Round 3: Year of Naturalization and Year of Entry (Group 1), Weeks Worked and Income (Group 2)
American Community Survey
Cognitive Test
Interviewer-administered Survey
June 9, 2017
Year of Naturalization and Year of Entry (Group 1) - Version 1
Participant ID #: |___|___|___|___|___|___|___|___|___|___|
DETAILED QUESTIONS-PERSON 1
|
NAME ____________________ |
7a. I will now be asking a series of questions about you. The next few questions deal with your place of birth and citizenship...
Where were you born?
ENTER STATE, IF KNOWN. IF STATE NOT KNOWN, ENTER U.S.
|
_______ State = Go to 10a1 OR Not born in the US = Go to 7b
|
7b. In what country were you born?
|
___________ Country |
INSTRUCTION D IF COUNTRY IN 7b IS PUERTO RICO, GUAM, THE U.S. VIRGIN ISLANDS, OR NORTHERN MARIANAS, GO TO QUESTION 9a. OTHERWISE GO TO QUESTION 8a.
|
|
8a. Are you a citizen of the United States? |
Yes = Go to 8b No = Go to 9a |
8b. Were you born abroad of U.S. citizen parent or parents, or did you become a citizen by naturalization?
|
Born abroad of U.S. citizen parent or parents = Go to 9a Citizen by naturalization = Go to 8c |
(YEAR OF NATURALIZATION: 8c – 8d)
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *8c. In what year did you become a naturalized citizen of the United States? Was it before 1985, between 1985 and 1996, between 1997 and 2004, or 2005 or later? IF THIS PERSON WAS BORN BETWEEN 1985 AND 1996, READ THIS: *8c. In what year did you become a naturalized citizen of the United States? Was it between 1985 and 1996, between 1997 and 2004, or 2005 or later? IF THIS PERSON WAS BORN BETWEEN 1997 AND 2004, READ THIS: *8c. In what year did you become a naturalized citizen of the United States? Was it between 1997 and 2004, or 2005 or later? |
Before 1985 = Go to 9a 1985 – 1996 = Go to 9a 1997 – 2004 = Go to 9a 2005 or later = Go to 8d
|
*8d. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON BECAME A NATURALIZED CITIZEN IN 2005 OR LATER.
|
_______________ Year |
(YEAR OF ENTRY: 9a – 9b)
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *9a. In what year did you come to live in the United States? Was it before 1985, between 1985 and 1996, between 1997 and 2004, or 2005 or later? If you came to live in the United States more than once, give the latest year. IF THIS PERSON WAS BORN BETWEEN 1985 AND 1996, READ THIS: *9a. In what year did you come to live in the United States? Was it between 1985 and 1996, between 1997 and 2004, or 2005 or later? If you came to live in the United States more than once, give the latest year. IF THIS PERSON WAS BORN BETWEEN 1997 AND 2004, READ THIS: *9a. In what year did you come to live in the United States? Was it between 1997 and 2004, or 2005 or later? If you came to live in the United States more than once, give the latest year. |
Before 1985 = Go to 10a1 1985 - 1996 = Go to 10a1 1997 - 2004 = Go to 10a1 2005 or later = Go to 9b
|
*9b. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON CAME TO LIVE IN THE US IN 2005 OR LATER.
|
_________________ Year |
10a1. The next questions are about schooling and education.
At any time IN THE LAST 3 MONTHS, have you attended school or college? Include only nursery or preschool, kindergarten, elementary school, home school, and schooling that leads to a high school diploma or a college degree.
|
Yes No = Go to 11 |
10a2. Was that a public school or college, a private school or college, or home school?
|
Public school or college Private school or college or home school
|
10b. What grade or level were you attending?
|
Nursery school or preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College undergraduate years, that is a college freshman to senior Graduate or professional school beyond a bachelor’s degree, for example a Master’s or PhD program or medical or law school
|
11. What is the highest degree or level of school you have COMPLETED?
|
No schooling completed Nursery school Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12, no diploma Regular high school diploma GED or alternative credential Some college, no degree Associate’s degree (for example: AA, AS) Bachelor’s degree (for example: BA, BS). Master’s degree (for example: MA, MS, MEng, MEd, MSW, MBA) Professional degree beyond a bachelor’s degree (for example: MD, DDS, DVM, LLB, JD) Doctorate degree (for example: PhD, EdD) Vocational or technical license
|
INSTRUCTION E IF RESPONSE TO QUESTION 11 IS BACHELOR’S DEGREE OR HIGHER, ASK QUESTION 12. OTHERWISE GO TO QUESTION 13.
|
|
12.
