Attachment G - CEQ Information Booklet

Attachment G - CE 305 2017 CEQ INFOBOOK OMB.pdf

Consumer Expenditure Surveys: Quarterly Interview and Diary

Attachment G - CEQ Information Booklet

OMB: 1220-0050

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TABLE OF CONTENTS
Page
Privacy Act Statement

4

Demographics

5

Section 1 – General Housing Characteristics

7

Section 2 – Rented Living Quarters

8

Section 3 – Owned Living Quarters and Other Owned Real Estate

9

Section 4 – Utilities and Fuels

12

Section 5 – Construction, Repairs, Alterations, and Maintenance of Property

13

Section 6 – Appliances, Household Equipment and Other Selected Items

16

Section 7 – Household Item Repairs, Service Contracts, and Extended Warranties

23

Section 8 – Home Furnishings and Related Household Items

24

Section 9 – Clothing and Clothing Services

28

Sections 10 and 11 – Rented, Leased, and Owned Vehicles

31

Section 12 – Vehicle Operating Expenses

32

Section 13 – Health Insurance

34

Section 14 – Medical and Health Expenses

35

Section 15 – Insurance Other than Health

36

Section 16 – Educational Expenses

38

Section 17 – Subscriptions, Memberships, Books, and Entertainment Expenses

39

Section 18 – Trips and Vacations

41

Section 19 – Miscellaneous Expenses

43

Section 20 – Expense Patterns for Selected Services and Goods

46

Section 21 – Occupations

47

Section 21 – Work Experience and Income

48

Section 22 – Assets and Liabilities

51

2017 Calendar

53

2018 Calendar

54

Fraction Conversion Chart

55

Language Identification Cards

56

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PRIVACY ACT STATEMENT
The U.S. Census Bureau is conducting the Consumer Expenditure
Surveys for the Bureau of Labor Statistics of the U.S. Department of Labor
under Title 29, United States Code. The survey’s purpose is to obtain
information on what Americans are purchasing in order to update the
Consumer Price Index. All survey information will be used for statistical
purposes only.
Any information you provide for this survey is confidential, by law, under
Title 13, United States Code. Participation in this survey is voluntary and
there are no penalties for refusing to answer any question(s). However,
your cooperation is extremely important to help ensure the completeness
and accuracy of these data.

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DEMOGRAPHICS

Hispanic Origin
1. Mexican
2. Mexican-American
3. Chicano
4. Puerto Rican
5. Cuban

Race
(Please choose one or more)
1. White
2. Black or African American
3. American Indian or Alaska Native
4. Asian
5. Native Hawaiian
6. Guamanian or Chamorro
7. Samoan
8. Other Pacific Islander

Asian Origin
1. Chinese
2. Filipino
3. Japanese
4. Korean
5. Vietnamese
6. Asian Indian

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Demographics

Education
1. No schooling completed, or less than 1 year
2. Nursery, kindergarten, and elementary
(grades 1-8)
3. High school (grades 9-12, no degree)
4. High school graduate – high school diploma
or the equivalent (GED)
5. Some college but no degree
6. Associate’s degree in college
7. Bachelor’s degree (BA, AB, BS, etc.)
8. Master’s, professional, or doctoral degree
(MA, MS, MBA, MD, JD, PhD, etc.)

Armed Forces
A person is considered to be in the Armed
Forces if he or she serves in any branch of the
U.S. military. This includes the Army, Navy,
Marine Corps, Air Force, and Coast Guard; their
Reserve components; and the Air and Army
National Guard.

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SECTION 1 – GENERAL HOUSING CHARACTERISTICS
Type of Structure
1. Single family detached
A detached structure with only one primary residence;
however, the structure could include a rental unit(s) in the
basement, attic, etc.
2. Row or townhouse
An inner unit (2, 3, or 4 story structure) with 2 walls in common with other units and a
private ground level entrance; it may have a rental unit as part of the structure.
3. End row or end townhouse
Shares only one common wall with other units.
4. Duplex
A detached two unit structure with all units occupying the same level or levels.
5. 3-plex or 4-plex
3 or 4 unit structure with all units occupying the same level or levels.
6. Garden
A multi-unit structure, usually wider than it is high, having 2, 3, or possibly 4 floors;
characteristically the units not only have common walls but are also stacked on top of one
another.
7. High rise
A multi-unit structure which has 4 or more floors.
8. Apartment or flat
A unit not described above; it could be located in the basement, attic, second floor, or over
the garage of one of the units described above.
9. Mobile home or trailer
10. College dormitory

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SECTION 2 – RENTED LIVING QUARTERS
Included in the Housing Unit
Cooking stove, range, or oven
Refrigerator or home freezer
Built-in dishwasher
Portable dishwasher
Clothes washer
Clothes dryer

Included with the Rental Payment
Electricity
Gas
Piped-in water
Heating
Trash/garbage collection
Garage and parking facilities
Telephone services
Television services
Internet services
Furniture

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SECTION 3 – OWNED LIVING QUARTERS AND OTHER
OWNED REAL ESTATE
Included with this Housing Unit
1. Swimming pool
2. Off-street parking
3. Porch, terrace, patio, or balcony
4. Apartment or guest house
5. Central air conditioning
6. Window air conditioning
7. Solar panels

Types of Owned Real Estate
1. A home in which you used to live
2. Other homes, vacation homes, and recreational
properties including timeshares
3. Commercial real estate or farmland
4. Homes rented out or owned only for investment purposes
5. Land with no buildings on it

Closing Costs
Property survey charges

Points paid by buyer

Title search

Deed preparation

Recording fees

Lawyer’s fees

Transfer taxes

Advertising costs

Escrow payment

Real estate listing fees

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Section 3 – Owned Living Quarters and Other Owned Real Estate

Costs for Selling a Property
Commission to Realtor

Lawyer’s fees

Closing costs

Advertising costs

Points for financing

Deferred mortgage interest
payment

Mortgage penalties

Real estate listing fees

Property inspection

Mortgage Payment Items
1. Principal
2. Interest
3. Property taxes
4. Property insurance
5. Mortgage guarantee insurance
6. Any other payments (specify)

Fees for Cooperatives
1. Repayment of loans owed by cooperative
2. Property taxes
3. Property insurance
4. Management
5. Repairs or maintenance, including lawn care or snow
removal
6. Improvements
7. Recreational, including swimming, golf, or tennis, facilities
8. Security, including guards or alarm systems
9. Utilities, such as gas, electricity, water, heat
10. Trash collection
11. Other (Specify)

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Section 3 – Owned Living Quarters and Other Owned Real Estate

Homeowner’s Associations or
Condominium Fees
1. Management
2. Repairs or maintenance, including lawn care or snow
removal
3. Improvements
4. Utilities, such as gas, electricity, water, heat
5. Parking
6. Recreational, including swimming, golf, or tennis facilities
7. Security, including guards or alarm systems
8. Maid service
9. Medical services
10. Trash collection
11. Other (specify)

