Various Demographic Pretesting Activities

Generic Clearence for Questionnaire Pretesting Research

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Various Demographic Pretesting Activities

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AHS Cognitive Interviewing Questionnaire: Healthy Homes, Home Accessibility, and Mortgage Modules

Final Version: 9-8-10

  • Ask 1. NAME, 2. AGE, and 2b. REL for one household member before moving to next

  • Enter Names, Ages, and Relationships on Household Roster






1. NAME Now I will ask you some questions about the people who live here.

What are the names of all persons living or staying here? Start with the name of the person, or one of the persons, who owns or rents this home.


2. AGE What is [your/NAME’s] age?



2b. REL (Enter ‘0’ without asking for the person on Line 1)



What is [your/NAME’s] relationship to [fill name of person on Line 1 of the Household Roster]?



  1.  Spouse 7. Foster Child

  2.  Unmarried Partner 8. Housemate/Roommate

  3.  Child 9. Roomer/Boarder

  4.  Grandchild 10. Other Non-relative

  5.  Parent 11. Dk

  6.  Other Relative 12. Ref





3. TENURE Is your home…



(Read categories until “yes” reply is received)



  1. Owned?

  2. Rented?

  3. Occupied without payment of rent?





4. OWNER In whose name is this home [fill with answer to TENURE]?



(Place an asterisk (*) next to owners’/renters’ name on Household Roster)



5. STYPE Are your living quarters in a…


(Read categories until “yes” reply is received)


  1. 1 unit building, detached from any other building?

  2. 1 unit building, attached to one or more buildings?

  3. Building with two or more apartments?

  4. Manufactured/Mobile Home?



6. FLOORS How many stories are there in your home including finished attics and basements?

  1. ________________________________







7. BEDRMS How many bedrooms are in your home?

(Enter 10 for 10 or more bedrooms)



  1. _________________________________







8. BATHS How many full bathrooms are in your home?



(Enter 10 for 10 or more bathrooms)



  1. __________________________________


9. BRKDNINTRO The next series of questions are about problems that some people have experienced with their homes.  We are interested in knowing if you have experienced these types of problems too.


10. EVROD

Have you ever seen signs of mice or rats INSIDE your home?
(Exclude rats/mice kept as pets or snake food or otherwise deliberately brought inside.)



1.

 Yes

2.

Shape1 No

 Dk

 Ref

-Skip to 14. EROACH

3.

4.



11. M3ROD

Was that in the last 3 months that is, since [fill date three months prior]?



1.

 Yes

2.

Shape2 No

 Dk

 Ref

-Skip to 13. RATMICE

3.

4.





12. RATFREQ

How often have you seen any evidence of mice or rats in your home since [fill date three months prior]? Would you say it was daily, weekly, monthly, or a few times a year?



1.

 Daily

2.

 Weekly

3.

 Monthly

4.

 A few times a year

5.

 Dk

6.

 Ref



13. RATMICE

Was it a rat, a mouse, or aren't you sure what it was?
(Mark all that apply)



1.

 Rat

2.

 Mouse

3.

 Not Sure

4.

 Dk

5.

 Ref



14. EROACH

Have you ever seen signs of live or dead cockroaches or cockroach feces INSIDE your home? 



1.

 Yes

2.

 No

 Dk

 Ref


3.

4.

If Yes continue to 15. M3ROACH If No, Dk, or Ref and unit is owned (3. TENURE = 1) skip to 25. HHMINTRO
If No, Dk, or Ref and unit is rented or occupied w/o payment (3. TENURE = 2,3) skip to 17. MAJR1













15. M3ROACH

Was that within the last 3 months that is, since [fill date three months prior]?



1.

 Yes

2.

 No

 Dk

 Ref


3.

4.

If Yes continue to 16. ROACH FRQ If No, Dk, or Ref and unit is owned (3. TENURE = 1) skip to 25. HHMINTRO
If No, Dk, or Ref and unit is rented or occupied w/o payment (3. TENURE = 2,3) skip to 17. MAJR1






16. ROACHFRQ

How often have you seen any live or dead cockroaches or cockroach feces INSIDE your home since [fill date three months prior]? Would you say it was daily, weekly, monthly, or a few times a year?



1.

 Daily

 Weekly

 Monthly

 A few times a year

 Dk

 Ref




2.

3.

4.

5.

6.

17. MAJR1

When the owner has to do MAJOR maintenance or repairs:
Do they start quickly enough?

1.

 Yes usually

2.

 Not usually

3.

 Very mixed

4.

 Haven't needed any

-Skip to 20. MINR1

5.

 Landlord not responsible for maintenance

-Skip to 23. BLDMNT

6.

 Dk

7.

 Ref



18. MAJR2

Do they solve the problem quickly once they start?



1.

 Yes

2.

 No

3.

 Mixed

4.

 Dk

5.

 Ref





19. MAJR3

Are they polite and considerate of your home?



1.

 Yes

2.

 No

3.

 Mixed

4.

 Dk

5.

 Ref



20. MINR1

For MINOR maintenance or repairs:
Do they start quickly enough?



1.

 Yes usually

2.

 Not usually

3.

 Very mixed

4.

 Haven't needed any

5.

 Landlord not responsible for maintenance -Skip to 23. BLDMNT

6.

 Dk

7.

 Ref



21. MINR2

Do they solve the problem quickly once they start?



1.

 Yes

2.

 No

3.

 Mixed

4.

 Dk

5.

 Ref



22. MINR3

Are they polite and considerate of your home?



1.

 Yes

2.

 No

3.

 Mixed

4.

 Dk

5.

 Ref





23. BLDMNT

On maintenance of the building, are you completely satisfied, partly satisfied, or dissatisfied?



1.

 Completely satisfied

2.

 Partly satisfied

3.

 Dissatisfied

4.

 Landlord not responsible for this maintenance

5.

 Dk

6.

 Ref



24. GRDMNT

On maintenance of the grounds, are you completely satisfied, partly satisfied, or dissatisfied?



1.

 Completely satisfied

2.

 Partly satisfied

3.

 Dissatisfied

4.

 Landlord not responsible for this maintenance

5.

 Dk

6.

 Ref





25. HHMINTRO We now have some questions about the health of your home.



27. MOLD In the last 12 months, was there mold covering an area greater than or equal to the size of an 8” x 11” piece of paper in any of the following rooms in your home…

(Read bold categories and mark all that apply)

  1. Kitchen?

  2. Bathroom(s)?

  3. Bedroom(s)?

  4. Living Room?

  5. Basement?

  6. None of the above?

  7.  Dk

  8.  Ref



28. MUST In the last 12 months, how often have you noticed any musty smells inside your home? Would you say it was daily, weekly, a few times a year or never? (Musty smells are smells of dampness, mold, or mildew.)

