid-up insurance policies

<11> Other or don't know (SPECIFY) --ENTER LAST

PROBE: Any other source?

<N> No more

===>__ ===>__ ===>__ ===>__ ===>__

>Q58Coth< SPECIFY OTHER SOURCE OF INCOME AS SURVIVOR OR WIDOW

ENTER "SURVIVOR BENEFITS" IF THE ANSWER IS "DON'T KNOW"

===>_____________________________________________________________

>Q58E1< How much did (name/you) receive in...

(1st answer to Q58c) during 1994?

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

Enter <X> for None.

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q58E2< ...(2nd answer to Q58c)

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

Enter <X> for None.

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q58E3< ...(3rd answer to Q58c)

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

Enter <X> for None.

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q58E4< ...(4th answer to Q58c)

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

Enter <X> for None.

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q59a< (Do you/Does anyone in this household) have a health problem or disability which prevents (you/them) from working or which limits the kind or amount of work (you/they) can do?

<1> Yes

<2> No goto Q60a

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q59b< **ASK ONLY IF NECESSARY**

Who is that?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q60a< (Did you/Is there anyone in this household who) ever (retire or leave/retired or left) a job for health reasons?

<1> Yes

<2> No goto Q62a

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q60b< **ASK ONLY IF NECESSARY**

Who is that?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q61b< Did (name/you) receive any income in 1994 as a result of (your/his/her) health problem, (other than Social Security/other than VA benefits/other than Social Security or VA benefits)?

(blank/IF AMOUNT WAS REPORTED PREVIOUSLY AS COMPENSATION FROM A JOB)

(blank/RELATED INJURY OR ILLNESS, THEN ENTER PRECODE 2.)

(blank/AMOUNT PREVIOUSLY REPORTED IN (Q52cT) WAS: $(amount))

<1> Yes

<2> No

===>_

>Q61c< What was the source of this income?

ASKING ABOUT: (name) (blank/--CURRENT RESPONDENT)

PROBE: Any other income related to this health condition or disability?

(blank/<2> Worker's compensation)

<3> Company or union disability

<4> Federal Government (CIVIL SERVICE) disability

<5> U.S. Military retirement disability

<6> State or Local government employee disability

<7> U.S. Railroad retirement disability

<8> Accident or disability insurance

<9> Black Lung miner's disability

<10> State temporary sickness

<11> Other or don't know - SPECIFY - ENTER LAST

<N> NO OTHER SOURCES OF INCOME

===>__ ===>__ ===>__ ===>__ ===>__

>Q61c-oth< SPECIFY OTHER SOURCE OF INCOME FROM HEALTH PROBLEM OR DISABILITY

ENTER "OTHER HEALTH PROBLEM/DISABILITY" IF THE ANSWER IS "DON'T KNOW"

===>______________________________________________________

>Q61E1< How much did (name/you) receive from...

(1st answer to Q61c) during 1994?

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q61E2< ...(2nd answer to Q61c)

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q61E3< ...(3rd answer to Q61c)

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q61E4< ...(4th answer to Q61c)

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q62a< During 1994, did (you/anyone in this household) receive any pension or retirement income from a previous employer or union, or any other type of retirement income (other than Social Security/other than VA benefits/ other than Social Security or VA benefits)?

<1> Yes

<2> No goto Q63A1

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q62b< **ASK ONLY IF NECESSARY**

Who received pension or retirement income?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q62c< What was the source of this income?

ASKING ABOUT: (name) (blank/--CURRENT RESPONDENT)

<1> Company or union pension (INCLUDE PROFIT SHARING)

<2> Federal Government (CIVIL SERVICE) retirement

<3> U.S. Military retirement

<4> State or Local government pension

<5> U.S. Railroad Retirement

<6> Regular payments from annuities or paid up insurance policies

<7> Regular payments from IRA, KEOGH or 401(k) accounts

<8> Other sources or don't know -- SPECIFY -- ENTER LAST

PROBE: Any other pension or retirement income?

<N> NO OTHER SOURCES OF INCOME

===>_ ===>_ ===>_ ===>_

>Q62c-oth< ENTER OTHER SOURCE OF PENSION OR RETIREMENT INCOME

ENTER "OTHER PENSION OR RETIREMENT" IF THE ANSWER IS "DON'T KNOW"

===>__________________________________________________________

>Q62E1p< What is the easiest way for you to report (name's/your) (first fill from 62c or 62c-oth) payments; weekly, bi-weekly, twice monthly, monthly or yearly?

<1> Weekly

<2> Every other week (bi-weekly)

<3> Twice monthly

<4> Monthly

<5> Yearly

==>___ goto Q56E1

<D> or <R> goto Q62E2p if other precode in Q62c or 62c-oth, else

goto Q63A1

>Q62E1< How much did (name/you) receive (weekly/bi-weekly/twice monthly/monthly/ ) before deductions in (first fill from 62c or 62c-oth) payments in 1994?

Enter dollar amount $ If Q62E1p is <5> enter amount in 62E1T and

goto 62E1C1, else goto Q62E12

<D> or <R> goto Q62E2p if other precode in Q62c or 62c-oth, else

goto Q63A1

>Q62E12< How many (weekly/bi-weekly/twice monthly/monthly) payments did (name/you) receive in (first fill from 62c or 62c-oth) payments in 1994?

goto Q62E13

<1-52>

<D> or <R> goto Q62E2p if other precode in Q62c or 62c-oth,

else goto Q63A1

>Q62E1C2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (FIRST FILL FROM 62c OR 62c-oth) PAYMENTS RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes go to Q62E2p if other precode in Q62c or 62c-oth,

else goto Q63A1

<2> No goto Q62E1 (TO CORRECT ENTRY)

>Q62E13< According to my calculations (name/you) received (total) dollars altogether from (first fill from 62c or 62c-oth) payments in 1994? Does that sound about right?