This question focuses on your BACHELOR’S DEGREE. What was
the specific major or majors of any BACHELOR’S DEGREES you
have received? For example, chemical engineering, elementary
teacher education |
____________________________ ____________________________ ____________________________ |
13. What is your ancestry or ethnic origin? (For example: Italian, Jamaican, African-American, Cambodian, Cape Verdean, Norwegian, Dominican, French Canadian, Haitian, Korean, Lebanese, Polish, Nigerian, Mexican, Taiwanese, Ukrainian and so on.)
|
____________________________ ___________________________ _ |
14a. Do you speak a language other than English at home?
|
Yes No = Go to INSTRUCTION F
|
14b. What is this language?
|
__________________________ |
14c. How well do you speak English – very well, well, not well, not at all?
|
Very well Well Not well Not at all |
INSTRUCTION F If there is another person to collect detailED person data for, Continue to person 2. Otherwise, end interview. |
|
DETAILED QUESTIONS-PERSON 2
|
NAME ____________________ |
7a. I will now be asking a series of questions about <Name>. The next few questions deal with <Name’s> place of birth and citizenship...
Where was <Name> born?
ENTER STATE, IF KNOWN. IF STATE NOT KNOWN, ENTER U.S.
|
_______ State = Go to 10a1 OR Not born in the US = Go to 7b
|
7b. In what country was <Name> born?
|
___________ Country |
INSTRUCTION D IF COUNTRY IN 7b IS PUERTO RICO, GUAM, THE U.S. VIRGIN ISLANDS, OR NORTHERN MARIANAS, GO TO QUESTION 9a. OTHERWISE GO TO QUESTION 8a.
|
|
8a. Is <Name> a citizen of the United States? |
Yes = Go to 8b No = Go to 9a |
8b. Was <Name> born abroad of U.S. citizen parent or parents, or did <Name> become a citizen by naturalization?
|
Born abroad of U.S. citizen parent or parents = Go to 9a Citizen by naturalization = Go to 8c |
(YEAR OF NATURALIZATION: 8c – 8d)
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it before 1985, between 1985 and 1996, between 1997 and 2004, or 2005 or later? IF THIS PERSON WAS BORN BETWEEN 1985 AND 1996, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 1985 and 1996, between 1997 and 2004, or 2005 or later? IF THIS PERSON WAS BORN BETWEEN 1997 AND 2004, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 1997 and 2004, or 2005 or later? |
Before 1985 = Go to 9a 1985 – 1996 = Go to 9a 1997 – 2004 = Go to 9a 2005 or later = Go to 8d
|
*8d. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON BECAME A NATURALIZED CITIZEN IN 2005 OR LATER.
|
_______________ Year |
(YEAR OF ENTRY: 9a – 9b)
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *9a. In what year did <Name> come to live in the United States? Was it before 1985, between 1985 and 1996, between 1997 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year. IF THIS PERSON WAS BORN BETWEEN 1985 AND 1996, READ THIS: *9a. In what year did <Name> come to live in the United States? Was it between 1985 and 1996, between 1997 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year. IF THIS PERSON WAS BORN BETWEEN 1997 AND 2004, READ THIS: *9a. In what year did <Name> come to live in the United States? Was it between 1997 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year. |
Before 1985 = Go to 10a1 1985 - 1996 = Go to 10a1 1997 - 2004 = Go to 10a1 2005 or later = Go to 9b
|
*9b. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON CAME TO LIVE IN THE US IN 2005 OR LATER.
|
_________________ Year |
10a1. The next questions are about schooling and education.
At any time IN THE LAST 3 MONTHS, has <Name> attended school or college? Include only nursery or preschool, kindergarten, elementary school, home school, and schooling that leads to a high school diploma or a college degree.
|
Yes No = Go to 11
|
10a2. Was that a public school or college, a private school or college, or home school?
|
Public school or college Private school or college or home school
|
10b. What grade or level was <Name> attending?
|
Nursery school or preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College undergraduate years, that is a college freshman to senior Graduate or professional school beyond a bachelor’s degree, for example a Master’s or PhD program or medical or law school
|
11. What is the highest degree or level of school <Name> has COMPLETED?
|
No schooling completed Nursery school Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12, no diploma Regular high school diploma GED or alternative credential Some college, no degree Associate’s degree (for example: AA, AS) Bachelor’s degree (for example: BA, BS). Master’s degree (for example: MA, MS, MEng, MEd, MSW, MBA) Professional degree beyond a bachelor’s degree (for example: MD, DDS, DVM, LLB, JD) Doctorate degree (for example: PhD, EdD) Vocational or technical license
|
INSTRUCTION E IF RESPONSE TO QUESTION 11 IS BACHELOR’S DEGREE OR HIGHER, ASK QUESTION 12. OTHERWISE, GO TO QUESTION 13. |
|
12.
This question focuses on <Name’s>
BACHELOR’S DEGREE. What was the specific major or majors of
any BACHELOR’S DEGREES <Name>
has
received? For example, chemical engineering, elementary teacher
education |
____________________________ ____________________________ ____________________________ |
13. What is <Name’s> ancestry or ethnic origin? (For example: Italian, Jamaican, African-American, Cambodian, Cape Verdean, Norwegian, Dominican, French Canadian, Haitian, Korean, Lebanese, Polish, Nigerian, Mexican, Taiwanese, Ukrainian and so on.)
|
____________________________ ____________________________ |
14a. Does <Name> speak a language other than English at home?
|
Yes No = Go to INSTRUCTION F |
14b. What is this language?
|
__________________________ |
14c. How well does <Name> speak English – very well, well, not well, not at all?
|
Very well Well Not well Not at all |
INSTRUCTION F If there is another person to collect detailED person data for, Continue to person 3. Otherwise, end interview. |
|
DETAILED QUESTIONS-PERSON 3
|
NAME ____________________ |
7a. I will now be asking a series of questions about <Name>. The next few questions deal with <Name’s> place of birth and citizenship...