  1.  Daily

  2.  Weekly

  3.  Monthly

  4.  A few times a year

  5.  Never

  6.  Dk

  7.  Ref



29. SMKR Do any members of your household smoke tobacco inside your home?

  1.  Yes -Skip to 32. HHSAFE

  2.  No

  3.  Dk

  4.  Ref



30. SMKVIS Do any visitors to your household smoke tobacco inside your home?


  1.  Yes -Skip to 32. HHSAFE

  2.  No

  3.  Dk

  4.  Ref



31. SECSMK In the last 12 months, how often has second hand smoke entered inside your home from somewhere else in or around the building? Would you say it was daily, weekly, monthly, a few times a year or never?


  1.  Daily

  2.  Weekly

  3.  Monthly

  4.  A few times a year

  5.  Never

  6.  Dk

  7.  Ref



32. HHSAFE Does your household have any of the following…

(Read bold categories and mark all that apply)

  1. Working exhaust in all the bathrooms?

  2. All bathtubs and showers have non-slip surfaces such as mats, non-slip coatings or tiles?

  3. Window guards on all second floor or higher windows?

  4. Water stain or water damage anywhere inside the home?

  5. Condensation on windows?

  6. Cords on any windows, blinds or other window coverings?

  7. None of the above?

  8.  Dk

  9.  Ref



38. SMOKE Do you currently have a working smoke detector inside your home?



  1.  Yes

  2. Shape3 No

  3.  Dk -Skip to 41. FIREX

  4.  Ref





39. SMOKPWR Is your smoke detector powered by electricity, batteries or both?



  1.  Electricity -Skip to 41. FIREX

  2.  Batteries

  3.  Both

  4. Shape4 Dk - Skip to 41. FIREX

  5.  Ref





40. BATTERY Have the batteries in your smoke detector been replaced in the past 6 months?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



41. FIREX Do you have a fire extinguisher in your home that was purchased or recharged in the last 2 years?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref





42. SPRNKLR Is there a fire sprinkler system inside your home?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref







43. MONOX Do you have a working carbon monoxide detector inside your home?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



  • If No, Dk, or Ref and unit is a Multi-unit structure skip to 46. H2OMF

  • If No, Dk, or Ref and unit is NOT a Multi-unit structure skip to 47. H2OHT















44. COPWR Is your carbon monoxide detector powered by electricity, batteries or both?



  1.  Electricity

  2.  Batteries

  3.  Both

  4.  Dk

  5.  Ref

  • If Batteries or Both continue to 45. COBATT

  • If Electricity, Dk or Ref and unit is a Multi-unit structure skip to 46. H2OMF

  • If Electricity, Dk or Ref and unit is NOT a Multi-unit structure skip to 47. H2OHT

















45. COBATT Have the batteries in your smoke detector been replaced in the past 6 months?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref

  • If unit is a Multi-unit structure continue to 46. H2OMF

  • If unit is NOT a Multi-unit structure skip to 47. H2OHT











46. H2OMF Do you have access to the water heater for your unit?



  1.  Yes

  2. Shape5 No

  3.  Dk -Skip to 49. H2HRT

  4.  Ref





47. H2OHT Have you ever checked the temperature of your hot water?



  1.  Yes

  2. Shape6 No

  3.  Dk -Skip to 49. H2HRT

  4.  Ref





48. H2OT What was the temperature of your hot water?



  1.  Less than 120 F

  2.  120-124 F

  3.  125 F

  4.  Higher than 125 F

  5.  Dk

  6.  Ref





49. H2HRT In the last 6 months, has anyone been scalded by hot water in your home?

(Being scalded means to be burned by hot water or steam.)



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref

  • If Yes continue to 50. H2MED

  • If No, Dk, or Ref and NO children younger than 5 in the household skip to 51. NOHHKID

  • If No, Dk, or Ref and children younger than 5 in the household skip to 52. OUTLET

















50. H2MED Did the scalding require medical attention?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



  • If NO children younger than 5 in the household continue to 51. NOHHKID

  • If children younger than 5 in the household skip to 52. OUTLET











51. NOHHKID Do any children 4 years or younger visit your home on a regular basis?



  1.  Yes

  2. Shape7 No

  3.  Dk -Skip to 54. EXTC

  4.  Ref





52. OUTLET Do all, some, or none of the electrical outlets in your home have child tamper-resistant outlet covers?



  1.  All

  2.  Some

  3.  None

  4.  Dk

  5.  Ref





53. CHEMSTOR Are all some or none of the chemicals, pesticides, cleaning supplies and medicines stored out of the reach of young children?



  1.  All

  2.  Some

  3.  None

  4.  Dk

  5.  Ref





54. EXTC Do you use extension cords at home?



  1.  Yes

  2. Shape8 No

  3.  Dk -Skip to 56. POOLACC

  4.  Ref





55. EXTCOND Are any of the extension cords used in the home cracked or worn?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref





56. POOLACC Do you have access to an outdoor swimming pool on your property?



If apartment building: (This includes a swimming pool anywhere on the grounds.)



  1.  Yes

  2. Shape9 No

  3.  Dk -Skip to 58. STAIRS

  4.  Ref





57. POOLFEN Is there a fence at least 4 feet tall that goes around all the way around the pool with a gate that closes and latches automatically? (Fences around the yard do not count. Do not include trees, foliage, and other shrubbery. A wall of the home cannot count as a side of the fence unless there is no way to access the pool area in that wall (i.e. no doors, windows, or openings of any kind).)

  1.  Yes

  2.  No

  3.  Dk

  4.  Ref





58. STAIRS Does your home have any stairs inside, such as stairs to upstairs, basement, attic, etc.? Stairs are sets of three or more steps.



  1.  Yes

  2. Shape10 No

  3.  Dk - Skip to 65. DSBINTRO

  4.  Ref





59. STAIRRL Are the railings on all or some of these stairs firmly attached or are none of them firmly attached? (Firmly attached means secured strongly enough to be used with complete confidence.)

  1.  All of them

  2.  Some of them

  3.  None of them

  4.  Dk

  5.  Ref





60. STAIRMIS Are there any missing or broken railings on these stairs?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref





61. STAIRBRK Are any of the steps missing or broken on these stairs?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



62. STAIRCOV Do the steps on these stairs have any type of nonslip covering such as fixed carpets, nonslip coatings, etc.?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref





63. STAIRLGT Is there lighting at the top and bottom of all the stairs, of some of the stairs or none of the stairs? (Is there enough lighting to see the top and bottom of the stairs at all times of the day.)



  1.  All of them

  2.  Some of them

  3.  None of them

  4.  Dk

  5.  Ref







64. STAIRGAT Are there gates on all of these stairs, some of these stairs, or on none of these stairs?



  1.  All of them

  2.  Some of them

  3.  None of them

  4.  Dk

  5.  Ref






65. DSBINTRO

With this next set of questions, we want to learn about the health of the household members.

