ITEMS BOOKLET - March 1996
HH32b< Did (name of reference person) live at this address during the week and >SNAD1< of November 19, 1995?
<1> Yes
<2> No
===>_
>HH32d< Did any of the following household members live
here during the and >SNAD2< week of November 19, 1995?
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
===>_
>APIintro< This month, we are asking Asian and
Pacific Islanders to indicate the specific Asian or Pacific Islander
group from which they originate.
ENTER <P> 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)
===>__
>APIhelp<
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
IwoJiman
ENTER <P> TO PROCEED
===>_
>SSN-scrn< What is (name's/your) Social Security or Railroad
Retirement number?
===>__
>FAMINscrn< 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
===>__
>Princom< **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 <P> TO PROCEED
ENTER <I> FOR IMPORTANCE OF RESPONDING
===>_
>Q29a< Did (name/you) work at a job or business at any
time during 1995?
<1> Yes
<2> No
===>_
>Q29b< Did (you/he/she) do any temporary, parttime,
or seasonal work even for a few days during 1995?
<1> Yes
<2> No
===>_
>Q30< Even though (name/you) did not work in 1995, did
(you/he/she) spend any time trying to find a job or on layoff?
<1> Yes
<2> No
===>_
>Q31< How many different weeks (were/was) (name/you)
looking for work or on layoff from a job?
<152>
===>__
>Q32< What was the main reason (you/he/she) did not work
in 1995?
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
===>_
>Q33< During 1995 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 <152> OR <M> IF RESPONDENT
CAN ONLY ANSWER IN MONTHS
===>__
>Q33mon< ENTER NUMBER OF MONTHS WORKED
<112>
===>__
>Q33ver< Then (name/you) worked about (number)
weeks. Is that correct?
<1> Yes
<2> No back to Q33 and obtain estimate
===>_
>Q35< Did (name/you) lose any full weeks of work in 1995
because (you/he/she) (were/was) on layoff from a job or lost a
job?
NUMBER OF WEEKS WORKED IN 1995: (number)
<1> Yes
<2> No
<M> Mistake made in number of weeks worked in 1995Specify
===>_
>Q36< You said (name/you) worked about (number) (week/weeks)
in 1995. How many OF THE REMAINING (number) WEEKS (were/was) (you/he/she)
looking for work or on layoff from a job?
<X> None
===>__
>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 1995?
<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 1995?
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 1995, 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 1995?
NUMBER OF WEEKS WORKED IN 1995: (number)
(NUMBER OF WEEKS WAS REPORTED IN ITEM Q33)
<152>
===>__
>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 1995?
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 EMPLOYEDINCORPORATED/SELF
EMPLOYEDUNINCORPORATED)
<S> Same as listed
<N> Not the same job
===>_
>Q47a< For whom did (name/you) work(?/at) (blank/(your/his/her)
(blank/longest job during 1995?)
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 1995)
===>__________________________________________________________
>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
<2> private for profit company
<3> Non-profit organization including tax exempt and charitable organizations
<4> Self employed
<5> Working in family business
>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> 1024
<3> 2599
<4> 100499
<5> 500999
<6> 1,000+
===>_
>Q48a< How much did (name/you) earn from this employer
before taxes and other deductions during 1995?
Enter dollar amount $ Enter <X> for None
READ IF NECESSARY: Is this a weekly, every other week, twice
a month, monthly or yearly amount?
Per <1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
Q48ap ==>___
>Q48a1< For how many (weekly/every other week/twice a
month/monthly) pay periods did (name/you) earn (fill from Q48a)
from this employer in 1995?
>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
<2> No
>Q48aV< According to my calculations (name/you) earned
(total) dollars altogether from this employer in 1995 before deductions.
Does that sound about right?
<1> Yes
<2> No
>Q48a2< What is your best estimate of (name's/your) correct
total amount of earnings from this employer during 1995 before
deductions?
Enter dollar amount $
>Q48a3< Does this amount include all tips, bonuses, overtime
pay or commissions (name/you) may have received from this employer
in 1995?
<1> Yes
<2> No
Q48aad How much did (name/you) earn in tips, bonuses, overtime
pay or commissions from this employer in 1995?
Enter dollar amount $
>Q48b< What were (name's/your) net earnings from this
(business/farm) after expenses during 1995?
IF RESPONSE IS "NONE" OR "BROKE EVEN" THEN
ENTER 1.
<L> Lost Money
Enter dollar amount $
>Q48BL< ENTER AMOUNT OF MONEY LOST IN 1995.
===>$___,___ .00
>Q48bp< Is this an annual, quarterly, monthly, weekly,
or other amount?
Per <1> Annual
<2> Quarterly
<3> Monthly
<4> Weekly
<5> Other
Q48bp ==>___
>Q48b1 *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL ANNUAL BUSINESS
INCOME ENTERED IS (AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No goto 48b (TO CORRECT ENTRY)
>Q48b2< What is your best estimate of (name's/your) ANNUAL
net earnings from this business/farm after expenses in 1995?
PREVIOUS ENTRIES: Q48b: (amount)
Q48b1: (periodicity)
Enter dollar amount $
>Q48b2L< What is your best estimate of (name's/your)
ANNUAL net LOSS from this business/farm after expenses in 1995?
PREVIOUS ENTRIES: Q48b: (amount)
Q48b1: (periodicity)
Enter dollar amount $
>Q48b3< What were (name's/your) net earnings from this
(business/farm) during the FIRST quarter of 1995?
<X> IF RESPONSE IS "NONE" or "BROKE EVEN"
<L> Lost Money
Enter dollar amount $
>Q48b3L< ENTER AMOUNT OF MONEY LOST IN THE FIRST QUARTER
OF 1995.
===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY
>Q48b4< What were (name's/your) net earnings from this
(business/farm) during the SECOND quarter of 1995?
<X> IF RESPONSE IS "NONE" or "BROKE EVEN"
<L> Lost Money
Enter dollar amount $
>Q48b4L< ENTER AMOUNT OF MONEY LOST IN THE SECOND QUARTER
OF 1995.
===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY
>Q48b5< What were (name's/your) net earnings from this
(business/farm) during the THIRD quarter of 1995?
<X> IF RESPONSE IS "NONE" or "BROKE EVEN"
<L> Lost Money
Enter dollar amount $
>Q48b5L< ENTER AMOUNT OF MONEY LOST IN THE THIRD QUARTER
OF 1995.