<1> Yes goto Q62E2p if other precode in Q62c or 62c-oth,

else goto Q63A1

<2> No goto Q62E14

If 1, <D> or <R> put (total) amount in 62E1T

<D> or <R> goto Q62E2p if other precode in Q62c or 62c-oth,

else goto Q63A1

>Q62E14< What is your best estimate of the correct amount (name\you) received from (first fill from 62c or 62c-oth) payments during 1994?

PREVIOUS ENTRIES: Q62E1: (amount)

Q62E1p: (periodicity)

Q62E12: (number of pay periods)

Enter dollar amount goto Q62E2p if other precode in Q62c or 62c-oth,

else goto Q63A1

Put this amount in 62E1T

If <D> or <R> put (total) from 62E13 in 62E1T

<D> or <R> goto Q62E2p if other precode in Q62c or 62c-oth,

else goto Q63A1

>Q62E2p< What is the easiest way for you to report (name's/your) (second fill from 62c or 62c-oth) payments; weekly, bi-weekly, twice monthly, monthly or yearly?

<1> Weekly

<2> Every other week (bi-weekly)

<3> Twice monthly

<4> Monthly

<5> Yearly

==>___ goto Q62E2

<D> or <R> goto Q62E3p if other precode in Q62c or 62c-oth,

else goto Q63A1

>Q62E2< How much did (name/you) receive (weekly/bi-weekly/twice monthly/monthly/ )

in (second fill from 62c or 62c-oth) payments in 1994?

Enter dollar amount $ If Q62E2p is <5> enter amount in 62E2T and

goto 62E2C1, else goto Q62E22

<D> or <R> goto Q62E3p if other precode in Q62c or 62c-oth,

else goto Q63A1

>Q62E22< How many (weekly/bi-weekly/twice monthly/monthly) payments did (name/you) receive in (second fill from 62c or 62c-oth) payments in 1994?

goto Q62E23

<1-52>

<D> or <R> goto Q62E3p if other precode in Q62c or 62c-oth,

else goto Q63A1

>Q62E2C2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (SECOND FILL FROM 62c OR 62c-oth) PAYMENTS RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q62E3p if other precode in Q62c or 62c-oth,

else goto Q63A1

<2> No goto Q62E2 (TO CORRECT ENTRY)

>Q62E23< According to my calculations (name/you) received (total) dollars altogether from (second fill from 62c or 62c-oth) payments in 1994? Does that sound about right?

<1> Yes goto Q62E3p if other precode in Q62c or 62c-oth,

else goto Q63A1

<2> No goto Q62E24

If 1, <D> or <R> put (total) amount in 62E2T

<D> or <R> goto Q62E3p if other precode in Q62c or 62c-oth,

else goto Q63A1

>Q62E24< What is your best estimate of the correct amount (name\you) received from (second fill from 62c or 62c-oth) payments during 1994?

PREVIOUS ENTRIES: Q62E2: (amount)

Q62E2p: (periodicity)

Q62E22: (number of pay periods)

Enter dollar amount goto Q62E3p if other precode in Q62c or 62c-oth,

else goto Q63A1

Put this amount in 62E2T

If <D> or <R> put (total) from 62E13 in 62E2T

<D> or <R> goto Q62E3p if other precode in Q62c or 62c-oth,

else goto Q63A1

>Q62E3p< What is the easiest way for you to report (name's/your) (third fill from 62c or 62c-oth) payments; weekly, bi-weekly, twice monthly, monthly or yearly?

<1> Weekly

<2> Every other week (bi-weekly)

<3> Twice monthly

<4> Monthly

<5> Yearly

==>___ goto Q62E3

<D> or <R> goto Q63A1

>Q62E3< How much did (name/you) receive (weekly/bi-weekly/twice monthly/monthly/ )

in (third fill from 62c or 62c-oth) payments in 1994?

Enter dollar amount $ If Q62E3p is <5> enter amount in 62E3T and

goto 62E3C1, else goto Q62E32

<D> or <R> goto Q63A1

>Q62E32< How many (weekly/bi-weekly/twice monthly/monthly) payments did (name/you) receive in (third fill from 62c or 62c-oth) payments in 1994?

goto Q62E33

<1-52>

<D> or <R> goto Q63A1

>Q62E3C2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (THIRD FILL FROM 62c OR 62c-oth) PAYMENTS RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q63A1

<2> No goto Q62E3 (TO CORRECT ENTRY)

>Q62E33< According to my calculations (name/you) received (total) dollars altogether from (third fill from 62c or 62c-oth) payments in 1994? Does that sound about right?

<1> Yes goto Q63A1

<2> No goto Q62E34

If 1, <D> or <R> put (total) amount in 62E3T

<D> or <R> goto Q63A1

>Q62E34< What is your best estimate of the correct amount (name\you) received from (third fill from 62c or 62c-oth) payments during 1994?

PREVIOUS ENTRIES: Q62E1: (amount)

Q62E1p: (periodicity)

Q62E12: (number of pay periods)

Enter dollar amount goto Q63A1

Put this amount in 62E3T

If <D> or <R> put (total) from 62E33 in 62E3T

<D> or <R> goto Q63A1

>Q63A1< At anytime during 1994 did (you/anyone in this household):

Have money in any kind of savings account or money market fund?

