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pdfOMB Control Number: 3170-0038
Expiration Date: 08/31/2016
Instrument 4: Three-Month Survey
Thank you for completing this survey as part of our evaluation of this training on Your
Money, Your Goals. This information is being collected to help CFPB improve the Your
Money, Your Goals materials. CFPB and its contractor will review responses to identify
potential enhancements to the materials.
Complete this survey providing short written responses and selecting from response options, as
prompted by the survey questions. Please note that your responses will be kept private to the
extent permitted by law and when survey results are reported none of your answers will be
directly connected to you. Please see the Paperwork Reduction Act statement and Privacy
Notice on the last page of this survey.
The organization sponsoring the delivery of the Consumer Financial Protection Bureau’s Your Money,
Your Goals that you attended (may be the same as or different from your employer):
__________________________________________________________________________________
1) Since being trained in the use of Your Money, Your Goals…
# of Workers
With how many workers have you discussed financial information?
With how many workers have you used tools and resources from Your
Money, Your Goals?
How many workers have you referred to other financial resources (such as
credit counselors, free tax preparation, financial coaching, etc.)?
2) Do you think Your Money, Your Goals has affected your interactions with workers?
Yes, it has affected them a lot
Yes, it has affected them some
Yes, it has affected them a little
No, it has not affected my interactions with workers
2b) Please explain your answer to this question.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
3) Have workers had any financial issues or made any requests related to financial topics that you
have not known how to address? If so, please describe below.
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OMB Control Number: 3170-0038
Expiration Date: 08/31/2016
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
5) Did you use Your Money, Your Goals with workers? (check all that apply)
In a group setting
In a one-on-one setting in person
In a one-on-one setting by telephone
Other:____________________
None of the above
6) In which group settings did you use Your Money, Your Goals with workers?
__________________________________________________________________________________
__________________________________________________________________________________
7) In which one-on-one settings did you use Your Money, Your Goals with workers?
__________________________________________________________________________________
__________________________________________________________________________________
8) Thinking about the goal of equipping people who serve workers to integrate financial
empowerment tools into their work, please provide any suggestions you have for how this
training could be improved:
a. Generally
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
b. In a group setting
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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OMB Control Number: 3170-0038
Expiration Date: 08/31/2016
c. In a one-on-one setting
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
9) How confident are you in your ability to…
Very
Confident
Confident
Somewhat
Confident
Not at All
Confident
Understand core financial management topics,
such as budgeting, saving, and setting financial
goals?
Discuss core financial management topics with
workers?
Assess workers’ financial condition or situation?
Get help if you or the workers you serve have
questions about financial issues?
Refer workers to community resources such as
credit-debt counseling and tax filing assistance?
Know where to go for unbiased information or
help in supporting workers on financial
management topics?
Help workers manage their financial challenges?
Provide the right financial content at the right time
in the context of your support to workers?
Access and use tools and materials from the
Consumer Financial Protection Bureau (CFPB)
through its consumer website?
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OMB Control Number: 3170-0038
Expiration Date: 08/31/2016
10) The Financial Empowerment Training Toolkit includes a variety of tools and information on a number of different topics. In your work, how
useful have you found each of the following tools and resources?
With how many workers have you
used this tool?
Module 2: Assessing the Situation
Tool 1—Financial Empowerment
Self-Assessment
Tool 3— Goals and Financial
Situation Assessment
Module 3: Starting the Conversation
Information on starting the
conversation
Module 4: Emotional and Cultural
Influence on Financial Decisions
Information on emotional and
cultural influence on financial
decisions
Module 5: Financial Empowerment
in a Group Setting
Information on financial
empowerment in a group setting
Module 6: Setting Goals
Tool 1—Goal setting worksheet
Module 7: Saving for the
Unexpected, Emergencies and Goals
Tool 1—Savings plan
Tool 2—Benefits and asset limits
How useful did you and your workers find this tool?
N/A Topic
Somewhat
Not at All
Very
Useful
Not
Useful
Useful
Useful
Covered
______ workers
None
______ workers
None
______ workers
None
______ workers
None
______ workers
None
______ workers
None
______ workers
______ workers
None
None
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OMB Control Number: 3170-0038
Expiration Date: 08/31/2016
With how many workers have you
used this tool?