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SECTION 4 – UTILITIES AND FUELS
Part A – Telephone, Internet, and Cable/Satellite TV Expenses
1. Telephone service
Residential service, including Voice over IP (VoIP)
Mobile/cellular service, including pre-paid
2. Internet service
broadband DLS

dial-up

3. Cable or satellite TV
Cable TV
Direct TV

Dish TV

TiVo

Includes DVR service and on-demand/pay-per-view

Part B – Other Telephone or Internet Expenses
Pre-paid long distance telephone cards/minutes
Internet or wireless internet access away from home, at places such as cafés, hotels, or
airplanes

Part C – Utilities, Fuels, and Services
1. Electricity
2. Natural or utility gas
3. Fuel oil
4. Bottled or tank gas
propane

kerosene

5. Other fuels including wood
6. Piped-in water and sewerage maintenance
7. Garbage and recycling collection, including –
hazardous waste collection

waste disposal

recyclable material collection

8. Water softening service
9. Septic tank cleaning

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SECTION 5 – CONSTRUCTION, REPAIRS, ALTERATIONS,
AND MAINTENANCE OF PROPERTY
Job Types
1. Homes under construction, including a vacation
home or second home
2. Building an addition to the house or a new structure,
such as a porch, garage, or new rooms
kitchen, bedrooms, family rooms, general purpose
rooms, basement, etc.
decks, porches, patio, and terraces added or improved
attached garages, carports, breezeways, greenhouses, and sheds
detached garages or carports added or improved
other detached outside buildings added or improved (sheds, greenhouses, storm cellars)
other outside additions or alterations (boat docks, terracing, grading and filling, retaining
walls)
3. Finishing a basement or an attic or enclosing a porch
4. Remodeling one or more rooms in the house
interior restructuring or other areas (removing or adding walls and/or the creation
of new rooms within the structure or the demolition of part of the structure)
bathroom remodeling
kitchen remodeling
5. Landscaping the grounds or planting new shrubs or trees
6. Building outdoor patios, walks, fences, or other enclosures, driveways, permanent
swimming pools, or hot tubs
recreational facilities
patios and terraces
fences added or improved
detached building
driveways and walkways added or improved

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Section 5 – Construction, Repairs, Alterations, and Maintenance of Property

7. Repairing outdoor patios, walks, fences, driveways, or permanent swimming pools
(including permanent above-ground swimming pools)
fences

patios and terraces

8. Painting, either interior or exterior, or wallpapering
combination of painting and wallpapering
varnish, sealant, lacquer, and waterproofing

recreational facilities

wallpaper

9. Plastering or paneling
also includes drywall patching
10. Plumbing or water heating installations or repairs
plumbing fixtures
water heater
septic tank
built-in dishwasher or laundry tubs
all interior water pipes
external sprinkler systems, septic tanks, and wells
garbage disposal
11. Electrical work
includes garage door opener
12. Heating or air conditioning jobs
13. Flooring installation, repair, or replacement, including carpeting, wood, vinyl, and tile
carpet
other flooring including wood, slate, marble, or
tile, linoleum, or vinyl
concrete
14. Insulation
15. Roofing, gutters, or downspouts
complete re-roofing
combined replacements
including re-roofing

repair of shingles, gutters, downspouts, etc.
combined maintenance and repairs including
roofing

16. Siding
17. Installation, repair, or replacement of window panes, screens, storm doors, awnings,
and the like
windows (interior or exterior)
doors (interior or exterior)
18. Masonry, brick, or stucco work
19. Other improvements or repairs (include security systems that are hard-wired into
the home)

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Section 5 – Construction, Repairs, Alterations, and Maintenance of Property

Appliances
1. Cooking stove, range, or oven
2. Microwave oven
3. Refrigerator or home freezer
mini refrigerator
wine refrigerator
4. Built-in dishwasher
5. Portable dishwasher
6. Garbage disposal
7. Clothes washer or dryer
8. Range hood
9. Smoke alarms and detectors
10. Window air conditioner
11. Portable cooling and heating equipment
portable dehumidifiers
humidifiers
fans

space heaters

Do not include window air conditioners.
12. Lamps, lighting fixtures, or ceiling fans
13. Other major home appliances and equipment
trash compactor
water softener
furnace
heat pump

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central air conditioner

15

SECTION 6 – APPLIANCES, HOUSEHOLD EQUIPMENT,
AND OTHER SELECTED ITEMS
Part A – Major Household Appliances
1. Microwave oven
2. Cooking stove, range, or oven
3. Range hood
4. Refrigerator or home freezer
mini refrigerator
wine refrigerator
5. Built-in dishwasher
6. Portable dishwasher
7. Garbage disposal
8. Clothes washer or dryer

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Section 6 – Appliances, Household Equipment, and Other Selected Items

Part B – Household Appliances and Other Selected Items
SMALL HOUSEHOLD APPLIANCES
1. Small electrical kitchen appliances, including –
blender
breadmaker
coffee grinder
coffee maker
crockpot
deep fryer
electric barbecue
electric can opener

electric grill
electric fondue set
electric frying pan
electric iron
electric knife
electric timer
electric wine chiller
electric wok

food processor
hot plate
ice cream maker
juicer
mixer
pizza oven
popcorn maker

2. Electrical personal care appliances, including –
curling iron
digital scale
hair dryer
denture cleaner
electric toothbrush
heating pad
electric hair trimmer facial sauna
make-up mirror
electric razor
foot bath
massager

rice cooker
sandwich grill
slow cooker
smoothie maker
toaster
toaster oven
waffle iron

water-pik

3. Electrical floor cleaning equipment, including –
vacuum cleaner

hand vacuum

rug shampooer

floor polisher/buffer

4. Other household appliances, including –
trash compactor
home security device (burglar alarm) including console,
air purifier
control modules, burglar alarm console, door and window
water filters
transmitters
smoke detector
carbon monoxide detector
water leak alarm
5. Sewing machines (with or without cabinet), including –
knitting machines

quilting machines

sergers

6. GPS devices, calculators, and fax machines, including –
typewriters

copy machines

7. Digital book readers or tablets, including –
iPad

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Kindle

Nook

Galaxy tablet

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Section 6 – Appliances, Household Equipment, and Other Selected Items
8. Computers, computer systems, or related hardware, including
CD/DVD drive
monitors
memory
home computers with or
computer printers
fax modems
modems
without monitors
netbooks
scanner
cables
external hard drive
laptops
keyboards
mouse
Google Glass
9. Computer software, including computer games
10. Computer accessories, including –
printer cartridges
mouse pads
11. Portable memory, such as flash drives, memory cards, and recordable discs and
tapes, including –
thumb drives
blank CDs/DVDs
memory stick
USB flash drive
SD card
12. Video game hardware or accessories, including –
Nintendo Wii
Gamecube
Nintendo DS
Gameboy
Playstation
Xbox
Do not include video games.
13. Telephones or accessories, including –
cell phones
headsets
answering machines
chargers
phone jacks and cords

PSP

cordless telephones
cell phone covers
Bluetooth accessories

smartphones
Apple Watch

14. Photographic equipment, including –
camera
filter
projection screen
battery pack for camera flash
digital camera
winder
electro flash
motor driven film advancer
lens
enlarger
projector
strobe light (for photographs)
tripod
Do not include film, film processing, or other photographic supplies.