===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY
>Q48b6< What were (name's/your) net earnings from this
(business/farm) during the FOURTH quarter of 1995?
<X> IF RESPONSE IS "NONE" or "BROKE EVEN"
<L> Lost Money
Enter dollar amount $
>Q48b6L< ENTER AMOUNT OF MONEY LOST IN THE FOURTH QUARTER
OF 1995.
===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY
>Q48b7< Does this amount include all tips, bonuses, overtime
pay or commissions (name/you) may have received in 1995?
<1> Yes
<2> No
>Q48bad< How much did (name/you) earn in tips, bonuses,
overtime pay or commissions in 1995?
Enter dollar amount $
>Q49a< Did (name/you) earn money from any other work
(you/he/she) did during 1995?
<1> Yes
<2> No
===>_
>Q49B1< How much did (name/you) earn from all other employers
before taxes and other deductions during 1995?
Enter dollar amount $
<X> none
READ IF NECESSARY: Is this a weekly, every other week, twice
a month, monthly or yearly amount?
Per <1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
>Q49B1p< ==>___
>Q49B11< For how many (weekly/every other week/twice
a month/monthly) pay periods did (name/you) earn (fill from Q49B1)
from all other employers in 1995?
>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
<2> No
>Q49B1V< According to my calculations (name/you) earned
(total) dollars altogether from all other employers in 1995. Does
that sound about right?
<1> Yes
<2> No
>Q49B12< What is your best estimate of (name's/your)
correct total amount of earnings from all other employers during
1995?
PREVIOUS ENTRIES: Q48a: (amount)
Q48ap: (periodicity)
Q48a1: (number of pay periods)
Enter dollar amount $
>Q49B13< Does this amount include all tips, bonuses,
overtime pay or commissions (name/you) may have received from
all other employers in 1995?
<1> Yes
<2> No
>Q49B1A< How much did (name/you) earn in tips, bonuses,
overtime pay or commissions from all other employers in 1995?
Enter dollar amount $
>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
>Q51A1< At any time during 1995 did (names/you) receive
any State or Federal unemployment compensation?
<1> Yes
<2> No
>Q51A1p< What is the easiest way for you to report (name's/your)
State or Federal unemployment compensation; weekly, every other
week, twice a month, monthly, or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q51A11< How much did (name\you) receive
(weekly/ every other week/twice a month/monthly/ ) in State
or Federal unemployment compensation during 1995?
Enter dollar amount $
>Q51A1C< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL STATE OR FEDERAL
UNEMPLOYMENT COMPENSATION RECEIVED IN 1995 WAS (AMOUNT). IS THIS
A CORRECT ENTRY?
<1> Yes
<2> No
>Q51A12< How many (weekly/ every other week/twice a month/monthly)
payments did (name/you) receive from State or Federal unemployment
compensation during 1995?
<1-52>
>Q51A13< According to my calculations (name/you) received
(total) dollars altogether from State or Federal unemployment
compensation during 1995. Does that sound about right?
<1> Yes
<2> No
>Q51A14< What is your best estimate of the correct total
amount (name/you) received from State or Federal unemployment
compensation during 1995?
PREVIOUS ENTRIES: Q51A11: (amount)
Q51A1p: (periodicity)
Q51A12: (number of pay periods)
Enter dollar amount $
>Q51A2< At any time during 1995 did (name/you) receive
any Supplemental Unemployment Benefits?
<1> Yes
<2> No
===>_
>Q51A2p< What is the easiest way for you to report (name's/your)
Supplemental Unemployment Benefits; weekly, every other week,
twice a month, monthly, or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q51A21< How much did (name\you) receive
(weekly/ every other week/twice a month/monthly/ ) in Supplemental
Unemployment Benefits during 1995?
Enter dollar amount $
>Q51A2C2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL SUPPLEMENTAL
UNEMPLOYMENT BENEFITS RECEIVED IN 1995 WAS (AMOUNT). IS THIS A
CORRECT ENTRY?
<1> Yes
<2> No
>Q51A22< How many (weekly/ every other week/twice a month/monthly)
payments did (name/you) receive from Supplemental Unemployment
Benefits during 1995?
<1-52>
>Q51A23< According to my calculations (name/you) received
(total) dollars altogether from Supplemental Unemployment Benefits
during 1995. Does that sound about right?
<1> Yes
<2> No
>Q51A24< What is your best estimate of the correct total
amount (name/you) received from Supplemental Unemployment Benefits
during 1995?
PREVIOUS ENTRIES: Q51A21: (amount)
Q51A2p: (periodicity)
Q51A22: (number of pay periods)
Enter dollar amount $
>Q51A3< At any time during 1995 did (name/you) receive
any Union Unemployment or Strike Benefits?
<1> Yes
<2> No
===>_
>Q51A3p< What is the easiest way for you to report (name's/your)
Union Unemployment or Strike Benefits; weekly, every other week,
twice a month, monthly, or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q51A31< How much did (name\you) receive (weekly/every
other week/twice a month/monthly/ ) in Union Unemployment or Strike
Benefits during 1995?
Enter dollar amount $
>C251A3< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL UNION UNEMPLOYMENT
OR STRIKE BENEFITS RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT
ENTRY?
<1> Yes
<2> No
>Q51A32< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive from Union Unemployment or Strike
Benefits during 1995?
<1-52>
>Q51A33< According to my calculations (name/you) received
(total) dollars altogether from Union Unemployment or Strike Benefits
during 1995. Does that sound about right?
<1> Yes
<2> No
>Q51A34< What is your best estimate of the correct total
amount (name/you) received from Union Unemployment or Strike Benefits
during 1995?
PREVIOUS ENTRIES: Q51A31: (amount)
Q51A3p: (periodicity)
Q51A32: (number of pay periods)
Enter dollar amount $
>Q52a< During 1995 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
>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, every other week, twice a month,
monthly, or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q52c1< How much did (name\you) receive (weekly/every
other week/twice a month/monthly/ ) in Worker's Compensation during
1995?
Enter dollar amount $
>Q52cC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL WORKER'S COMPENSATION
RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q52c2< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive from Worker's Compensation during
1995?
<1-52>
>Q52c3< Then (name/you) received (total) dollars altogether
from Worker's Compensation during 1995. Does that sound about
right?
