Section 4, Part A - Work Experience and Income - Week 2 Diary Pick-up

Section 4, Part A collects detailed information about the work experience and income of each member of the consumer unit 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.

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 strictly confidential.

1. Enter 1 to continue.

In the last 12 months, including paid vacation and sick leave, how many weeks did [YOU or the CU member in question] work?
* If CU member did not work, enter zero.

[enter value] ______________

0. Did not work

In the weeks that [YOU or the CU member in question] worked, how many hours did you/he/she usually work per week?

[enter value] _____________

The job in which you received the most earnings in the past 12 months fits best in which of the following categories?

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/he/she:

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?
6. Self-employed in your/his/her OWN farm?
7. Working WITHOUT PAY in a family business or farm?

Is your/his/her business incorporated?

1. Yes
2. No

What was the main reason you/he/she 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 wages, salaries, 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] ______________

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

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] ______________

Do not know the exact amount

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] ______________

Do not know the exact amount

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] ______________

Do not know the exact amount

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 did you receive in Supplemental Security Income checks from ALL government sources?

[enter value] ______________

Do not know the exact amount

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. $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 »

End of Section 4A

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

Go to CE Diary Household Characteristics Questionnaire Home Page »

 

Last Modified Date: April 5, 2011