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Section 6 – Appliances, Household Equipment, and Other Selected Items
15. Musical instruments, supplies, or accessories, including –
keyboards
music books
clarinet
brass instruments
guitar
saxophone
drums
carrying case
piano
sheet music
music stand
stringed instruments
reeds
trumpet
picks
strings for musical instruments
trombone
valve oil
rosin
any other musical accessories
woodwinds
Do not include repairs, music lessons, or band uniforms.
16. Lawn mowing machinery or other yard equipment, including –
rake
lawn mower
snow blower
electric lawn trimmer
shovel
tiller
wheelbarrow
tractor (farm, garden, etc.)
spreader
garden hose
weed digger
edger
TOOLS FOR HOME USE
17. Power tools, including –
lathe
electric drill
router
electric saw
sander
electric plane

cordless drill
electric polisher
trouble light

18. Non-power tools including –
axe
hammer
caulking gun
level
plane
sockets

pliers
saw

cordless circular saw
air compressor
electric swimming pool
cleaning equipment
screwdriver
wrench

HEATING AND COOLING EQUIPMENT
19. Window air conditioners
20. Portable cooling or heating equipment, including –
space heater
dehumidifier
humidifier

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fan

19

Section 6 – Appliances, Household Equipment, and Other Selected Items
TVS, RADIOS, VIDEO, AND SOUND EQUIPMENT INCLUDING IN VEHICLES
21. Televisions, all types including those installed in vehicles, including –
combo TV/DVD players
HD TV
3-D TV
TVs in cars
22. DVD players, VCRs, DVRs, or video cameras, including –
TiVo unit
digital TV converter box
Blu-ray disc player
video tape recorder/player
high definition disc player
video laser disc player
combination of VCR/DVD player
video cassette recorder/player
23. Satellite dishes, receivers, or accessories
24. Handheld personal music players, including –
iPod
personal mp3 players
25. Stereos, radios, speakers, and sound components, including those installed in
vehicles, including –
car stereo
amplifier
equalizer
satellite radio
CB radio
clock radio
compact disc players
audio cassette
mixer
receiver
short-wave radio
players/recorders
speakers
turntable
tuner
stereo
walkie talkie
stereo system
26. Other sound or video equipment including accessories, including –
earphones/headphones
battery packs
adapter for sound equipment
power converter
power booster
base station CB antenna
antenna (TV, radio, etc.)
headset
microphone

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Section 6 – Appliances, Household Equipment, and Other Selected Items
SPORTS, RECREATION, AND EXERCISE EQUIPMENT
27. General sports equipment, including –
roller blades
baseball bat
baseball glove
badminton set
sports uniform
football
boxing equipment soccer ball
tennis racket
basketball
lawn games
golf bag
bowling ball
racquetball
Frisbee
golf clubs
basketball hoop
skateboard
volleyball
karate equipment
racquetball racket
helmets
pads
table tennis equipment
other sports
Fitbit
protective
equipment
Do not include specialized athletic shoes such as for football, baseball, soccer, biking,
and bowling.
28. Health and exercise equipment, including –
trampoline
exercise mat
weight bench
weights
home gym
treadmill
rowing machine
29. Camping equipment, including –
tent
sleeping bag
kerosene lantern
sleeping pad
frame packs and
other camping
packs

camping stove
camping cookware
portable heater

pedometer
exercycle

canteen
air mattress
screenhouse

30. Hunting and fishing equipment, including all guns, including –
bow and arrow
knife
BB/pellet gun
handgun
fishing rod and
rifle
ammunition
scopes
tackle
shotgun
crossbow
fishing lures

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Section 6 – Appliances, Household Equipment, and Other Selected Items
31. Winter sports equipment, including –
snow skis
ski poles
toboggan
ski boots
ice skates
snowboard equipment
snowboard
ice boat
sledding equipment
32. Water sports equipment, including –
water skis
snorkel
diving equipment
life jacket
water ski vest
raft
skim board
wake board
wind/paddle board

sled

swim cap
surf board
boogie board

33. Outboard motors
34. Bicycles or bicycle equipment, including –
bicycle helmets
stand
tires
bicycle parts
locks
rack
bike pump

tubes
supplies

35. Tricycles or battery powered riders, including –
Big Wheels
36. Playground equipment, including –
portable swimming pool
swing set

sand box

gym set

37. Other sports or recreation equipment, including –
telescope
metal detector
paintball equipment

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SECTION 7 – HOUSEHOLD ITEM REPAIRS, SERVICE
CONTRACTS, AND EXTENDED WARRANTIES

1. Garbage disposal, range hood, or built-in dishwasher
2. Other household appliances, such as –
washer

refrigerator

range/oven

portable heating equipment

portable air conditioning equipment

window air conditioner

portable fans

dehumidifiers

sewing machines

vacuum cleaners

3. Televisions, radios, video and sound equipment, including those installed in
automobiles or other vehicles
4. Computers, computer systems, or related equipment for non-business use
technical support

accidental damage

AppleCare

Geek Squad

smartphone repair
5. Lawn and garden equipment
lawn mower repair

snow blower repair

6. Musical instruments or accessories
professional tuning
7. Hand or power tools
8. Photographic equipment
9. Sport or recreational equipment
bicycle repair

outdoor sports equipment repairs

golf club repair

exercise equipment repairs

tennis racket repair

gun repair

10. Termite or pest control
11. Heating or air conditioning service contracts, covering –
central air conditioners

central coolers

furnaces

heat pumps

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SECTION 8 – HOME FURNISHINGS AND RELATED
HOUSEHOLD ITEMS
Part A – Purchases
LIVING, FAMILY, OR RECREATION ROOM FURNITURE
1. Sofas, including –

sofabed

loveseat

sectionals

futon

2. Living room chairs, including –

recliner
bean bag chair

convertible chair

rocker

swivel chair

3. Living room tables, including –

coffee table

end tables

TV table

lamp table

4. Ping-pong tables, pool tables, or other similar recreation room items
5. Other living, family, or recreation room furniture including desks, wall units, and

shelving, including –
bookcase
curio cabinet
room divider
bar stools
coat rack
gun cabinet

entertainment center
desk/chair
portable bar or cart

card table/chairs
foot stool (ottoman)

6. Living room furniture combinations, including –

sofa, chair, and table combinations or suites
DINING ROOM AND KITCHEN FURNITURE
7. Dining room or kitchen furniture, including –

dinette set
kitchen chairs

buffet
china cabinet

serving table or cart
dining table and chairs

BEDROOM FURNITURE
8. Mattresses or box springs, including roll-aways
9. Bedroom furniture other than mattresses or box springs, including –

headboard
bed frames
chest

24

dresser
vanity
armoire

mirrors
chairs
mattress topper

bunk bed
night tables
water bed

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Section 8 – Home Furnishings and Related Household Items
INFANTS FURNITURE AND EQUIPMENT
10. Infants’ furniture, including –

crib
playpen
high chair

mattress
dresser
chest

toy chest
bassinet

changing table
portable crib

11. Infants’ equipment, including –

carriage
stroller
car seat

baby gate
swing
guard rail

baby bottle sterilizer
baby travel systems
baby carrier/backpack

baby monitor
jogging stroller

OUTDOOR FURNITURE AND EQUIPMENT
12. Patio, porch, or outdoor furniture, including –

patio umbrella
porch swing

chaise lounge
hammock

picnic table
canopy

beach chair
patio set

13. Barbecue grills or outdoor decorative items, including –

patio lanterns
fountain
planters

patio statues
statue
tiki torches

bird houses
outdoor flag
inflatable lawn
decorations

bird bath
wind chimes

OFFICE FURNITURE FOR HOME USE
14. Office furniture for home use, including –

file cabinet
office chairs
computer furniture
drafting table
safe
Do not include any furniture used exclusively for business.

