Scale Questionaire

CFPB financial well being scale questionnaire.pdf

Generic Information Collection Plan for Qualitative Consumer Education, Engagement and Experience Information Collections

Scale Questionaire

OMB: 3170-0036

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CFPB FINANCIAL WELL-BEING SCALE

Questionnaire

NAME OR NUMBER

Part 1: How well does this statement describe you or your situation?
This statement describes me	

Completely	 Very well	

Somewhat	 Very little	 Not at all

1.	 I could handle a major unexpected expense	

	

	

	

	

2.	 I am securing my financial future	

	

	

	

	

3.	 Because of my money situation, I feel like
I will never have the things I want in life	

	

	

	

	

4.	 I can enjoy life because of the way
I’m managing my money	

	

	

	

	

5.	 I am just getting by financially	

	

	

	

	

6.	 I am concerned that the money I have
or will save won’t last	

	

	

	

	

Part 2: How often does this statement apply to you?
This statement applies to me	

Always	

Often	

Sometimes	

Rarely	

7.	 Giving a gift for a wedding, birthday or other
occasion would put a strain on my finances
for the month	

	

	

	

	

8.	 I have money left over at the end of the month	

	

	

	

	

9.	 I am behind with my finances	

	

	

	

	

10.	My finances control my life	

	

	

	

	

Never

Part 3: Tell us about yourself.
11.	How old are you?	

18-61	

62+

12.	How did you take the questionnaire? 	

I read the questions	

Someone read the questions to me


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