<1> Yes

<2> No goto Q63A2

===>_

>Q63A2< Have any bonds, treasury notes, IRA's, or certificates of deposit?

<1> Yes

<2> No goto Q63A3

===>_

>Q63A3< Have an interest earning checking account or any other investments which pay interest?

<1> Yes

<2> No

===>_ goto Q64a

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q63b< **ASK ONLY IF NECESSARY**

Which members of this household ages 15 and over had (savings accounts or money market funds/bonds, treasury notes, or certificates of deposit/investments which pay interest)?

INCLUDE EACH IN CASES OF JOINT ACCOUNTS OR OWNERSHIP

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q63c< How much did (name/you) receive in interest from these sources during 1994, including even small amounts reinvested or credited to accounts?

SEPARATE AMOUNTS FOR JOINT ACCOUNTS

USE THE "ALREADY INCLUDED" PRECODE IF THE RESPONDENT CANNOT SEPARATE AMOUNTS FOR JOINT ACCOUNTS AND YOU PREVIOUSLY RECORDED THE INTEREST

DO NOT INCLUDE INTEREST EARNED FROM SERIES E, F, AND J U.S. SAVINGS BONDS WHICH WERE NOT CASHED DURING 1994.

(blank/<A> Already included)

<C> Calculate total using sources

<X> None

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q63c-calc< ENTER PAYMENT RECEIVED FROM EACH SOURCE.

<X> None

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

Savings accounts or money market funds ===>$___,___ ENTER ANNUAL AMOUNT ONLY

Bonds, treasury notes, IRA, or CD ===>$___,___ ENTER ANNUAL AMOUNT ONLY

Interest earning checking account or Other ===>$___,___ ENTER ANNUAL AMOUNT ONLY

>Q64a< (blank/At any time during 1994 did (anyone in this household ages 15 and over/you))

Own any shares of stock in corporations (PAUSE) or any mutual fund shares?

<1> Yes

<2> No goto Q65A1

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q64b< **ASK ONLY IF NECESSARY**

Which members of this household?

INCLUDE EACH PERSON IN CASE OF JOINT OWNERSHIP

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q64c< How much did (name/you) receive in dividends from stocks (mutual funds) during 1994?

SEPARATE AMOUNTS FOR JOINT OWNERSHIP

(blank/<A> Already included)

<X> None

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q65A1< During 1994 did (you/anyone in this household):

Own any land, business property, apartments, or houses which were rented to others?

<1> Yes

<2> No

===>_

>Q65A2< Receive income from royalties or from roomers or boarders? (exclude amounts paid by relatives)

<1> Yes

<2> No

===>_

>Q65A3< Receive income from estates or trusts? (exclude estates or trusts already reported)

<1> Yes

<2> No

===>_

Check Item: If No in Q65A1, Q65A2 and Q65A3 goto Q66a, else goto Q65b

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q65b< **ASK ONLY IF NECESSARY**

Who received this (income/rent)?

INCLUDE EACH IN CASES OF JOINT OWNERSHIP FOR SELF-EMPLOYED PERSONS, DETERMINE IF INCOME WAS ALREADY INCLUDED

SE LN NAME SE LN NAME

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

<H> (Help) Self-employed income previously reported

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q65c< How much did (name/you) receive in income from rent (blank/, roomers or boarders, estates, trusts, or royalties/, roomers or boarders, or royalties/, estates or trusts) AFTER EXPENSES for 1994?

IF RESPONSE IS "BROKE EVEN" THEN ENTER 1.

SEPARATE AMOUNTS FOR JOINT OWNERSHIP

(blank/<A> Already included)

<L> Lost money

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q65CLO< ENTER AMOUNT OF MONEY LOST IN 1994.

FOR AMOUNTS $10,000 AND OVER, ENTER $9,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q66a< During 1994 did (you/anyone in this household) attend school beyond the high school level including a college, university, or other schools? (include vocational, business, or trade schools)

<1> Yes

<2> No goto Q70a

===>_

>Q66b< Did (you/anyone in this household) receive any educational assistance for tuition, fees, books, or living expenses during 1994?

EXCLUDE LOANS, ASSISTANCE FROM HOUSEHOLD MEMBERS, AND VA EDUCATIONAL BENEFITS

<1> Yes

<2> No goto Q70a

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q66c< **ASK ONLY IF NECESSARY**

Which member received assistance?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q66d< What type of assistance did (name/you) receive?

EXCLUDE ASSISTANCE FROM HOUSEHOLD MEMBERS

<2> Pell Grant

<3> Some other government assistance

<4> Scholarships, grants, etc.

<5> Other assistance (employers, friends, etc.)

PROBE: Any other assistance?

<N> No other assistance

===>_ ===>_ ===>_ ===>_

>Q69F88< How much did (name/you) receive in Pell Grants during 1994?

FOR AMOUNTS $50,000 AND OVER, ENTER $49,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q66h< (blank/Aside from the Pell Grant assistance,) (How/how) much did (name/you) receive in ( /other) educational assistance during 1994?

FOR AMOUNTS $50,000 AND OVER, ENTER $49,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q70a< During 1994 did (anyone in this household/you) receive:

Any child support payments?

<1> Yes

<2> No goto Q71a

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q70b< **ASK ONLY IF NECESSARY**

Who received these payments?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q70cp< What is the easiest way for you to report (name's/your) child support payments; weekly, bi-weekly, twice monthly, monthly or yearly?

<1> Weekly

<2> Every other week (bi-weekly)

<3> Twice monthly

<4> Monthly

<5> Yearly

==>__ goto Q70c

<D> or <R> goto Q71a

>Q70c< How much did (name/you) receive

(weekly/bi-weekly/twice monthly/monthly/ )

in child support payments in 1994?