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Section 8 – Home Furnishings and Related Household Items
HOUSEHOLD DECORATIVE ITEMS
15. Lamps, lighting fixtures, or ceiling fans, including –

chandeliers
floor lamps
recessed lighting

sconces
track lights

table lamps
ceiling fans with/without lights

16. Other household decorative items, including –

painting
vase
wall hangings
plant stand
Christmas lights

baskets
silk flowers
mirror
book ends

fireplace equipment and accessories
seasonal decorations (Christmas)
wreaths
clocks

CLOSET STORAGE AND TRAVEL ITEMS
17. Closet and storage items, including –

garment bag
garment racks
drawer organizers

hangers
hanging bags
hampers

shoe rack
shoe bag
underbed storage

drawers
shelf organizers
storage bins

18. Travel items including luggage, also including –

travel garment bags
messenger bag
passport holder

trunk
tote bag

briefcase
toiletry bag

backpack
travel pillow

DISHES, DINNERWARE, FLATWARE, GLASSWARE, AND COOKWARE
19. Stainless, silver, or other flatware, except plastic
20. Non-electric cookware, including –

skillet
saucepan

roaster
pans

pots
teakettle

pressure cooker
casserole dishes

21. Dishes, glasses, or serving pieces, including –

trays
mugs
stemware

26

pitchers
plates
china

bowls
platters
Tupperware

cups
crystal

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Section 8 – Home Furnishings and Related Household Items
HOUSEHOLD LINENS
22. Bedroom linens, including –

sheets
pillowcases
pillows

comforter
mattress pad
quilt

baby blanket
electric blanket
duvet

blanket
bedspread

bath mat
wash cloths

toilet cover

23. Bathroom linens, including –

towels
face cloths

shower curtain
tub mat

24. Kitchen, dining room, or other linens, including –

tablecloths
dish towels
doilies

cloth napkins
dish cloths
chair pads

placemats
furniture protectors

small appliance covers
covers for living room tables

25. Slipcovers, decorative pillows, or cushions, custom or ready-made

FLOOR AND WINDOW COVERINGS
26. Rugs or other non-permanent floor coverings, including carpet squares
27. Curtains or drapes (either custom or ready-made)
28. Blinds, shades, or other window coverings (either custom or ready-made)

Part B – Rental, Leasing, or Repair of Furniture
Rental or leasing of furniture
Repairing, refinishing, or reupholstering furniture, including the cost for fabric

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SECTION 9 – CLOTHING AND CLOTHING SERVICES
Part A – Clothing, Footwear, and Accessories
1. Coats, jackets, or furs, including –
shawl/stole
raincoat

down vest

2. Sport coats, tailored jackets, or blazers
3. Suits, including –
woman’s suit (of two or more pieces)
man’s suit (of two or more pieces)
Do not include tuxedo rentals.

formal suit
tuxedo

4. Vests (purchased separately, not with a suit), excluding sweater vests and outerwear
vests
5. Shirts, sweaters, blouses, or tops, including –
cardigan
pullover
sweater
sweater vest
tank top
polo shirt
dress shirts
t-shirts
Do not include any sweat shirts or athletic wear.
6. Pants, jeans, or shorts, including –
jump suit
overalls
maternity pants
short sets
rompers
crops/capris
Do not include any athletic wear.
7. Dresses, including –
two-piece dresses
wedding gown

maternity dresses

knit blouses
maternity tops

dress slacks

formals or semi-formals

8. Skirts, including skorts
Do not include any tennis skirts, golf skirts, or other athletic wear.
9. Undergarments, including –
bras
undershirts
shapewear
underwear

slips
thermal underwear

10. Hosiery, including –
socks
knee-highs
tights
pantyhose
Do not include medical compression or surgical hosiery.
11. Nightwear or loungewear, including –
pajamas
night shirt
night gown
robe
house coat
thermal sleeping garments

28

CE-305 (4-1-2017)

Section 9 – Clothing and Clothing Services
12. Accessories, including –
umbrellas
gloves
belts
mittens
ties
purse
scarves
wallet
hat
suspenders

apron
ear muffs
handkerchiefs
bridal headpiece

13. Swimsuits or warm-up or ski suits, including –
athletic shorts
tennis outfit
sweatshirt
athletic shirt
jogging suit
swimwear
hunting wear
leotards
bike shorts
Do not include any sports uniforms.

fold-up rain accessories
bandannas
hand bag
non-prescription
sunglasses
swimwear accessories
snow and ski suit
workout clothes

14. Uniforms, other than sport, for which the cost is not reimbursed, including
school uniforms
scout uniforms
work uniforms
medical scrubs
barber smocks
lab smocks
military uniforms
15. Costumes, including –
dance and ballet performances
stage performances
Halloween
16. Footwear, including athletic footwear –
dress shoes
sandals
bedroom slippers
sneakers
casual shoes
boots
jogging, aerobic, basketball, or tennis shoes
work boots
cleats
Include specialized athletic shoes such as for football, soccer, bowling, biking, or
baseball, except if included in the rental or activity fee for the sport.
17. Diapers, including disposable
Do not include diaper service.
18. Layettes
19. Watches
pocket watches
wristwatches
Do not include GPS or heartrate watches or “smartwatches” such as Apple Watch.
20. Jewelry, including –
rings
bracelets

CE-305 (4-1-2017)

infants jewelry
necklaces
costume jewelry cufflinks

earrings

29

Section 9 – Clothing and Clothing Services

Part B – Clothing Services
1. Repair, alteration, and tailoring for clothing and accessories
hemming
sew buttons
zipper replacement dress alterations
wallet repair
handbag repair
2. Shoe repair or other shoe services
new soles
stretching
waterproofing
dyeing

replace heel
inserting lifts

3. Watch or jewelry repair, including cleaning
ring sizing
replace setting
replace/add stones
replace battery

re-stitching
orthopedic modification
cleaning

4. Clothing or accessory rental, including formal wear
tuxedo or suit rental
handbag rental
5. Clothing storage outside the home
cold storage for furs

30

CE-305 (4-1-2017)

SECTIONS 10 AND 11 – RENTED, LEASED, AND OWNED
VEHICLES
1. Automobile, truck, minivan, van, and SUV
Include fees for car sharing services such as Zipcar in rented vehicles.

