Student Loan Repayment Loan Form Testing

CFPB Student Loan Form Testing (TO16) Interview Screener
Quota:
•

In-Depth-Interviews (IDI):
o Sixty four adults (20 years of age and older) for participation in 30-minute interviews
to be held in Arlington, VA.
o Interviews will be conducted in four rounds. Each round will include 16 participants;
eight who self-identify as “in distress” and eight who self-identify as “not in distress.”
Participants will be segmented based on their responses to the distress question
(Q5_2).
o Participants should be conversant in English and be able to read and respond to a
disclosure form.
o We will seek to recruit a diverse mix of gender, age, race/ethnicity, institution type,
degree completion status, loan type, and education debt levels.
Recruitment Plan:
• The study will be advertised by:
o Emailing and calling contacts in the facility databases
o Posting fliers in the local communities, and
o Posting notices to social media sites
• Respondents must first complete the web screener
• Respondents who qualify based on the web screener are then called and administered the
phone screener
• Respondents are sent a confirmation email with directions to the facility
• Respondents are contacted the day before the interview to remind them about their
appointment
• Participants’ information is reconfirmed upon arrival, and
• Participants are compensated $65 for their time (30 minutes) upon completion

Recruitment Language
Seeking Consumers with Student Loans in Repayment for Interviews
We are currently recruiting people to participate in individual interviews about student loan
repayment. If you have one or more student loans in repayment or default status, you might qualify
to participate in an interview.
The interview will last 30 minutes and participants will be paid $65. The study will take place at
[location] and we are currently scheduling participants for [dates]. This research is being sponsored
by the Consumer Financial Protection Bureau (CFPB), a Federal Government agency that was
created to help consumers. Feedback from the interviews will be used to help the CFPB understand
consumers’ experiences with repaying their student loans.
If you are interested in participating, please contact us at [contact info]. We will ask you to complete
a short screener and we will notify you if you qualify for the study.
Thank you!

Web-Based Screener
[NEW SCREEN]
Thank you for your interest in participating in a study with Fors Marsh Group. We are seeking
participants for one-on-one interviews to discuss your experiences with repaying your student loans.
Interviews will take place the week of [month/date] at [location]. If you are interested in
participating, please complete this questionnaire. If you qualify for this study, we will contact you to
schedule a time that is convenient for you. Compensation ($65) will be provided to those who
participate.
Thank you for your interest.
[NEW SCREEN]
Please note that your responses to these questions will remain private and will only be used for the
purpose of scheduling your session if you qualify for the study. The following Privacy Act Statement
guides the handling of your responses.
Privacy Act Statement
5 U.S.C. 552(a)(e)(3)
The information you provide through your responses to Fors Marsh Group will assist the study
sponsor, the Consumer Financial Protection Bureau (CFPB), in determining your eligibility to
participate in a study that will focus on the development and improvement of CFPB tools and
resources to assist student loan borrowers.
Information collected on behalf of the Bureau by Fors Marsh Group will be treated in accordance
with the System of Records Notice (SORN), CFPB.021 – CFPB Consumer Education and Engagement
Records, 77 F.R. 60382. This information will only be disclosed as outlined in the Routine Uses for
the SORN. Direct, identifying information will only be used to facilitate the study 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.
Participation in this study is voluntary. You are not required to participate or share any identifying
information with Fors Marsh Group, including name, email address and video recording, and you may
withdraw participation at any time. However, if you do not include the requested information, you
may not participate in the interview.
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 3170-0022. It expires on 2/28/2019. The
2

time required to complete this information collection is estimated to average approximately
5 minutes per response. 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 the Bureau at the
Consumer Financial Protection Bureau (Attention: PRA Office), 1700 G Street NW, Washington, DC
20552, or by email to CFPB_PRA@cfpb.gov.
[NEW SCREEN]
Q1_1. First name:
[Open-end text box]
Q1_2. Last name:
[Open-end text box]
Q1_3. Email:
[Open-end text box]
[Validate email]
Q1_4. Mobile number:
[Open-end text box]
[Validate telephone]
Q1_5. Alternate number:
[Open-end text box]
[Validate telephone]
[NEW SCREEN]
Q2. What is your age?
[Single Punch]
0–19
20–29

