Section 22, Part A - Work Experience and Income - Second Quarter, Fifth Quarter, or New Households Only

Section 22, Part A collects detailed information about the work experience and income of each member of the household age 14 and older, including occupation, hours and weeks worked, deductions from pay, and amount of income from wages and salaries, self employment, and Social Security. Note that this section is also asked in the 3rd or 4th interview for anyone turning 14 years old or members who previously did not work but are now working.

The next few questions are about income. We know people aren’t used to discussing their income, but please be assured that, like all other information you have provided, these answers will be kept strickly confidential.

1. Enter 1 to continue

In the last 12 months, including paid vacation and sick leave, how many weeks did you/(NAME) work?

[enter value] ______________

0. Did not work

In the weeks that you worked, how many hours did you/he/she usually work per week? [enter value] _____________

Which of the following categories best describes the job in which you received the most earnings during the last 12 months?

1. Administrator, manager
2. Teacher
3. Professional
4. Administrative support, including clerical
5. Sales, retail
6. Sales, business goods and services
7. Technician
8. Protective service
9. Private household service
10. Other service
11. Machine operator, assembler, inspector
12. Transportation operator
13. Handler, helper, laborer
14. Mechanic, repairer, precision production
15. Construction, mining
16. Farming
17. Forestry, fishing, groundskeeping
18. Armed Forces

For definitions Information Booklet »

Were/Was you:

1. An employee of a PRIVATE company, business, or individual working for wages or salary?
2. A Federal government employee?
3. A State government employee?
4. A local government employee?
5. Self-employed in your/his/her OWN business, partnership, professional practice, or farm?
6. Working WITHOUT PAY in a family business or farm

Is your business incorporated?

1. Yes
2. No

What was the main reason you did not work during the last 12 months?

Were/Was you/he/she -

1. Retired?
2. Taking care of home/family?
3. Going to school?
4. Ill, disabled, unable to work?
5. Unable to find work?
6. Doing something else? Specify

* Specify: [enter text] _____________

During the last 12 months, did you receive any money in wages or salary? Include all bonuses and overtime pay, commissions, tips, allowances, Armed Forces pay, severance pay, teaching fellowships, etc.

1. Yes
2. No

During the last 12 months, how much did you receive in wages and salaries for ALL JOBS before any deductions?

[enter value] ______________

1. Do not know the exact amount

Could you tell me which range on CARD A best reflects your total wages and salaries for ALL JOBS during the last 12 months

0. Loss
1. $0-$4,999
2. $5,000-$9,999
3. $10,000-$14,999
4. $15,000-$19,999
5. $20,000-$29,999
6. $30,000-$39,999
7. $40,000-$49,999
8. $50,000-$69,999
9. $70,000-$89,999
10. $90,000-$119,999
11. $120,000 and over

For definitions Information Booklet »

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What was the amount of your last pay before any deductions? [enter value] _____________

What period of time did this cover?

1. One week
2. Two weeks
3. Month
4. Quarter
5. Year
6. Twice a month
7. Other

* Specify: [enter text] _____________

Was there any money deducted from your pay for -
Federal income tax?

1. Yes
2. No

How much? [enter value] _____________

Was there any money deducted from your pay for -
State or local income tax?

1. Yes
2. No

How much? [enter value] _____________

Was there any money deducted from your pay for -
Private pension fund?

1. Yes
2. No

How much? [enter value] _____________

Was there any money deducted from your pay for -
Government retirement?

1. Yes
2. No

How much? [enter value] _____________

Was there any money deducted from your pay for -
Railroad retirement?

1. Yes
2. No

How much? [enter value] _____________

Was there any money deducted from your pay for -
Social Security including Medicare?

1. Yes
2. No

Are Social Security payments NORMALLY deducted from your pay?

1. Yes
2. No

Does the money deducted for Social Security cover only the Medicare portion of Social Security?

1. Yes
2. No

Other than Social Security, did any employer or union contribute to your pension or retirement plan in the last 12 months?

1. Yes
2. No

During the last 12 months, did you have any income or loss from your own nonfarm business, partnership, or professional practice?

1. Yes
2. No

What was the amount of income or loss after expenses? [enter value] _____________

Was this an income or loss?

1. Loss
2. Income

Could you tell me which range on CARD A best reflects your income or loss from your own nonfarm business, partnership or professional practice during the last 12 months?

0. Loss
1. $0-$4,999
2. $5,000-$9,999
3. $10,000-$14,999
4. $15,000-$19,999
5. $20,000-$29,999
6. $30,000-$39,999
7. $40,000-$49,999
8. $50,000-$69,999
9. $70,000-$89,999
10. $90,000-$119,999
11. $120,000 and over

For definitions Information Booklet »

During the last 12 months, did you have any income or loss from your own farm?

1. Yes
2. No

What was the amount of income or loss after expenses? [enter value] _____________

Was this an income or loss?

1. Loss
2. Income

Could you tell me which range on CARD A best reflects your income or loss from your own farm during the last 12 months?

0. Loss
1. $0-$4,999
2. $5,000-$9,999
3. $10,000-$14,999
4. $15,000-$19,999
5. $20,000-$29,999
6. $30,000-$39,999
7. $40,000-$49,999
8. $50,000-$69,999
9. $70,000-$89,999
10. $90,000-$119,999
11. $120,000 and over

For definitions Information Booklet »

During the last 12 months, did you place any money in a retirement plan such as an Individual Retirement Account (IRA) or Keogh? Do not include rollovers.

1. Yes
2. No

How much? [enter value] _____________

During the last 12 months, did you receive, from the US Government, any money from -
Social Security checks?

1. Yes
2. No

During the last 12 months, did you receive, from the US Government, any money from -
Railroad Retirement checks?

1. Yes
2. No

What was the amount, if any, of the last Social Security or Railroad Retirement payment received? [enter value] _____________

Could you tell me which range on CARD B best reflects the amount of your last Social Security or Railroad Retirement payment during the last 12 months?

1. Less than $300
2. $300-$399
3. $400-$499
4. $500-$599
5. $600-$699
6. $700-$799
7. $800-$899
8. $900-$999
9. $1,000-$1,499
10. $1,500 and over

For definitions Information Booklet »

Is this amount AFTER the deduction for a Medicare premium?

1. Yes
2. No

During the last 12 months, how many Social Security or Railroad Retirement payments did you receive? [enter value] _____________

During the last 12 months, did you receive any -
Supplemental Security Income (SSI) payments from the US Government?

1. Yes
2. No

During the last 12 months, did you receive any -
Supplemental Security Income (SSI) payments from the STATE or LOCAL government?

1. Yes
2. No

During the last 12 months, how much, if any, did you receive in Supplemental Security Income checks from ALL government sources? [enter value] _____________

Could you tell me which range on CARD C best reflects the amount you received in Supplemental Security income from all government sources during the last 12 months?

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

For definitions Information Booklet »

End of Section 22A

Go to Section 22 Part B - Work Experience and Income - Second Quarter, Fifth Quarter, or New Households Only - Ask for entire household as a group »

Go to CE CAPI Survey Instrument Home Page »

 

Last Modified Date: April 5, 2010