Household Respondent's Screen Questions

HOUSEHOLD RESPONDENT’S SCREEN QUESTIONS

36a.

I’m going to read some examples that will give you an
idea of the kinds of crimes this study covers.
As I go through them, tell me if any of these
happened to you in the last 6 months, that is
since __________ ______, 20 ____.

Briefly describe incident(s)

Was something belonging to YOU stolen, such as –
(a) Things that you carry, like luggage, a wallet,
purse, briefcase, book –
(b) Clothing, jewelry, or cellphone –
(c) Bicycle or sports equipment –
(d) Things in your home – like a TV, stereo, or tools
(e) Things outside your home such as a garden
hose or lawn furniture –
(f) Things belonging to children in the household –
(g) Things from a vehicle, such as a package,
groceries, camera, or CDs –
OR
(h) Did anyone ATTEMPT to steal anything
belonging to you?

36b.

MARK OR ASK –
Did any incidents of this type happen to you?

532

1
2

36c.

Yes – What happened?
Describe above
No – SKIP to 37a

How many times?
533

Number of times (36c)

37a.

37b.

(Other than any incidents already mentioned,)
has anyone –
(a) Broken in or ATTEMPTED to break into your
home by forcing a door or window, pushing
past someone, jimmying a lock, cutting a
screen, or entering through an open door or
window?
(b) Has anyone illegally gotten in or tried to get
into a garage, shed, or storage room?
OR
(c) Illegally gotten in or tried to get into a hotel or
motel room or vacation home where you were
staying?

MARK OR ASK –
Did any incidents of this type happen to you?

Briefly describe incident(s)

534

1
2

37c.

Yes – What happened?
Describe above
No – SKIP to 38

How many times?
535

Number of times (37c)

FORM NCVS-1 (9-16-2004)

Page 3

HOUSEHOLD RESPONDENT’S SCREEN QUESTIONS

38.

What was the TOTAL number of cars, vans, trucks,
motorcycles, or other motor vehicles owned by you or
any other member of this household during the last
6 months? Include those you no longer own.

536

0
1
2
3
4

39a.

During the last 6 months, (other than any incidents
already mentioned,) (was the vehicle/were any of
the vehicles) –

None – SKIP to 40a
1
2
3
4 or more

Briefly describe incident(s)

(a) Stolen or used without permission?
(b) Did anyone steal any parts such as a tire, car
stereo, hubcap, or battery?
(c) Did anyone steal any gas from (it/them)?
OR
(d) Did anyone ATTEMPT to steal any vehicle or parts
attached to (it/them)?

39b.

MARK OR ASK –
Did any incidents of this type happen to you?

537

1
2

39c.

Yes – What happened?
Describe above
No – SKIP to 40a

How many times?
538

Number of times (39c)

40a.

(Other than any incidents already mentioned,)
since __________ ______, 20 ____, were you attacked
or threatened OR did you have something stolen
from you –

Briefly describe incident(s)

(a) At home including the porch or yard –
(b) At or near a friend’s, relative’s, or
neighbor’s home –
(c) At work or school –
(d) In places such as a storage shed or laundry
room, a shopping mall, restaurant, bank, or
airport –
(e) While riding in any vehicle –
(f) On the street or in a parking lot –
(g) At such places as a party, theater, gym,
picnic area, bowling lanes, or while fishing
or hunting –
OR
(h) Did anyone ATTEMPT to attack or ATTEMPT
to steal anything belonging to you from any of
these places?

40b.

MARK OR ASK –
Did any incidents of this type happen to you?

539

1
2

40c.

Yes – What happened?
Describe above
No – SKIP to 41a

How many times?
540

Number of times (40c)
Page 4

FORM NCVS-1 (9-16-2004)

HOUSEHOLD RESPONDENT’S SCREEN QUESTIONS

41a.

(Other than any incidents already mentioned,)
has anyone attacked or threatened you in any
of these ways (Exclude telephone threats) –

Briefly describe incident(s)

(a) With any weapon, for instance, a gun or
knife –
(b) With anything like a baseball bat, frying
pan, scissors, or stick –
(c) By something thrown, such as a rock or
bottle –
(d) Include any grabbing, punching, or choking,
(e) Any rape, attempted rape or other type of
sexual attack –
(f) Any face to face threats –
OR
(g) Any attack or threat or use of force by anyone
at all? Please mention it even if you are not
certain it was a crime.

41b.

MARK OR ASK –
Did any incidents of this type happen to you?

541

1
2

41c.

Yes – What happened?
Describe above
No – SKIP to 42a

How many times?
542

Number of times (41c)

42a.

People often don’t think of incidents committed
by someone they know. (Other than any incidents
already mentioned,) did you have something
stolen from you OR were you attacked or
threatened by (Exclude telephone threats) –
(a) Someone at work or school –
(b) A neighbor or friend –
(c) A relative or family member –

Briefly describe incident(s)

(d) Any other person you’ve met or known?

42b.

MARK OR ASK –
Did any incidents of this type happen to you?

543

1
2

42c.

Yes – What happened?
Describe above
No – SKIP to 43a

How many times?
544

Number of times (42c)

43a.

Incidents involving forced or unwanted sexual
acts are often difficult to talk about. (Other than
any incidents already mentioned,) have you been
forced or coerced to engage in unwanted sexual
activity by –

Briefly describe incident(s)

(a) Someone you didn’t know before –
(b) A casual acquaintance –
OR
(c) Someone you know well?

43b.

MARK OR ASK –
Did any incidents of this type happen to you?

545

1
2

43c.

Yes – What happened?
Describe above
No – SKIP to 44a

How many times?
546

Number of times (43c)
FORM NCVS-1 (9-16-2004)

Page 5

HOUSEHOLD RESPONDENT’S SCREEN QUESTIONS

44a.

During the last 6 months, (other than any
incidents already mentioned,) did you call the
police to report something that happened to YOU
which you thought was a crime?

Briefly describe incident(s)

547

1
2

548

Yes – What happened?
Describe above
No – SKIP to 45a
OFFICE USE ONLY

*
CHECK
ITEM B

44b.

Look at 44a. If unsure, ASK, otherwise, mark without
asking. Were you (was the respondent) attacked or
threatened, or was something stolen or an
attempt made to steal something that
belonged to you (the respondent) or another
household member?

549

1
2

Yes – Ask 44b
No – SKIP to 45a

How many times?

550

Number of times (44b)

45a.

During the last 6 months, (other than any
incidents already mentioned,) did anything which
you thought was a crime happen to YOU, but you
did NOT report to the police?

Briefly describe incident(s)

551

1
2

552

Yes – What happened?
Describe above
No – SKIP to INTRO 1 at top of
page 7
OFFICE USE ONLY

*
CHECK
ITEM C

45b.

Look at 45a. If unsure, ASK, otherwise, mark without
asking. Were you (was the respondent) attacked or
threatened, or was something stolen or an
attempt made to steal something that
belonged to you (the respondent) or another
household member?

553

1
2

Yes – Ask 45b
No – SKIP to INTRO 1 at top of
page 7

How many times?

554

Number of times (45b)
NOTES

Page 6

FORM NCVS-1 (9-16-2004)