6

  • If there are any children between the ages of 6 and 17 continue to 65c. ASTHMA

  • If there are any children under the age of 5 skip to 65e. UND18INJ

  • If there are NO household members under the age of 18 skip to 66. HEARING


5b. HLTH

Would you say that your health in general is excellent, very good, fair, or poor?


  1.  Excellent

  2.  Very Good

  3.  Fair

  4.  Poor

  5.  Dk

  6. Ref

65c.ASTHMA










65d.ASTHEMR










  • If there are household members younger than 18 skip to 65e. UND18INJ

  • If there are NO household members under the age of 18 skip to 66. HEARING











65e.UND18INJ












66. HEARING

Has a doctor or other health professional ever told you that any of your children have asthma?


  1.  Yes

  2. Shape11 No

  3.  Dk -Skip to 66. HEARING

  4.  Ref



During the last 12 months, did [fill name of youngest household member with asthma] have to visit an emergency room because of [his/her] asthma?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref










During the past three months, that is since [fill date three months prior] has anyone in the household under 18 had an injury where any part of the body was hurt and required medical attention?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref




Now, thinking about everyone in your household. Is anyone in the household deaf or do they have serious difficulty hearing even when wearing a hearing aid?


  1.  Yes

  2. Shape12 No

  3.  Dk - Skip to 69. SEEING

  4.  Ref



67. HEARDIFF

(Is anyone in this household deaf or do they have serious difficulty hearing even when wearing a hearing aid?)

Who is that?

(Mark all that apply)

(Probe:)  Anyone else?


  • Mark all that apply on Household Roster then go to 69. SEEING.



  • Continue in this manner through 99. SPELLEN





69. SEEING

Is anyone in this household blind or do they have serious difficulty seeing, even when wearing glasses?


  1.  Yes

  2. Shape13 No

  3.  Dk - Skip to 72. MEMRY

  4.  Ref



70. SEEDIFF

(Is anyone in this household blind or do they have serious difficulty seeing, even when wearing glasses?)

Who is that?

(Mark all that apply)

  (Probe:)  Anyone else?





72. MEMRY

(Please answer this next set of questions for all household members that are five years old and over.)

Because of a physical, mental, or emotional condition, does anyone in this household have serious difficulty concentrating, remembering, or making decisions? 


  1.  Yes

  2. Shape14 No

  3.  Dk - Skip to 75. WALKING

  4.  Ref



73. MEMDIFF

(Please answer this next set of questions for all household members that are five years old and over.)

(Because of a physical, mental, or emotional condition, does anyone in this household have serious difficulty concentrating, remembering, or making decisions?)

Who is that?

(Mark all that apply)

  (Probe:)  Anyone else?



75. WALKING

(Please answer this next set of questions for all household members that are five years old and over.)

Does anyone in this household have serious difficulty walking or climbing stairs?


  1.  Yes

  2. Shape15 No

  3.  Dk - Skip to 78. SELFCARE

  4.  Ref



76. WALKDIFF

(Please answer this next set of questions for all household members that are five years old and over.)

(Does anyone in this household have serious difficulty walking or climbing stairs?)

Who is that?

(Mark all that apply)

 (Probe:)  Anyone else?



78. SELFCARE

(Please answer this next set of questions for all household members that are five years old and over.)

Does anyone in this household have serious difficulty dressing or bathing?


  1.  Yes

  2. Shape16 No

  3.  Dk - Skip to 81. ERRANDS

  4.  Ref



79. CAREDIFF

(Please answer this next set of questions for all household members that are five years old and over.)

(Does anyone in this household have serious difficulty dressing or bathing?)

Who is that?

(Mark all that apply)

(Probe:)  Anyone else?






81. ERRANDS

(Please answer this next question for all household members who are 15 years old or over.)

Because of a physical, mental, or emotional condition, does anyone in this household have difficulty doing errands alone such as visiting a doctor's office or shopping?


  1.  Yes

  2. Shape17 No

  3.  Dk - Skip to 93. HWRKPROB

  4.  Ref



82. ERRNDIFF

(Please answer this next question for all household members who are 15 years old or over.)

(Because of a physical, mental, or emotional condition, does anyone in this household have difficulty doing errands alone such as visiting a doctor's office or shopping?)

Who is that?

(Mark all that apply)

(Probe:)  Anyone else?










93. HWRKPROB

(Please answer this next set of questions for all household members that are fifteen years old and over.)

Does anyone in the household have difficulty doing laundry?


  1.  Yes

  2. Shape18 No

  3.  Dk - Skip to 98. SPLEDWHAT

  4.  Ref



94. HWRKWHO

(Please answer this next set of questions for all household members that are fifteen years old and over.)


(Does anyone in this household have difficulty doing laundry?)

Who is that?

(Mark all that apply)


(Probe:)   Anyone else?







98. SPLEDWHAT

Please answer this question for everyone in the household. Does anyone in the household use any of the following equipment?


(Read bold categories and mark all that apply)


1. Manually operated wheelchair?


2. Motorized wheelchair, cart or scooter?


3. Chairlift?

4. Crutches?

5. Cane or walker?

6. Something else?


7. None of the above?


8. Dk


9. Ref


For questions 99a and 99b, if a respondent answers yes, ask who in the household has a problem with that activity. Write the person’s name in the space provided.













99a.Without assistance, does anyone in the household over five years of age have problems with any of the following:


1. Reaching kitchen cabinets



2. Opening kitchen cabinets



3. Turning the stove on and off



4. Using kitchen counters



5. Getting to the bathroom



6. Using the sink



7. Turning the faucets on or off



8. Getting into or out of the bathtub



9. Getting into or out of the walk-in shower



















99b. Without the use of any special equipment, does anyone in the household over five years of age have problems with any of the following:


1. Stooping, kneeling, or bending?



2. Reaching over their head?



3. Using their fingers to grasp small objects?





For this next set of questions if a respondent answers YES, then they will be asked the corresponding question about the use of the feature after answering questions 101-122.










100. HMDINTRO









Now I have some questions about certain convenience and safety features you might have in your home.



101. RAMPS

Does your home currently have any of the following features:

Ramps inside your home?






102. ELEVATE

(Does your home currently have any of the following features :)

An elevator inside your home?

(If apartment building, probe :) This is inside of your apartment, not just inside the apartment building?






103. ENTBD

(Does your home currently have any of the following features :)

Bedroom on the entry level?






104. ENTBTH

(Does your home currently have any of the following features :)

Bathroom on the entry level?






105. HNDRLS

(Does your home currently have any of the following features :)

Handrails or grab bars on both sides of any of the stairs or steps inside your home?






106. BATHRLS

(Does your home currently have any of the following features :)

Handrails or grab bars in any of your bathrooms, such as in the shower or bathtub area?





107. OTHERRLS

(Does your home currently have any of the following features :)

Handrails or grab bars in any other areas of your home?






108. BRSEATS

(Does your home currently have any of the following features :)

Built-in seats in the shower area of the bathroom?






