Consumer Expenditure Survey

Section 4, Part B - Work Experience and Income - Week 2 Diary Pick-up - Ask for entire CU as a group

Section 4, Part B deals with income received by the consumer unit as a whole, including interest income, dividends, pension income, unemployment and workers' compensation, money from food stamps and other government assistance, rental income, alimony and child support, tax refunds, and other income.

Up until this point, we have discussed earnings for individual members. Now, I would like to talk to you about your CU as a whole. During the last 12 months, did you or any member of your CU receive income from any of the following-
Interest on bank accounts, money market funds, CDs, or bonds?

  1. Yes
  2. No

What was the total amount received by all CU members?

[enter value] ______________

Do not know the exact amount

Could you tell me which range on CARD C best reflects the total amount of interest received by all CU members during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

During the last 12 months, did you or any member of your CU receive any-
REGULAR income from dividends, trusts, estates or royalties?

  1. Yes
  2. No

What was the total amount received by all CU members?

[enter value] ______________

Do not know the exact amount

Could you tell me which range on CARD C best reflects the total amount of income from dividends, trusts, estates or royalties during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

During the last 12 months, did you or any member of your CU receive income from-
Retirement, disability and survivor pensions or annuities from private companies, military, Government, IRA or Keogh?

  1. Yes
  2. No

What was the total amount received by all CU members?

Could you tell me which range on CARD C best reflects the total amount of retirement pensions and annuities during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

During the last 12 months, did you or any member of your CU receive any income from-
Unemployment compensation or supplemental unemployment compensation?

  1. Yes
  2. No

What was the total amount received by all CU members?

Could you tell me which range on CARD C best reflects the total amount received in unemployment compensation during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

During the last 12 months, did you or any member of your CU receive any income from-
Worker's compensation or veteran's benefits including the GI Bill but not including military retirement?

  1. Yes
  2. No

What was the total amount received by all CU members?

Could you tell me which range on CARD C best reflects the total amount of income from worker's compensation during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

During the last 12 months, did you or any member of your CU receive any-
Food stamps or electronic benefit transfers (EBTs)?

  1. Yes
  2. No

In how many of the last 12 months were food stamps or EBTs received?

In the last month have you or any members of your CU received any food stamps or EBTs?

  1. Yes
  2. No

What was the dollar value of the last food stamps or EBT received?

[enter value] ______________

During the last 12 months, did you or any member of your CU receive any state or local government welfare program, such as TANF, or short-term emergency help? This would include checks, direct deposits, or EBT cards, but would not include food stamps.

  1. Yes
  2. No

What was the total amount received by all CU members?

[enter value] ______________

Do not know the exact amount

Could you tell me which range on CARD C best reflects the total amount of income from cash assistance from state or local government welfare programs during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

During the last 12 months, did you or any member of your CU have any net income or loss from any type of rental rooms or living units?

  1. Yes
  2. No

How much net income or loss was received from roomers or boarders?

[enter value] ______________

None

Do not know the exact amount

Could you tell me which range on CARD C best reflects your net income or loss from roomers or boarders?

  1. Loss
  2. $0-$999
  3. $1,000-$1,999
  4. $2,000-$2,999
  5. $3,000-$3,999
  6. $4,000-$4,999
  7. $5,000-$9,999
  8. $10,000-$14,999
  9. $15,000-$19,999
  10. $20,000-$29,999
  11. $30,000-$39,999
  12. $40,000-$49,999
  13. $50,000 and over

For definitions Information Booklet »

* Do not read.

Was this an income or a loss?

  1. Loss
  2. Income

How much net income or loss was received from other rental units?

[enter value] ______________

None

Do not know the exact amount

Could you tell me which range on CARD C best reflects your net income or loss from other rental units during the last 12 months?

  1. Loss
  2. $0-$999
  3. $1,000-$1,999
  4. $2,000-$2,999
  5. $3,000-$3,999
  6. $4,000-$4,999
  7. $5,000-$9,999
  8. $10,000-$14,999
  9. $15,000-$19,999
  10. $20,000-$29,999
  11. $30,000-$39,999
  12. $40,000-$49,999
  13. $50,000 and over

For definitions Information Booklet »

* Do not read.

Was this an income or a loss?

  1. Loss
  2. Income

During the last 12 months, did you or any member of your CU receive any income from child support?

  1. Yes
  2. No

Did you receive a one time lump sum payment for child support?

  1. Yes
  2. No

What was the total amount of lump sum payments for child support received by ALL CU members in the last 12 months?

Could you tell me which range on CARD C best reflects the total amount received in lump sum payments for child support by ALL CU members during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

Did you receive any child support payments in other than a lump sum amount?

  1. Yes
  2. No

What was the total amount of non-lump sum payments received by ALL CU members in the last 12 months?

[enter value] ______________

Do not know the exact amount

Could you tell me which range on CARD C best reflects the total amount received in child support payments, other than lump sum amounts, by ALL CU members during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

During the last 12 months, did you or any member of your CU receive any REGULAR income from -
Alimony?

