Interviewer Observation Form

Case ID:

Building Name:

Address:

City: State: Zip:

Lister Comments:

OBSERVATION FORM – CONTACT PRETEST

1. Is the building…

• Less than 500 square feet? [END]

• 100% manufacturing/industrial?  GO TO 2

• 100% agricultural?  GO TO 2

• More than 75% residential? [END]

• Not a building? [END]

• 100% parking garage? [END]

• Under construction? [END]

• Condemned/demolished? [END]

• Does not exist? [END]

• High security? [END]

• None of these?  GO TO 3

2. Are there any retail walk up sales in this [Agricultural/Industrial] building?

• Yes  GO TO 3

• No [END]

**END: This building is not eligible for the pretest. You are finished with this case.**

3. Is the sampled structure a...

• Strip shopping center?

• Series of attached storage units?

• Block of motel rooms?

• Block of classrooms?

• None of these?

**INTERVIEWER: The building is eligible for the pretest. Next, complete the Respondent Identification Form**

Version date: 8/2/2018