Where was <Name> born?
ENTER STATE, IF KNOWN. IF STATE NOT KNOWN, ENTER U.S.
|
_______ State = Go to 10a1 OR Not born in the US = Go to 7b
|
7b. In what country was <Name> born?
|
___________ Country |
INSTRUCTION D IF COUNTRY IN 7b IS PUERTO RICO, GUAM, THE U.S. VIRGIN ISLANDS, OR NORTHERN MARIANAS, GO TO QUESTION 9a. OTHERWISE, GO TO QUESTION 8a.
|
|
8a. Is <Name> a citizen of the United States? |
Yes = Go to 8b No = Go to 9a |
8b. Was <Name> born abroad of U.S. citizen parent or parents, or did <Name> become a citizen by naturalization?
|
Born abroad of U.S. citizen parent or parents = Go to 9a Citizen by naturalization = Go to 8c |
(YEAR OF NATURALIZATION: 8c – 8d)
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it before 1985, between 1985 and 1996, between 1997 and 2004, or 2005 or later? IF THIS PERSON WAS BORN BETWEEN 1985 AND 1996, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 1985 and 1996, between 1997 and 2004, or 2005 or later? IF THIS PERSON WAS BORN BETWEEN 1997 AND 2004, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 1997 and 2004, or 2005 or later? |
Before 1985 = Go to 9a 1985 – 1996 = Go to 9a 1997 – 2004 = Go to 9a 2005 or later = Go to 8d
|
*8d. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON BECAME A NATURALIZED CITIZEN IN 2005 OR LATER.
|
_______________ Year |
(YEAR OF ENTRY: 9a – 9b)
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *9a. In what year did <Name> come to live in the United States? Was it before 1985, between 1985 and 1996, between 1997 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year. IF THIS PERSON WAS BORN BETWEEN 1985 AND 1996, READ THIS: *9a. In what year did <Name> come to live in the United States? Was it between 1985 and 1996, between 1997 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year. IF THIS PERSON WAS BORN BETWEEN 1997 AND 2004, READ THIS: *9a. In what year did <Name> come to live in the United States? Was it between 1997 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year. |
Before 1985 = Go to 10a1 1985 - 1996 = Go to 10a1 1997 - 2004 = Go to 10a1 2005 or later = Go to 9b
|
*9b. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON CAME TO LIVE IN THE US IN 2005 OR LATER.
|
_________________ Year |
10a1. The next questions are about schooling and education.
At any time IN THE LAST 3 MONTHS, has <Name> attended school or college? Include only nursery or preschool, kindergarten, elementary school, home school, and schooling that leads to a high school diploma or a college degree.
|
Yes No = Go to 11 |
10a2. Was that a public school or college, a private school or college, or home school?
|
Public school or college Private school or college or home school
|
10b. What grade or level was <Name> attending?
|
Nursery school or preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College undergraduate years, that is a college freshman to senior Graduate or professional school beyond a bachelor’s degree, for example a Master’s or PhD program or medical or law school
|
11. What is the highest degree or level of school <Name> has COMPLETED?
|
No schooling completed Nursery school Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12, no diploma Regular high school diploma GED or alternative credential Some college, no degree Associate’s degree (for example: AA, AS) Bachelor’s degree (for example: BA, BS). Master’s degree (for example: MA, MS, MEng, MEd, MSW, MBA) Professional degree beyond a bachelor’s degree (for example: MD, DDS, DVM, LLB, JD) Doctorate degree (for example: PhD, EdD) Vocational or technical license
|
INSTRUCTION E IF RESPONSE TO QUESTION 11 IS BACHELOR’S DEGREE OR HIGHER, ASK QUESTION 12. OTHERWISE, GO TO QUESTION 13. |
|
12.
This question focuses on <Name’s>
BACHELOR’S DEGREE. What was the specific major or majors of
any BACHELOR’S DEGREES <Name>
has
received? For example, chemical engineering, elementary teacher
education |
____________________________ ____________________________ ____________________________ |
13. What is <Name’s> ancestry or ethnic origin? (For example: Italian, Jamaican, African-American, Cambodian, Cape Verdean, Norwegian, Dominican, French Canadian, Haitian, Korean, Lebanese, Polish, Nigerian, Mexican, Taiwanese, Ukrainian and so on.)
|
____________________________ ____________________________ |
14a. Does <Name> speak a language other than English at home?
|
Yes No = Go to INSTRUCTION F
|
14b. What is this language?
|
__________________________ |
14c. How well does <Name> speak English – very well, well, not well, not at all?
|
Very well Well Not well Not at all |
INSTRUCTION F end interview. |
|
Year of Naturalization and Year of Entry (Group 1) - Version 2
Participant ID #:|___|___|___|___|___|___|___|___|___|___|
DETAILED QUESTIONS-PERSON 1
|
NAME ____________________ |
7a. I will now be asking a series of questions about you.