Enter dollar amount $ If Q70cp is <5> enter amount in 70cT and

goto 70cC1, else goto Q70c2

<D> or <R> goto Q71a

>Q70c2< How many (weekly/bi-weekly/twice monthly/monthly) child support payments did (name/you) receive in 1994?

goto Q70c3

<1-52>

<D> or <R> goto Q71a

>Q70cC2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL CHILD SUPPORT PAYMENTS RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q71a

<2> No goto Q70c (TO CORRECT ENTRY)

>Q70c3< According to my calculations (name/you) received (total) dollars altogether from child support payments in 1994? Does that sound about right?

<1> Yes goto Q71a

<2> No goto Q70c4

If 1, <D> or <R> put (total) amount in 70cT

<D> or <R> goto Q71a

>Q70c4< What is your best estimate of the correct amount (name\you) received from child support payments during 1994?

PREVIOUS ENTRIES: Q70c: (amount)

Q70cp: (periodicity)

Q70c2: (number of pay periods)

Enter dollar amount goto Q71a

Put this amount in 70cT

If <D> or <R> put (total) from 70c3 in 70cT

<D> or <R> goto Q71a

>Q71a< (blank/During 1994 did (anyone in this household receive:/you receive:)

Any alimony payments?

<1> Yes

<2> No goto Q72a

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q71b< **ASK ONLY IF NECESSARY**

Who received these payments during 1994?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q71cp< What is the easiest way for you to report (name's/your) alimony payments; weekly,

bi-weekly, twice monthly, monthly or yearly?

<1> Weekly

<2> Every other week (bi-weekly)

<3> Twice monthly

<4> Monthly

<5> Yearly

==>__ goto Q71c

<D> or <R> goto Q72a

>Q71c< How much did (name/you) receive

(weekly/bi-weekly/twice monthly/monthly/ )

in alimony payments in 1994?

Enter dollar amount $ If Q71cp is <5> enter amount in 71cT and

goto 71cC1, else goto Q71c2

<D> or <R> goto Q72a

>Q71c2< How many (weekly/bi-weekly/twice monthly/monthly) alimony payments did (name/you) receive in 1994?

goto Q71c3

<1-52>

<D> or <R> goto Q72a

>Q71cC2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL ALIMONY PAYMENTS RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q72a

<2> No goto Q71c (TO CORRECT ENTRY)

>Q71c3< According to my calculations (name/you) received (total) dollars altogether from alimony payments in 1994? Does that sound about right?

<1> Yes

<2> No goto Q71c4

If 1, <D> or <R> put (total) amount in 71cT

<D> or <R> goto Q72a

>Q71c4< What is your best estimate of the correct amount (name\you) received from alimony payments during 1994?

PREVIOUS ENTRIES: Q71c: (amount)

Q71cp: (periodicity)

Q71c2: (number of pay periods)

Enter dollar amount goto Q72a

Put this amount in 71cT

If <D> or <R> put (total) from 71c3 in 71cT

<D> or <R> goto Q72a

>Q72a< (blank/During 1994 did (anyone in this household receive:/you receive:)

(Any other/Any) regular financial assistance from friends or relatives not living in this household?

DO NOT INCLUDE LOANS

<1> Yes

<2> No goto Q73A1

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q72b< **ASK ONLY IF NECESSARY**

Who received this assistance?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q72cp< What is the easiest way for you to report (name's/your) regular financial assistance; weekly, bi-weekly, twice monthly, monthly or yearly?

<1> Weekly

<2> Every other week (bi-weekly)

<3> Twice monthly

<4> Monthly

<5> Yearly

==>___ goto Q72c

<D> or <R> goto Q73A1

>Q72c< How much did (name/you) receive

(weekly/bi-weekly/twice monthly/monthly/ )

in regular financial assistance in 1994?

Enter dollar amount $ If Q72cp is <5> enter amount in 72cT and

goto 72cC1, else goto Q72c2

<D> or <R> goto Q73A1

>Q72c2< How many (weekly/bi-weekly/twice monthly/monthly) payments did (name/you) receive in regular financial assistance in 1994?

goto Q72c3

<1-52>

<D> or <R> goto Q73A1

>Q72cC2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL REGULAR FINANCIAL ASSISTANCE PAYMENTS RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q73A1

<2> No goto Q72c (TO CORRECT ENTRY)

>Q72c3< According to my calculations (name/you) received (total) dollars altogether from regular financial assistance in 1994? Does that sound about right?

<1> Yes goto Q73A1

<2> No goto Q72c4

If 1, <D> or <R> put (total) amount in 72cT

<D> or <R> goto Q73A1

>Q72c4< What is your best estimate of the correct amount (name\you) received from regular financial assistance during 1994?

PREVIOUS ENTRIES: Q72c: (amount)

Q72cp: (periodicity)

Q72c2: (number of pay periods)

Enter dollar amount goto Q73A1

If this amount in 72cT

If <D> or <R> put (total) from 72c3 in 72cT

<D> or <R> goto Q73A1

>Q73A1< Sometimes people forget about small amounts of income, or income received for only part of the year.

During 1994, did (anyone in this household/you) receive income from:

Hobbies, home businesses, farms, or business interests not already covered?

<1> Yes

<2> No goto SHI1

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q73A1b< **ASK ONLY IF NECESSARY**

Who received this income?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q73A1c< What was the source of this income?

SPECIFY ASKING ABOUT: (name/name--CURRENT RESPONDENT)

===>______________________________________________________

>Q73A1d< How much did (name/you) receive altogether in 1994?