109. RTOILET

(Does your home currently have any of the following features :)

Raised toilets?






110. HANDLE

(Does your home currently have any of the following features :)

Door handles instead of knobs on all doors?






111. SKLEVERS

(Does your home currently have any of the following features :)

Handles or levers for any sink faucets instead of knobs on any faucets?






112. XWDOOR

(Does your home currently have any of the following features :)

Extra wide doors or hallways?






113. HIOUTLET

(Does your home currently have any of the following features :)

Wheelchair accessible electrical outlets, that is outlets positioned slightly higher than standard?






114. LSWITCH

(Does your home currently have any of the following features :)

Wheelchair accessible electrical switches, that is switches positioned slightly lower than standard?






115. LOWCAB

(Does your home currently have any of the following features :)

Wheelchair accessible kitchen cabinets?






116. KITRAY

(Does your home currently have any of the following features :)

Kitchen cabinets with rollout trays or lazy susans?






117. CLCTRL

(Does your home currently have any of the following features :)

Wheelchair accessible climate controls?






118. BTWCHAIR

(Does your home currently have any of the following features :)

Bathroom designed to allow wheelchair access?






119. KITWCHAIR

(Does your home currently have any of the following features :)

Kitchen designed to allow wheelchair access?





120. CTRWCHAIR

(Does your home currently have any of the following features :)

Wheelchair accessible countertops?






121. LEVEL

(Does your home currently have any of the following features :)

All areas on the same level, meaning no steps between rooms?



1

  • The following questions should only be asked if the respondent reported the corresponding feature in the previous section. (i.e., if 101. RAMPS is Yes, then ask 124. RAMPSYES)

  • Enter answers to this section directly on the questionnaire

22. AUDIBLE

(Does your home currently have any of the following features :)

Visual strobe light system to indicate doorbell, telephone, smoke, or carbon monoxide detectors?









123. MODYESINTRO

Now I have some questions about the use of features you have in your home.









125. RAMPSYES

Earlier you reported that you have ramps in the home. Does anyone in the household currently use the ramps in the home on a regular basis because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



127. ELEVATEYES

Earlier you reported that you have an elevator in the home. Does anyone in the household currently use the elevator in the home on a regular basis because of a physical limitation?




  1.  Yes

  2.  No

  3.  Dk

  4.  Ref





129. ENTBDYES

Earlier you reported that you have an entry level bedroom in the home. Does anyone in the household currently use the entry level bedroom in the home on a regular basis because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref







131. ENTBTHYES

Earlier you reported that you have an entry level bathroom in the home. Does anyone in the household use the entry level bathroom in the home on a regular basis because of a physical limitation?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref







133. HNDRLSYES

Earlier you reported that you have handrails or grab bars in the home. Does anyone in the household use the handrails or grab bars on both sides of the stairs or steps inside your home on a regular basis because of a physical limitation?



  1.  Yes

  2.  No

  3.  Dk

  4.  Ref







135. BTHRLSYES

Earlier you reported that you have handrails or grab bars in the bathroom. Does anyone in the household use the handrails or grab bars in the bathroom, such as the shower or bathtub area on a regular basis because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref





137. OTHRLSYES

Earlier you reported that you have other rails in the home.  Does anyone in the household use handrails or grab bars in other areas of your home on a regular basis because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref









139. BRSEATYES

Earlier you reported that you have built in seats in the shower area. Does anyone in the household use the built-in seats in the shower area of the bathroom on a regular basis because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref





140. RTOILETYES

Earlier you reported that you have raised toilets in the home. Does anyone in the household use the raised toilets in the home because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref









141. HANDLEYES

Earlier you reported that you have door handles instead of knobs in the home. Does anyone in the household use the door handles instead of knobs in the home because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



142. SKLEVERYES

Earlier you reported that you have handles or levers for sink faucets in the home. Does anyone in the household use the handles or levers for the sink faucets instead of knobs because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref

143. XWDOORYES

Earlier you reported that you have extra-wide doors or hallways in the home. Does anyone in the household use the extra-wide doors or hallways because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



144. HIOUTLETYES

Earlier you reported that you have electrical outlets positioned slightly higher than standard in the home. Does anyone in the household use these electrical outlets because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



145. LSWITCHYES

Earlier you reported that you have electrical switches positioned slightly lower than standard in the home. Does anyone in the household use these electrical switches because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



146. LOWCABYES

Earlier you reported that you have wheelchair accessible kitchen cabinets in the home. Does anyone in the household use these kitchen cabinets because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



147. KITRAYES

Earlier you reported that you have kitchen cabinets with rollout trays or lazy susans in the home. Does anyone in the household use these kitchen cabinets because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref

148. CLCTRLYES

Earlier you reported that you have wheelchair accessible climate controls in the home. Does anyone in the household use these climate controls because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref

149. BCHAIRYES

Earlier you reported that you have a wheelchair accessible bathroom in the home. Does anyone in the household use this bathroom because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



150. KCHAIRYES

Earlier you reported that you have a wheelchair accessible kitchen in the home. Does anyone in the household use this kitchen because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



151. CCHAIRYES

Earlier you reported that you have wheelchair accessible countertops in the home. Does anyone in the household use these countertops because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref



152a. LEVELYES

Earlier you reported that you have all areas on the same level in the home. Does anyone in the household use this feature because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref

152b. VISUALYES

Earlier you reported that you have a visual strobe light system in the home. Does anyone in the household use this system because of a physical limitation?


  1.  Yes

  2.  No

  3.  Dk

  4.  Ref













152c. RETINTRO

Now I’d like to ask more questions about your home.

153. MARKT

Is this home currently for rent or sale?



1.

 Yes

2.

 No – Skip to 155. NROWNR

3.

 Dk

4.

 Ref





154. MARKET

Is it for…



1.

Rent only?

2.

Rent or for sale?

3.

Sale only?

4.

 Dk

5.

 Ref



155. NROWNR

Is the ownership of the home shared with anyone NOT living here?



1.

 Yes

2.

 No

3.

 Dk

4.

 Ref





156. NRPAYM

Are some of the mortgage or utility costs paid by someone NOT living here?



1.

 Yes

2.

 No

3.

 Dk

4.

 Ref



  • If unit is owned (3. TENURE = 1) and the respondent is the owner (person with asterisk (*) next to their name on Household Roster), continue with MORTINTRO

  • If unit is owned (3. TENURE = 1) and the respondent is NOT the owner, if possible, ask to speak to the owner to continue with MORTINTRO. Conduct the remainder of the interview with the owner

  • If owner is unavailable or the unit is rented or occupied w/o payment (3. TENURE = 2,3) skip to End of Interview












157. MORTINTRO

The next questions are about mortgages and other loans that are secured by the property.  

Please refer to your mortgage loan statement or any additional records that you may have regarding the mortgages on the property.