The next few questions deal with your place of birth and citizenship... Where were you born?
ENTER STATE, IF KNOWN. IF STATE NOT KNOWN, ENTER U.S.
|
_______ State = Go to 10a1 OR Not born in the US = Go to 7b
|
7b. In what country were you born?
|
___________ Country |
INSTRUCTION D IF COUNTRY IN 7b IS PUERTO RICO, GUAM, THE U.S. VIRGIN ISLANDS, OR NORTHERN MARIANAS, GO TO QUESTION 9a. OTHERWISE GO TO QUESTION 8a.
|
|
8a. Are you a citizen of the United States? |
Yes = Go to 8b No = Go to 9a |
8b. Were you born abroad of U.S. citizen parent or parents, or did you become a citizen by naturalization?
|
Born abroad of U.S. citizen parent or parents = Go to 9a Citizen by naturalization = Go to 8c |
YEAR OF NATURALIZATION: 8c – 8d)
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *8c. In what year did you become a naturalized citizen of the United States? Was it before 1985, between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later?
IF THIS PERSON WAS BORN BETWEEN 1985 AND 1989, READ THIS: *8c. In what year did you become a naturalized citizen of the United States? Was it between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later?
IF THIS PERSON WAS BORN BETWEEN 1990 AND 1994, READ THIS: *8c. In what year did you become a naturalized citizen of the United States? Was it between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later?
IF THIS PERSON WAS BORN BETWEEN 1995 AND 1999, READ THIS: *8c. In what year did you become a naturalized citizen of the United States? Was it between 1995 and 1999, between 2000 and 2004, or 2005 or later?
|
Before 1985 Go to 9a 1985 – 1989 Go to 9a 1990 – 1994 Go to 9a 1995 – 1999 Go to 9a 2000 – 2004 Go to 9a 2005 or later Go to 8d
|
*8d. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON BECAME A NATURALIZED CITIZEN IN 2005 OR LATER.
|
_______________ Year |
(YEAR OF ENTRY: 9a – 9b)
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *9a. In what year did you come to live in the United States? Was it before 1985, between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later? If you came to live in the United States more than once, give the latest year.
IF THIS PERSON WAS BORN BETWEEN 1985 AND 1989, READ THIS: *9a. In what year did you come to live in the United States? Was it between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later? If you came to live in the United States more than once, give the latest year.
IF THIS PERSON WAS BORN BETWEEN 1990 AND 1994, READ THIS: *9a. In what year did you come to live in the United States? Was between 1990 and 1994, 1995 and 1999, between 2000 and 2004, or 2005 or later? If you came to live in the United States more than once, give the latest year.
IF THIS PERSON WAS BORN BETWEEN 1995 AND 1999, READ THIS: *9a. In what year did you come to live in the United States? Was between 1995 and 1999, between 2000 and 2004, or 2005 or later? If you came to live in the United States more than once, give the latest year.
|
Before 1985 Go to 10a1 1985 - 1989 Go to 10a1 1990 - 1994 Go to 10a1 1995 - 1999 Go to 10a1 2000 - 2004 Go to 10a1 2005 or later Go to 9b
|
*9b. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON CAME TO LIVE IN THE US IN 2005 OR LATER.
|
_________________ Year |
10a1. The next questions are about schooling and education.
At any time IN THE LAST 3 MONTHS, have you attended school or college? Include only nursery or preschool, kindergarten, elementary school, home school, and schooling that leads to a high school diploma or a college degree.
|
Yes No = Go to 11
|
10a2. Was that a public school or college, a private school or college, or home school?
|
Public school or college Private school or college or home school
|
10b. What grade or level were you attending?
|
Nursery school or preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College undergraduate years, that is a college freshman to senior Graduate or professional school beyond a bachelor’s degree, for example a Master’s or PhD program or medical or law school
|
11. What is the highest degree or level of school you have COMPLETED?
|
No schooling completed Nursery school Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12, no diploma Regular high school diploma GED or alternative credential Some college, no degree Associate’s degree (for example: AA, AS) Bachelor’s degree (for example: BA, BS). Master’s degree (for example: MA, MS, MEng, MEd, MSW, MBA) Professional degree beyond a bachelor’s degree (for example: MD, DDS, DVM, LLB, JD) Doctorate degree (for example: PhD, EdD) Vocational or technical license
|
INSTRUCTION E
IF RESPONSE TO QUESTION 11 IS BACHELOR’S DEGREE OR HIGHER, ASK QUESTION 12. OTHERWISE, GO TO QUESTION 13.
|
|
12.