2. Motor home
3. Trailer-type camper
4. Other attachable-type camper
5. Motorcycle, motor scooter, or moped (motorized bicycle)
6. Boat with a motor
jet skis
power boat

yacht
launch

cabin cruiser
pontoon boat

boat with outboard
motor

7. Boat without a motor
canoes
rowing shells

kayaks

rowboats

sailboats

cargo trailer
ATV trailer

utility trailer

horse trailer

gliders

helicopters

8. Trailer other than camper
boat trailer
motorcycle trailer
9. Private aircraft
planes
10. Any other vehicle
snowmobile
Segway

CE-305 (4-1-2017)

dune buggy

ATV

riding golf cart (except if
rental included in
golfing fees)

31

SECTION 12 – VEHICLE OPERATING EXPENSES
Part A – Vehicle Maintenance and Repair, Parts, and
Equipment
1. Oil change, lubrication, or oil filter
2. Motor tune-up, including –
air/fuel filters
computer sensor
distributor cap, rotor PCV valve
emission controls
spark plugs

ignition wires
valve adjustment
air filter element

ignition timing or mixture
adjustment

3. Battery purchases or installation
4. Tire purchases or mounting
5. Tire repairs
6. Front end alignment, wheel balancing, or wheel rotation
7. Shock absorber replacement, including MacPherson struts
8. Body work or painting, including –
convertible top
doors
T-roof
glass replacement
vinyl top
rust proofing

crash repairs
window repair

9. Any other vehicle or engine repairs, including –
air conditioning
brake pads
alternator
clutch or transmission
carburetor
fan switch or belt
electrical system work
car computer
axle work
engine repair/replacement
compressor
recharge A/C
exhaust system work
condenser
ignition system
transmission
fuel injector
muffler
steering
gaskets
timing belt
suspension
radiator
power steering
10. Vehicle accessories or customizing, including –
alarm system
carpeting
running boards
bike/ski racks
fender skirts
seat covers
bumper guards
luggage rack
11. Other vehicle services, parts, or equipment, including –
battery cables
vent filters
jack
gas cable/cap/can
brake lights
gasket sets
light bulbs
wheel lugs
headlights
wheels/rims
hub caps
upholstery work

sanding

brake work
bushings
battery charge
bearings
differential
fuel pump
hydraulic system

steering wheel covers
spoilers

charcoal canister filters
windshield wipers
speedometer cable
tire/wheel combination

12. Vehicle cleaning services including car washes, including –
boat cleaning services
vacuuming
vehicle detailing services
32

CE-305 (4-1-2017)

Section 12 – Vehicle Operating Expenses

Part B – Licensing, Registration, and Inspection of Vehicles
1. Driver’s licenses
2. Vehicle inspection
emissions inspection

safety inspection

3. State vehicle registration
4. Local vehicle registration
5. Personal property taxes for vehicles

Part C – Other Vehicle Operating Expenses
Average monthly expense for gasoline
Paid for electric vehicle charging away from home
Purchased any antifreeze, brake fluid, transmission fluid, windshield wiper fluid, or
additives
Parking
parking garages

parking lot fees

parking meters

Do not include expenses that are part of your property ownership or rental
costs, a business expense, or expenses that will be totally reimbursed.
Local tolls or electronic toll passes
Docking and landing fees for boats and planes
Auto repair service policies such as extended warranties
Do not include service policies for vehicles used entirely for business.
Automobile service clubs such as AAA or services such as OnStar or LoJack
Towing charges, not already reported
Bottled or tank gas for recreational vehicles, including vans, campers, and boats

CE-305 (4-1-2017)

33

SECTION 13 – HEALTH INSURANCE

1. Private health insurance, including employer and healthcare exchange plans
HMO (Health Maintenance Organization)
IPA (Individual Practice Association)
PPO (Preferred Provider Association)
Fee-for-service
2. Medicare
Part A & B
Part C
Part D
3. Medicare Supplemental Insurance (Medi-Gap)
4. Medicaid
5. Children’s Health Insurance Program (CHIP/SCHIP)
6. Military health care
Tricare

VA

CHAMPVA

7. Indian Health Service (IHS)
8. Single service plans
dental insurance
long-term care insurance
prescription insurance
vision care insurance
9. No coverage of any type

34

CE-305 (4-1-2017)

SECTION 14 – MEDICAL AND HEALTH EXPENSES
EYE CARE
1. Eye examinations, treatment, or surgery, such as –
eye examinations
laser surgery
eye treatments
2. Purchase of eye glasses or contact lenses, such as –
eye glasses
contact lenses
contact lens insurance
warranty expenses
fittings
kits and equipment
prescription sunglasses
DENTAL CARE
3. Dental care, such as –
cleanings
braces/Invisalign
dentures
caps or crowns
bridges
extractions

implants
root canals
fillings

X-rays
cosmetic dentistry
teeth whitening in a
dental office

INPATIENT CARE
4. Hospital room or hospital services, including –
anesthetics
injections
operating room
blood transfusions
oxygen
intensive care unit
drugs and medicine
laboratory tests
recovery room
treatment rooms
therapy
any other services
From facilities, such as –
general care hospitals
psychiatric hospitals

examinations
nursing services
X-rays

substance abuse hospitals
birthing centers

SERVICES BY MEDICAL PROFESSIONALS OTHER THAN PHYSICIANS
5. All services provided by medical professionals other than physicians, such as –
chiropractor
podiatrist
psychologist
substance abuse
acupuncturist
midwife
homeopath
professionals
marriage counselor
physical therapist
nurse practitioners
medical massage
therapist
Include services provided both inside and outside the home.
PHYSICIAN SERVICES
6. All services provided and billed by physicians, such as –
general practitioner
internist
pediatrician
dermatologist
urologist
psychiatrist
surgeon
plastic surgeon
osteopath

CE-305 (4-1-2017)

gynecologist
any other type of
physicians

35

Section 14 – Medical and Health Expenses
OTHER MEDICAL CARE SERVICES
7. Lab tests or x-rays
X-rays
blood tests
MRI
CAT scan
other types of lab tests
Do not include services received in a hospital as an inpatient or services for
eye and dental care.
8. Care in convalescent or nursing homes
Include all services provided and billed by a convalescent or nursing home.
9. Care for invalids, convalescents, handicapped, or elderly persons in the home
Do not include institutional or medical care.
10. Adult day care centers
11. Other medical care and services, such as –
blood donation
oxygen services
rescue services
ambulance services dialysis services
emergency room
services

outpatient hospital care

If medical care is given in outpatient department or emergency room, include –
injections
baby shots
electro cardiogram
physicians check up
allergy shots
skin treatment
cardiology test
broken bones/sprains
hearing test
cancer treatment immunizations
blood pressure check
MEDICINE OR MEDICAL SUPPLIES
12. Hearing aids
13. Prescription drugs, including –
medical marijuana
insulin

asthma inhalers

birth control

14. Purchase or rental of supportive or rehabilitative medical equipment, such as –
braces
splints
whirlpools
crutches
cervical collars
slings
canes
wheelchairs
ace bandages
walkers
orthotics
power chair/scooter
prosthetics
15. Purchase or rental of medical or surgical equipment for general use, such as –
ice bags
insulin needles
hot water bottles
syringes
ostomy supplies
heating pads
blood pressure kits
oxygen
pollen masks
vaporizers
home defibrillator
orthopedic appliances
(supports)
Do not include items such as band-aids, gauze, cotton roll, and cotton balls.