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>Q73A2< During 1994, did (anyone in this household/you) receive income from:

Any unemployment compensation, severance pay, welfare, foster child care payments, or any other money income not already covered?

<1> Yes

<2> No

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>Q73A2b< **ASK ONLY IF NECESSARY**

Who received this income?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>Q73A2c< What was the source of this income?

SPECIFY ASKING ABOUT: (name/name--CURRENT RESPONDENT)

===>______________________________________________________

>Q73A2d< How much did (name/you) receive altogether in 1994?

FOR AMOUNTS $100,000 AND OVER, ENTER $99,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>SHI1< These next questions are about health insurance coverage during the calendar year 1994. The questions apply to ALL persons of ALL ages.

ENTER TO PROCEED

===>_

>SHI2< At any time in 1994, (were you/was anyone in this household) covered by a health plan provided through (their/your) current or former employer or union? (EXCLUDE MILITARY HEALTH INSURANCE)

<1> Yes

<2> No goto SHI7

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>SHI3< Who in this household were policyholders?

PROBE: Anyone else? ENTER <N> FOR NO MORE

R LN NAME R LN NAME

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>SHI4< In addition to (you/name), who else in this household was covered by (name's/your) plan?

PROBE: Anyone else? ENTER <X> FOR NONE

ENTER <N> FOR NO MORE

R LN NAME R LN NAME

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>SHI5< Did (name's/your) plan cover anyone living outside this household?

<1> Yes

<2> No

===>_

>SHI6< Did (name's/your) former or current employer or union pay for all, part, or none of the health insurance premium?

(NOTE: REPORT HERE EMPLOYER'S CONTRIBUTION TO EMPLOYEE'S HEALTH INSURANCE PREMIUMS, NOT THE EMPLOYEE'S MEDICAL BILLS.)

<1> All

<2> Part

<3> None

===>_

>SHI7< At anytime during 1994, (were you/was anyone in this household) covered by a plan that (you/they) PURCHASED DIRECTLY, that is, not related to current or past employer?

<1> Yes

<2> No SHI11

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>SHI8< Who in this household were policyholders?

PROBE: Anyone else? ENTER <N> FOR NO MORE

R LN NAME R LN NAME

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>SHI9< In addition to (you/name), who else in this household was covered by (name's/your) plan?

PROBE: Anyone else? ENTER <X> FOR NONE

ENTER <N> FOR NO MORE

R LN NAME R LN NAME

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>SHI10< Did (name/you) plan cover anyone living outside this household?

<1> Yes

<2> No

===>_

>SHI11< At any time in 1994, (were you/was anyone in this household) covered by the health plan of someone who does not live in this household?

<1> Yes

<2> No goto SHI15

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>SHI12< Who was that?

PROBE: Anyone else? ENTER <N> FOR NO MORE

R LN NAME R LN NAME

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>SHI13< At any time in 1994, (were you/was anyone in this household) covered by Medicare, the health insurance for persons 65 years old and over or persons with disabilities?

<1> Yes

<2> No

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>SHI14< Who was that?

PROBE: Anyone else? ENTER <N> FOR NO MORE

R LN NAME R LN NAME

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>SHI15< At any time in 1994, (were you/was anyone in this household) covered by Medicaid/(fill state name), the government assistance program that pays for health care?

<1> Yes

<2> No goto SHI18

===>_

State fills for item SHI15:

MED-CAL: California

WELFARE: Oregon

MEDI-KAN: Kansas

MEDICAL ASSISTANCE:

Alaska Kentucky Oklahoma

Arkansas Louisiana Pennsylvania

Colorado Maine Rhode Island

Delaware Maryland South Carolina

District of Columbia Massachusetts Texas

Georgia Michigan Virginia

Hawaii Minnesota Washington

Idaho New Jersey Wisconsin

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>SHI16< Who was that?

PROBE: Anyone else? ENTER <N> FOR NO MORE

R LN NAME R LN NAME

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>SHI17< How many months during 1994, (were/was) (name/you) covered by Medicaid/(local name)?

ENTER NUMBER OR MONTHS

===>__

(1-12)

>SHI18< At any time in 1994, (were you/was anyone in this household) covered by CHAMPUS, CHAMP-VA, VA or military health care, or by any other kind of health insurance?

NOTE: "CHAMP-VA" IS THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERAN'S AFFAIRS.

<1> Yes

<2> No goto SHIC1

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>SHI19< Who was that?

PROBE: Anyone else? ENTER <N> FOR NO MORE

R LN NAME R LN NAME

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>SHI20a< What plan (were/was) (name/you) covered by?

<1> CHAMPUS or military health care

<2> CHAMP-VA

<3> VA

<4> Indian Health Service

<5> Other

===>_

>SHIC1< Other than the plans I have already talked about, during 1994, was anyone in this household covered by a health insurance plan (such as the [use fill specified for particular state shown below] plan or any other type of plan/of any other type)?

<1> Yes

<2> No

===> _____

Fills for State-specific health insurance programs for low-income uninsured individuals (to be used in SHIC1).