This question focuses on your BACHELOR’S DEGREE. What was
the specific major or majors of any BACHELOR’S DEGREES you
have received? For example, chemical engineering, elementary
teacher education |
____________________________ ____________________________ ____________________________ |
13. What is your ancestry or ethnic origin?
(For example: Italian, Jamaican, African-American, Cambodian, Cape Verdean, Norwegian, Dominican, French Canadian, Haitian, Korean, Lebanese, Polish, Nigerian, Mexican, Taiwanese, Ukrainian and so on.)
|
____________________________ ____________________________ |
14a. Do you speak a language other than English at home?
|
Yes No = Go to INSTRUCTION F
|
14b. What is this language?
|
__________________________ |
14c. How well do you speak English – very well, well, not well, not at all?
|
Very well Well Not well Not at all |
INSTRUCTION F If there is another person to collect detailED person data for, Continue to person 2. Otherwise, end interview. |
|
DETAILED QUESTIONS-PERSON 2
|
NAME ____________________ |
7a. I will now be asking a series of questions about <Name>. The next few questions deal with <Name’s> place of birth and citizenship...
Where was <Name> born?
ENTER STATE, IF KNOWN. IF STATE NOT KNOWN, ENTER U.S.
|
_______ State = Go to 10a1 OR Not born in the US = Go to 7b
|
7b. In what country was <Name> born?
|
___________ Country |
INSTRUCTION D IF COUNTRY IN 7b IS PUERTO RICO, GUAM, THE U.S. VIRGIN ISLANDS, OR NORTHERN MARIANAS, GO TO QUESTION 9a. OTHERWISE GO TO QUESTION 8a.
|
|
8a. Is <Name> a citizen of the United States? |
Yes = Go to 8b No = Go to 9a |
8b. Was <Name> born abroad of U.S. citizen parent or parents, or did <Name> become a citizen by naturalization?
|
Born abroad of U.S. citizen parent or parents = Go to 9a Citizen by naturalization = Go to 8c |
(YEAR OF NATURALIZATION: 8c – 8d)
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it before 1985, between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later?
IF THIS PERSON WAS BORN BETWEEN 1985 AND 1989, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later?
IF THIS PERSON WAS BORN BETWEEN 1990 AND 1994, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later?
IF THIS PERSON WAS BORN BETWEEN 1995 AND 1999, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 1995 and 1999, between 2000 and 2004, or 2005 or later?
IF THIS PERSON WAS BORN BETWEEN 2000 AND 2004, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 2000 and 2004, or 2005 or later?
|
Before 1985 Go to 9a 1985 – 1989 Go to 9a 1990 – 1994 Go to 9a 1995 – 1999 Go to 9a 2000 – 2004 Go to 9a 2005 or later Go to 8d
|
*8d. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON BECAME A NATURALIZED CITIZEN IN 2005 OR LATER.
|
_______________ Year |
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *9a. In what year did <Name> come to live in the United States? Was it before 1985, between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year.
IF THIS PERSON WAS BORN BETWEEN 1985 AND 1989, READ THIS: *9a. In what year did <Name> come to live in the United States? Was it between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year.
IF THIS PERSON WAS BORN BETWEEN 1990 AND 1994, READ THIS: *9a. In what year did <Name> come to live in the United States? Was between 1990 and 1994, 1995 and 1999, between 2000 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year.
IF THIS PERSON WAS BORN BETWEEN 1995 AND 1999, READ THIS: *9a. In what year did <Name> come to live in the United States? Was between 1995 and 1999, between 2000 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year.
IF THIS PERSON WAS BORN BETWEEN 2000 AND 2004, READ THIS: *9a. In what year did <Name> come to live in the United States? Was between 2000 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year.
|
Before 1985 Go to 10a1 1985 - 1989 Go to 10a1 1990 - 1994 Go to 10a1 1995 - 1999 Go to10a1 2000 - 2004 Go to 10a1 2005 or later Go to 9b
|
*9b. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON CAME TO LIVE IN THE US IN 2005 OR LATER.
|
_________________ Year |
10a1. The next questions are about schooling and education.
At any time IN THE LAST 3 MONTHS, has <Name> attended school or college? Include only nursery or preschool, kindergarten, elementary school, home school, and schooling that leads to a high school diploma or a college degree.
|
Yes No = Go to 11
|
10a2. Was that a public school or college, a private school or college, or home school?
|
Public school or college Private school or college or home school
|
10b. What grade or level was <Name> attending?
|
Nursery school or preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College undergraduate years, that is a college freshman to senior Graduate or professional school beyond a bachelor’s degree, for example a Master’s or PhD program or medical or law school
|
11. What is the highest degree or level of school <Name> has COMPLETED?
|
No schooling completed Nursery school Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12, no diploma Regular high school diploma GED or alternative credential Some college, no degree Associate’s degree (for example: AA, AS) Bachelor’s degree (for example: BA, BS). Master’s degree (for example: MA, MS, MEng, MEd, MSW, MBA) Professional degree beyond a bachelor’s degree (for example: MD, DDS, DVM, LLB, JD) Doctorate degree (for example: PhD, EdD) Vocational or technical license
|
INSTRUCTION E IF RESPONSE TO QUESTION 11 IS BACHELOR’S DEGREE OR HIGHER, ASK QUESTION 12. OTHERWISE, GO TO QUESTION 13.
|
|
12.