36

CE-305 (4-1-2017)

SECTION 15 – INSURANCE OTHER THAN HEALTH

1. Life insurance or other policies which provide benefits in case of death or disability,
including –
term insurance
income or disability insurance
whole-life insurance
group-life insurance
cash benefits
straight-life insurance
flight insurance
life endowments
veterans insurance
burial insurance
annuities
2. Homeowners' insurance, which protects your home, furniture, personal effects, or
other property against fire, flood, theft, loss, or damage, including –
flood insurance
fire and extended coverage
3. Renters' insurance, which protects your furniture, personal effects, or other property
against fire, flood, theft, loss, or damage
4. Automobile or other vehicle insurance, including –
liability insurance
bodily injury insurance
collision insurance
property damage insurance
comprehensive insurance
no-fault insurance
5. Other types of non-health insurance, including –
credit card insurance
personal liability insurance
pet insurance
mortgage guarantee insurance
ambulance
Do not include malpractice insurance.

CE-305 (4-1-2017)

37

SECTION 16 – EDUCATIONAL EXPENSES
1. Recreational lessons or other instructions, including –
golf
dancing
driving
music
photography
skiing
sailing
swimming
sewing
skydiving
needlepoint
cooking
driving lessons
horseback riding

tennis
painting
instructional day camps
self defense

2. Preschool or child day care centers, including non-instructional day camps
3. Tuition, including pre-paid tuition, for –
college or university
business school
elementary school
high school
secretarial school
parochial school
vocational school
technical school
adult education
seminary
preparatory school
middle/junior high
Include only expenses paid directly to the school or other educational facility.
Do not report student loan payments.
4. Housing while attending school, including –
student dormitory
sorority
fraternity
housing for married students
Include only expenses paid directly to the school or other educational facility.
5. Food or board while attending school
Include only expenses paid directly to the school or other educational facility.
6. Private school bus service
7. Test preparation or tutoring services
8. Purchase of any school books, supplies, or equipment, which has not already been
reported, including –
text books
ruler
drafting equipment
laboratory equipment
microscopes
art supplies
technical books
cap and gown
9. Other school related expenses not already reported, including the rental of any
school books or expenses, including –
laboratory fees
matriculation fees
transportation fees
registration fees
health fees
student union fees
laundry fees
athletic fees
rental of school books
cap and gown rentals
administration fees
rental of school equipment
SAT/GRE test fees
conferences and seminars
Do not report student loan payments.

38

CE-305 (4-1-2017)

SECTION 17 – SUBSCRIPTIONS, MEMBERSHIPS, BOOKS,
AND ENTERTAINMENT EXPENSES
1. Golf courses or country clubs
2. Health clubs, fitness centers, swimming pools, weight loss centers, or other sports
or recreational organizations
3. Fees for participating in sports such as golf, bowling, biking, hockey, football, or
swimming, including –
tennis
running races
baseball

billiards
martial arts
bikesharing

triathlons
club sports

hunting and fishing licenses
basketball

4. Vacation clubs, including –
Disney Vacation Club

RCI

Hilton Grand Vacations

5. Civic, service, fraternal, or other social organizations
6. Credit card membership fees
credit card annual fees
7. Shopping club memberships including warehouse clubs like Sam’s Club and
discount memberships like Amazon Prime
8. Direct or online dating services, including –
Match.com

eHarmony

9. Single or season tickets to spectator sporting events, including –
football
auto racing

baseball
basketball

hockey
track events

soccer

10. Single or season tickets to plays, operas, or concerts
11. Movie tickets
12. Tickets to parks or museums, including –
historic sites
Disney World

zoos
water parks

national/state parks

amusement parks

13. Single copies of newspapers, magazines, or periodicals including digital
14. Subscriptions to newspapers, magazines, or periodicals including digital
15. Books, digital books, or book subscriptions, including –
digital books
audio books
Audible.com Listener
Kindle Unlimited
paperbacks
hardcovers
Do not include reference books or school books.

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39

Section 17 – Subscriptions, Memberships, Books, and Entertainment
Expenses
16. Photo printing or processing, including –
digital photo processing
video film processing
17. Photographic film or disposable cameras, including –
35 mm film
single-use film cameras

photo books
8 mm film

18. Purchased music files, CDs, or records, including –
iTunes
Amazon
Do not include blank/recordable discs or tapes.
19. Sirius or XM satellite radio service
20. Subscription music services such as Spotify or Pandora, including –
Apple Music
Rdio
Google Play Music
21. Purchased video files, Blu-Ray discs, or DVDs, including –
iTunes
Amazon Instant Video
UltraViolet
Do not include blank/recordable discs or tapes.
22. Rented video files or DVDs or streaming video subscriptions, including –
Netflix
iTunes
RedBox
Amazon Instant Video
Hulu Plus
MLB.TV
Do not include on-demand movies or pay-per-view paid through your TV service.
23. Purchased video games, not including computer games, including –
Nintendo games
Wii games
Xbox games
PlayStation games
24. Rented video games, including –
GameFly
Gamerang
25. Applications, games, or ringtones for a cellphone or mobile device, not already
reported, , including –
App Store
Google Play
Amazon App Store
26. Online games or other internet entertainment sites
Xbox Live

40

CE-305 (4-1-2017)

SECTION 18 TRIPS AND VACATIONS
Types of Trips
1. Visiting relatives or friends
2. Business trips
3. Recreational trips, such as –
sightseeing
sports events

club or organizational meetings
outdoor recreation

4. Any other trips that occur overnight or longer
5. Any day trips to a place at least 75 miles away

Types of Transportation
COMMERCIAL
1. Local
taxi

SuperShuttle

public transportation (bus, subway, local rail and ferries)

2. Airplane
3. Train
4. Bus
Greyhound

Trailways

5. Ship
cruise ships

long-distance ferries

Megabus

Hampton Jitney
river cruises

RENTED
6. Automobile, truck, van
7. Motorcycle, moped
8. Private plane
9. Boat, trailer
10. Camper
11. Other vehicles
PRIVATE
12. Automobiles or other vehicles privately owned or leased by household
13. Vehicle owned by someone else
14. Other transport

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41

Section 18 – Trips and Vacations

Fees to Play Sports, Exercise, or Rent Sports Equipment
Boating
Golf
Fishing
Swimming
Tennis
Skiing/snowboarding
Bowling
Exercise classes
Scuba/snorkeling
Bikesharing
Other sports

Entertainment or Admissions
Movies
Theater
Concerts
Museums
Tours
Sports events
Other entertainment events

42

CE-305 (4-1-2017)