Arizona........ Medically Indigent Program

California...... AIM (Access for Infants and Mothers)

California's children's health insurance program

Colorado....... Children's Health Plan

Connecticut.... Healthy Steps

Delaware....... Nemours Child Program

Florida........ Healthy Kids

Hawaii......... Hawaii HealthQUEST

Iowa........... Iowa coverage for unemployed workers

Kansas......... Kansas Caring Program for Kids

Maine.......... Maine Health Program

Maryland....... AIDS Insurance Assistance Program

Massachusetts.. Healthy Kids

CenterCare Program

Medical Security Plan

Michigan....... Caring for Children

Minnesota...... Minnesota Care

Mississippi.... Mississippi subsidized insurance coverage

Missouri....... Missouri's coverage for unemployed

New Hampshire.. Healthy Kids

New Jersey..... New Jersey's coverage for pregnant women and children

Health Access New Jersey

New York....... Child Health Plus

New York's subsidized insurance

Ohio........... Children's Health Care Program

Oregon......... Oregon Health Plan

Pennsylvania... Children's Health Insurance Programs

Rhode Island... RIte Care

Tennessee...... TennCare

Washington..... Children's Health Plan

Basic Health Plan

Wisconsin...... Healthy Start

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>SHIC2< Who has insurance?

ENTER LINE NUMBER OF INSURED PERSON.

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

(Ask SHIC3 for each person listed in SHIC2)

>SHIC3< What type of insurance did (you/name) have in 1994.

<1> Medicare

<2> Medicaid

<3> CHAMPUS

<4> CHAMPVA ("CHAMPVA" IS THE CIVILIAN HEALTH AND MEDICAL

PROGRAM OF THE DEPARTMENT OF VETERAN'S AFFAIRS.)

<5> VA health care

<6> Military health care

<7> Indian Health Service

<8> Other government health care

<9> Employer/union-provided (policyholder)

<10> Employer/union-provided (as dependent)

<11> Privately purchased (policyholder)

<12> Privately purchased (as dependent)

<13> Plan of someone outside the household

<14> Other

===>__

>SHI21< These next questions are about CURRENT health insurance coverage, that is, health coverage last week. (Were you/Was anyone in this household) covered by ANY type of health insurance plan last week?

<1> Yes

<2> No SHI24

===>_

NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS

>SHI22< Who was that?

PROBE: Anyone else? ENTER <N> FOR NO MORE

R LN NAME R LN NAME

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>SHI23a< What types of plans (were/was) (name/you) covered by last week?

<1> Same as last year

<2> Medicare

<3> Medicaid/(state fill name)

<4> CHAMPUS

<5> CHAMPVA ("CHAMPVA" IS THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERAN'S AFFAIRS.)

<6> VA health care

<7> Military health care

<8> Indian Health Service

<9> Other government health care

<10> Employer/union-provided (policyholder)

<11> Employer/union-provided (as dependent)

<12> Privately purchased (policyholder)

<13> Privately purchased (as dependent)

<14> Plan of someone outside the household

<15> Other

===>__

>SHI24< An important factor in evaluating a person's or family's health insurance situation is their current health status and/or the current health status of other family members.

ENTER TO PROCEED

===>_

>SHI25< Would you say (name's/your) health in general is:

<1> Excellent

<2> Very good

<3> Good

<4> Fair

<5> Poor

===>_ Ask for all persons

>Q74a< Other than Social Security did the (ANY) employer or union that (name/you) worked for in 1994 have a pension or other type of retirement plan for any of its employees?

<1> Yes

<2> No

===>_

>Q74b< (Were/Was) (name/you) included in that plan?

<1> Yes

<2> No

===>_

>SUNITS< *** ASK IF NECESSARY ***

How many housing units are in this structure?

<1> Only one

<2> Two

<3> Three or four

<4> Five to nine

<5> Ten or more

===>___

Check Item: Some HH members 5-18 years old goto Q80

No HH members 5-18 years old goto Q85

>Q80< During 1994 how many of the children ages 5 to 18 in this household usually ate a complete lunch offered at school?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

<X> None <9> Nine or more

===>__ TOTAL NUMBER OF CHILDREN COVERED

Check Item: FAMINC less than $50,000 goto Q83

FAMINC equal or greater than $50,000 goto MIGSAM

>Q83< During 1994 how many of the children in this household received free or reduced price lunches because they qualified for the Federal School Lunch program?

Number of children who ate hot lunch offered at school: (entry in Q80)

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

<X> None <9> Nine or more

===>__ TOTAL NUMBER OF CHILDREN COVERED

>Q85< Is this house in a public housing project, that is, is it owned by a local housing authority or other public agency?

<1> Yes

<2> No

===>_

>Q86< Are you paying lower rent because the Federal, State, or local government is paying part of the cost?

<1> Yes

<2> No

===>_

>Q87< Did (you/anyone in this household) get food stamps at any time during 1994?

<1> Yes

<2> No goto Q93

===>_

>Q88< How many of the people now living here were covered by food stamps during 1994?

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

<X> None <9> Nine or more

===>_

>Q90p< What is the easiest way for you to report the value of the food stamps; monthly or yearly?

<1> Monthly

<2> Yearly

==>___ goto Q90

<D> or <R> goto Q93

>Q90< What is the (monthly/ ) value of food stamps received in 1994?

Enter dollar amount $ If Q90p is <2> enter amount in 90T and

goto 90C1, else goto Q902

<D> or <R> goto Q93

>Q902< How many months were food stamps received in 1994?

goto Q903

<1-52>

<D> or <R> goto Q93

>Q90C2< *** DO NOT READ TO THE RESPONDENT ***

THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL FOOD STAMPS PAYMENTS RECEIVED IN 1994 WAS (AMOUNT). IS THIS A CORRECT ENTRY?

<1> Yes goto Q93

<2> No goto Q90 (TO CORRECT ENTRY)

>Q903< According to my calculations (total) dollars was received altogether from food stamps in 1994? Does that sound about right?