This question focuses on <Name’s>
BACHELOR’S DEGREE. What was the specific major or majors of
any BACHELOR’S DEGREES <Name>
has
received? For example, chemical engineering, elementary teacher
education |
____________________________ ____________________________ ____________________________ |
13. What is <Name’s> ancestry or ethnic origin? (For example: Italian, Jamaican, African-American, Cambodian, Cape Verdean, Norwegian, Dominican, French Canadian, Haitian, Korean, Lebanese, Polish, Nigerian, Mexican, Taiwanese, Ukrainian and so on.)
|
____________________________ ____________________________ |
14a. Does <Name> speak a language other than English at home?
|
Yes No = Go to INSTRUCTION F
|
14b. What is this language?
|
__________________________ |
14c. How well does <Name> speak English – very well, well, not well, not at all?
|
Very well Well Not well Not at all |
INSTRUCTION F If there is another person to collect detailED person data for, Continue to person 3. Otherwise, end interview. |
|
DETAILED QUESTIONS-PERSON 3
|
NAME ____________________ |
7a. I will now be asking a series of questions about <Name>. The next few questions deal with <Name’s> place of birth and citizenship...
Where was <Name> born?
ENTER STATE, IF KNOWN. IF STATE NOT KNOWN, ENTER U.S.
|
_______ State = Go to 10a1 OR Not born in the US = Go to 7b
|
7b. In what country was <Name> born?
|
___________ Country |
INSTRUCTION D IF COUNTRY IN 7b IS PUERTO RICO, GUAM, THE U.S. VIRGIN ISLANDS, OR NORTHERN MARIANAS, GO TO QUESTION 9a. OTHERWISE, GO TO QUESTION 8a.
|
|
8a. Is <Name> a citizen of the United States? |
Yes = Go to 8b No = Go to 9a |
8b. Was <Name> born abroad of U.S. citizen parent or parents, or did <Name> become a citizen by naturalization?
|
Born abroad of U.S. citizen parent or parents = Go to 9a Citizen by naturalization = Go to 8c |
(YEAR OF NATURALIZATION: 8c – 8d)
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it before 1985, between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later?
IF THIS PERSON WAS BORN BETWEEN 1985 AND 1989, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later?
IF THIS PERSON WAS BORN BETWEEN 1990 AND 1994, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later?
IF THIS PERSON WAS BORN BETWEEN 1995 AND 1999, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 1995 and 1999, between 2000 and 2004, or 2005 or later?
IF THIS PERSON WAS BORN BETWEEN 2000 AND 2004, READ THIS: *8c. In what year did <Name> become a naturalized citizen of the United States? Was it between 2000 and 2004, or 2005 or later?
|
Before 1985 = Go to 9a 1985 – 1989 = Go to 9a 1990 – 1994 = Go to 9a 1995 – 1999 = Go to 9a 2000 – 2004 = Go to 9a 2005 or later = Go to 8d
|
*8d. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON BECAME A NATURALIZED CITIZEN IN 2005 OR LATER.
|
_______________ Year |
(YEAR OF ENTRY: 9a – 9b)
IF THIS PERSON WAS BORN BEFORE 1985, READ THIS: *9a. In what year did <Name> come to live in the United States? Was it before 1985, between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year.
IF THIS PERSON WAS BORN BETWEEN 1985 AND 1989, READ THIS: *9a. In what year did <Name> come to live in the United States? Was it between 1985 and 1989, between 1990 and 1994, between 1995 and 1999, between 2000 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year.
IF THIS PERSON WAS BORN BETWEEN 1990 AND 1994, READ THIS: *9a. In what year did <Name> come to live in the United States? Was between 1990 and 1994, 1995 and 1999, between 2000 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year.
IF THIS PERSON WAS BORN BETWEEN 1995 AND 1999, READ THIS: *9a. In what year did <Name> come to live in the United States? Was between 1995 and 1999, between 2000 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year.
IF THIS PERSON WAS BORN BETWEEN 2000 AND 2004, READ THIS: *9a. In what year did <Name> come to live in the United States? Was between 2000 and 2004, or 2005 or later? If <Name> came to live in the United States more than once, give the latest year.
|
Before 1985 Go to 10a1 1985 - 1989 Go to 10a1 1990 - 1994 Go to 10a1 1995 - 1999 Go to 10a1 2000 - 2004 Go to 10a1 2005 or later Go to 9b
|
*9b. In what year was that?
ENTER SPECIFIC YEAR THIS PERSON CAME TO LIVE IN THE US IN 2005 OR LATER.
|
_________________ Year |
10a1. The next questions are about schooling and education.
At any time IN THE LAST 3 MONTHS, has <Name> attended school or college? Include only nursery or preschool, kindergarten, elementary school, home school, and schooling that leads to a high school diploma or a college degree.
|
Yes No = Go to 11
|
10a2. Was that a public school or college, a private school or college, or home school?
|
Public school or college Private school or college or home school
|
10b. What grade or level was <Name> attending?
|
Nursery school or preschool Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 College undergraduate years, that is a college freshman to senior Graduate or professional school beyond a bachelor’s degree, for example a Master’s or PhD program or medical or law school
|
11. What is the highest degree or level of school <Name> has COMPLETED?
|
No schooling completed Nursery school Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12, no diploma Regular high school diploma GED or alternative credential Some college, no degree Associate’s degree (for example: AA, AS) Bachelor’s degree (for example: BA, BS). Master’s degree (for example: MA, MS, MEng, MEd, MSW, MBA) Professional degree beyond a bachelor’s degree (for example: MD, DDS, DVM, LLB, JD) Doctorate degree (for example: PhD, EdD) Vocational or technical license
|
INSTRUCTION E IF RESPONSE TO QUESTION 11 IS BACHELOR’S DEGREE OR HIGHER, ASK QUESTION 12. OTHERWISE, GO TO QUESTION 13. |
|
12.