158. REGMOR

How many mortgages of any type do you have on this property?  Include all regular mortgages, home equity credit lines, or any loan that is secured by the value of this home.

  1. _________________________________



  • Ask the 159. MGTYPE through 234. IMPROV, as appropriate, for one mortgage/loan before moving to next

  • If 158. REGMOR is 0 and owner or co-owner are older than 62 skip to 235. RAM

  • Enter answers to the following questions on the Mortgage Table










159. MGTYPE

What type of mortgage is the loan…


(Read bold categories)

1.

Regular Mortgage? For example: fixed rate loans, adjustable rate loans, or any loan where a fixed amount was borrowed and must be repaid at pre-determined intervals?

2.

Home Equity Lump Sum Loan?

3.

Home Equity Line of Credit?

4.

 Dk

5.

 Ref



160. MATBUY

Did you get the mortgage the same date you bought your home?



1.

 Yes – Skip to 163. PMT

2.

 No

3.

 Dk

4.

 Ref



161. YRMOR

What year did you get the mortgage?


(Enter year from 1900 to 2010)



1.

_________________________________



162. MNMOR

What month did you get the mortgage?



1.

_________________________________





163. PMT

Looking at your statement, how much is the current payment on the mortgage?

(Include as much Principal, Interest, Taxes, and Insurance (PITI) as they pay.)

(Enter 9998 for $9,998 or more)



1.

_________________________________





164. UNPBAL

Looking at your statement, what is the amount that you still owe on the mortgage? That is, what is the unpaid principal balance?

(Enter 9999998 for $9,999,998 or more)



1.

_________________________________





165. INTW

Looking at your statement, what is the current interest rate on the mortgage?

(For example 6 1/4%:  Enter 6 here and fraction on next screen)



1.

_________________________________





166. INTF

(Looking at your statement, what is the interest rate on the mortgage? - Fraction)  
(Round down to nearest 1/8 percent)



0.

 0 - no fraction

1.

 1/8 (.125%)

2.

 1/4 (.25%)

3.

 3/8 (.375%)

4.

 1/2 (.5%)

5.

 5/8 (.625%)

6.

 3/4 (.75%)

7.

 7/8 (.875%)

8.

 Dk

9

  • If 159. MGTYPE =2 then Skip to 174. TERM2

  • If 159. MGTYPE=3 then Skip to 232. HECR


.

 Ref





167. REFI

Did this mortgage refinance a previous mortgage?



1.

 Yes

2.

Shape19

Skip to 173. PERUS1

No

3.

 Dk

4.

 Ref



168. REFNREAS

Homeowners refinance for many reasons.  I am now going to read you a list of reasons people give for refinancing.  Please tell me if any of these reasons apply to you.  Did you refinance to…

(Read bold categories)

(Enter all that apply, separate with commas)

1.

Shape20

Skip to

170. LNFNBR
unless 6 is marked



To get a lower interest rate?

2.

To permanently reduce the mortgage payment?

3.

To reduce the payment period for the mortgage?

4.

To receive cash or increase the outstanding balance of the loan?

5.

For the option to suspend or temporarily reduce mortgage payments?

6.

Anything else? — Continue to 169. OTRFSP

7.

Shape21

Skip to 170. LNFNBR

Dk

8.

 Ref


  • If 6 is selected continue to 169. OTRFSP

  • If 6 is NOT selected skip to 170. LNFNBR




169. OTRFSP

 Please specify other reasons for refinancing



1.

_________________________________





170. LNFNBR

Did you select the financial institution that refinanced this mortgage because the company called you on the telephone or sent you a solicitation in the mail?



1.

 Yes

2.


No

3.

 Dk

4.

 Ref

  • If 168. REFNREAS is 4 continue to 171. CASH

  • If 168. REFNREAS is NOT 4 skip to 173. PERUS1




171. CASH

When you refinanced this mortgage how much cash did you receive?


(Enter 999998 for $999,998 or more)



1.

_________________________________







172. ADDTNS

What percentage of this mortgage was used for additions, improvements or repairs to the home?



1.

_________________________________



  • Skip to 174. TERM2










173. PERUS1

What percentage of this loan was used for the purchase of the home or additions, improvements or repairs to this home?



1.

_________________________________





174. TERM2

From the date that you obtained this mortgage, how many years did you have to pay it off?

(Enter 0 if it varies)



1.

_________________________________



  • If 15 or more skip to 176a. PMTPARTS










175. AMRTZ

At your current payments, how much longer will it take to pay off the loan?



1.

_________________________________



176a. PMTPARTS

Looking at your statement, which of the following are included in your payment…
(Read bold categories)
(Enter all that apply, separate with commas)



1.

Shape22 Principal?

2.

Skip to

178. OTHPMT


Interest?

3.

Property Taxes?

4.

Homeowners Insurance (Insurance that protects homeowners in case of fire or other accidental damage to the home, robberies, and third party injuries on the premises)?

5.

FHA/VA Insurance? — Continue to 176b. FHVAAMT

6.

— Continue to

177. PMIAMT

Private Mortgage Insurance or PMI (Insurance that a lender generally requires a home buyer to obtain if the down payment made by the home buyer is below a certain percentage)?

7.

Shape23

Skip to 178. OTHPMT

Dk

8.

 Ref

  • If 5 or 6 is NOT selected skip to 178. OTHPMT

  • If 5 is selected continue to 176b. FHVAAMT

  • If 6 is selected continue to 177. PMIAMT









176b. FHVAAMT




How much was the Federal Housing/Veterans Administration Insurance or FHA/VA payment in the last calendar year?


(Enter 999998 for $999,998 or more)


  1. __________________________________

177. PMIAMT

How much was the private mortgage insurance or PMI payment in the last calendar year?

(Enter 999998 for $999,998 or more)



1.

_________________________________





178. OTHPMT

Does your payment include anything else I have not mentioned?



1.

 Yes

2.

Shape24

Skip to 181. PMTF

No

3.

 Dk

4.

 Ref





179. OTHPMTSP

What else is included in your payment for the loan?



1.

_________________________________





180. AMTM

How much were these other charges last calendar year?

(Exclude property tax, homeowners insurance and PMI)


(Enter 9999998 for $9,999,998 or more)

1.

_________________________________





181. PMTF

How often do you make a payment on your loan…


(Read bold categories)

1.

Shape25

Skip to

183. PMTCHYR

Once a month?

2.

Twice a month?

3.

Every two weeks?

4.

Something else? — Continue to 182. PMTFSP

5.

Shape26

Skip to 183. PMTCHYR

Dk

6.

 Ref



  • If 4 is selected continue to 182. PMTFSP

  • If 4 is NOT selected skip to 183. PMTCHYR










182. PMTFSP

Specify how often you make a payment on your loan.



1.

_________________________________





183. PMTCHYR

Over the last 12 months, has the amount of your loan payment increased or decreased by any amount?



1.

 Yes

2.

Shape27

Skip to 189. RULEINTRO

No

3.