01
02

Ineligible
Eligible

30–39

03

40–49
50–59
60–69
70+

04
05
06
07

Eligible
Eligible
Eligible
Eligible
Eligible

[NEW SCREEN]
Q3_1. What is the name of the school you last attended?
Name [Open-end text box]
City [Open-end text box]
State [Open-end text box]
Q3_2. What is the highest level of education you have completed?
[Single Punch]
Less than high school degree or equivalent

01

Ineligible

3

High school graduate (GED or diploma)
Some certificate or trade school courses completed

02
03

Ineligible
Eligible

Trade school certificate

04

Some college courses completed
Associate degree (2-year)
Bachelor’s degree (4-year)
Some graduate courses completed
Post-graduate degree (master’s or doctorate)

05
06
07
08
09

Eligible
Eligible
Eligible
Eligible
Eligible
Eligible

[NEW SCREEN]
Q4_1. Are you the primary person responsible for making payments on a student loan that is either
in your name or in another person’s name?
[Single Punch]
Yes
No
Don’t know/Not sure
Refused

01
02
98
-99

Eligible
Ineligible
Ineligible
Ineligible

Q4_2. What kind of student loan(s) do you have?
[Single Punch]
Federal student loans
Both federal and private student loans
Private (non-federal) student loans
Don’t know/not sure

01
02
03
04

Eligible
Eligible
Ineligible
Ineligible

[NEW SCREEN]
Q5_1. What is the repayment status of your student loan(s)? Select all that apply.
[Multi-Punch]
Active (I am currently taking classes and using funds from my student
loans)
In deferment or forbearance (I am NOT required to make payments at this
time)
In repayment (I am currently required to make monthly payments)
In good standing (I am up-to-date on my monthly payments)
Delinquent (I am behind on my student loan payments)
In default (I have missed payments and have been notified by my loan
servicer of being in default)
Defaulted on my loans but consolidated my defaulted loans
In the process of rehabilitating my defaulted loans by making nine
consecutive monthly payments
Don’t know/Not sure
Refused

01

Ineligible

02

Eligible

03
04
05
06

Eligible
Eligible
Eligible
Eligible

07
08

Eligible
Eligible

98
-99

Ineligible
Ineligible

Q5_2. Are you currently experiencing difficulty making your monthly student loan payment?
[Single Punch]
Yes
No

01
02

Eligible as “in distress”
Eligible as “not in distress”

4

Refused

-99

Ineligible

[NEW SCREEN]
Q6. Within the last five years, have you or an immediate family member worked for any of the
following types of business? Select all that apply.
[Multi-Punch]
An advertising or public relations firm
A marketing or market research firm or department
A marketing or market research consultant
Any kind of media company, like a TV or radio station or
newspaper
A government agency that regulates the financial industry
None of the above
Refused

01
02
03
04

Ineligible
Ineligible
Ineligible
Ineligible

05
06
-99

Ineligible
Eligible
Ineligible

Q7. When, if ever, was the last time you participated in a market research study, such as a consumer
interview or a group discussion?
[Single Punch]
Within the past six months
More than six months ago
Never
Refused

01
02
03
-99

Ineligible
Eligible
Eligible
Ineligible

[IF INELIGIBLE, TERMINATE HERE USING THE LANGUAGE BELOW; IF ELIGIBLE, CONTINUE TO
SECTION 2]
[NEW SCREEN]
We’re sorry, but you do not qualify for this study. Thank you for your interest.
[End Survey]
Section 2: Demographic Items
[NEW SCREEN]
Q8. What is your gender?
[Single Punch]
Male
Female
Other
Refused

01
02
03
-99

Q9. Are you of Hispanic or Latin American origin?
[Single Punch]
Yes

01

5

No
Don’t know/Not sure
Refused

02
98
-99

Q10. Which of the following best describes your race? Select all that apply.
[Multi-Punch]
[RANDOMIZE ORDER, BUT ALWAYS ASK “Some other race”
LAST.]
White
Black/African American
American Indian or Alaska Native
Asian
Native Hawaiian or Pacific Islander
Some other race