This question focuses on <Name’s>
BACHELOR’S
DEGREE. What was the specific major or majors of any BACHELOR’S
DEGREES <Name>
has
received? For example, chemical engineering, elementary teacher
education |
____________________________ ____________________________ ____________________________ |
13. What is <Name’s> ancestry or ethnic origin? (For example: Italian, Jamaican, African-American, Cambodian, Cape Verdean, Norwegian, Dominican, French Canadian, Haitian, Korean, Lebanese, Polish, Nigerian, Mexican, Taiwanese, Ukrainian and so on.)
|
____________________________ ____________________________ |
14a. Does <Name> speak a language other than English at home?
|
Yes No = Go to INSTRUCTION F
|
14b. What is this language?
|
__________________________ |
14c. How well does <Name> speak English – very well, well, not well, not at all?
|
Very well Well Not well Not at all |
INSTRUCTION F end interview. |
|
Participant ID #: |___|___|___|___|___|___|___|___|___|___|
DETAILED QUESTIONS-PERSON 1
DETAILED QUESTIONS-PERSON 2
|
NAME ___________ |
29a. Now, I am going to ask a series of questions about <Name’s> employment…
LAST WEEK, did <Name> work for pay at a job or business?
(Include any work even if <Name> worked only 1 hour, or helped without pay in a family business or farm for 15 hours or more, or was on active duty in the Armed Forces.)
|
Yes = go to 31 No |
29b. LAST WEEK, did <Name> do ANY work for pay, even for as little as one hour?
|
Yes No = go to 35a
|
31. LAST WEEK, how did <Name> USUALLY get to work?
(If <Name> usually used more than one method of transportation during the trip, report the one used for most of the distance.)
|
Car, truck, or van Bus or trolley bus Streetcar or trolley car Subway or elevated Railroad Ferryboat Taxicab Motorcycle Bicycle Walked Worked at home = go to 39 Other method
|
INSTRUCTION M IF RESPONSE TO QUESTION 31 IS “CAR, TRUCK, OR VAN”, GO TO QUESTION 32. OTHERWISE, GO TO QUESTION 33.
|
|
32. LAST WEEK, how many people including <Name> usually rode to work together?
|
____ |
33. LAST WEEK, what time did <Name> usually leave for work?
(What hour?) (How many minutes past the hour?) (Was that AM or PM?) |
Hour Minute __ : __ a.m. p.m. p.m. |
34. LAST WEEK, how many minutes did it usually take <Name> to get from home to work?
ENTER A ONE-WAY COMMUTE TIME FOR THE PERSON’S USUAL DAILY COMMUTE FROM HOME TO WORK LAST WEEK.
|
___ Minutes |
INSTRUCTION N IF RESPONSE TO QUESTION 29B IS “NO” ASK QUESTION 35A. OTHERWISE, GO TO QUESTION 39.
|
|
35a. LAST WEEK, was <Name> on layoff from a job?
|
Yes = go to 35c No
|
35b. LAST WEEK, was <Name> TEMPORARILY absent from a job or business because of vacation, temporary illness, maternity leave, other family or personal reasons, bad weather, etc.?
|
Yes = go to 38 No = go to 36 |
35c. Has <Name> been informed that she/he will be recalled to work within the next 6 months OR been given a date to return to work? |
Yes = go to 37a No
|
36. During the LAST 4 WEEKS, has <Name> been ACTIVELY looking for work? |
Yes No = go to 38
|
37a. LAST WEEK, could <Name> have started a job if offered one (or returned to work if recalled)? |
Yes = go to 38 No
|
37b. Why was that?
|
Own temporary illness Going to school or some other reason |
38. When did <Name> last work, even for a few days?
|
Within the past 12 months Between 1 and 5 years ago Over 5 years ago or never worked = go to 47e
|
(WEEKS WORKED AND HOURS WORKED: 39 – 40c)
*39. During the 52 weeks covering 2016, that is from January 1, 2016 to December 31, 2016, in the weeks <Name> worked, how many hours did <Name> usually work each week?
|
____ Usual hours each week
|
*40a. During the 52 weeks covering 2016, did <Name> work EVERY week? Count paid vacation, paid sick leave, and military service as work.
|
__Yes = go to 41a __ No |
*40b. During the 52 weeks covering 2016, how many WEEKS did <Name> work? Include paid time off and include weeks when <Name> only worked for a few hours. If you would rather give your answer in months, you may do so.