 Dk

4.

 Ref







184. WHYPMTCH

Payments change for many reasons.  I am now going to read you a list of reasons why mortgage payments change.  Please tell me if any of these reasons applied to you over the last 12 months…

(Read bold categories)
(Enter all that apply, separate with commas)



1.

Shape28 Property taxes or homeowners insurance changed?

2.

The adjustable interest rate changed?

3.

The minimum allowable payment increased?

4.

Skip to

186. PMTINC

unless 9 is also selected

Mortgage changed from fixed rate to adjustable rate or vice versa?

5.

Mortgage changed from interest only to interest plus payment in order to reduce mortgage balance?

6.

Mortgage no longer allows you to decide how much to pay?

7.

Mortgage was refinanced?

8.

— Continue to 185. VARMSP

Lender modified mortgage to prevent foreclosure?

9.

Anything else?

10.

Shape29

Skip to 186. PMTINC

Dk

11.

 Ref



  • If 9 is selected continue to 185. VARMSP

  • If 9 is NOT selected skip to 186. PMTINC








185. VARMSP

Please specify other reason(s) why the mortgage payment changed over the last 12 months.



1.

_________________________________



186. PMTINC

Over the last 12 months, did the total mortgage payment increase or decrease as a result of these changes?



1.

 Increase

2.

 Decrease

3.

Shape30

Skip to 189. RULEINTRO

Dk

4.

 Ref



187. PMTCHAMT

Over the last 12 months, how much (in dollars) did the mortgage payment [increase/decrease], overall?

(Enter 9998 for $9,998 or more)



1

  • If 186. PMTINC = 1 continue to 188. SHOCK

  • If 186. PMTINC = 2 skip to 189. RULEINTRO


.

_________________________________




188. SHOCK

Was the increase in the mortgage payment so great as to make it difficult to afford the new payment?



1.

 Yes

2.

 No

3.

 Dk

4.

 Ref





189. RULEINTRO

Now we have a series of questions about how your mortgage works.  Previously we asked you to look at your mortgage statement and answer questions about the payment you make on your mortgage and how much of that regular payment is charged to principal, interest, and other charges.  Now we want to know the terms and conditions that are used to calculate these payments.  The terms may not be on your mortgage statement.  We are asking you to remember how your lender described your mortgage when you signed your mortgage documents.





  • If 159. MGTYPE =2 skip to 192. BANK

  • If 159. MGTYPE is 1, 3, 4, or 5, continue to 190. MORTIN










190. MORTIN

Is the mortgage an FHA, VA, Rural Housing Service/Rural Development
mortgage, or none of these?



1.

 FHA

2.

 VA

3.

 Rural Housing Service/Rural Development

4.

 None of these

5.

 Dk

6.

 Ref





191. SUBMOR

There are State and local government programs that provide low cost mortgages. Did you get the mortgage/loan through a State or local government program that provides low cost mortgages?



1.

 Yes – Skip to 195. MORGTYPE1

2.

Shape31

Continue to 192. BANK unless 167. REFI = 1. If 167. REFI = 1, skip to 195. MORGTYPE1

No

3.

 Dk

4.

 Ref





  • If 167. REFI =1 and/or 191. SUBMOR = 1 skip to 195. MORGTYPE1

  • If 191. SUBMOR is 2, 3, or 4 and 167. REFI is 2, 3, or 4, continue to 192. BANK




192. BANK

Did you borrow money from a bank or organization OR from an individual?



1.

 Bank or Organization – Skip to 193. DOC

2.

 Individual – Skip to 194. SELL

3.

Shape32

Skip to 195. MORGTYPE1

Dk

4.

 Ref



193. DOC

Were you able to get this mortgage without the lender verifying your income, assets, and debts?



1.

 Yes

2.

 No

3.

 Dk

4.

 Ref

  • If 192. BANK is 1 skip to 195. MORGTYPE1







194. SELL


Was that the former owner of the home?



1.

 Yes

2.

 No

3.

 Dk

4.

 Ref



  • If 192. BANK=1, Dk, Ref and 167. REFI=1 skip to 195. MORGTYPE1

  • If 192. BANK =2 and 167. REFI is 2, Dk, Ref skip to 196. MORGTYPE3












195. MORGTYPE1

What type of mortgage is this loan…



(Read bold categories)

1.

Shape33 Fixed rate mortgage?

2.

Adjustable rate mortgage?

3.

Hybrid adjustable rate mortgage?

4.

Skip to 199. MORGTYPE

Renegotiable rate (rollover) mortgage?

5.

Balloon mortgage (includes interest-only loans)?

6.

Graduated payment mortgage?

7.

Assumable mortgage?

8.

Payment option mortgage?

9.

None of the above?

10.

Shape34

Skip to 216. AMMORT2

Dk

11.

 Ref





196. MORGTYPE3

What type of mortgage is this loan…



(Read bold categories)

1.

Shape35 Seller take back mortgage?

2.

Skip to 199. MORGTYPE

Wraparound mortgage?

3.

Land contract mortgage?

4.

Shape36 None of the above?

5.

Skip to 216. AMMORT2

Dk

6.

 Ref



199. MORGTYPE

  • If 196. MORGTYPE3=1 skip to 206. MORGCHK7

  • If 196. MORGTYPE3=2 skip to 207. MORGCHK8

  • If 196. MORGTYPE3=3 skip to 208. MORGCHK9

  • If 196. MORGTYPE3=4 skip to 211. MRGTYPSP

  • If 195. MORGTYPE1=1 skip to 200. MORGCHK1

  • If 195. MORGTYPE1=2 skip to 201. MORGCHK2

  • If 195. MORGTYPE1=3 skip to 209. MORGCHK13

  • If 195. MORGTYPE1=4 skip to 202. MORGCHK3

  • If 195. MORGTYPE1=5 skip to 203. MORGCHK4

  • If 195. MORGTYPE1=6 skip to 204. MORGCHK5

  • If 195. MORGTYPE1=7 skip to 205. MORGCHK6

  • If 195. MORGTYPE1=8 skip to 210. MORGCHK14

  • If 195. MORGTYPE1=9 skip to 211. MRGTYPSP
























200. MORGCHK1

I need to verify,

A fixed rate mortgage is a long-term (usually 15-30 years) loan with a fixed interest rate. With this type of loan, the principal and interest payments remain the same until the debt is paid in full.


Does this describe your mortgage?


— Skip to 216. AMMORT2

1.

— Skip to 210b. MORGTYPE4

Yes

2.

 No

3.

Shape37

Skip to 216. AMMORT2

Dk

4.

 Ref

  • If Yes, Dk, Ref skip to 216. AMMORT2

  • If No skip to 210b. MORGTYPE4









201. MORGCHK2


I need to verify,

An adjustable rate mortgage is a long-term (usually 15-30 years) loan with an interest rate that rises or falls in conjunction with a reference rate. The starting interest rate for this type of loan is generally less than conventional loans, and there are usually interest rate caps that prevent huge fluctuations in monthly payments.