<1> Yes
<2> No
Q52c4 What is your best estimate of the correct total amount
(name/you) received from Worker's Compensation during 1995?
PREVIOUS ENTRIES: Q52c1: (amount)
Q52cp: (periodicity)
Q52c2: (number of pay periods)
Enter dollar amount $
>Q56a< During 1995 did (anyone in this household/you)
receive any Social Security payments from the U.S. Government?
<1> Yes
<2> No
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 PARENT OR GUARDIAN FOR PAYMENTS MADE TO CHILDREN
UNDER AGE 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
==>___
>Q56d< How much did (name/you) receive (monthly/quarterly/
) in Social Security payments in 1995?
( \<A> already included)
Enter dollar amount $
>Q56d1< What is the amount of the Social Security payment
(name/you) received last month?
Enter dollar amount $
>Q56d2< For how many (months/quarters) did (name/you)
receive Social Security in 1995?
<1-12>
>Q56d3< Is this (amount from Q56d/amount from Q56d1)
before or after the (46.10/42.50) per month medicare deduction?
<1> after
<2> before
>Q56d4< Was the cost of living increase the only change
which occurred in monthly payments?
<1> Yes
<2> No
>Q56dC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL SOCIAL SECURITY
RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q56d5< According to my calculations (name/you) received
(total) dollars altogether from Social Security in 1995. Does
that sound about right?
<1> Yes
<2> No
>Q56d6< What is your best estimate of the correct amount
(name\you) received in Social Security during 1995?
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
>SSR< What were the reasons (name/you) (was/were) getting
Social Security in 1995?
PROBE: Any other reason? <N> No more
<1> Retired
<2> Disabled
<3> Widowed
<4> Spouse
<5> Surviving child
<6> Dependent child
<7> On behalf of children
<8> Other
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
NOTE: THIS ITEM DOES NOT APPEAR IF ONLY ONE CHILD IN THE HOUSEHOLD
>SSC< Which children under age 23 were receiving Social
Security in 1995?
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?
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
>SSCR< What were the reasons (Child's name/the children)
(was/were) getting Social Security in 1995?
PROBE: Any other reason? <N> No more
<1> Disabled child/children
<2> Surviving child/children
<3> Dependent child/children
<4> Other
===>__ ===>__ ===>__ ===>__
>Q56f< Did anyone in this household receive any Social
Security income in 1995 that we have not already counted on behalf
of children in this household?
INCLUDES ALL CHILDREN UNDER 23 YEARS OF AGE
<1> Yes
<2> No
<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 PARENT OR 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
==>___
>Q56i< How much did (name/you) receive (monthly/quarterly/
) in Social Security payments for children in this household in
1995?
( \<A> already included)
Enter dollar amount $
>Q56i1< What is the amount of the Social Security payment
(name/you) received for children in this household last month?
Enter dollar amount $
>Q56i2< For how many (months/quarters) did (name/you)
receive Social Security in 1995?
<1-12>
>Q56i3< Was the cost of living increase the only change
which occurred in monthly payments for children in this household?
<1> Yes
<2> No
>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 1995 WAS (AMOUNT).
IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q56i4< According to my calculations (name/you) received
(total) dollars altogether for children in this household from
Social Security in 1995. Does that sound about right?
<1> Yes
<2> No
>Q56i5< What is your best estimate of the correct amount
(name\you) received in Social Security for children in this household
during 1995?
PREVIOUS ENTRIES: Q56i1: (amount)
Q56ip: (periodicity)
Q56i2: (number of pay periods)
Q56i3: (cost of living subtracted per month)
Enter dollar amount
>RSS< What were the reasons (name/you) (was/were) getting
Social Security for children in this household in 1995?
PROBE: Any other reason? <N> No more
<1> Surviving child
<2> Dependent child
<3> On behalf of children
<4> Other
===>__ ===>__ ===>__ ===>__
NOTE: THIS ITEM DOES NOT APPEAR IF ONLY ONE CHILD IN THE HOUSEHOLD
>CSS< Which children under age 23 were receiving Social
Security in 1995?
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?
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
>CRSS< What were the reasons (Child's name/the children)
(was/were) getting Social Security in 1995?
PROBE: Any other reason? <N> No more
<1> Disabled child/children
<2> Surviving child/children
<3> Dependent child/children
<4> Other
===>__ ===>__ ===>__ ===>__
>Q57a< During 1995 did (anyone in this household receive:/you receive:)
Any SSI payments, that is, Supplemental Security Income?
NOTE: SSI ARE ASSISTANCE PAYMENTS TO LOWINCOME AGED, BLIND
AND DISABLED PERSONS AND COME FROM STATE OR LOCAL WELFARE OFFICES,
THE FEDERAL GOVERNMENT, OR BOTH.
<1> Yes
<2> No
===>_
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
==>___
>Q57c< How much did (name/you) receive (monthly/quarterly/
) in Supplemental Security Income payments in 1995?
Enter dollar amount $
>Q57c1< What is the amount of the Supplemental Security
Income payment (name/you) received last month?
Enter dollar amount $
>Q57c2< For how many (months/quarters) did (name/you)
receive Supplemental Security Income in 1995?
<1-12>
>Q57c3< Was the cost of living increase the only change
which occurred in monthly payments?
<1> Yes
<2> No
>Q57cC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL SUPPLEMENTAL
SECURITY INCOME RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT
ENTRY?
<1> Yes
<2> No
>Q57c4< According to my calculations (name/you) received
(total) dollars altogether from Supplemental Security Income in
1995. Does that sound about right?
<1> Yes
<2> No
>Q57c5< What is your best estimate of the correct amount
(name\you) received in Supplemental Security Income during 1995?
PREVIOUS ENTRIES: Q57c1: (amount)
Q57cp: (periodicity)
Q57c2: (number of pay periods)
Q57c3: (amount subtracted per month)
Enter dollar amount
>SSIR< What were the reasons (name/you) (was/were) getting
Supplemental Security Income in 1995?
PROBE: Any other reason? <N> No more
<1> Disabled
<2> Blind
<3> On behalf of a disabled child
<4> On behalf of a blind child
<5> Other
===>__ ===>__ ===>__ ===>__ ===>__
NOTE: THIS ITEM DOES NOT APPEAR IF ONLY ONE CHILD IN THE HOUSEHOLD
>SSIC< Which children under age 18 were receiving Supplemental
Security Income in 1995?
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?
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
>Q57d< Did anyone in this household receive any Supplemental
Security Income in 1995 that we have not already counted on behalf
of children in this household?
INCLUDES ALL CHILDREN UNDER 18 YEARS OF AGE
<1> Yes
<2> No
<H> (Help) Supplemental Security Income previously reported
===>_
NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS
>Q57e< **READ ONLY IF NECESSARY**
Who received these Supplemental Security Income payments?
ENTER LINE NUMBER OF PARENT OR 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) Supplemental Security Income previously reported
ENTER LINE NUMBER <N> No more
PROBE: Anyone else?
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
>Q57ip< What is the easiest way for you to the Supplemental
Security Income (name/you) received on behalf of children?
<1> monthly
<2> quarterly
<3> yearly
==>___
>Q57i< How much did (name/you) receive (monthly/quarterly/
) in Supplemental Security Income on behalf of children in 1995?
Enter dollar amount $
>Q57i1< What is the amount of the Supplemental Security
Income payment (name/you) received on behalf of children last
month?
Enter dollar amount $
>Q57i2< For how many (months/quarters) did (name/you)
receive Supplemental Security Income on behalf of children in
1995?
<1-12>
>Q57i3< Was the cost of living increase the only change
which occurred in monthly payments?
<1> Yes
<2> No
>Q57iC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL SUPPLEMENTAL
SECURITY INCOME RECEIVED IN 1995 ON BEHALF OF CHILDREN WAS (AMOUNT).
IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q57i4< According to my calculations (name/you) received
(total) dollars altogether from Supplemental Security Income on
behalf of children in 1995. Does that sound about right?
<1> Yes
<2> No
>Q57i5< What is your best estimate of the correct amount
(name\you) received in Supplemental Security Income on behalf
of children during 1995?
PREVIOUS ENTRIES: Q57i1: (amount)
Q57cp: (periodicity)
Q57c2: (number of pay periods)
Q57c3: (amount subtracted per month)
Enter dollar amount
>RSSI< What were the reasons (name/you) (was/were) getting
Supplemental Security Income on behalf of children in 1995?
PROBE: Any other reason? <N> No more
<1> On behalf of a disabled child/children
<2> On behalf of a blind child/children
<3> Other
===>__ ===>__ ===>__
NOTE: THIS ITEM DOES NOT APPEAR IF ONLY ONE CHILD IN THE HOUSEHOLD
>CSSI< Which children under age 18 were receiving Supplemental
Security Income in 1995?
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?
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
>Q59A88< At any time during 1995, 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
===>_
NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS
>Q59b88< 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, every other week,
twice a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q59e< How much did (name/you) receive
(weekly/every other week/twice a month/monthly/ ) in Public
Assistance or Welfare Payments in 1995?
Enter dollar amount $
>Q59e2< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive from Public Assistance or Welfare
Payments in 1995?
<1-52>
>Q59eC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL PUBLIC ASSISTANCE
OR WELFARE PAYMENTS RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT
ENTRY?
<1> Yes
<2> No
>Q59e3< According to my calculations (name/you) received
(total) dollars altogether from Public Assistance or Welfare Payments
in 1995. Does that sound about right?
<1> Yes
<2> No
>Q59e4< What is your best estimate of the correct amount
(name\you) received in Public Assistance or Welfare Payments during
1995?
PREVIOUS ENTRIES: Q59e: (amount)
Q59ep: (periodicity)
Q59e2: (number of pay periods)
Enter dollar amount
NOTE: THIS ITEM DOES NOT APPEAR IF ONLY ONE CHILD IN THE HOUSEHOLD
>AFWC< Which children in the household were covered by
(name's/your) Aid to Families With Dependent Children (AFDC)/Aid
to Dependent Children (ADC) in 1995?
NOTE: INCLUDE CHILDREN UNDER 19 YEARS OLD ONLY
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
<A> All
PROBE: Anyone else?
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
>Q60A88< At any time during 1995 did (anyone in this household
receive:/you receive:) Any Veterans' (VA) payments?
<1> Yes
<2> No
===>_
NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS
>Q60b88< **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?
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
>Q60c88< What type of Veterans' payments did (name/you)
receive?
<1> Serviceconnected 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
===>_
>Q60V1p< What is the easiest way for you to report (name's/your) (fill from first answer
in Q60c-88); weekly, every other week, twice a month, monthly
or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q60V1< How much did (name/you) receive (weekly/every other week/twice a month/
monthly/ ) before deductions in (fill from first answer in
Q60c-88) in 1995?
Enter dollar amount $
>Q60V12< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in (fill from first answer in
Q60c-88) in 1995?
<1-52>
>Q60V1C< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (FILL FROM
FIRST ANSWER IN Q60c-88) RECEIVED IN 1995 WAS (AMOUNT). IS THIS
A CORRECT ENTRY?
<1> Yes
<2> No
>Q60V13< According to my calculations (name/you) received
(total) dollars altogether from (fill from first answer in Q60c-88)
in 1995. Does that sound about right?
<1> Yes
<2> No
>Q60V14< What is your best estimate of the correct amount
(name\you) received from (fill from first answer in Q60c-88) during
1995?
PREVIOUS ENTRIES: Q60V1: (amount)
Q60V1p: (periodicity)
Q60V12: (number of pay periods)
Enter dollar amount
>Q60V2p< What is the easiest way for you to report (name's/your) (fill from second answer
in Q60c-88); weekly, every other week, twice a month, monthly
or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q60V2< How much did (name/you) receive (weekly/every other week/twice a month/
monthly/ ) in (fill from second answer in Q60c-88) in 1995?
Enter dollar amount $
>Q60V22< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in (fill from second answer in
Q60c-88) in 1995?
<1-52>
>Q60V2C< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (FILL FROM
SECOND ANSWER IN Q60c-88) RECEIVED IN 1995 WAS (AMOUNT). IS THIS
A CORRECT ENTRY?
<1> Yes
<2> No
>Q60V23< According to my calculations (name/you) received
(total) dollars altogether from (fill from second answer in Q60c-88)
in 1995. Does that sound about right?
<1> Yes
<2> No
>Q60V24< What is your best estimate of the correct amount
(name\you) received from (fill from second answer in Q60c-88)
during 1995?
PREVIOUS ENTRIES: Q60V2: (amount)
Q60V2p: (periodicity)
Q60V22: (number of pay periods)
Enter dollar amount
>Q58a< Did (you/anyone in this household) receive any survivor benefits in 1995 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
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 paidup 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"
===>_____________________________________________________________
>Q58E1p< What is the easiest way for you to report (name's/your)
(fill from first answer in Q58c or Q58Coth); weekly, every other
week, twice a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q58E1< How much did (name/you) receive (weekly/every
other week/twice a month/monthly/ ) in (fill from first answer
in Q58c or Q58Coth) in 1995?
Enter dollar amount $
>Q58E12< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in (fill from first answer in
Q58c or Q58Coth) in 1995?
<1-52>
>Q58E1C< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (FILL FROM
FIRST ANSWER IN Q58c or Q58Coth) PAYMENTS RECEIVED IN 1995 WAS
(AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q58E13< According to my calculations (name/you) received
(total) dollars altogether from (fill from first answer in Q58c
or Q58Coth) in 1995. Does that sound about right?
<1> Yes
<2> No
>Q58E14< What is your best estimate of the correct amount
(name\you) received from (fill from first answer in Q58c or Q58Coth)
during 1995?
PREVIOUS ENTRIES: Q58E1: (amount)
Q58E1p: (periodicity)
Q58E12: (number of pay periods)
Enter dollar amount
>Q58E2p< What is the easiest way for you to report (name's/your)
(fill from second answer in Q58c or Q58Coth); weekly, every other
week, twice a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q58E2< How much did (name/you) receive (weekly/every
other week/twice a month/monthly/ ) in (fill from second answer
in Q58c or Q58Coth) in 1995?
Enter dollar amount $
>Q58E22< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in (fill from second answer in
Q58c or Q58Coth) in 1995?
<1-52>
>Q58E2C< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (FILL FROM
SECOND ANSWER IN Q58c or Q58Coth) RECEIVED IN 1995 WAS (AMOUNT).
IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q58E23< According to my calculations (name/you) received
(total) dollars altogether from (fill from second answer in Q58c
or Q58Coth) in 1995. Does that sound about right?
<1> Yes
<2> No
>Q58E24< What is your best estimate of the correct amount
(name\you) received from (fill from second answer in Q58c or Q58Coth)
during 1995?
PREVIOUS ENTRIES: Q58E2: (amount)
Q58E2p: (periodicity)
Q58E22: (number of pay periods)
Enter dollar amount
>Q58E3p< What is the easiest way for you to report (name's/your)
(fill from third answer in Q58c or Q58Coth); weekly, every other
week, twice a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q58E3< How much did (name/you) receive (weekly/every
other week/twice a month/monthly/ ) in (fill from third answer
in Q58c or Q58Coth) in 1995?
Enter dollar amount $
>Q58E32< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in (fill from third answer in
Q58c or Q58Coth) in 1995?
<1-52>
>Q58E3C< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (FILL FROM
THIRD ANSWER IN Q58c or Q58Coth) RECEIVED IN 1995 WAS (AMOUNT).
IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q58E33< According to my calculations (name/you) received
(total) dollars altogether from (fill from third answer in Q58c
or Q58Coth) in 1995. Does that sound about right?
<1> Yes
<2> No
>Q58E34< What is your best estimate of the correct amount
(name\you) received from (fill from third answer in Q58c or Q58Coth)
during 1995?
PREVIOUS ENTRIES: Q58E2: (amount)
Q58E2p: (periodicity)
Q58E22: (number of pay periods)
Enter dollar amount
>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
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
===>_
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 1995 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
===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__
>Q61coth< SPECIFY OTHER SOURCE OF INCOME FROM HEALTH
PROBLEM OR DISABILITY
ENTER "OTHER HEALTH PROBLEM/DISABILITY" IF THE ANSWER
IS "DON'T KNOW"
===>______________________________________________________
>Q61E1p< What is the easiest way for you to report (name's/your)
(first fill from Q61c or Q61c-oth) payments; weekly, every other
week, twice a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q61E1< How much did (name/you) receive (weekly/every
other week/twice a month/monthly/ ) before deductions in (first
fill from Q61c or Q61c-oth) payments in 1995?
Enter dollar amount $
>Q61E12< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in (first fill from Q61c or Q61c-oth)
payments in 1995?
<1-52>
>Q61E1C< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (FIRST FILL
FROM Q61c OR Q61c-oth) PAYMENTS RECEIVED IN 1995 WAS (AMOUNT).
IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q61E13< According to my calculations (name/you) received
(total) dollars altogether from (first fill from Q61c or Q61c-oth)
payments in 1995. Does that sound about right?
<1> Yes
<2> No
>Q61E14< What is your best estimate of the correct amount
(name\you) received from (first fill from Q61c or Q61c-oth) payments
during 1995?
PREVIOUS ENTRIES: Q61E1: (amount)
Q61E1p: (periodicity)
Q61E12: (number of pay periods)
Enter dollar amount
>Q61E2p< What is the easiest way for you to report (name's/your)
(second fill from Q61c or Q61c-oth) payments; weekly, every other
week, twice a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q61E2< How much did (name/you) receive (weekly/every
other week/twice a month/monthly/ ) in (second fill from Q61c
or Q61c-oth) payments in 1995?
Enter dollar amount $
>Q61E22< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in (second fill from Q61c or Q61c-oth)
payments in 1995?
<1-52>
>Q61E2C< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (SECOND FILL
FROM Q61c OR Q61c-oth) PAYMENTS RECEIVED IN 1995 WAS (AMOUNT).
IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q61E23< According to my calculations (name/you) received
(total) dollars altogether from (second fill from Q61c or Q61c-oth)
payments in 1995. Does that sound about right?
<1> Yes
<2> No
>Q61E24< What is your best estimate of the correct amount
(name\you) received from (second fill from Q61c or Q61c-oth) payments
during 1995?
PREVIOUS ENTRIES: Q61E2: (amount)
Q61E2p: (periodicity)
Q61E22: (number of pay periods)
Enter dollar amount
>Q62a< During 1995, 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
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 (name's/your) income?
<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
===>_ ===>_ ===>_ ===>_
===>_ ===>_ ===>_ ===>_
>Q62coth< 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); weekly, every other week, twice
a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q62E1< How much did (name/you) receive (weekly/every
other week/twice a month/monthly/ ) in (first fill from 62c or
62c-oth) in 1995?
Enter dollar amount $
>Q62E12< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in (first fill from 62c or 62c-oth)
in 1995?
<1-52>
>Q62E1C< *** 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 1995 WAS (AMOUNT). IS
THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q62E13< According to my calculations (name/you) received
(total) dollars altogether from (first fill from 62c or 62c-oth)
in 1995. Does that sound about right?
<1> Yes
<2> No
>Q62E14< What is your best estimate of the correct amount
(name\you) received from (first fill from 62c or 62c-oth) during
1995?
PREVIOUS ENTRIES: Q62E1: (amount)
Q62E1p: (periodicity)
Q62E12: (number of pay periods)
Enter dollar amount
>Q62E2p< What is the easiest way for you to report (name's/your)
(second fill from 62c or 62c-oth); weekly, every other week, twice
a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q62E2< How much did (name/you) receive (weekly/every other week/twice a month/
monthly/ ) in (second fill from 62c or 62c-oth) in 1995?
Enter dollar amount $
>Q62E22< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in (second fill from 62c or 62c-oth)
in 1995?
<1-52>
>Q62E2C< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (SECOND FILL
FROM 62c OR 62c-oth) RECEIVED IN 1995 WAS (AMOUNT). IS THIS A
CORRECT ENTRY?
<1> Yes
<2> No
>Q62E23< According to my calculations (name/you) received
(total) dollars altogether from (second fill from 62c or 62c-oth)
in 1995. Does that sound about right?
<1> Yes
<2> No
>Q62E24< What is your best estimate of the correct amount
(name\you) received from (second fill from 62c or 62c-oth) during
1995?
PREVIOUS ENTRIES: Q62E2: (amount)
Q62E2p: (periodicity)
Q62E22: (number of pay periods)
Enter dollar amount
>Q62E3p< What is the easiest way for you to report (name's/your)
(third fill from 62c or 62c-oth); weekly, every other week, twice
a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q62E3< How much did (name/you) receive (weekly/every other week/twice a month/
monthly/ ) in (third fill from 62c or 62c-oth) in 1995?
Enter dollar amount $
>Q62E32< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in (third fill from 62c or 62c-oth)
in 1995?
<1-52>
>Q62E3C< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL (THIRD FILL
FROM 62c OR 62c-oth) RECEIVED IN 1995 WAS (AMOUNT). IS THIS A
CORRECT ENTRY?
<1> Yes
<2> No
>Q62E33< According to my calculations (name/you) received
(total) dollars altogether from (third fill from 62c or 62c-oth)
in 1995. Does that sound about right?
<1> Yes
<2> No
>Q62E34< What is your best estimate of the correct amount
(name\you) received from (third fill from 62c or 62c-oth) during
1995?
PREVIOUS ENTRIES: Q62E1: (amount)
Q62E1p: (periodicity)
Q62E12: (number of pay periods)
Enter dollar amount
>Q63A1< At anytime during 1995 did (you/anyone in this household):
Have money in any kind of savings account or money market fund?
<1> Yes
<2> No
===>_
>Q63A2< Have any bonds, treasury notes, IRA's, or certificates
of deposit?
<1> Yes
<2> No
===>_
>Q63A3< Have an interest earning checking account or
any other investments which pay interest?
<1> Yes
<2> No
===>_
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?
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
>Q63cp< What is the easiest way for you to report (name's/your)
interest income; weekly, every other week, twice a month, monthly
or yearly?
ONLY INCLUDE INTEREST RECEIVED FROM U. S. SAVINGS BONDS CASHED
DURING 1995
SEPARATE AMOUNTS FOR JOINT OWNERSHIP
(blank/<A> Already included)
<X> None
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q63c< How much did (name/you) receive (weekly/every
other week/twice a month/monthly/ ) in interest from these sources
during 1995, including even small amounts reinvested or credited
to accounts?
SEPARATE AMOUNTS FOR JOINT OWNERSHIP
(blank/<A> Already included)
<X> None
Enter dollar amount $
>Q63c2< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in interest income in 1995?
<1-52>
>Q63cC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL INTEREST INCOME
RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q63c3< According to my calculations (name/you) received
(total) dollars altogether from interest income in 1995. Does
that sound about right?
<1> Yes
<2> No
>Q63c4< What is your best estimate of the correct amount
(name\you) received from interest payments during 1995?
PREVIOUS ENTRIES: Q63c: (amount)
Q63cp: (periodicity)
Q63c2: (number of pay periods)
Enter dollar amount
>Q64a< (blank/At any time during 1995 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
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?
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
>Q64cp< What is the easiest way for you to report (name's/your)
dividend income; weekly, every other week, twice a month, monthly
or yearly?
SEPARATE AMOUNTS FOR JOINT OWNERSHIP
(blank/<A> Already included)
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q64c< How much did (name/you) receive (weekly/every
other week/twice a month/monthly/ ) in dividends from stocks (mutual
funds) during 1995?
SEPARATE AMOUNTS FOR JOINT OWNERSHIP
(blank/<A> Already included)
<X> None
Enter dollar amount $
>Q64c2< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in dividends from stocks (mutual
funds) in 1995?
<1-52>
>Q64cC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL DIVIDEND PAYMENTS
RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q64c3< According to my calculations (name/you) received
(total) dollars altogether from dividend payments in 1995. Does
that sound about right?
<1> Yes
<2> No
>Q64c4< What is your best estimate of the correct amount
(name\you) received from dividend payments during 1995?
PREVIOUS ENTRIES: Q64c: (amount)
Q64cp: (periodicity)
Q64c2: (number of pay periods)
Enter dollar amount
>Q65A1< During 1995 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
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 SELFEMPLOYED
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) Selfemployed 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
during 1995?
SEPARATE AMOUNTS FOR JOINT OWNERSHIP
(blank/<A> Already included)
<X> None
<L> Lost
Enter dollar amount $
>Q65cL< ENTER AMOUNT OF MONEY LOST IN 1995.
===>$___,___ .00
>Q65cp< Is this an annual, quarterly, monthly, weekly,
or other amount?