  1. Yes
  2. No

During the last 12 months, did you or any member of your CU receive any REGULAR income from -
Other sources such as from persons outside your CU?

  1. Yes
  2. No

Altogether, what was the total amount received by all CU members from alimony and other sources in the last 12 months?

[enter value] ______________

Do not know the exact amount

Could you tell me which range on CARD C best reflects the total amount received in alimony and other sources during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

During the last 12 months, did you or any member of your CU receive any -
Lump sum payments from insurance, estates, trusts, royalties, alimony, prizes or games of chance, or from persons outside your CU?

  1. Yes
  2. No

What was the total amount received by all CU members?

[enter value] ______________

Do not know the exact amount

Could you tell me which range on CARD C best reflects the total lump sum payments during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

During the last 12 months, did you or any member of your CU receive any -
Money from the sale of household furnishings, equipment, clothing, jewelry, pets, or other belongings, not including the sale of vehicles or real estate?

  1. Yes
  2. No

What was the total amount received by all CU members?

Could you tell me which range on CARD C best reflects the total amount received from these sales during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

During the last 12 months, did you or any member of your CU receive any -
Other money income, including money received from cash scholarships and fellowships, stipends not based on working, or from the care of foster children?

  1. Yes
  2. No

What was the total amount received by all CU members?

Could you tell me which range on CARD C best reflects the total amount of other money income received during the last 12 months?

  1. $0-$999
  2. $1,000-$1,999
  3. $2,000-$2,999
  4. $3,000-$3,999
  5. $4,000-$4,999
  6. $5,000-$9,999
  7. $10,000-$14,999
  8. $15,000-$19,999
  9. $20,000-$29,999
  10. $30,000-$39,999
  11. $40,000-$49,999
  12. $50,000 and over

For definitions Information Booklet »

During the last 12 months, did you or any member of your CU receive any REFUNDS from any of the following -
Federal income tax?

  1. Yes
  2. No

What was the total amount received by ALL CU members?

[enter value] ______________

During the last 12 months, did you or any member of your CU receive any REFUNDS from any of the following -
State and local income tax?

  1. Yes
  2. No

What was the total amount received by ALL CU members?

[enter value] ______________

During the last 12 months, did you or any member of your CU receive any REFUNDS from any of the following -
Overpayment on Social Security?

  1. Yes
  2. No

What was the total amount received by ALL CU members?

[enter value] ______________

During the last 12 months, did you or any member of your CU receive any REFUNDS from any of the following -
Insurance policies?

  1. Yes
  2. No

What was the total amount received by ALL CU members?

[enter value] ______________

During the last 12 months, did you or any member of your CU receive any REFUNDS from any of the following -
Property taxes?

  1. Yes
  2. No

What was the total amount received by ALL CU members?

[enter value] ______________

During the last 12 months, did you or any member of your CU receive any REFUNDS from any of the following -
Other sources, including any other taxes?

  1. Yes
  2. No

* Specify: [enter text] ______________

What was the total amount received by ALL CU members?

[enter value] ______________

During the last 12 months, did you or any member of your CU PAY any of the following -
Federal income tax in addition to that withheld from earnings?

  1. Yes
  2. No

What was the total amount paid by ALL CU members?

[enter value] ______________

During the last 12 months, did you or any member of your CU PAY any of the following -
State and local income tax in addition to that withheld from earnings?

  1. Yes
  2. No

What was the total amount paid by ALL CU members?

[enter value] ______________

During the last 12 months, did you or any member of your CU PAY any of the following -
Personal property taxes for vehicles?

  1. Yes
  2. No

What was the total amount paid by ALL CU members?

[enter value] ______________

During the last 12 months, did you or any member of your CU PAY any of the following -
Personal property taxes and other taxes not reported elsewhere? Do not include Social Security tax for the self-employed.

  1. Yes
  2. No

* Specify: [enter text] ______________

What was the total amount paid by ALL CU members?

[enter value] ______________

During the last 12 months, did you or any member of your CU have any occupational expenses such as union dues, tools, uniforms, business or professional association dues, licenses, or permits?

  1. Yes
  2. No

What was the total amount of these occupational expenses?

[enter value] ______________

During the last 12 months, have you or any member of your CU received any free meals at work as part of your pay?

  1. Yes
  2. No

About what was the weekly dollar value of such meals?

[enter value] ______________

How many weeks did you or any member of your CU receive such meals during the last 12 months?

[enter value] ______________

During the last 12 months, have you or any member of your CU received any free or reduced rent for this unit as a form of pay?

  1. Yes
  2. No

What is the rental charge to another tenant for a similar unit?

[enter value] ______________

What period of time does this cover?

  1. Week
  2. 2 Weeks
  3. Month
  4. Other

* Specify: [enter text] ______________

End of Section 4B

Go to Section 5 - Post Diary Assessment Questions »

Go to CE Diary Household Characteristics Questionnaire Home Page »

Last Modified Date: November 24, 2006

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