Yes

Refused

01
01
01
01
01
01

-99
-99
-99
-99
-99
-99

Q11. What is your zip code?
[Open-end text box]
[Validate zip code]
[NEW SCREEN]
Q12_1. Which of the following best describes your current employment status? Select all that apply.
[Multi-Punch]
Yes
01
02
03
04
05
06
07
08
11
12

Employed full-time
Employed part-time
Full-time student
Part-time student
Homemaker
Self-employed
Retired
Disabled
Not currently employed
Other

Refused
-99
-99
-99
-99
-99
-99
-99
-99
-99
-99

Q12_2. What is your annual income?
[Single Punch]
Less than $29,999
$30,000 to $49,999
$50,000 to $99,999
$100,000 to $149,999
More than $150,000
Don’t know/Not sure
Refused

01
02
03
04
05
98
-99

[NEW SCREEN]
Q13_1. Are you a servicemember or a spouse or dependent of a servicemember?
[Single Punch]
Servicemember

01

6

Spouse or dependent of servicemember
No
Refused

[If Q13 ≠ 01, skip Q14]

02
03
99

Q14. What is your servicemember status?
[Single Punch]
Active
Reserve
National Guard
Retired
Veteran

01
02
03
04
05

[NEW SCREEN]
Q15. What is your current student loan balance?
[Single Punch]
Less than $29,384
More than $29,384
Don’t know/Not sure
Refused

01
02
98
-99

[NEW SCREEN]
Q16. What type of federal student loans do you have? Select all that apply.
[Multi-Punch]
Federal Family Education Loan Program (FFELP)
Direct subsidized loans (Federal)
Direct unsubsidized loans (Federal)
Direct PLUS loans (Federal)
Perkins loans (Federal)
Federal Consolidation Loan
Don’t know/Not sure

Yes
01
02
03
04
05
06
07

Refused
-99
-99
-99
-99
-99
-99
-99

Q17. Which of the following statements describe your student loan repayment situation? Select all
that apply.
[Multi-Punch]
I have made late payments on my student loan in the last six months
I have temporarily missed student loan payments due to unemployment, medical
emergency, etc.
I delay paying other bills to make my student loan payments
I routinely miss student loan payments because my student loan payment is too high
I routinely miss payments because my monthly student loan payment is too high
I routinely miss student loan payments because my income changes from month to month.
I have decided to stop paying my student loans
None of the above

Yes
01
02

Refused
-99

03
04
05
06
07
08

-99
-99
-99
-99
-99
-99

-99

7

Q18. Have you ever been removed from an income-driven repayment plan due to default or failure to
recertify?
[Single Punch]
Yes
No
Don’t know/Not sure
Refused

01
02
98
-99

[NEW SCREEN]
Q19. Do you have any of the following loans other than your student loans? Select all that apply.
[Multi-Punch]
Mortgage loan
Car loan
Other type of loan

Yes
01
02
03

Refused
-99
-99
-99

[NEW SCREEN]
Final Message [if they qualify and complete survey]
Thank you for completing this questionnaire. If you qualify for this study, we will be in contact with
you to schedule a time that is convenient for you.
If you have any questions, please contact us at ux@forsmarshgroup.com or call us at 571-858-3817.
You can also visit our website at www.forsmarshgroup.com or our Facebook page at
http://www.facebook.com/ForsMarshGroup.

8

Phone-Based Screener (for those who qualify based on web-based screener)
Hello ______. Thank you for your interest in participating in our interviews about student loan
repayment at Fors Marsh Group. My name is ________ and I wanted to follow up regarding a
screener that you completed recently for an upcoming study. I wanted to ask a couple more
questions and see if we can schedule you. Your participation is completely voluntary. Do you have a
few minutes?
This survey has been approved under the Paperwork Reduction Act of 1995 by the Federal
Government’s Office of Management and Budget and assigned OMB control number 3170-0022.
Without this OMB control number we could not conduct this survey. The survey is voluntary and will
only take about 3 minutes.
1. Can you please verify your age?
2. Can you please verify whether you have federal student loans currently in repayment or in default?
3. Can you please verify your highest level of education?
[If responses are confirmed – proceed with scheduling.]
Thank you for your time.

9