Per <1> Annual
<2> Quarterly
<3> Monthly
<4> Weekly
<5> Other
Q65cp ==>___
>Q65c2< What is your best estimate of (name's/your) ANNUAL
net earnings from rent (blank/, roomers or boarders, estates,
trusts, or royalties/, roomers or boarders, or royalties/, estates
or trusts) AFTER EXPENSES in 1995?
PREVIOUS ENTRIES: Q65c: (amount)
Q65cp: (periodicity)
Enter dollar amount $
>Q65cC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL SUPPLEMENTAL
SECURITY INCOME RECEIVED IN 1995 ON BEHALF OF CHILDREN WAS (AMOUNT).
IS THIS A CORRECT ENTRY?
<1> Yes
<2> No goto 65c (TO CORRECT ENTRY)
>Q65c2L< What is your best estimate of (name's/your)
ANNUAL LOSS from rent (blank/, roomers or boarders, estates, trusts,
or royalties/, roomers or boarders, or royalties/, estates or
trusts) AFTER EXPENSES in 1995?
PREVIOUS ENTRIES: Q65cL: (amount)
Q65c1: (periodicity)
Enter dollar amount $
>Q66a< During 1995 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
>Q66b< Did (you/anyone in this household) receive any
educational assistance for tuition, fees, books, or living expenses
during 1995?
EXCLUDE LOANS, ASSISTANCE FROM HOUSEHOLD MEMBERS, AND VA EDUCATIONAL
BENEFITS
<1> Yes
<2> No
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 1995?
FOR AMOUNTS $50,000 AND OVER, ENTER $49,999
===>$___,___ .00 ENTER ANNUAL AMOUNT ONLY
>Q66hp< What is the easiest way for you to report (name's/your)
educational assistance during 1995; weekly, every other week,
twice a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q66h< (blank/Aside from the Pell Grant assistance,)
(How/how) much did (name/you) receive (weekly/every other week/twice
a month/monthly/ ) in educational assistance during 1995?
Enter dollar amount $
>Q66h2< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in educational assistance in 1995?
<1-52>
>Q66hC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL EDUCATIONAL
ASSISTANCE RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q66h3< According to my calculations (name/you) received
(total) dollars altogether from educational assistance in 1995.
Does that sound about right?
<1> Yes
<2> No
>Q66h4< What is your best estimate of the correct amount
(name\you) received from educational assistance during 1995?
PREVIOUS ENTRIES: Q66h: (amount)
Q66hp: (periodicity)
Q66h2: (number of pay periods)
Enter dollar amount
>Q70a< During 1995 did (anyone in this household/you) receive:
Any child support payments?
<1> Yes
<2> No
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, every other week, twice a month,
monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q70c< How much did (name/you) receive
(weekly/every other week/twice a month/monthly/ )
in child support payments in 1995?
Enter dollar amount $
>Q70c2< How many (weekly/every other week/twice a month/monthly)
child support payments did (name/you) receive in 1995?
<1-52>
>Q70cC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL CHILD SUPPORT
PAYMENTS RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q70c3< According to my calculations (name/you) received
(total) dollars altogether from child support payments in 1995.
Does that sound about right?
<1> Yes
<2> No
>Q70c4< What is your best estimate of the correct amount
(name\you) received from child support payments during 1995?
PREVIOUS ENTRIES: Q70c: (amount)
Q70cp: (periodicity)
Q70c2: (number of pay periods)
Enter dollar amount
>Q71a< (blank/During 1995 did (anyone in this household receive:/you receive:)
Any alimony payments?
<1> Yes
<2> No
NOTE: THIS ITEM DOES NOT APPEAR FOR SINGLE PERSON HOUSEHOLDS
>Q71b< **ASK ONLY IF NECESSARY**
Who received these payments during 1995?
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,
every other week, twice a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q71c< How much did (name/you) receive
(weekly/every other week/twice a month/monthly/ )
in alimony payments in 1995?
Enter dollar amount $
>Q71c2< How many (weekly/every other week/twice a month/monthly)
alimony payments did (name/you) receive in 1995?
<1-52>
>Q71cC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL ALIMONY PAYMENTS
RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q71c3< According to my calculations (name/you) received
(total) dollars altogether from alimony payments in 1995. Does
that sound about right?
<1> Yes
<2> No
>Q71c4< What is your best estimate of the correct amount
(name\you) received from alimony payments during 1995?
PREVIOUS ENTRIES: Q71c: (amount)
Q71cp: (periodicity)
Q71c2: (number of pay periods)
Enter dollar amount
>Q72a< (blank/During 1995 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
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, every other week, twice
a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q72c< How much did (name/you) receive
(weekly/every other week/twice a month/monthly/ )
in regular financial assistance in 1995?
Enter dollar amount $
>Q72c2< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in regular financial assistance
in 1995?
<1-52>
>Q72cC2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL REGULAR FINANCIAL
ASSISTANCE PAYMENTS RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT
ENTRY?
<1> Yes
<2> No
>Q72c3< According to my calculations (name/you) received
(total) dollars altogether from regular financial assistance in
1995. Does that sound about right?
<1> Yes
<2> No
>Q72c4< What is your best estimate of the correct amount
(name\you) received from regular financial assistance during 1995?
PREVIOUS ENTRIES: Q72c: (amount)
Q72cp: (periodicity)
Q72c2: (number of pay periods)
Enter dollar amount
>Q73A1< During 1995, did (anyone in this household/you)
receive income from:
Hobbies, home businesses, farms, or business interests not
already covered?
<1> Yes
<2> No
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/nameCURRENT RESPONDENT)
===>______________________________________________________
>Q731p< What is the easiest way for you to report (name's/your)
income from hobbies, home business, farms, or business interest
not already covered during 1995; weekly, every other week, twice
a month, monthly or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q731< How much did (name/you) receive (weekly/every
other week/twice a month/monthly/ ) in income from hobbies, home
business, farms, or business interest not already covered during
1995?
Enter dollar amount $
>Q7312< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in income from hobbies, home business,
farms, or business interest not already covered in 1995?
<1-52>
>Q731C2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL INCOME FROM
HOBBIES, HOME BUSINESS, FARMS, OR BUSINESS INTEREST NOT ALREADY
COVERED IN 1995 WAS (AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q7313< According to my calculations (name/you) received
(total) dollars altogether from hobbies, home business, farms,
or business interest not already covered in 1995. Does that sound
about right?