Does this describe your mortgage?


— Skip to 216. AMMORT2

1.

— Skip to 210b. MORGTYPE4

Yes

2.


No

3.

Shape38

Skip to 216. AMMORT2

Dk

4

  • If Yes, Dk, Ref skip to 216. AMMORT2

  • If No skip to 210b. MORGTYPE4


.

 Ref






202. MORGCHK3






I need to verify,

A renegotiable rate (rollover) mortgage is a loan with an interest rate and monthly payments that are constant for several years, with possible changes thereafter. Interest rates are usually fixed for 3-5 years, which gives the borrower more payment stability than with typical adjustable rate mortgages.


Does this describe your mortgage?


— Skip to 216. AMMORT2

1.

— Skip to 210b. MORGTYPE4

Yes

2.


No

3.

Shape39

Skip to 216. AMMORT2

Dk

4.

 Ref

  • If Yes, Dk, Ref skip to 216. AMMORT2

  • If No skip to 210b. MORGTYPE4





203. MORGCHK4


I need to verify,

A balloon mortgage is a loan with a large payment due at the end of the mortgage’s term. For some balloon mortgages, the monthly payments satisfy only the interest charges, and the entire principal must be paid off or refinanced at the end of the term (usually 5-7 years).


Does this describe your mortgage?


— Skip to 212. BALLNTRM

1.

— Skip to 210b. MORGTYPE4

Yes

2.


No

3.

Shape40

Skip to 216. AMMORT2

Dk

4.

 Ref



  • If Yes skip to 212. BALLNTRM

  • If No skip to 210b. MORGTYPE4

  • If Dk, Ref skip to 216. AMMORT2












204. MORGCHK5

I need to verify,

A graduated payment mortgage is a long-term (usually 15 or 30 years) loan with low initial monthly payments that gradually rise (usually during the first 5-10 years) and eventually level off for the duration of the mortgage’s term.


Does this describe your mortgage?


— Skip to 216. AMMORT2

1.

— Skip to 210b. MORGTYPE4

Yes

2.


No

3.

Shape41

Skip to 216. AMMORT2


Dk

4.

 Ref



  • If Yes, Dk, Ref skip to 216. AMMORT2

  • If No skip to 210b. MORGTYPE4









205. MORGCHK6


I need to verify,

An assumable mortgage is a loan that permits the home buyer to take over the seller’s existing mortgage with the bank’s approval.


Does this describe your mortgage?


— Skip to 214. AMMORT1


1.

— Skip to 210b. MORGTYPE4

Yes

2.


No

3.

Shape42

Skip to 216. AMMORT2

Dk

4.

 Ref



  • If Yes skip to 214. AMMORT1

  • If Dk, Ref skip to 216. AMMORT2

  • If No skip to 210b. MORGTYPE4











206. MORGCHK7

I need to verify,

A seller take back mortgage is a loan in which the seller lends funds to the buyer to purchase of the property. The seller earns interest on the debt and uses the property as collateral in case of default, just as a traditional financial institution would.


Does this describe your mortgage?


— Skip to 216. AMMORT2

1.

— Skip to 210b. MORGTYPE4

Yes

2.


No

3.

Shape43

Skip to 216. AMMORT2

Dk

4.

 Ref



  • If Yes, Dk, Ref skip to 216. AMMORT2

  • If No skip to 210b. MORGTYPE4












207. MORGCHK8

I need to verify,

A wraparound mortgage is a loan in which the buyer makes payments to the seller who forwards a portion to the financial institution that holds the original mortgage.


Does this describe your mortgage?


— Skip to 216. AMMORT2

1.

— Skip to 210b. MORGTYPE4

Yes

2.


No

3.

Shape44

Skip to 216. AMMORT2

Dk

4.

 Ref



  • If Yes, Dk, Ref skip to 216. AMMORT2

  • If No skip to 210b. MORGTYPE4










208. MORGCHK9

I need to verify,

A land contract is a seller-financed loan in which the seller retains the original mortgage-the transfer of the title does not occur until the loan is completely repaid.


Does this describe your mortgage?


— 216. AMMORT2

1.

— Skip to 210b. MORGTYPE4

Yes

2.


No

3.

Shape45

Skip to 216. AMMORT2

Dk

4.

 Ref

  • If Yes, Dk, Ref skip to 216. AMMORT2

  • If No skip to 210b. MORGTYPE4






209. MORGCHK13

I need to verify,

A hybrid adjustable rate mortgage is a long-term (usually 15-30 years) loan that has a period with a fixed rate, usually 2 to 7 years, followed by a period where the interest rate rises or falls in conjunction with a reference rate.


Does this describe your mortgage?


— Skip to 216. AMMORT2

1.

— Skip to 210b. MORGTYPE4

Yes

2.


No

3.

Shape46

Skip to 216. AMMORT2

Dk

4.

 Ref



  • If Yes, Dk, Ref skip to 216. AMMORT2

  • If No skip to 210b. MORGTYPE4












210. MORGCHK14

I need to verify,

A payment option mortgage is an adjustable rate mortgage with interest rates and payments that change frequently. Borrowers are offered options for their loan payment amount. These options can include interest-only payments or “minimum” payments that are usually less than the interest–only payment. This minimum payment option results in a growing loan balance, which is termed “negative amortization.”


Does this describe your mortgage?


— Skip to 216. AMMORT2

1.

— Skip to 210b. MORGTYPE4

Yes

2.


No

3.

Shape47

Skip to 216. AMMORT2

Dk

4.

 Ref



  • If Yes, Dk, Ref skip to 216. AMMORT2

  • If No skip to 210b. MORGTYPE4










210b. MORGTYPE4

So, what type of mortgage is it…


(Read bold categories)

1.

Fixed rate mortgage?

2.

Adjustable rate mortgage?

3.

Hybrid adjustable rate mortgage?

4.

— Skip to 212. BALLNTRM

Renegotiable rate (rollover) mortgage?

5.

Balloon mortgage (includes interest-only loans)?

6.

— Skip to 214. AMMORT1

Graduated payment mortgage?

7.

Assumable mortgage?

8.

Payment option mortgage?

9.

Seller take back mortgage?

10.

Wraparound mortgage?

11.

— Continue to 211. MGTYPSP

Land contract mortgage?

12.

Something else?

13.

Skip to 216. AMMORT2

Shape48 Dk

14.

 Ref



  • If 5 is selected skip to 212. BALLNTRM

  • If 7 is selected skip to 214. AMMORT1

  • If 12 is selected continue to 211.MRGTYPSP

  • If 1-4, 6, 8-11, Dk, Ref is selected skip to 216. AMMORT2












211. MRGTYPSP

Please specify other mortgage loan type.



1.

_________________________________



  • Skip to 216. AMMORT2





212. BALLNTRM




From the time you took out your mortgage, how many years before the final balloon payment is due?



1.

_________________________________



213. BALLNAMT

What will the final balance due or balloon payment be?

(Enter 9999998 for $9,999,998 or more)



1.

_________________________________



  • Skip to 216. AMMORT2


214. AMMORT1

How much was left to pay off when you assumed the mortgage?

(Enter 9999998 for $9,999,998 or more)



1.

_________________________________




215. TERM1


How many years remained on the mortgage when you assumed it?



1.

_________________________________



  • Skip to 217. MGREAS









216. AMMORT2


How much was borrowed?



1.

_________________________________





217. MGREAS

Homeowners choose mortgages for many reasons.  I am now going to read you a list of reasons people give for choosing mortgages.  Please tell me if any of these reasons apply to you.  Did you select this type of mortgage because…
(Read bold categories)
(Enter all that apply, separate with commas)



1.

Shape49 the interest rate was lower, more reasonable, or the best available rate?

2.

of the size of (monthly) payments or payment amount?

3.

See box before

219. FRSTTERM

of the amount of upfront costs for the loan (for example: amount of points, loan fees, closing costs, or settlement costs)?

4.

you thought interest rates would decline in the future so payments would go down?

5.

— Continue to 218. MGREASSP MGREASSP

it was easier to get credit (for example: requiring less information or collateral; less stringent rules for giving credit; getting credit approval faster; no red tape)?

6.

Anything else?

7.

 Dk

8.

 Ref



218. MGREASSP



Please specify the other reason(s) why you chose this type of mortgage for the first loan.



1.

_________________________________

  • If 195. MORGTYPE1 is 1, 8, 9, 10, or 11 skip to next loan or End of Interview

  • If 195. MORGTYPE1 is 2, 3, 4, 5, 6, 7, 8 continue to 219. FRSTTERM

  • If 196. MORGTYPE3 is 1, 2, 3, 4, 5, 6 skip to skip to next loan or End of Interview

  • If 210b. MORGTYPE4 is 1, 8, 9, 10, 11, 12, 13, 14 skip to next loan or End of Interview

  • If 210b. MORGTYPE4 is 2, 3, 4, 5, 6, 7, 8 continue to 219. FRSTTERM
















219. FRSTTERM



From the time you took out the mortgage, how many years did your principal and interest payments remain fixed?



1.

_________________________________





221. ADJDPEND

The interest rate on an adjustable rate mortgage typically rises or falls in conjunction with another interest rate, which is known as the reference rate. What is the reference rate for your loan?


(Read bold categories)

Shape50

1.

Prime (interest) Rate?

2.

Skip to

223. ADJRATEF

Treasury Bill/Bond Rate (T-Bill rate)?

3.

LIBOR (London Interbank Offered Rate)?

4.

— Continue to 222. ADJDPNSP

None of the above: Changes on specified schedule but doesn’t depend on another rate?

5.

Something else?

6.

Shape51

Skip to 223. ADJRATEF

Dk

7.

 Ref



  • If 5 is selected continue to 222. ADJDPNSP

  • If 5 is NOT selected skip to 223. ADJRATEF






222. ADJDPNSP

Please specify the reference rate.



1.

_________________________________







223. ADJRATEF

How often can your interest rate change…
(Read bold categories)
(Code without asking if already mentioned)



1.

Shape52 More frequent than monthly?

2.

Skip to 225. MAXADJ

Monthly?

3.

Quarterly?

4.

Twice per year; every six months?

5.

— Continue to 224. ADJRATEO

Yearly?

6.

A longer period than yearly?

7.

Shape53

Skip to 225. MAXADJ

Dk

8

  • If 6 is selected continue to 224. ADJRATEO

  • If 6 is NOT selected skip to 225. MAXADJ


.

 Ref







224. ADJRATEO

Specify how frequently your interest rate can change.



1.

_________________________________





225. MAXADJ

Is there a limit to the number of times your interest rate can change over the course of the loan?



1.

 Yes

2.

Shape54

Skip to 227. ADJFIX

No

3.

 Dk

4.

 Ref





226. MAXADJTM

How many times is that?



1.

_________________________________





227. ADJFIX

For what period is/was the interest rate fixed…



(Read bold categories)

1.

One month?

2.

More than one, up to six months?

3.

More than six months but less than one year?

4.

One year?

5.

Two years?

6.

Three years?

7.

More than three years?

8.

 Dk

9.

 Ref



228. ORIGINTW

What was the original interest rate on the mortgage?

(For example 6 1/4%: Enter 6 here and fraction on next screen)



1.

_________________________________


229. ORIGINTF


(What was the original interest rate on the mortgage? – Fraction)

(Round down to nearest 1/8 percent)



0.

 0 - no fraction

1.

 1/8 (.125%)

2.

 1/4 (.25%)

3.

 3/8 (.375%)

4.

 1/2 (.5%)

5.

 5/8 (.625%)

6.

 3/4 (.75%)

7.

 7/8 (.875%)

8.

 Dk

9.

 Ref







230. MAXINTW

What is the highest the interest rate can go up to over the life of the mortgage?

(We want the highest rate allowed, not the maximum amount by which the rate could increase over a specified period.)


(For example 6 1/4%: Enter 6 here and fraction on next screen)



1.

_________________________________



231. MAXINTF

(What is the highest the rate can go up to over the life of the mortgage? - Fraction)

(Round down to nearest 1/8 percent)



0.

 0 - no fraction

1.

 1/8 (.125%)

2.

 1/4 (.25%)

3.

 3/8 (.375%)

4.

 1/2 (.5%)

5.

 5/8 (.625%)

6.

 3/4 (.75%)

7.

 7/8 (.875%)

8.

 Dk

9.

 Ref



  • Skip to next loan or End of Interview







232. HECR

What is your total credit limit on the line of credit?


(Enter 9999998 for $9,999,998 or more)



1.

_________________________________





233. HEBAL

Do you now have an outstanding loan borrowed against the line of credit?



1.

 Yes

2.

 No

3.

 Dk

4.

 Ref





234. IMPROV

Did you use any of the funds for additions, improvements or repairs to this home?



1.

 Yes

2.

 No

3.

 Dk

4.

 Ref



  • If the owner is age 62 or over continue to 235. RAM

  • If the owner’s spouse is age 62 or over continue to 235. RAM

  • If not skip to End of Interview










235. RAM

     Some people take out a special mortgage called a
     Reverse Annuity Mortgage or Home Equity Conversion
     Mortgage that borrows against the equity in their
     homes to give them retirement money or income.
    

Some of these loans do not have to be paid back
     during the owner's lifetime because it will be paid
     back by the sale of the home if you move out or when the estate is
     settled.  Some provide monthly income over a specified
     period of time, after which it must be paid back.

    Do you have this type of mortgage?



1.

 Yes

2.

 No

3.

 Dk

4.

 Ref









55

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