SECTION 19 – MISCELLANEOUS EXPENSES
Part A – Miscellaneous Expenses
1. Fresh flowers or potted plants
2. Professional photography
3. Services of lawyers or other legal professionals, including –
will
arbitration services
civil litigation, including lawsuits, bankruptcies, etc.
divorce
estate settlement
criminal litigation
contracts
mediation
bail bonds
Do not include fees for business purposes or for real estate closing costs.
4. Accounting fees, including –
estate management
trust management

income tax preparation

Do not include fees for business purposes.
5. Occupational expenses, such as union dues or professional licenses
6. Gardening or lawn care services, including –
fertilizing
lawn cutting
plowing
hedge trimming
planting
tilling

tree pruning
tree removal

Include any services provided under service contracts.
Do not include services covered by management or maintenance fees.
7. Housekeeping services, including –
cleaning
laundering
carpet cleaning

cooking

window washing

8. Home security system service fees
9. Other home services or small repair jobs around the house, not previously reported
snow removal
diaper service
pool maintenance
10. Moving, storage, or freight, including –
moving companies
mini-warehouses

self-storage units

cargo shipping

Do not include expenses reimbursed by an employer or other persons outside of the
household.
11. Stamp or coin collecting, including –
stamp albums
coin albums
Do not include postage.

first day covers

12. Lotteries or games of chance

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43

Section19 – Miscellaneous Expenses
13. Babysitting, nanny services, or other child care inside or outside your home
Do not include nursery school care or care in a day care center.
14. Toys or games, including –
trains
dart board
infant toys
stuffed animals
15. Arts or crafts kits, including –
model kits
rug kits

action figures
dolls

games
trucks

needlepoint kits

scrapbook supplies

16. Sewing, knitting, or quilting materials and items, including –
beads
felt
needles
buttons
fiberfill
patterns
crochet hooks
Interfacing
quilt pad
embroidery hoops
knitting equipment
rug material
fabric
measuring tapes
seam binding

sewing kit
sequins
stuffing
thread/yarn
zipper

17. Purchase of pets, pet supplies, or medicine for pets, including –
aquarium
tropical fish
dog house
collars
hamster cage
pet toys
bird cage
dog
guinea pig
cat
bird
hamster
gerbil
Do not include pet food.
18. Pet services, including –
grooming
kennels
pet resorts
dog walking

license
training

19. Veterinarian expenses for pets, including –
vet visits
surgery
vaccinations
20. Catering, for –
bridal showers
weddings

parties
graduations

Bar/Bat Mitzvahs
anniversaries

pet daycare

veterinary treatment
quinceañeras
confirmations

21. Arrangement of live entertainment for special occasions
22. Rental of party supplies
23. Purchase or upkeep of cemetery lots or vaults
24. Funerals, burials, or cremation, including –
burial fees
flowers for funeral funeral transcript
limousines (used during
burial plans
headstones
musician honoraria
funeral)
clergy
footstones

44

CE-305 (4-1-2017)

Section 19 – Miscellaneous Expenses

Part B – Contributions
GIVEN ANY MONEY BY CASH, CHECKS, OR GIVEN ANY GIFT CARDS TO –
1. College students living away from home
Money to pay for tuition, room, board, books, fees, transportation, clothing, and
entertainment expenses
2. Any other people not in your household, such as –
friends
co-workers
homeless persons
street musicians
birthday money
wedding money
cash gifts at the office
money to assist others
PAID ANY OF THE FOLLOWING –
3. Child support
4. Alimony
GIVEN ANY MONEY BY CASH, CHECKS, MONEY ORDERS, OR CREDIT CARDS TO BENEFIT –

5. Educational institutions, including –
alumni funds
educational endowments
scholarship funds
school fund raisers
6. Political organizations, including –
political parties
political candidates

parochial schools

Political Action Committees (PACs)

7. Religious organizations, including churches, temples, and mosques, including –
tithes and offerings
religious fund raisers
building funds
religious television/radio ministries
8. Charities or other organizations, including –
Red Cross
civic organizations
fine arts and literary
United Way
Humane Society
Combined Federal
Campaign (CFC)

American Cancer Society
American Heart Association

GIVEN ANY STOCKS, BONDS, OR MUTUAL FUNDS
9. Stocks, bonds, mutual funds
Include only funds given to persons or organizations outside of your household

CE-305 (4-1-2017)

45

SECTION 20 – EXPENSE PATTERNS FOR SELECTED
SERVICES AND GOODS
Grocery shopping
Restaurants, fast food places, cafeterias, carryouts, or other such places
Cigarettes
Other tobacco products
cigars
pipe tobacco

chewing tobacco

vaping products

Alcohol, including beer and wine
Meals at school for preschool through high school
Self-service laundry machines
clothing
quilts
coats
rugs

linens
drapes

Dry cleaning or laundry service
clothing
quilts
coats
rugs

linens
drapes

Haircutting, styling, attached hair pieces, manicures, massages and other salon
services
hair coloring
pedicures
facials
waxing
tanning salons
hair weaves
Removable hairpieces, wigs, or toupees
temporary hair extensions
Safe deposit box rental in a bank or similar financial institution
Charges or fees for bank services such as ATM or overdraft fees or account service
charges from a bank or similar financial institution –
ATM fees
check order fee
overdraft fee
certified check fee
money order fee
online banking and bill payment fee
check cashing fee
regular service
below minimum balance fee
charges
fees for personal loans, except those for real estate
management fees for trust, custodial or escrow accounts
Taxis, limousine service, or car rides booked through an app
Include Super Shuttle, Uber, and Lyft
Public transportation services such as bus, subway, train, or passenger ferry

46

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SECTION 21 – OCCUPATIONS
1. Administrator, Manager
administrator
manager
2. Teacher
teacher
3. Professional
registered nurse
lawyer

funeral director

guidance counselor
accountant
engineer

physician
clergy

social worker
photographer

computer systems
analyst

receptionist

computer assistant

4. Administrative Support, including Clerical
secretary
bookkeeper
clerk
5. Sales, Retail
cashier

commodity salesperson
apparel salesperson

door-to-door salesperson
motor vehicle salesperson

6. Sales, Business Goods and Services
mining sales representative
real estate salesperson
manufacturing sales representative wholesale sales representative
7. Technician
health technician
electronic technician

practical nurse

8. Protective Service
private guard
police officer

drafting

financial services
insurance
salesperson

clinical laboratory technician

firefighter

9. Private Household Service
nanny
household worker
10. Other Service (except private household)
janitor
child care worker waiter/waitress food preparer
cook
hairstylist
maid/houseman orderly
11. Machine or Transportation Operator, Laborer
truck driver
assembler
tractor operator
bus driver
packager
machine operator
freight handler
stock handler
12. Construction Workers, Mechanics
automobile mechanic
machine repairer
carpenter
electrician
sheet metal worker
mining worker
13. Farming
farmer

machinist
painter

food counter/
fountain worker

taxi driver
inspector

construction laborer
material handler

meat cutter
plumber

farm worker

14. Forestry, Fishing, Groundskeeping
forestry worker
fisher
groundskeeper

animal caretaker

15. Armed Forces

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47

SECTION 21 – WORK EXPERIENCE AND INCOME

CARD A

0. Loss
1. $ 1

– $ 4,999

2. $ 5,000

– $ 9,999

3. $ 10,000 – $ 14,999
4. $ 15,000 – $ 19,999
5. $ 20,000 – $ 29,999
6. $ 30,000 – $ 39,999
7. $ 40,000 – $ 49,999
8. $ 50,000 – $ 69,999
9. $ 70,000 – $ 89,999
10. $ 90,000 – $ 119,999
11. $ 120,000 and over

