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[p. 191]

Section L -- FAMILY RESOURCES -- Continued

Mark box or ask each nondeleted family member, including Armed Forces members living at home:

0[] Under 14 (NP)

8a. Did -- have a job or business in (month)?

1[] Yes (8b)
2[] No (NP)
9[] DK (NP)


b. How many hours did -- usually work per week at all jobs in (month)?

Hours ____ number
99[] DK


9. Was -- working for an employer or was -- self-employed in (month)?
Read if necessary: Examples of self-employment include a business, professional practice, or farm.

1[] Employer only (10)
2[] Self-employed only (11)
3[] Both (10)
9[] DK (NP)


10a. How much income did -- receive in (month) before deductions form all jobs? Include any tips, bonuses, overtime pay, and commissions.

(Dollars) $____
9999999[] DK


b. In how many of the past 12 months did -- have a job?

12[] All
Months ____
99[] DK


Ask 11a and b if box 2 or 3 in 9; otherwise, go to NP.
11a. How much income did -- receive in (month) from self-employment? Report NET income, after business expenses.
Read if necessary: For farms, include any earnings as a tenant farmer or sharecropper.

1[] Already included
0[] Loss
(Dollars) $____
9999999[] DK


b. In how many of the past 12 months was -- self-employed?

12[] All
Months ____ number
99[] DK


12a. In (month), did anyone in the family receive Social Security or Railroad Retirement payments?
Read if necessary: Social Security checks are either automatically deposited in the bank or mailed to arrive on the 3rd of every month. If mailed, they are sent in a gold colored envelope.

1[] Yes (12b)
2[] No (13)
9[] DK (13)

b. Who was this
Mark "SS/RR" box in person's column.

[] SS/RR

c. Anyone else?

[] Yes (Reask 12b and c)
[] No


Ask 12d for each person with "SS/RR" in 12b.
d. How much income did -- receive in (month) from Social Security or Railroad Retirement?

1[] Already included
(Dollars) $____
9999[] DK


Ask 12e-f for each person under 65 with "SS/RR" in 12b.
e. Was -- Social Security or Railroad Retirement income received as a disability benefit?

1[] Yes (12f)
2[] No (12e for NP under 65 for "SS/RR" in 12b)
9[] DK (12e for NP under 65 with "SS/RR" in 12b)


f. Did -- receive this benefit because -- is disabled?

1[] Yes
2[] No
9[] DK

[p. 192]


13a. (In (month), did anyone in the family receive) Supplemental Security Income or SSI?
Read if necessary: Federal SSI checks are either automatically deposited in the bank or mailed to arrive on the first of every month. If mailed, they are sent in a blue colored envelope.

1[] Yes (13b)
2[] No (14)
9[] DK (14)

b. Who was this
Mark "SSI" box in person's column.

1[] SSI

c. Anyone else?

[] Yes (Reask 13b and c)
[] No


Ask 13d for each person with "SSI" in 13b.
d. How much income did -- receive in (month) from Supplemental Security Income or SSI?

(Dollars) $____
9999[] DK


14a. (In (month), did anyone in the family receive) Any (other) disability pension (other than Social Security or Railroad Retirement)?

1[] Yes (14b)
2[] No (15)
9[] DK (15)

b. Who was this
Mark "Disability" box in person's column.

1[] Disability

c. Anyone else?

[] Yes (Reask 14b and c)
[] No


Ask 14d for each person with "Disability" marked in 14b.
d. How much did -- receive in (month) BEFORE deductions came from a disability pension?

1[] Already included
(Dollars) $____
9999[] DK


15a. (In (month), did anyone in the family receive) Any (other) retirement or survivor pension (other than (Social Security or Railroad Retirement/(or) disability pension))?

1[] Yes (15b)
2[] No (16)
9[] DK (16)

b. Who was this
Mark "Pension" box in person's column.

1[] Pension

c. Anyone else?

[] Yes (Reask 15b and c)
[] No


Ask 15d for each person with "Pension" marked in 15b.
d. How much income did -- receive BEFORE deductions from retirement or survivor pensions (other than (Social Security or Railroad Retirement/(or) disability pension)) in (month)?

1[] Already included
(Dollars) $____
999999[] DK


16a. (In (month), did anyone in the family receive) Public assistance or welfare payments from the State or local welfare office? Do not include SSI.

1[] Yes (16b)
2[] No (17)
9[] DK (17)

b. Who was this
Mark "Welfare" box in person's column.

1[] Welfare

c. Anyone else?

[] Yes (Reask 16b and c)
[] No


Ask 16d-f for each person with "Welfare" marked in 16b.
d. Did -- receive Aid to Families with Dependent Children, sometimes called AFDC or ADC, or some other type of assistance payments in (month)?

1[] AFDC
2[] Other
3[] Both
9[] DK


e. In how many of the past 12 months did -- receive these payments?

12[] All
Months ____
99[] DK


f. How much income did -- receive from public assistance or welfare in (month)?

1[] Already included
(Dollars) $____
9999[] DK

[p. 193]

Section L -- FAMILY RESOURCES -- Continued


17a. In (month), did anyone in the family receive food stamps?

1[] Yes (17b)
2[] No (18)
9[] DK (18)

b. Did this food stamp allotment include anyone who lived here who was not in your family?

1[] Yes (17c)
2[] No (17d)
9[] DK (17d)

c. How many other persons who lived here in (month) besides your family were included in this food stamp allotment?

(Number) ____
99[] DK


d. What was the total value of the food stamp allotment received in (month)?

(Dollars) $____
9999[] DK


18a. In (month), did anyone in the family have money in any kind of savings or other bank account which earned interest? Do not include dividends.

Read if necessary: Include savings accounts, money market funds, treasury notes, IRA's, or certificates of deposit, interest earning checking accounts, bonds, or any other investments which earn interest.

1[] Yes (18b)
2[] No (19)
9[] DK (19)

b. Who was this?
Mark "Interest" box in person's column.

1[] Interest

c. Anyone else?

[] Yes (Reask 18b and c)
[] No


Ask 18d for each person with "Interest" marked in 18b.
d. What is your best estimate of the total amount of interest that -- earned in (month)?

1[] Already included
(Dollars) $____
99999[] DK


19a. Did anyone in the family receive dividend income from stocks or mutual funds or income from rental property, royalties, estates, or trusts in (month)?

1[] Yes (19b)
2[] No (20)
9[] DK (20)

b. Who was this?
Mark "Dividends" box in person's column.

1[] Dividends

c. Anyone else?

[] Yes (Reask 19b and c)
[] No


Ask 19d for each person with "Dividends" marked in 19b.
d. What is your best estimate of the total amount that -- received form dividends, net rental property income, royalties, estates, or trusts in (month)?

1[] Already included
0[] Loss
(Dollars) $____
99999[] DK


20a. In (month), did anyone in the family receive income from any other sources, such as veterans payment, worker's or unemployment compensation, child support, or alimony? Do not include lump payments, such as money from an inheritance or the sale of a home.

1[] Yes (20b)
2[] No (Cover page)
9[] DK (Cover page)

b. Who was this?
Mark "Other income" box in person's column.

1[] Other income

c. Anyone else?

[] Yes (Reask 20b and c)
[] No


Ask 20d for each person with "Other income" marked in 20b.
d. How much income did -- receive in (month) from all other sources?

1[] Already included
(Dollars) $____
99999[] DK