Tool 3—Finding a safe place for
savings
Tool 4—Saving in retirement
Module 8: Managing Income and
Benefits
Tool 1—Income and financial
resource tracker
Tool 2—Strategies for increasing
sources of cash and financial
resources
Tool 3—Cash, paychecks, direct
deposit, payroll cards and EBT—
understanding the pros and cons
Tool 4—Increasing income
through tax credits
Module 9: Paying Bills and Other
Expenses
Tool 1—Spending tracker
Tool 2—Bill calendar
Tool 3—Strategies for cutting
expenses
Tool 4—When cash is short—
prioritizing bills and spending
Module 10: Managing Cash Flow
Tool 1—Cash flow budget
Tool 2—Cash flow calendar
How useful did you and your workers find this tool?
N/A Topic
Somewhat
Not at All
Very
Useful
Not
Useful
Useful
Useful
Covered
______ workers
None
______ workers
None
______ workers
None
______ workers
None
______ workers
None
______ workers
None
______ workers
______ workers
None
None
______ workers
None
______ workers
None
______ workers
______ workers
None
None
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OMB Control Number: 3170-0038
Expiration Date: 08/31/2016
With how many workers have you
used this tool?
Tool 3—Improving cash flow
checklist
Module 11: Dealing with Debt
Tool 1—Debt management
worksheet
Tool 2—Debt-to-income
worksheet
Tool 3—Debt reduction worksheet
Tool 4—Student loan debt
Tool 5—When debt collectors call
Module 12: Understanding Credit
Reports and Scores
Tool 1—Getting your credit
reports and scores
Tool 2—Credit report review
checklist
Tool 3—Improving credit reports
and scores
Module 13: Evaluating Financial
Service Providers, Products, and
Services
Tool 1—Selecting financial
services products and providers
Tool 2—Evaluating financial
service providers
Tool 3—Types of financial services
How useful did you and your workers find this tool?
N/A Topic
Somewhat
Not at All
Very
Useful
Not
Useful
Useful
Useful
Covered
______ workers
None
______ workers
None
______ workers
None
______ workers
______ workers
______ workers
None
None
None
______ workers
None
______ workers
None
______ workers
None
______ workers
None
______ workers
None
______ workers
None
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OMB Control Number: 3170-0038
Expiration Date: 08/31/2016
With how many workers have you
used this tool?
Tool 4—Opening an account
checklist
Module 14: Protecting Consumer
Rights
Tool 1—Red flags
Tool 2—Protecting Your Identity
Tool 3—Submitting a Complaint
Tool 4—Learning More about
Consumer Protection
How useful did you and your workers find this tool?
N/A Topic
Somewhat
Not at All
Very
Useful
Not
Useful
Useful
Useful
Covered
______ workers
None
______ workers
______ workers
______ workers
______ workers
None
None
None
None
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OMB Control Number: 3170-0038
Expiration Date: 08/31/2016
Paperwork Reduction Act
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection
of information unless it displays a valid OMB control number. The OMB control number for this collection is 3170-0038. It expires on 08/31/2016.
The time required to complete this information collection is estimated to average approximately 20 minutes per response, including the time for
reviewing any instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. The obligation to respond to this collection of information is voluntary. Comments regarding this collection of
information, including the estimated response time, suggestions for improving the usefulness of the information, or suggestions for reducing the
burden to respond to this collection should be submitted to Bureau at the Consumer Financial Protection Bureau (Attention: PRA Office), 1700 G
Street NW, Washington, DC 20552, or by email to PRA@cfpb.gov.
Privacy Notice
Information you provide in response to this survey will help the survey sponsor the Consumer Financial Protection Bureau (“CFPB”) evaluate the
effectiveness of the Your Money, Your Goals toolkit, and to assess the scope of partner organizations’ use of the toolkit.
The CFPB will not obtain or access any information that directly identifies respondents, and any answers or comments you provide will not be tied to
you individually. The agency will only obtain and access de-identified results and aggregated analyses of those results. Any directly identifying
information will only be used by ICF International (survey facilitator) and partner organizations to facilitate distribution and collection of surveys and
survey responses. Survey responses will not be shared and will be kept private except as required by law.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and 1022, codified at 12 U.S.C. §§ 5493 and 5512.
Your participation is voluntary, and you may withdraw participation at any time.
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| File Type | application/pdf |
| Author | Mike Long |
| File Modified | 2014-05-14 |
| File Created | 2014-05-14 |