<1> Yes goto Q93

<2> No goto Q904

If 1, <D> or <R> put (total) amount in 90T

<D> or <R> goto Q93

>Q904< What is your best estimate of the correct amount received from food stamps during 1994?

PREVIOUS ENTRIES: Q90: (amount)

Q90p: (periodicity)

Q902: (number of pay periods)

Enter dollar amount goto Q93

Put this amount in 90T

If <D> or <R> put (total) from 903 in 90T

<R> or <R> goto Q93

>Q93< The government has an energy assistance program which helps pay heating costs. This assistance can be received directly by the household or it can be paid directly to the electric company, gas company, or fuel dealer.

Since October 1, 1994, (have you/has this household) received assistance of this type from the federal, state, or local government?

<1> Yes

<2> No

===>_ goto Q93PR1

>Q93PR1< Do you remember receiving an additional or unexpected check that was sent during the winter to help pay heating costs?

<1> Yes

<2> No goto MIGSAM

===>_

>Q93PR2< Was it used to pay heating costs?

<1> Yes

<2> No goto MIGSAM

===>_

>Q94< Altogether, how much energy assistance has been received since October 1, 1994?

FOR AMOUNTS $25,000 AND OVER, ENTER $24,999

===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY

>MIGSAM< Now I want to ask you some questions about (reference person's name/your) previous residence. (Was (reference person's name)/Were you) living in this house (or apartment) five years ago; that is, on March 1, 1990?

<1> Yes, this house (apt)

<2> No, different house in U.S.

<3> No, outside the U.S.

>MIGLIV< Where did (reference person's name/you) live on March 1, 1990?

>MIGPLC< Name of city/town/post office <S> Same city, town, post office

_______________________ CURRENT: (city)

>MIGSTA< Name of State

<W> For persons living on a ship at sea

<S> Same state

<H> Help, State codes

_______________________ CURRENT: (state)

>MIGZIP< ZIP Code

_____ CURRENT: (zip code)

>MIGCLM< Did (reference person's name/you) live inside the city limits of (place name)?

<1> Yes, inside city limits

<2> No, outside city limits or post office name only

>MIGCOU< What (county/parish) is (place name) in?

________________________ (goto MIGCKA)

Note: Enter "IND CITY" if an independent city, not in a county.

>MIGCN1< What country did (reference person's name/you) live in 5 years ago?

301 Canada 383 Guyana 315 Mexico

206 Cambodia 342 Haiti 316 Nicaragua

207 China 314 Honduras 385 Peru

379 Colombia 209 Hong Kong 231 Philippines

337 Cuba 117 Hungary 128 Poland

339 Dominican Republic 210 India 129 Portugal

380 Ecuador 212 Iran 72 Puerto Rico

312 El Salvador 119 Ireland/Eire 192 Russia

139 England 120 Italy 140 Scotland

109 France 343 Jamaica 238 Taiwan

110 Germany 215 Japan 239 Thailand

116 Greece 217 Korea/South Korea 351 Trinidad & Tobago

313 Guatemala 221 Laos 242 Vietnam

===>___ Other country ===> <M>

Note: More countries on additional screens (MIGCN2-MIGCN4).

>MIGCN2< Other Countries

200 Afghanistan 103 Belgium 415 Egypt

60 American Samoa 300 Bermuda 417 Ethiopia

375 Argentina 376 Bolivia 507 Figi

185 Armenia 377 Brazil 108 Finland

102 Austria 205 Burma 421 Ghana

501 Australia 378 Chile 138 Great Britain

130 Azores 311 Costa Rica 340 Grenada

333 Bahamas 155 Czech Republic 66 Guam

202 Bangladesh 105 Czechoslovakia 126 Holland

334 Barbados 106 Denmark 211 Indonesia

310 Belize 338 Dominica

===>___ Other country ===> <M>

Note: More countries on additional screens (MIGCN3-MIGCN4).

>MIGCN3< Other Countries

213 Iraq 440 Nigeria 134 Spain

214 Israel 142 Northern Ireland 136 Swedan

216 Jordan 127 Norway 137 Switzerland

427 Kenya 229 Pakistan 237 Syria

183 Latvia 253 Palestine 240 Turkey

222 Lebanon 317 Panama 78 U.S. Virgin Islands

184 Lithuania 132 Romania 195 Ukraine

224 Malaysia 233 Saudi Arabia 387 Uruguay

436 Morocco 234 Singapore 180 USSR

126 Netherlands 156 Slovakia/Slovak Rep. 388 Venezuela

514 New Zealand 449 South Africa 147 Yugoslavia

===>___ Other country ===> <M>

Note: More countries on additional screens (MIGCN3-MIGCN4).

>MIGCN4< PROBE: The country you have named is not on my list. Can you tell me what part the world that country is in?

353 Caribbean 148 Europe 245 Asia

318 Central America 252 Middle East 527 Pacific Islands

389 South America 468 North Africa 555 Elsewhere

304 North America 462 Other Africa

===>___

>MIGALL< (There are (number) other persons in this household ages 5 year or over./There is one other person in this household age 5 year or over.) Did (all of these persons/this person) live with (reference person's name/you) in (this house/name of country/name of city, State) 5 years ago?

<1> Yes, all lived with reference person/you

<2> No, some or all did not live with reference person/you

>MIGM< Which of the other members of this household did NOT live with (reference person's name/you) 5 years ago? (Enter all that apply.)

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

>NXTSAM< Did (NEXTMOVER's name/you) live in this house 5 years ago; that is, on March 1, 1990?

<1> Yes, this house (apt)

<2> No, different house in U.S.

<3> No, outside the U.S.