IF THE ANSWER IS BETWEEN 1 AND 12, READ: (Is that weeks or months?)
|
__Weeks __Months |
41a. The next series of questions are about the type of business <Name> worked for and the type of work that <Name> did last. If <Name> had more than one job, describe the one at which the most hours were worked.
Let’s start with the first question. I am going to read 5 categories. Please pick the one that best describes who <Name> worked for - a private organization or company, government, the U.S. Armed Forces (active duty), self-employed, or working without pay in a family business.
|
Private organization or company Government = go to 41c U.S. Armed Forces (active duty) = go to 42b Self-employed = go to 41d Working without pay in a family business = go to 42a |
41b. Was this a non-profit organization or for-profit company? |
Non-profit organization = go to 42a For-profit company = go to 42a
|
41c. Was this for local, state, or the federal government?
|
Local = go to 42a State = go to 42a Federal = go to 42a |
41d. Was this self-employment incorporated or not incorporated?
|
Incorporated Not incorporated |
42a. What was the name of <Name’s> company, business or other employer?
|
_____________________ = go to 43 |
42b. Which branch of the Armed Forces does <Name> work for? |
U.S. Army = go to 45 U.S. Navy = go to 45 U.S. Air Force = go to 45 U.S. Marine Corps = go to 45 U.S. Coast Guard = go to 45
|
43. What kind of business or industry was this? For example: hospital, newspaper publishing, mail order house, auto engine manufacturing, bank.
|
_____________________ |
44. Is this business mainly -- manufacturing, wholesale trade, retail trade or some other kind of business?
|
Manufacturing Wholesale trade Retail trade Other (agriculture, construction, service, government, etc.) |
45. What kind of work was <Name> doing at this job? For example: registered nurse, personnel manager, supervisor of order department, secretary, accountant.
|
_________________________ |
46. What was <Name’s> most important activities or duties at this job? For example, patient care, directing hiring policies, supervising order clerks, typing and filing, reconciling financial records.
|
|
(INCOME: 47a - 48)
The next few questions are about income received in 2016, that is from January 1, 2016 to December 31, 2016…
*47a. Did <Name> receive any wages or salary?
|
Yes No
|
If “yes” to 47a, read: *47b. Did <Name> receive any additional tips, bonuses or commissions in 2016?
If “No” to 47a, read: *47b. Did <Name> receive any tips, bonuses or commissions in 2016?
|
Yes No |
*47c. Did <Name> receive any self-employment income in 2016, including work that was paid for in cash? Consider income from own businesses (farm or non-farm) including proprietorships and partnerships.
|
Yes No = go to 47e
|
*47d. Was this income a loss? |
Yes No
|
*47e. if “OVER 5 YEARS AGO OR NEVER WORKED” TO 38 READ: The next few questions are about income received in 2016, that is from January 1, 2016 to December 31, 2016…
Did <Name> receive any interest or dividends? Consider even small amounts credited to an account.
Otherwise, READ: Did <Name> receive any interest or dividends in 2016? Consider even small amounts credited to an account.
|
Yes No
|
*47f. Did <Name> receive any net rental income in 2016? |
Yes No = go to 47h
|
*47g. Was this income a loss? |
Yes No |
*47h. Did <Name> receive any royalty income or income from estates and trusts in 2016?
|
Yes No |
*47i. Did <Name> receive any Social Security or Railroad Retirement benefits in 2016?
|
Yes No |
*47j. Did <Name> receive any Supplemental Security Income (SSI) payments in 2016?
|
Yes No |
*47k. Did <Name> receive any public assistance or public welfare payments from the state or local welfare office in 2016?
|
Yes No |
*47l . Did <Name> receive any retirement, survivor, or disability pensions in 2016?
(Do not include Social Security.)
|
Yes No |
*47m. Did <Name> receive income on a REGULAR basis from any other sources such as Department of Veterans Affairs (VA) payments, unemployment compensation, child support or alimony in 2016?
(Do not include lump sum payments such as money from an inheritance or sale of a home.)
|
Yes No |
*48. If “Yes” to ONLY 47A or 47b (either one or both), READ: What was <Name’s> TOTAL income in 2016? Include amount from all jobs before taxes and other deductions.
If “Yes” to ONLY 47c, Read: What was <Name’s> TOTAL self-employment income in 2016, including amount received in cash? Report total after operating expenses.
If “Yes” to ONLY 47c And 47D (BOTH), Read: What was <Name’s> TOTAL self-employment income in 2016, including amount received in cash? Report total after operating expenses and report losses as a negative amount.
OTHERWISE, continue as follows:
Read: What was <Name’s> total income in 2016 from all of the sources you just mentioned?
If “Yes” to 47A or 47b, READ: Include amount from all jobs before taxes and other deductions.
If “Yes” to 47c, Read: For self-employment income, include amount received in cash and report the total after operating expenses.
If “Yes” to 47D or 47g, Read: Subtract the loss amount from the total.
If “Yes” to 47E, 47F, OR 47H, Read: For income received jointly, include the appropriate portion for <Name> in the total.
|
$_________________________ Total Income If net income was a loss precede amount with a '-' |
INSTRUCTION O end interview. |
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |