2012 National Census Test
2012 National Census Test
Attachment F
2012 National Census Test
OMB: 0607-0970
2012 NCT CFU Spec June 15, 2012
Body of instrument
Module A – Contacting the Household
(COMMENT: DK/REF are not allowed in any A questions)
{if MARK < ‘11’, ask RIGHTHH; if MARK >= ’11’, ask PT1}
RIGHTHH
Have I reached the {fill LAST NAME} household?
(INT NOTE: Go to FAQs or Help Screen for any questions regarding the survey.)
Label: Reached Right Household
(Yes,
No)
{flowcheck RIGHTHH: if RIGHTHH =yes, ask RESPWHO; if RIGHTHH =no, ask RIGHTADD}
RIGHTADD
Have I reached {fill ADDRESS}?
(INT NOTE: If address is not a private residence, press F10 and exit case. Set proper out-of-scope outcome. Go to FAQs or Help Screen for any questions regarding survey.)
Label: Reached Right Address
(Yes,
No)
{flowcheck RIGHTADD: if RIGHTADD=yes, ask BINTRO; if RIGHTADD=no, ask NEWNUMEXIT}
RESPWHO
Do you know who completed the 2012 National Census Test form?
(Yes,
No)
Label: Know who the original census respondent
{flowcheck RESPWHO: if RESPWHO = yes, then ask RESPWHONAME; if RESPWHO = no, ask P1RESPAVAIL}
RESPWHONAME
Who is that person?
(Selection:
FULL NAME of P1 through Pn where age >15 or blank,
NOHH, “Respondent who filled out census form and is not living at Household”
NO15, “Respondent who filled out census form and is 15 or under ”)
Label: Original Census Response Name
{flowcheck RESPWHONAME: if RESPWHONAME = name, then ask CFRESPAVAIL; if RESPWHONAME = NOHH/NO15/DK/REF, then ask P1RESPAVAIL}
P1RESPAVAIL
{Upon getting this screen, increment CALLCOUNT by one.}
May I speak to {fill FULL NAME of P1}?
Label: Is Respondent Available
(Yes, “Yes, (fill FULLNAME of P1) is available”,
No1 “No, respondent no longer lives here”,
No2, “No, respondent is currently not available”)
{If P1RESPAVIAL=Yes1, set RESPNAME=FULLNAME of P1 and Mark = 10}
{flowcheck P1RESPAVAIL: if P1RESPAVAIL =yes1 and RESPWHONAME = NOHH or NO15, ask RWNTRAN; if P1RESPAVAIL = yes1 and RESPWHONAME is not equal to NOHH or NO15, ask CINTRO; if P1RESPAVAIL =no1, ask NEWRESP; if P1RESPAVAIL =no2 and CALLCOUNT<3, go to F10EXIT; if P1RESPAVAIL =no2 and CALLCOUNT>=3, ask NEWRESP}
RWNTRAN
In the interview whenever I say 'you' I mean {fill FULLNAME of P1}.
(1, Proceed)
{flowcheck: ask CINTRO}
CFRESPAVAIL
{Upon getting this screen, increment CALLCOUNT by one.}
May I speak to {fill FULL NAME of name selected in RESPWHONAME}?
Label: Is Respondent Available
(Yes, “Yes, (fill FULLNAME of RESPWHONAME) is available”,
No1 “No, respondent no longer lives here”,
No2, “No, respondent is currently not available”)
{If CFRESPAVIAL=Yes1, set RESPNAME=FULLNAME of P1 and MARK = 10}
{flowcheck CFRESPAVAIL: if CFRESPAVAIL =yes1, ask CINTRO, if CFRESPAVAIL =no1, ask NEWRESP; if CFRESPAVAIL =no2 and CALLCOUNT<3, go to F10EXIT; if CFRESPAVAIL =no2 and CALLCOUNT>=3, ask NEWRESP}
NEWRESP
Can I speak with an adult member of the {fill LAST NAME} household who was living here on {fill surveydt}?
Label: There is a new respondent
(Yes,
No)
{flowcheck NEWRESP: if NEWRESP=yes, ask NEWRESPNAME; if NEWRESP=no, ask F10EXIT}
NEWRESPNAME
(INT NOTE: Once person who filled out the form is on the phone, introduce yourself if necessary.)
What is your name?
Label: Name of the New Respondent
({drop down of FULL NAME where age > 15 or blank})
{Set RESPNAME=NEWRESPNAME and MARK = 10}
{flowcheck NEWRESPNAME: ask CINTRO}
Module B – Identifying the Correct Household
BINTRO
The purpose of my call is to help the Census Bureau take the most accurate census. We need to be sure that we counted everyone at the right address during the 2012 Census Test.
This survey is authorized by law, Title 13, Section 182, of the United States Code. This survey is required by law. Your cooperation is very important. All the information you provide will remain confidential by that same law. Our approval number from the Office of Management and Budget is {fill OMBNUM} and this approval expires {TBD}. Without that number we could not conduct this survey or require your participation. The interview will take approximately 10 minutes and may be monitored to evaluate my performance.
(1, “Proceed”)
{Set Mark = ‘11’}
{flow check: ask BKNOWHH}
BKNOWHH
Do you know the {fill LAST NAME} household?
Label: New Respondent Knows Household
(Yes,
No)
{flowcheck BKNOWHH: if BKNOWHH=yes, ask BMOVENBOR; if BKNOWHH=no, ask BLIVEHERE}
BMOVENBOR
Did the {fill LAST NAME} household move out, are they neighbors who live nearby, or do you know them some other way?
Label: How the new respondent knew Household
(Moved “Moved out”,
Neighbors “They are our neighbors” ,
Other)
{flowcheck BMOVENBOR: if BMOVENBOR=moved, ask BMOVEMON; if BMOVENBOR=neighbors or others, ask BCONTACT; if BMOVENBOR= DK/REF, ask BCONTACT}
BMOVEMON BMOVEDAY BMOVEYEAR
When did they move out?
Label: The Month the Household Moved/The Day the Household Moved/ The Year the Household Moved
(BMOVEMON {drop down} BMOVEDAY {drop down}, BMOVEYEAR {typein: valid values 1879-2012}
{flowcheck: if (BMOVEMON = surveymonth and BMOVEYEAR = curyear and BMOVEDAY = DK) or ( BMOVEMON = DK and BMOVEYEAR = curyear) or (BMOVEYEAR = DK), ask BMOVE41; else ask BCONTACT}
BMOVE41
Did the {fill LAST NAME} household move out before, on, or after {fill surveydt}?
Label: General Time Frame the Household Moved out
(Before “Before {fillsruveydt}”,
On “{fill surveydt}”,
After “After {fill surveydt}”)
{flowcheck BMOVE41: ask BCONTACT}
BCONTACT
Do you know how to contact the {fill LAST NAME} household?
Label: New Respondent Can Contact Household
(Yes,
No,)
{flowcheck BCONTACT: if BCONTACT=yes, ask BCONTHN; if BCONTACT=no, ask BLIVEHERE;}
BCONTHN BCONTSTREET BCONTCITY BCONTST BCONTZIP BCONTZIP4 BCONTPH
What is the address and phone number?
(INT NOTE: Prompt for City and State or as much of the address as possible.)
Label: House Number where Household Moved/Street Name where Household Moved/City where Household Moved/State Where Household Moved/Zip where Household Moved/New Phone Number of Household that moved
( HOUSE NUMBER{allow 21}, STREET NAME {allow 60}, CITY {allow 20}, STATE {look up - allow 2}, ZIP CODE {allow 5}, ZIP+4 {allow 4} PHONE NUMBER {allow10} (COMMENT: See page 5,Req.7 for valid values))
{flowcheck: ask BLIVEHERE}
BLIVHERE
Were you living at {fill ADDRESS} on {fill Surveydt}?
Label: The New Respondent was living at this Address on Survey Date
(Yes,
No)
{flowcheck BLIVEHERE: ask BOTHADDYN}
BOTHADDYN
Is there another address that people might use to refer to this place such as a different street name, apartment number or a 911 address?
Label: Another Address this place is known as
(Yes,
No)
{flowcheck BOTHADDYN: if BOTHADDYN=yes, ask BOTHHN; if BOTHADDYN =no, ask BDESBLDG }
BOTHHN BOTHSTREET BOTHCITY BOTHST BOTHZIP BOTHZIP4
What is that address?
Label: Other House Number used at this place/Other Street Name used at this place/Other City used at this place/Other State used at this place/ Other Zip Used at this place.
( HOUSE NUMBER{allow 21}, STREET NAME {allow 60}, CITY {allow 20}, STATE {look up -allow 2}, ZIP CODE {allow 5}, ZIP+4{allow 4})
{flowcheck: ask BDESBLDG}
BDESBLDG
How would you describe this building? Is It:
A Mobile Home?
A House?
An Apartment?
A boat, RV, van, etc.?
Label: Type of Place the address is
(Mobile Home
House
Apartment
A boat, RV, van, etc.)
{flowcheck BDESBLDG: if BDESBLDG=Mobile Home, ask COMPEXIT; if BDESBLDG=House, ask HOUSETYPE; if BDESBLD=Apartment, ask APTTYPE; if BDESBLDG=Boat, RV, Van, Etc., ask COMPEXIT}
HOUSETYPE
Does this house have an apartment such as a basement or garage apartment?
(Yes,
No)
Label: House has an apartment
{Flowcheck: ask COMPEXIT}
APTTYPE
From the following categories, how many apartments are in your building?
1 (such as an apartment over a business or connected to a house)
2
3 or 4
5 to 9
10 or more?
Label: Number of Apartments
(1, “1”
2, “2”
3, “3 or 4”
5, “5 to 9”
10, “10 or more”)
{Flowcheck: ask COMPEXIT}
Module C – Housing Unit Questions
CINTRO
(INT NOTE: INTRODUCE YOURSELF, IF NECESSARY.)
The purpose of my call is to be sure that no one has been left out or counted at more than one place in the 2012 Census Test.
This survey is authorized by law, Title 13, Section 182, of the United States Code. This survey is required by law. Your cooperation is very important. All the information you provide will remain confidential by that same law. Our approval number from the Office of Management and Budget is {fill OMBNUM} and this approval expires TBD. Without that number we could not conduct this survey or require your participation. The interview will take approximately 10 minutes and may be monitored to evaluate my performance.
(1, “Proceed”)
{Set MARK = ‘11’}
{flowcheck: ask CRIGHTADD}
CRIGHTADD
Have I reached {fill ADDRESS}?
Label: Is the Address Correct
(Yes,
No)
{flowcheck CRIGHTADD: if CRIGHTADD=yes, ask COTHADDYN; if CRIGHTADD=no, ask CHHLIVEHERE}
CHHLIVHERE
The {fill LAST NAME} household was reported in the census as living at {fill ADDRESS} on {fill surveydt}. Did they live there on that date?
Label: Did the Household Live here on the survey date
(Yes,
No)
{flowcheck CHHLIVEHERE: if CHHLIVEHERE=yes, ask HEREEXP; if CHHLIVEHERE=no, ask COMPEXIT; if CHHLIVEHERE=dk/rf, ask COTHADDYN}
HEREEXP
In the rest of the interview whenever I say “this place” or “here”, I am referring to {fill ADDRESS}.
(1 “Proceed”)
{flowcheck HEREEXP: ask COTHADDYN}
COTHADDYN
Is there another address that people might use to refer to this place such as a different street name, apartment number, or 911 address?
Label: Another address this place uses
(Yes,
No)
{flowcheck COTHADDYN: if COTHADDYN=yes, ask COTHHN; if COTHADDYN =no, ask CDESBLDG}
COTHHN COTHSTREET COTHCITY COTHST COTHZIP COTHZIP4
What is that address?
Label: Other House Number used at this place/Other Street Name used at this place/Other City used at this place/Other State used at this place/ Other Zip Used at this place.
( HOUSE NUMBER{allow 21}, STREET NAME {allow 60}, CITY {allow 20}, STATE {look up - allow 2}, ZIP {allow 5} ZIP+4 {allow 4})
{flowcheck: ask CDESBLDG}
CDESBLDG
How would you describe this building? Is it:
A Mobile Home?
A House?
An Apartment?
A boat, RV, van, etc.?
Label: Type of Place the address is
(Mobile Home
House
Apartment
A boat, RV, van, etc.)
{flowcheck CDESBLDG: if CDESBLDG=Mobile Home, ask DINTRO; if CDESBLDG=House, ask CHOUSETYPE; if CDESBLD=Apartment, ask CAPTTYPE; if CDESBLDG=Boat, RV, Van, Etc., ask DINTRO}
CHOUSETYPE
Does this house have an apartment such as a basement or garage apartment?
(Yes,
No)
Label: House has an apartment
{Flowcheck: ask DINTRO}
CAPTTYPE
How many apartments are in your building?
1 (such as an apartment over a business or connected to a house)
2
3 or 4
5 to 9
10 or more?
Label: Number of Apartments
(1, “1”
2, “2”
3, “3 or 4”
4, “5 to 9”
5, “10 or more”)
{Flowcheck: ask DINTRO}
(COMMENT: Modules D, E and F all have instructions on how to transpose the questions to the rectangular file. They are included after the answer choices and in {}. )
Module D – Review of Roster
(COMMENT: We would like a Hot Key for the Roster for questions DACTION, MISSBABIES-MISSTEMP, Section E and Section F. The roster should be updated with the name edits or people who are added based on MISSBABIES – MISSTEMP. Notes on when to change or add to the display are defined with the questions. )
DINTRO
Now, let’s review the list of people we counted here on {fill surveydt}:
(1, Proceed)
{flowcheck: ask DROSTER}
DROSTER
(INT NOTE: Read only names. Do not read ages. Ages should only be used to clarify between names if necessary.)
{fill
FULLNAME for P1, AGE of P1
FULLNAME for P2, AGE of P2
Etc, for all Pn for MAFID}
{If PERSON COUNT = 1, fill “Is your name correct?”}
{If PERSON COUNT not equal 1, fill “Is there anyone on this list you don’t know?
(INT NOTE: Select Yes to mark anyone on the roster whose name is unknown or incorrect.) “}
(Yes,
No)
{flowcheck DROSTER: if DROSTER = No, ask DMORE1; if DROSTER = Yes, ask DACTION}
DMORE1
{ask if only more than one person on list}
Is there anyone on this list more than once?
(Yes,
No)
{flowcheck DMORE1: if DMORE1 = No; ask MISSBABY; if DMORE1 = Yes, ask DACTION}
(COMMENT: DACTION – DLNAME should all be on the same screen with the question rotating based on the answer box they are on for the form pane. There should also be an extra column for AGE though it is not editable. The form pane should be in a list(spreadsheet style) for collection. If there are to many lines on the roster it should scroll up and down. Below is an example of a already answered version of the screen
Does Tina Smith need to be corrected?
|
||||
|
||||
P # |
Action |
Link |
First Name |
Last Name |
P(1) |
4 |
|
Mark |
Smith |
P(2) |
1 |
|
Mary
|
Smith |
P(3) |
2 |
|
Robert |
Markenson |
P(4) |
3 |
2 |
Mary |
Smith |
P(5) |
|
|
Tina |
Smith |
)
DACTION
(INT NOTE: Read if Necessary)
Does {fill FULL NAME of person line} need to be corrected?
(INT NOTE: Assign appropriate action for each person on the roster.)
(1, “Name on list more than once (duplicate)”
2, “Person Unknown”
3, “Edit Name”
4, “No Change”)
{See pg 5, Req 7 for logic checks for DACTION}
{flowcheck DACTION: if DACTION=1, ask DLINK; if DACTION=2, ask DACTION for next person line; if DACTION=3, ask DFNAME; if DACTION=4, ask DACTION for next person line; if no other person lines, ask DSUMMARY}
DLINK
(INT NOTE: (Read if Necessary))
Who is {fill FULL NAME} the same as?
(type in - person number {allow2})
{See pg 5, Req 7 for logic checks for DLINK}
{flowcheck DLINK: ask DACTION for next person line; if no more person line numbers, ask DSUMMARY}
DFNAME
(INT NOTE: Edit First Name)
{Pre-fill with NAME_F}
(Type in {allow 20})
{See pg 5, Req 7 for logic checks for DFNAME}
{flowcheck DFNAME: ask DMI}
DMI
(INT NOTE: Add or Edit Middle Initial)
{Pre-Fill with NAME_MI}
(Type in (allow 1 and blank}
{flowcheck DMI: ask DLNAME}
DLNAME
(INT NOTE: Edit Last Name)
{Pre-fill with NAME_L}
(Type in {allow 40})
{See pg 5, Req 7 for logic checks for DLNAME}
{flowcheck DLNAME: ask DACTION for next person line; if no more person lines, ask DSUMMARY}
DSUMMARY
Let’s review the changes I made:
(INT NOTE: Read the names on roster and the action next to them if any.)
{fill
ACTION, FULLNAME for P1, AGE of P1
ACTION, FULLNAME for P2, AGE of P2
Etc, for all Pn, where ACTION is “Deleted” if DACTION = 1 or 2}
{highlight or gray out the deleted names if possible}
Is this correct?
(1, “Yes, Proceed”
2, “No, Needs Corrections”)
{flowcheck DSUMMARY: if DSUMMARY=2, return to previous screen with answers still filled starting at DACTION of P1; if DSUMMARY =1, ask MISSBABY)
{COMMENT: See pg 5, Req 7 for logic checks for all of the MISS Questions}
MISSBABY
I’d like to make sure that we are not missing anyone who lived or stayed here at {fill ADDRESS} on {fill surveydt2}. Other than the people we’ve already mentioned, were there:
Any newborns or babies?
(Yes,
No)
{if MISSBABY=yes then}
What is his or her name and age on September 5, 2012?
ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L {allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=NB}
{flowcheck MISSBABY if MISSBABY=yes, ask BABYELSE; if MISSBABY=no, ask MISSFOSTER}
BABYELSE
Are there any other newborns or babies?
(Yes,
No)
{if BABYELSE=yes then}
What is his or her name and age on September 5, 2012?
Label: ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L {allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=NB}
{flowcheck BABYELSE: if BABYELSE = yes, ask BABYELSE, if BABYELSE = no, ask MISSFOSTER}
MISSFOSTER
Any foster children?
(Yes,
No)
{if MISSFOSTER=yes then}
What is his or her name and age on September 5, 2012?
ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L {allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=FS}
{flowcheck MISSFOSTER: if MISSFOSTER=yes, ask FOSTERELSE; if MISSFOSTER=no, ask MISSCHILD}
FOSTERELSE
Are there any other foster children?
(Yes,
No)
{if FOSTERELSE=yes then}
What is his or her name and age on September 5, 2012?
Label: ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L {allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=FS}
{flowcheck FOSTERELSE: if FOSTERELSE = yes, ask FOSTERELSE, if FOSTERELSE = no, ask MISSCHILD}
MISSCHILD
Any non-related children?
(Yes,
No)
{if MISSCHILD=yes then}
What is his or her name and age on September 5, 2012?
ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L {allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=CH}
{flowcheck MISSCHILD: if MISSCHILD=yes, ask CHILDELSE; if MISSCHILD=no, ask MISSREL}
CHILDELSE
Are there any other non-related children?
(Yes,
No)
{if CHILDELSE=yes then}
What is his or her name and age on September 5, 2012?
Label: ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L {allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=CH}
{flowcheck CHILDELSE: if CHILDELSE = yes, ask CHILDELSE, if CHILDELSE = no, ask MISSREL}
MISSREL
Any other relatives who lived or stayed here?
(Yes,
No)
{if MISSREL=yes then}
What is his or her name and age on September 5, 2012?
Label: ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L{allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=RL}
{flowcheck MISSREL: if MISSREL=no, ask MISSROOM; if MISSREL=yes, ask RELELSE}
RELELSE
Are there any other relatives?
(Yes,
No)
{if RELELSE=yes then}
What is his or her name and age on September 5, 2012?
Label: ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing up for each added person
NAME_F {allow 15} MI {allow 1} NAME_L{allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=RL}
{flowcheck RELELSE: if RELELSE=no, ask MISSROOM; if RELELSE=yes, ask RELELSE}
MISSROOM
Any nonrelatives, roommates, or boarders?
(Yes,
No)
{if MISSROOM=yes then}
What is his or her name and age on September 5, 2012?
Label: ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L{allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=RM}
{flowcheck MISSROOM: if MISSROOM =no, ask MISSOFTEN; if MISSROOM=yes, ask ROOMELSE}
ROOMELSE
Are there any other roommates or nonrelatives?
(Yes,
No)
{if ROOMELSE=yes then}
What is his or her name and age on September 5, 2012?
Label: ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L{allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=RM}
{flowcheck ROOMELSE: if ROOMELSE =no, ask MISSOFTEN; if ROOMELSE=yes, ask ROOMELSE}
MISSOFTEN
Anyone else who stayed here often?
(Yes,
No)
{if MISSOFTEN=yes then}
What is his or her name and age on September 5, 2012?
Label: ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L{allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=OF}
{flowcheck MISSOFTEN: if MISSOFTEN=no, ask MISSTEMP; if MISSOFTEN=yes, ask OFTENELSE}
OFTENELSE
Are there any other people who stay here often?
(Yes,
No)
{if OFTENELSE=yes then}
What is his or her name and age on September 5, 2012?
Label: ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L{allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=OF}
{flowcheck OFTENELSE: if OFTENELSE=no, ask MISSTEMP; if OFTENELSE=yes, ask OFTENELSE}
MISSTEMP
Anyone else who had no other place to live?
(Yes,
No)
{if MISSTEMP=yes then}
What is his or her name and age on September 5, 2012?
Label: ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L{allow 20} AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=TP}
{flowcheck MISSTEMP: if MISSTEMP=no, ask EMVOUT; if MISSTEMP=yes, ask TEMPELSE}
TEMPELSE
Are there any other people who had no other place to live?
(Yes,
No)
{if TEMPELSE=yes then}
What is his or her name and age on September 5, 2012?
Label: ADDFN(n) ADDMI(n) ADDLN(n) ADDAGE(n) ADDPQN(n) where n is the sequential number starting at 71 and incrementing for each added person
NAME_F {allow 15} MI {allow 1} NAME_L{allow 20}
AGE {allow 3} {Valid values 0 – 125}
{endif}
{Update Roster - add person and age to display}
{Set ADDPQN(n)=TP}
{flowcheck TEMPELSE: if TEMPELSE=no, ask EMVOUT; if TEMPELSE=yes, ask TEMPELSE}
Module E – Movers
(COMMENT: If PERSON COUNT = 1, skip all questions in MODULE E. Ask FINTRO.)
EMVOUT
In August or September, did anyone move out {fill “including those people you just added” if MISSBABY through MISSTEMP equals Yes}?
(INT NOTE: Review Roster if necessary.)
Label: Anybody moved out on survey date
(Yes,
No)
{If EMVOUT = No, set MVOUT to 0 for each person }
{Set MARK = ‘12’}
{flowcheck EMVOUT: if EMVOUT=yes, ask MVOUTNAME; if EMVOUT=no, ask FINTRO}
MVOUTNAME
Who moved out? Please list all people who moved out around {fill surveydt}.
Label: Name of person who moved out
({checkboxes- mark all that apply} P1-Pn FULL NAME)
{Set MVOUT = 1 for each Person selected in MVOUTNAME, else set MVOUT to 0}
{flowcheck MVOUTNAME: ask MONMVOUT}
MONMVOUT DAYMVOUT YRMVOUT
What date did {fill FULL NAME from MVOUTNAME} move out?
Label: Date the Person Moved out
(MONTH {drop down} DAY {drop down} YEAR {prefill 2012 - type over}{valid values 1879-2012})
{flowcheck: if (MONMVOUT = surveymonth and YRMVOUT = curyear and DAYMVOUT = DK/REF) or ( MONMVOUT = DK/REF and YRMVOUT = curyear) or (YRMVOUT = DK/REF), ask BOAMVOUT; else ask CDOM}
BOAMVOUT
Did {fill FULL NAME from MVOUTNAME} move out before, on, or after {fill surveydt}?
Label: Moved on, before, or after survey date
(Before “Before {fill surveydt}”,
On “On {fill surveydt}”,
After “ After {fill surveydt}”)
{flowcheck BOAMVOUT: ask MVBACK}
CDOM
How certain are you about the date of the move?
Very Certain
Somewhat Certain
Somewhat Uncertain
Very Uncertain
Label: How certain R is of move out date
(VC “Very Certain”,
SC “Somewhat Certain”,
SU “Somewhat Uncertain”,
VU “Very Uncertain”)
{flowcheck CDOM: ask MVBACK}
MVBACK
Do you expect {fill FULL NAME of MVOUTNAME} to move back here?
Label: If person is planning on moving back
(Yes,
No, )
{flowcheck MVBACK: if all persons marked in MVOUTNAME have been asked MONMVOUT, ask FINTRO; else ask MONMVOUT for next person number selected in MVOUTNAME}
Module F – Other Addresses
(COMMENT: Module F has question loops that have to do with collection of person data, and all of it can be collected for more than one persons. An “Anyone Else?” loop is created in most of these cases. This is to show the logic and not necessarily how the instrument must work. We are expecting RTI to show us other ideas and ways of accomplishing the same thing. This also includes on how answer choices are available and displayed. A drop down suggestion must not be done but more of an indication that the answers need to be displayed. )
FINTRO
Some people live or stay in more than one place and we would like to make sure everyone was only counted once.
(1, Proceed)
{set MARK=13}
{flowcheck: if Partial – follow Partial Flow listed in Requirement 3.3, else ask FCOLYN}
PT4
We were asking about where each person in the Household should be actually counted.
{determine which persons are finished with Module F. If the following is true then the person is finished with Module F:
intcheck = no
intcheck = yes and (F11 = (“Census” or “Other”) or F12b = (“Census” or “Other”) or F12c = (“Census” or “Other”) or F12d = (“Census” or “ Other”) or 12e is answered)
For each person (P1 – Pn) not complete with Module F display the following in a list format:
“I show that {fill FULL NAME} stayed {fill TYPE OF PLACE} around {fill surveydt” }
(1, “Proceed”)
{flowcheck: go to first unanswered question for first person who hasn’t complete Module F}
FCOLYN
{ask only if 1 or more persons age = 17-25, blank, DK or REF}
In {fill semester},{fill” were you” (if person count = 1), else “was anyone”} attending college?
LABEL: People were attending college
(Yes,
No)
{if FCOLYN = No, Set COLYN = no for all persons}
{flowcheck FCOLYN: if FCOLYN=yes, ask COLNAME; if FCOLYN=no, ask FSC}
COLNAME
Who was attending college?
(INT NOTE: Select all the names that apply.)
Label: Name of People attending college
(FULL NAME of persons where age = 17 – 25, blank, DK, REF, Different member of household on roster)
{if DK is selected, set COLYN =no for all persons; set COLYN to Yes for name selected in COLNAME}
{flowcheck CONAME: if COLNAME = fill, ask COLWHERE; if COLNAME =DK/RF or Different member of household on roster, ask FSC}
COLWHERE
Where did {fill Name form COLNAME} stay while attending college:
At {fill address} or
Some other address
Label: where the person stayed for college
(address “At ADDRESS”,
elsewhere, “Stayed somewhere else”)
{flowcheck COLWHERE: if COLWHERE =address, ask FSC if no other person selected for COLNAME; if COLWHERE = elsewhere, ask COLHN; if COLWHERE =DK/RF, ask UNAME}
COLHN COLSTREET COLCITY COLST COLZIP COLZIP4 COLDORM
(INT NOTE: Probe for Dorm and Complex Name)
What is the address where {fill you were/he was/she was} staying while attending college?
Label: Address and dorm name of college student
(HOUSE NUMBER{allow 21}, STREET NAME {allow 60}, CITY {allow 20}, STATE {drop down - allow 2}, ZIP {allow 5} ZIP+4 {allow 4}, DORM or COMPLEX NAME {allow 20 – can be left blank})
{flowcheck: ask UNAME}
UNAME
What college or university did {fill you/he/she} attend?
Label: Name of the university or college
(COLLEGE/UNIVERSITY {allow 30})
{flowcheck UNAME: ask FSC if not other person selected for COLNAME; else ask COLWHERE}
FSC
{ask only if 1 or more Persons have age <18, blank, DK or REF}
In {fill surveymonths},{fill if person count = 1”were you”, else “was any child”} living or staying part of the time with someone else?
Label: Any children staying somewhere else
(Yes,
No)
{if FSC=no, set SC to no for all persons in output}
{flowcheck FSC: if FSC=yes, ask SCNAME; if FSC=no, ask FMILYN}
SCNAME
What is the child’s name?
(INT NOTE: Select all the names that apply.)
Label: Name of child in shared custody
(FULL NAME of persons where age < 18, blank, DK, REF, Different member of household on roster)
{if DK is selected, set SC =no for all persons; set SC to Yes for name selected in SCNAME}
{flowcheck SCNAME: if SCNAME=fill, ask SCHN; if SCNAME=DK/RF or Different member of household on roster, ask FMILYN}
SCHN SCSTREET SCCITY SCST SCZIP SCZIP4
What is the address where {fill you/FULL NAME} stayed?
Label: 2nd address of shared child
( HOUSE NUMBER{allow 21}, STREET NAME {allow 60}, CITY {allow 20}, STATE {lookup - allow 2}, ZIP {allow 5} ZIP+4 {allow 4})
{flowcheck: ZIP+4: if more then one person selected in SCNAME, ask SCSAPA, if no more persons selected in SCSAPA, ask FMILYN}
SCSAPA
What is the address where {fill you/FULL NAME} stayed?
(GREY INT NOTE:
Is it the same as:
{fill FULL ADDRESS of previously enter SCHN-SCZIP4}?)
(Yes,
No)
{flowcheck: if Yes, ask until all persons selected in SCNAME have address asked if no other persons, ask FMILYN; if SCSAPA=No, ask SCHN-SCZIP4}
FMILYN
{ask only if 1 or more persons age >= 17, blank, DK or REF}
{fill if person count = 1 “Were you”, else “Was anyone”} away from here because of military service?
(INT NOTE: Here refers to {fill address}.)
LABEL: People are in the military
(Yes,
No)
{if FMILYN = No, Set MILYN = no for all persons}
{flowcheck FMILYN: if FMILYN=yes, ask MILNAME; if FMILYN=no, ask FJOB}
MILNAME
Who was away in the military?
(INT NOTE: Select all the names that apply.)
Label: MILYN
({drop down} FULL NAME of persons where age >= 17, blank, DK, REF, Different member of household on roster)
{if DK is selected, set MILYN =no for all persons; set MILYN to Yes for name selected in MILNAME}
{flowcheck MILNAME: if MILNAME = fill, ask MILOVERSEAS; if MILNAME =DK/RF or Different member of household on roster, ask FJOB}
MILOVERSEAS
{fill Were you/Was FULL NAME from MILNAME} overseas?
(Yes,
No)
Label: Overseas for Military
{flowcheck MILOVERSEAS: if MILOVERSEAS=yes; then ask FJOB if no other persons marked in MILNAME; if MILOVERSEAS=no; then ask MILWHERE}
MILWHERE
What type of place did {fill you/FULL NAME from MILNAME} stay? Was it:
Military barracks,
A Ship,
Other housing either on-base or off-base?
Label: Type of place they were at in the military
(barracks “Military Barracks”,
ship “Ship”,
housing “Other housing”,
{flowcheck MILWHERE: ask MILHN}
MILHN MILSTREET MILCITY MILST MILZIP MILZIP4
What is the address where {fill you were/he was/she was} staying while away in the military?
Label: Address where military was
( HOUSE NUMBER{allow 21}, STREET NAME {allow 60}, CITY {allow 20}, STATE {drop down - allow 2}, ZIP {allow 5} ZIP+4 {allow 4})
{flowcheck: ask FJOB if no other persons selected for MILNAME, else ask MILWHERE}
FJOB
{ask only if 1 or more persons age >=16, blank, DK, or REF}
In{fill surveymonths}, did {fill if person count = 1 “you”, else “anyone”} live or stay away from here for a job or business?
(INT NOTE: Here refers to {fill address}.)
Label: Anyone away for a job
(Yes,
No)
{if FJOB = no, set JOB =No for all persons}
{flowcheck FJOB: if FJOB=yes, ask JOBNAME; if FJOB=no, ask FVAC}
JOBNAME
Who was living or staying away from here because of a job or business?
(INT NOTE: Select all the names that apply.)
Label: Name of person who stays away for job
({drop down} FULL NAME of person where age >=16, blank, DK, or REF)
{if DK is selected, set JOB=no for all persons; set JOB to Yes for name selected in JOBNAME}
{flowcheck JOBNAME: if JOBNAME = fill, ask JOBPL; if JOBNAME =DK/RF, ask FVAC}
JOBPL
Did {you/FULL NAME} have another place where {fill you/he/she} stayed regularly for that job or business?
Label: Regular place they were away
(Yes,
No)
{flowcheck JOBPL: if JOBPL=yes, ask JOBHN; if JOBPL=no, ask FVAC; }
JOBHN JOBSTREET JOBCITY JOBST JOBZIP JOBZIP4
What is the address of that place?
Label: Address of where person stays for job
( HOUSE NUMBER{allow 21}, STREET NAME {allow 60}, CITY {allow 20}, STATE {drop down }, ZIP {allow 5} ZIP+4 {allow 4})
{flowcheck: ask FVAC if no other persons selected in JOBNAME, else ask JOBPL}
FVAC
Did {fill if person count = 1 “you”, else “anyone”} have a seasonal home or second home?
Label: Anyone with a second home
(Yes,
No)
{If FVAC=No, set VAC = No for all persons}
{flowcheck FVAC: if FVAC =yes, ask VACNAME; if FVAC =no, ask FOTH;}
VACNAME
Who had a seasonal home or second home?
(INT NOTE: Select all the names that apply.)
Label: Name of person with a second home
{drop down} FULL NAME
{if DK is selected, set VAC=no for all persons; set VAC to Yes for name selected in VACNAME }
{flowcheck VACNAME: if VACNAME =fill, ask VACHN; if VACNAME =DK/RF, ask FOTH}
VACHN VACSTREET VACCITY VACST VACZIP
For {fill you/FULL NAME}, what is the address of that place?
Label: Address of the second home
( HOUSE NUMBER{allow 21}, STREET NAME {allow 60}, CITY {allow 20}, STATE {drop down }, ZIP {allow 5} ZIP+4 {allow 4}
{flowcheck: if all persons selected in VACNAME have address asked, ask FOTH; if not all persons selected in VACNAME have address asked ask VACSAPA}
VACSAPA
For {fill you/FULL NAME}, what is the address of that place?
(GREY INT NOTE:
Is it the same as:
{fill VACHN-VACZIP+4}?)
(Yes,
No)
{flowcheck: if VACSAPA=Yes, if all persons selected in VACNAME have address asked, ask FOTH; if not all persons selected in VACNAME have address asked ask VACSAPA: if VACSAPA=No, ask VACHN}
FOTH
In {fill surveymonths}, did {fill if person count = 1 “you”, else “anyone”} stay somewhere else for an extended time or live part of the time at another residence? (GRAY INT NOTE: For example, at a friends or relative’s home)
Label: Anyone stayed somewhere else part time
(Yes,
No)
{If FOTH =No, set FOTH=no for all persons}
{flowcheck FOTH: if FOTH =yes, ask OTHNAME; if FOTH =no, set intcheck}
OTHNAME
Who was staying elsewhere for an extended time during {fill surveymths}?
(INT NOTE: Select all the names that apply.)
Label: Name of person who is away part time
({drop down} FULL NAME for all people)
{if DK is selected, set FOTH=no for all persons; set FOTH to Yes for name selected in OTHNAME }
{flowcheck OTHNAME: if fill, ask FOTHHN; if DK/RF, ask GQTRAN}
FOTHHN FOTHSTREET FOTHCITY FOTHST FOTHZIP FOTHZIP4
For {fill FULL NAME}, what is the address of that place?
Label: Other Address for part time person
( HOUSE NUMBER{allow 21}, STREET NAME {allow 60}, CITY {allow 20}, STATE {allow 2}, ZIP {allow 5} ZIP+4 {allow 4})
{flowcheck: set intcheck if no other persons were selected in OTHNAME, else ask FOTHHN for next name}
(COMMENT: Set Intcheck variable for each person. If ((FSC, FMILYN, JOBPL, FOTH or FVAC = yes) or (COLWHERE= “elsewhere”)), set INTCHECK to 1. Else, set INTCHECK to 0.})
(COMMENT: MOSTTIME through STAYAPR1 are person based and should be asked of each person on roster and those persons added in Module D before moving to GQTRAN.)
MOSTTIME
{ask MOSTTIME if INTCHECK = 1, else skip to next person or if last person then ask GQTRAN}
In {fill surveymonths}, where did {fill you/FULL NAME} live or stay most of the time:
This Address,
The Other Place, or
Both Places Equally?
(Census “Census address”,
Other “Other place”,
Both “Both places”)
Label: where person spent most of the time
{flowcheck MOSTTIME: if f11=census, ask GQTRAN or loop to next person; if MOSTTIME =other, ask GQTRAN or loop to next person; if MOSTTIME =both, ask CYCLE; if MOSTTIME =dk/rf, ask CYCLE}
CYCLE
Which of the following categories most accurately describes the amount of time {fill you/FULL NAME} stay(s) at the other place?
A few days each week,
A few weeks each month,
Months at a time,
Some other period of time
(Days “A few days each week”,
Weeks “A few weeks each month”,
Months “Months at a time”,
Other “Some other period of time”)
Label: cycle between address
{flowcheck CYCLE: if CYCLE =days, ask MOREWEEK; if CYCLE =weeks, ask MOREMON; if CYCLE =months, ask MOREYR; if CYCLE =other, ask STAYAPR1; if CYCLE =dk/rf, ask MOREWEEK}
MOREWEEK
During a typical week, did {fill you/FULL NAME} spend more days at {fill ADDRESS} or the other place?
(Census “Census address”,
Other “Other place”)
Label: where they stay most of the week
{flowcheck MOREWEEK: if MOREWEEK =census, ask GQTRAN or loop to next person; if MOREWEEK =other, ask GQTRAN or loop to next person; if f12b=dk/rf, ask STAYAPR1}
MOREMON
During a typical month, did {fill you/FULL NAME} spend more weeks at {fill ADDRESS} or at the other place?
(Census “Census address”,
Other “Other place”)
Label: where they stay most of the month
{flowcheck MOREMON: if MOREMON =census, ask GQTRAN or loop to next person; if MOREMON =other, ask GQTRAN or loop to next person; if MOREMON =dk/rf, ask STAYAPR1}
MOREYR
Last year did {fill you/ FULL NAME} spend more months at {fill ADDRESS} or at the other place?
(Census “Census address”,
Other “Other place”)
Label: where they stay most of the year
{flowcheck MOREYR: if MOREYR =census, ask GQTRAN or loop to next person; if MOREYR =other, ask GQTRAN or loop to next person; if MOREYR =dk/rf, ask STAYAPR1}
STAYAPR1
{fill Were you/Was FULL NAME} staying at {fill ADDRESS} or at the other place on {fill surveydt}?
(Census “Census address”,
Other “Other place”)
Label: where were they on survey date
{flowcheck STAYAPR1: ask GQTRAN or loop to next person}
(COMMENT: The rest of Module F from this point on is person based. It should be asked for all persons that were not deleted in Section D.)
GRTRAN
Transition Screen –
The Census Bureau does a special count of people staying in group facilities. Next, we will check to be sure no one in your household was counted in one of those places on September 5th .
(1, “Proceed”)
{flowcheck: ask GQAL}
GQAL
{Fill Were you/Was FULL NAME of P1 or first person not deleted} staying in any of the following places on {fill surveydt}:
Assisted Living?
Label: Person was in assisted living
(yes,
No)
{flowcheck GQAL: if GQAL = yes, ask GQALNH; if GQAL = no, ask GQNH}
GQNH
(GREY INT NOTE: {Fill Were you/ Was FULL NAME of P1 or first person not deleted} staying in any of the following places on {fill surveydt}?)
Nursing Home?
Label: Person was in Nursing Home
(yes,
no)
{flowcheck GQNH: if GQNH = yes , ask GQALNH; if GQNH = no ask GQJAIL.
GQJAIL
(GREY INT NOTE: {Fill Were you/ Was FULL NAME of P1 or first person not deleted} staying in any of the following places on {fill surveydt}?)
A correctional facility such as a jail, detention center, or prison?
Label: Person was in correctional facility
(yes,
No)
{flowcheck GQJAIL: if GQJAIL = yes, ask GQNAME; if GQJAIL = no, ask GQSHELTER}
GQSHELTER
(GREY INT NOTE: {Fill Were you/ Was FULL NAME of P1 or first person not deleted} staying in any of the following places on {fill surveydt}?)
A emergency or transitional shelter?
Label: Person was in a shelter
(yes,
No)
{flowcheck GQSHELTER: if GQSHELTER = yes, ask GQNAME; if GQSHELTER = no, ask GQHOME}
GQHOME
(GREY INT NOTE: {Fill Were you/ Was FULL NAME of P1 or first person not deleted} staying in any of the following places on {fill surveydt}?)
A Group Home?
Label: Person was in a group home
(yes,
no)
{flowcheck GQHOME: if GQHOME = yes, ask GQNAME; if GQHOME = no ask GQOTHER}
GQOTHER
(GREY INT NOTE: {Fill Were you/Was FULL NAME of P1 or first person not deleted} staying in any of the following places on {fill surveydt}?)
Some other facility where groups of people stay?
Label: Person was in a GQ - other
(yes,
No)
{flowcheck GQOTHER: if GQOTHER = yes, ask GQTYPE; if GQOTHER = no, ask FGQYN}
{If GQNH, GQJAIL and GQOTHER = no, set GQYN = No for person 1; else set GQYN=Yes for person 1}
GQALNH
Does the facility provide 24 hour care by a skilled professional or nurse?
(Yes,
No)
Label: Determination of GQ Nursing Home
{flowcheck GQALNH: if GQALNH = yes, ask GQNAME; if GQALNH =no and there are other persons, ask FGQYN; if GQALNH = no and there are no other persons, ask G1.}
FGQYN
{Fill Were you/Was FULL NAME of P(2…n)} staying in any of those places?
(INT NOTE: Review the categories if necessary:
Assisted Living
Nursing Home
Correctional Facility
Emergency or Transitional Shelter
Group Home
Some Other Group Facility)
Label: Anyone staying in a GQ at the time
(Yes1, “Yes, Assisted Living”
Yes2, “Yes, Nursing Home”
Yes3, “Yes, A Correctional Facility”
Yes4, “Yes, A Shelter”
Yes5, “Yes, A Group Home”
Yes6, “Yes, Some Other Group Facility”
No, “No, none of those places”)
{Set the following :
If FGQYN=Yes1, set GQYN = Yes and GQAL = Yes for that person
If FGQYN=Yes2, set GQYN = Yes and GQNH = Yes for that person
If FGQYN=Yes3, set GQYN = Yes and GQJAIL=Yes for that person
If FGQYN=Yes4, set GQYN = Yes and GQSHELTER = Yes for that person
If FGQYN=Yes5, set GQYN = Yes and GQHOME = Yes for that person
If FGQYN=Yes6, set GQYN = Yes and GQOTHER=Yes for that person
If FGQYN=No, set GQYN = No}
{flowcheck FGQYN: if FGQYN = No, ask FGQYN until no other persons – then ask G1; if FGQYN = yes6, ask GQTYPE; if FGQYN =Yes3, Yes4, Yes5, ask GQNAME; If FGQYN=Yes1 or Yes2, then ask GQALNH)
GQTYPE
What kind of place is it?
Label: TYPE of GQ
(PLACE TYPE{allow 30})
{flowcheck GQTYPE: ask GQNAME}
GQNAME
What is the name of that place?
Label: NAME of GQ
(PLACE NAME{allow 30})
{flowcheck GQNAME: ask GQHN}
GQHN GQSTREET GQCITY GQST GQZIP GQZIP4
What is the address of that place?
Label: Address of GQ
( HOUSE NUMBER{allow 21}, STREET NAME {allow 60}, CITY {allow 20}, STATE {lookup-allow 2}, ZIP {allow 5} ZIP+4 {allow 4})
{flowcheck: if no other persons, ask G1; if other persons, ask FGQYN}
Module G - Demographics
{Set MARKTWO= ‘2’ as part of checking the logic for G1}
G1
{if any persons age, relationship, sex, date of birth, race Hispanic Origin or Ancestry are blank, ask G1, else ask compexit}
Now, I’m going to ask you about information that we don’t have from your census form.
(1,”Proceed”)
{flowcheck: ask GREL}
GREL
{if PERNUM not equal to 1 and all relationship variables (positions 135 through 151 on the SCIF) are blank or 0 , ask GREL; else ask GSEX}
{fill “Are you”/ “Is”FULL NAME of person with REL=blank} related to {fill FULL NAME of P1}?
(RELATED, “Yes, Related”
NONRELATED, “No, Not Related”)
{flowcheck: if GREL = Related, ask RELATED; if GREL = NONRELATED; ask NONREL}
RELATED
Which one of these categories best describe how {fill “you are”/FULL NAME from GREL “is”} related to {fill “you/FULL NAME of P1}?
Husband or Wife
Biological Son or Daughter
Adopted Son or Daughter
Stepson or Stepdaughter
Brother or Sister
Father or Mother
Grandchild
Parent In-Law
Son In-Law or Daughter In-Law
Other Relative
LABEL: Relationship to Person 1
(SPOUSE, “Husband or Wife”
BIOLOGICAL, “Biological Son or Daughter”
ADOPTED, “Adopted Son or Daughter”
STEP, “ Stepson or Stepdaughter”
SIBLING, “Brother or Sister”
PARENT, “Father or Mother”
GRANDCHILD, “ Grandchild”
PINLAW, “Parent In-Law”
CINLAW, “Son In-Law or Daughter In-Law”
OTHERREL, “Other Relative”)
{flowcheck: ask GSEX}
NONREL
Which one of these categories best describes {fill “your”/FULL NAME from GREL’s} relationship to {fill you/FULL NAMEof Person 1}?
Roomer or Boarder
Housemate or Roommate
Unmarried Partner
Foster Child or Foster Adult
Other nonrelative
Label: Nonrelative category
(ROOMER, “Roomer or Boarder”
HOUSEMATE, “Housemate or Roommate”
PARTNER, “Unmarried Partner”
FOSTER, “Foster Child or Foster Adult”
OTHERNON, “Other nonrelative”)
{Flowcheck GREL: ask GSEX}
GSEX
{SEX = blank or 3, ask GSEX; else ask MOB}
{fill Are you/ Is FULL NAME of person with blank SEX} male or female?
LABEL: SEX
(Male,
Female)
{flowcheck GSEX: ask MOB}
MOB DOB YOB
{If MOB, DOB or YOB = blank or MOB, DOB or YOB outside valid values, ask MOB DOB YOB; else ask GAGE}
What is {fill your/FULL NAME of person with blank DOB}’s date of birth?
LABEL: Month of Birth/Day of Birth/Year of Birth
(MOB {drop down} DOB{dropdown} YOB {allow 4 –valid value: 1880 - curyear})
{flowcheck: ask GAGE}
GAGE
{AGE = blank, ask GAGE; else ask GHO}
What was {fill your/FULLNAME of person with blank age}’s age on {fill surveydt}?
(INT NOTE: For babies less than 1, enter 0. Do not enter age in months.
If the respondent doesn’t know the exact age, please try and get an estimate.)
LABEL: AGE
(AGE, {allow 3}) {Valid values 0 – 125}
{flowcheck GAGE: compare GAGE to MOB, DOB, YOB - if GAGE doesn’t match, ask AGECHECK; if GAGE matches, ask GHO}
AGECHECK
For the Census, we need to record age as of {fill surveydt}. So just to confirm – {fill “You were“/FULL NAME of PERSON from GAGE “was”} {fill GAGE } on {surveydt}?
(Yes,
No)
flowcheck AGECHECK: if AGECHECK = Yes, ask DOBCHANGE; if AGECHECK = No, ask CHANGEAGE.}
CHANGEAGE
(INT NOTE: Enter correct Age.)
(AGE, valid values 0 – 125)
{Do hard edit check against DOB}
{flowcheck: if CHANGEAGE passes edit check, ask GHO; if CHANGEAGE fails the edit check, ask DOBCHANGE}
DOBCHANGE
Since {fill “your”/FULL NAME’s} age as of {fill surveydt} was {fill CHANGEAGE unless blank then fill with GAGE}, can you help me correct {fill “your”/FULL NAME’s} date of birth? I have {fill “your”/FULL NAMES’s} date of birth as {fill MOB, DOB, YOB}. What should it be?
{Prefill with MOB, DOB, YOB previously collected}
(MOB, Month of Birth
DOB, Day of Birth
YOB, Year of Birth)
{flowcheck: ask GHO}
GHO
{If HO = blank or 3, ask GHO; else ask GRACE}
{Fill Are you/Is FULL NAME of person with blank HO} of Hispanic, Latino or Spanish Origin?
LABEL:Hispanic Origin
(Yes,
No)
{flowcheck GHO: ask GRACE}
GRACE
{If WHITE, BLACK, AIAN, ASIAN, HAWPCI AND SOMEOTH = 0 or blank, ask GRACE}
What is {fill your/FULLNAME’s of person where race=blank} race. You may choose one or more races. For this census Hispanic origins are not races.
(INT NOTE: Read list aloud. Keep reading even if respondent interrupts with an answer. Mark all races mentioned.)
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Some other race
LABEL: RACE
({allowed to pick more than one}
WHITE “White”,
BLACK “Black or African American”,
AIAN “American Indian or Alaska Native”,
ASIAN “Asian”,
API “Native Hawaiian or Other Pacific Islander”
SOR, “Some Other Race”
COMMENTS, “Respondent Comments”)
{COMMENTS can not be the only answer choice selected}
{if GRACE = COMMENTS}
Open Text box (length 60)
{DK/REF is allowed and counts as an answer choice to allow COMMENTS}
{flowcheck GRACE: ask GANCESTRY
GANCESTRY
{If ANCESt_WI1, ANCEST_WI2, AND ANCEST_WI3 = blank and ANCEST_DK = blank or 0 then ask GANCESTRY; else ask COMPEXIT if all demographics have been collected for all people.}
(Int note): Enter 1 to continue.
{flowcheck: if another person has age, relationship, sex, date of birth, race or Hispanic Origin = blank, ask GREL, else ask COMPEXIT}
MODULE H – Exit
COMPEXIT
Those are all the questions that I have. If you have any comments about the amount of time we estimate to complete the survey or any other aspect of this survey, I can give you an address where you can write to express your comments. Would you like this address? (READ ONLY IF NECESSARY)
Associate Director for Administration
Paperwork Project {Fill OMBNUM}
U.S. Census Bureau
4600 Silver Hill Road
Room 3K138
Washington, D.C. 20233
You may also email comments to Paperwork@census.gov, use “Paperwork Project – {Fill OMBNUM} as the subject.
Thank you for your time and cooperation. You’ve been very helpful.
(1, “Proceed”)
{flowcheck COMPEXIT: ask COMPLANG}
COMPLANG
(INT NOTE: In what language did you conduct most of this interview?)
(1, “English”
2, “Spanish”
3, “Some Other Language”)
(OUTCOME IS BEING SET TO 1 – COMPLETE)
{set outcome = 1 and outcome subtype = 1}
{exit}
{display splash screen for both testing and production}
F10EXIT
{If the F10 key is pressed, ask F10exit}
Thank you for your time. I would like to set an appointment to call back at a better time to complete the interview. (INT NOTE: SET APPOINTMENT AND/OR APPROPIATE OUTCOME CODE IN WEBCATI)
(1, “Proceed”)
F10LANG
(INT NOTE: In what language did you conduct most of this interview?)
(1, “English”
2, “Spanish”
3, “Some Other Language”)
{exit}
{display splash screen for both testing and production}
NEWNUMEXIT
Thank you for your time. Those are all the questions I have for you.
(1, “Proceed”)
{Set outcome =112}
{exit}
{display splash screen for both testing and production}
Module P – Partials
PT1
Hello this is (specify name) from the U.S Census Bureau.
The purpose of my call is to help the Census Bureau take the most accurate census. We need to be sure that no one has been left out or counted at more than one place during the 2012 Census Test. We have completed part of the interview for this household and would like to finish it now.
(OR for incoming calls: Thank you for calling. The Census Bureau wants to take the most accurate census. We need to be sure that no one has been left out or counted at more than one place during the 2012 Census Test. We have completed part of the interview for this household. Thank you for calling me back to complete it. )
(1, “Proceed”)
{flowcheck: ask PRESPAVAIL}
PT2
{if person number from RESPNAME = person number from PRESPAVAILNAME, ask PT3; else ask PT2}
This survey is authorized by law, Title 13, Section 182, of the United States Code. This survey is mandatory and your cooperation is very important. All the information you provide will remain confidential by that same law. Our approval number from the Office of Management and Budget is {fill OMBNUM} and this approval expires TBD . Without that number we could not conduct this survey or require your participation. The interview will take approximately 10 minutes.
(1, “Proceed”)
{flowcheck: ask PT3}
PT3
This call may be monitored to evaluate my performance.
Some of the questions have already been answered. Let me see where we should begin.
(1, “Proceed”)
{flowcheck PT3: see flow listed in Requirement 3.3}
PRESPAVAIL
{Upon getting this screen, increment CALLCOUNT by one.}
May I speak to {fill FULL NAME of RESPNAME from previous interview} or an adult member of the household living here on {fill surveydate}?
Label: Respondent is Available
(Yes1 “Yes, (fill FULLNAME of RESPNAME) is available”,
Yes2 “Yes, an adult member is available,
No, “No, a respondent is currently not available”)
{flowcheck PRESPAVAIL: if PRESPAVAIL =yes1, ask PT3; if PRESPAVAIL =yes2, ask PNEWRESPNAME, if PRESPAVAIL =no, ask PNEWRESP}
PNEWRESP
Can I speak with an adult member of the {fill LAST NAME} household who was living here on {fill surveydt}?
Label: There is a new respondent
(Yes,
No)
{flowcheck PNEWRESP: if PNEWRESP=yes, ask PNEWRESPNAME; if PNEWRESP=no, ask F10EXIT}
PNEWRESPNAME
What is that person’s name?
Label: Name of the New Respondent
({drop down of FULL NAME where age > 15 or blank})
{Set RESPNAME = PNEWRESPNAME}
{flowcheck PNEWRESPNAME: if PNEWRESPNAME=fill, ask PT2}
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Census |
| File Modified | 0000-00-00 |
| File Created | 2021-01-30 |
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