>NXTLIV< Where did (NEXTMOVER's name/you) live on March 1, 1990?

>NXTPLC< Name of city/town/post office <S> Same city, town, post office

_______________________ CURRENT: (city)

>NXTSTA< Name of State

<W> For persons living on a ship at sea

<S> Same state

<H> Help, State codes

_______________________ CURRENT: (state)

>NXTZIP< ZIP Code

_____ CURRENT: (zip code)

>NXTCLM< Did (NEXTMOVER's name/you) live inside the city limits of (place name)?

<1> Yes, inside city limits

<2> No, outside city limits or post office name only

>NXTCOU< What (county/parish) is (place name) in?

________________________

>NXTCN1< What country did (NEXTMOVER's name/you) live in 5 years ago?

301 Canada 383 Guyana 315 Mexico

206 Cambodia 342 Haiti 316 Nicaragua

207 China 314 Honduras 385 Peru

379 Colombia 209 Hong Kong 231 Philippines

337 Cuba 117 Hungary 128 Poland

339 Dominican Republic 210 India 129 Portugal

380 Ecuador 212 Iran 72 Puerto Rico

312 El Salvador 119 Ireland/Eire 192 Russia

139 England 120 Italy 140 Scotland

109 France 343 Jamaica 238 Taiwan

110 Germany 215 Japan 239 Thailand

116 Greece 217 Korea/South Korea 351 Trinidad & Tobago

313 Guatemala 221 Laos 242 Vietnam

===>___ Other country ===> <M>

Blind <D> or <R> goto MIGCKC

Note: More countries on additional screens (NXTCN2-NXTCN4).

>NXTCN2< Other Countries

200 Afghanistan 103 Belgium 415 Egypt

60 American Samoa 300 Bermuda 417 Ethiopia

375 Argentina 376 Bolivia 507 Figi

185 Armenia 377 Brazil 108 Finland

102 Austria 205 Burma 421 Ghana

501 Australia 378 Chile 138 Great Britain

130 Azores 311 Costa Rica 340 Grenada

333 Bahamas 155 Czech Republic 66 Guam

202 Bangladesh 105 Czechoslovakia 126 Holland

334 Barbados 106 Denmark 211 Indonesia

310 Belize 338 Dominica

===>___ Other country ===> <M>

Note: More countries on additional screens (MIGCN3-MIGCN4).

>NXTCN3< Other Countries

213 Iraq 440 Nigeria 134 Spain

214 Israel 142 Northern Ireland 136 Swedan

216 Jordan 127 Norway 137 Switzerland

427 Kenya 229 Pakistan 237 Syria

183 Latvia 253 Palestine 240 Turkey

222 Lebanon 317 Panama 78 U.S. Virgin Islands

184 Lithuania 132 Romania 195 Ukraine

224 Malaysia 233 Saudi Arabia 387 Uruguay

436 Morocco 234 Singapore 180 USSR

126 Netherlands 156 Slovakia/Slovak Rep. 388 Venezuela

514 New Zealand 449 South Africa 147 Yugoslavia

===>___ Other country ===> <M>

Note: More countries on additional screens (MIGCN3-MIGCN4).

>NXTCN4< PROBE: The country you have named is not on my list. Can you tell me what part the world that country is in?

353 Caribbean 148 Europe 245 Asia

318 Central America 252 Middle East 527 Pacific Islands

389 South America 468 North Africa 555 Elsewhere

304 North America 462 Other Africa

===>___

>MOVSAM< Now I want to ask you some questions about where (you/reference person's name) lived 1 year ago. (Were/was) (you/reference person's name) living in this house (or apartment) on March 1, 1994?

<1> Yes, this house (apt)

<2> No, same house as 5 years ago

<3> No, elsewhere

>MOVLIV< Where did (reference person's name/you) live 1 year ago?

<1> Different house (apt) in this county

<2> Different county in this state

<3> Different state in the U. S.

<4> No, outside the United States

MOVSTA Name of State

<H> Help, State codes

_______________________ CURRENT: (state)

>MOVALL< (There are (number) other persons in this household ages 1 year or over./There is 1 other person in this household age 1 year or over.) Did (all of these persons/this person) live with (reference person's name/you) 1 year ago?

<1> Yes

<2> No

>MOVM< Which of the other members of this household did NOT live with (reference person's name/you) 1 year ago? (Enter all that apply.)

LN NAME RELATION LN NAME RELATION

(person 1) (person 9)

(person 2) (person 10)

(person 3) (person 11)

(person 4) (person 12)

(person 5) (person 13)

(person 6) (person 14)

(person 7) (person 15)

(person 8) (person 16)

ENTER LINE NUMBER <N> No more

PROBE: Anyone else?

===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__

Blind <D> or <R> goto THANKYOU screen

>NXTMOB< Did (NEXTMOVER's name/you) live in this house one year ago; that is, on March 1, 1994?

<1> Yes, this house (apt)

<2> No, same house as 5 years ago

<3> No, elsewhere

>NXTLIV< Where did (NEXTMOVER's name/you) live on March 1, 1994?

<1> Different house (apt) in this county

<2> Different county in this state

<3> Different state in the U. S.

<4> No, outside the United States

NEXTST Name of State

<H> Help, State codes

_______________________ CURRENT: (state)

Annual Demographic Survey (March CPS Supplement) 1995 Methodology and Documentation Page

CPS Home Page

Author: Ed Welniak-Census/HHES/ISB
Contact: (ask.census.gov) CPS Help-Census/DSD/CPSB
Last modified: May 22, 1996
URL: http://www.bls.census.gov/cps/ads/1995/sqestair.htm