<1> Yes
<2> No
>Q7314< What is your best estimate of the correct amount
(name\you) received from hobbies, home business, farms, or business
interest not already covered during 1995?
PREVIOUS ENTRIES: Q731: (amount)
Q731p: (periodicity)
Q7312: (number of pay periods)
Enter dollar amount
>Q73A2< During 1995, 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/nameCURRENT RESPONDENT)
===>______________________________________________________
>Q732p< What is the easiest way for you to report (name's/your)
income from any unemployment compensation, severance pay, welfare,
foster child care payments, or any other money not already covered
during 1995; weekly, every other week, twice a month, monthly
or yearly?
<1> Weekly
<2> Every other week
<3> Twice a month
<4> Monthly
<5> Yearly
==>___
>Q732< How much did (name/you) receive (weekly/every
other week/twice a month/monthly/ ) in income from any unemployment
compensation, severance pay, welfare, foster child care payments,
or any other money not already covered during 1995?
Enter dollar amount $
>Q7322< How many (weekly/every other week/twice a month/monthly)
payments did (name/you) receive in income from any unemployment
compensation, severance pay, welfare, foster child care payments,
or any other money not already covered in 1995?
<1-52>
>Q732C2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL INCOME FROM
ANY UNEMPLOYMENT COMPENSATION, SEVERANCE PAY, WELFARE, FOSTER
CHILD CARE PAYMENTS, OR ANY OTHER MONEY NOT ALREADY COVERED IN
1995 WAS (AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q7323< According to my calculations (name/you) received
(total) dollars altogether from any unemployment compensation,
severance pay, welfare, foster child care payments, or any other
money not already covered in 1995. Does that sound about right?
<1> Yes
<2> No
>Q7324< What is your best estimate of the correct amount
(name\you) received from any unemployment compensation, severance
pay, welfare, foster child care payments, or any other money not
already covered during 1995?
PREVIOUS ENTRIES: Q732: (amount)
Q732p: (periodicity)
Q7322: (number of pay periods)
Enter dollar amount
>SHI1< These next questions are about health insurance
coverage during the calendar year 1995. The questions apply to
ALL persons of ALL ages.
ENTER <P> TO PROCEED
===>_
>SHI2< At any time in 1995, (were you/was anyone in this
household) covered by a health plan provided through (their/your)
current or former employer or union? (MILITARY HEALTH INSURANCE
WILL BE COVERED LATER IN ANOTHER QUESTION.)
<1> Yes
<2> No
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 1995, (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
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 1995, (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
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 1995, (were you/was anyone in
this household) covered by Medicare?
READ IF NECESSARY: Medicare is 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 1995, (were you/was anyone in
this household) covered by Medicaid/(fill state name)?
READ IF NECESSARY: Medicaid/ (fill state name) is the government
assistance program that pays for health care?
<1> Yes
<2> No
State fills for item SHI15:
MEDCAL: California
WELFARE: Oregon
MEDIKAN: 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 1995, (were/was) (name/you)
covered by Medicaid/(local name)?
ENTER NUMBER OR MONTHS
===>__
(1-12)
>SHI18< At any time in 1995, (were you/was anyone in
this household) covered by CHAMPUS, CHAMP-VA, VA, military health
care, or Indian Health Service?
NOTE: "CHAMP-VA" IS THE CIVILIAN HEALTH AND MEDICAL
PROGRAM OF THE DEPARTMENT OF VETERAN'S AFFAIRS.
<1> Yes
<2> No
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 1995, 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
1995.
<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/unionprovided (policyholder)
<10> Employer/unionprovided (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
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/unionprovided (policyholder)
<11> Employer/unionprovided (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 <P> TO PROCEED
===>_
>SHI25< Would you say (name's/your) health in general
is:
<1> Excellent
<2> Very good
<3> Good
<4> Fair
<5> Poor
===>_
>Q74a< Other than Social Security did the (ANY) employer
or union that (name/you) worked for in 1995 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
===>___
>Q80< During 1995 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)
<A> All <18>
<X> None <9> Nine or more
===>__ TOTAL NUMBER OF CHILDREN COVERED
>Q83< During 1995 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)
<A> All <18>
<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 1995?
<1> Yes
<2> No
>Q88< Which of the people now living here were covered
by food stamps during 1995?
LIST ALL HOUSEHOLD MEMBERS COVERED BY FOOD STAMPS REGARDLESS OF
AGE
PROBE: Anyone else? ENTER <N> FOR NO MORE
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)
<A> All
<X> None
ENTER LINE NUMBER
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
>Q90p< What is the easiest way for you to report the
value of the food stamps; monthly or yearly?
<1> Monthly
<2> Yearly
==>___
>Q90< What is the (monthly/ ) value of food stamps received
in 1995?
Enter dollar amount $
>Q902< How many months were food stamps received in 1995?
<1-12>
>Q90C2< *** DO NOT READ TO THE RESPONDENT ***
THE ANNUAL RATE APPEARS OUT OF RANGE. THE TOTAL FOOD STAMPS
PAYMENTS RECEIVED IN 1995 WAS (AMOUNT). IS THIS A CORRECT ENTRY?
<1> Yes
<2> No
>Q903< According to my calculations (total) dollars was
received altogether from food stamps in 1995. Does that sound
about right?
<1> Yes
<2> No
>Q904< What is your best estimate of the correct amount
received from food stamps during 1995?
PREVIOUS ENTRIES: Q90: (amount)
Q90p: (periodicity)
Q902: (number of pay periods)
Enter dollar amount
>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, 1995, (have you/has this household) received
assistance of this type from the federal, state, or local government?
<1> Yes
<2> No
>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
===>_
>Q93PR2< Was it used to pay heating costs?
<1> Yes
<2> No
===>_
>Q94< Altogether, how much energy assistance has been
received since October 1, 1995?
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) one year ago;
that is, on March 1, 1995?
<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, 1995?
>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 1 year 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 Fiji
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 Sweden
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 1 year or over/ ). Did (all of these persons/person name)
live with (reference person's name/you) in (this house/name of
country/name of city, State) 1 year 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) 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?
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__ ===>__ ===>__ ===>__ ===>__ ===>__ ===>__
===>__
>NXTSAM< Did (NEXTMOVER's name/you) live in this house
1 year ago; that is, on March 1, 1995?
<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, 1995?
>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 1 year 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 Fiji
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 Sweden
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
===>___