48

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Section 21 – Work Experience and Income

CARD B

1. Less than $500
2. $ 500

– $ 699

3. $ 700

– $ 999

4. $ 1,000 – $ 1,299
5. $ 1,300 – $ 1,699
6. $ 1,700 and over

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49

Section 21 – Work Experience and Income

CARD C

0. Loss
1. $ 1

– $ 999

2. $ 1,000

– $ 1,999

3. $ 2,000

– $ 2,999

4. $ 3,000

– $ 3,999

5. $ 4,000

– $ 4,999

6. $ 5,000

– $ 9,999

7. $ 10,000 – $ 14,999
8. $ 15,000 – $ 19,999
9. $ 20,000 – $ 29,999
10. $ 30,000 – $ 39,999
11. $ 40,000 – $ 49,999
12. $ 50,000 and over
50

CE-305 (4-1-2017)

SECTION 22 – ASSETS AND LIABILITIES

CARD D

1. $ 1

– $ 1,999

2. $ 2,000

– $ 9,999

3. $ 10,000

– $ 49,999

4. $ 50,000

– $ 199,999

5. $ 200,000 – $ 449,999
6. $ 450,000 and over

CE-305 (4-1-2017)

51

Section 22 – Assets and Liabilities

CARD E

1. $ 1

– $ 499

2. $ 500

– $ 999

3. $ 1,000

– $ 2,499

4. $ 2,500

– $ 9,999

5. $ 10,000

– $ 34,999

6. $ 35,000 and over

52

CE-305 (4-1-2017)

2017 CALENDAR

JANUARY

JULY

S M T W T F S
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31

S

M

S
1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30 31

S

M

S

M

FEBRUARY
S

M

S

M

T

W T F S
1 2 3 4
5 6 7 8 9 10 11
12 13 14 15 16 17 18
19 20 21 22 23 24 25
26 27 28 29 30 31

3
10
17
24

F S
1 2
4 5 6 7 8 9
11 12 13 14 15 16
18 19 20 21 22 23
25 26 27 28 29 30

APRIL
W

T

F

M T W T F S
1 2 3 4 5 6
7 8 9 10 11 12 13
14 15 16 17 18 19 20
21 22 23 24 25 26 27
28 29 30 31

T F S
1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30

CE-305 (4-1-2017)

W

T

NOVEMBER
S

M

W T F S
1 2 3 4
5 6 7 8 9 10 11
12 13 14 15 16 17 18
19 20 21 22 23 24 25
26 27 28 29 30

S

M

JUNE
T

W

S M T W T F S
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31

MAY
S

M

T

OCTOBER

S
1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30

S

F

SEPTEMBER

T

T

T

T W T F S
1 2 3 4 5
6 7 8 9 10 11 12
13 14 15 16 17 18 19
20 21 22 23 24 25 26
27 28 29 30 31

MARCH

M

W

AUGUST

W T F S
1 2 3 4
5 6 7 8 9 10 11
12 13 14 15 16 17 18
19 20 21 22 23 24 25
26 27 28

S

T

T

DECEMBER
T

W

T

F S
1 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16
17 18 19 20 21 22 23
24 25 26 27 28 29 30
31

53

2018 CALENDAR

JANUARY

JULY

M T W T F S
1 2 3 4 5 6
7 8 9 10 11 12 13
14 15 16 17 18 19 20
21 22 23 24 25 26 27
28 29 30 31

S M T W T F S
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31

S

FEBRUARY
S

M

S

M

T

W

T F S
1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28

AUGUST
S

M

W T F S
1 2 3 4
5 6 7 8 9 10 11
12 13 14 15 16 17 18
19 20 21 22 23 24 25
26 27 28 29 30 31

S

M

MARCH
T

W

T F S
1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30 31

SEPTEMBER

2
9
16
23
30

S
1
3 4 5 6 7 8
10 11 12 13 14 15
17 18 19 20 21 22
24 25 26 27 28 29

APRIL
S M T W T F S
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30

W

T

F

OCTOBER
M T W T F S
1 2 3 4 5 6
7 8 9 10 11 12 13
14 15 16 17 18 19 20
21 22 23 24 25 26 27
28 29 30 31

NOVEMBER

T W T F S
1 2 3 4 5
6 7 8 9 10 11 12
13 14 15 16 17 18 19
20 21 22 23 24 25 26
27 28 29 30 31

T F S
1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30

JUNE

DECEMBER

S

M

F S
1 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16
17 18 19 20 21 22 23
24 25 26 27 28 29 30

54

T

S

MAY
S

T

M

T

W

T

S

S

M

M

T

T

W

W

T

F

S
1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30 31

CE-305 (4-1-2017)

Fractions to Percentages
Fraction

%

Fraction

%

Fraction

%

1/2

50.00

1/7

14.29

3/9

33.33

1/3

33.33

2/7

28.57

4/9

44.44

2/3

66.67

3/7

42.86

5/9

55.55

1/4

25.00

4/7

57.14

6/9

66.67

2/4

50.00

5/7

71.42

7/9

77.78

3/4

75.00

6/7

85.71

8/9

88.89

1/5

20.00

1/8

12.50

1/10

10.00

2/5

40.00

2/8

25.00

2/10

20.00

3/5

60.00

3/8

37.50

3/10

30.00

4/5

80.00

4/8

50.00

4/10

40.00

1/6

16.67

5/8

62.50

5/10

50.00

2/6

33.33

6/8

75.00

6/10

60.00

3/6

50.00

7/8

87.50

7/10

70.00

4/6

66.67

1/9

11.11

8/10

80.00

5/6

83.33

2/9

22.22

9/10

90.00

CE-305 (4-1-2017)

55

LANGUAGE IDENTIFICATION CARDS

Hello, I’m from the U.S. Census Bureau. Is someone here now who speaks
English and can help us? If not, please give me your phone number and
someone may contact you in English.

01. English

Buenos días (Buenas tardes), soy de la Oficina del Censo de los Estados
Unidos. ¿Se encuentra alguien que hable inglés y pueda ayudarnos? Si no,
por favor, dígame su número de teléfono; es possible que alguien se
comunique con usted en español.

02. Español/Spanish

Insert Arabic text from Census Language Identification Card

03. [Arabic]/Arabic

Insert Cantonese-Simplified text from Census Language Identification Card
04. [Cantonese
Simplified] /
CantoneseSimplified

Insert Mandarin-Simplified text from Census Language Identification Card
05. [Mandarin
Simplified] /
MandarinSimplified

Insert Korean text from Census Language Identification Card

06. [Korean]/Korean

56

CE-305 (4-1-2017)

Language Identification Cards
Dzień dobry. Jestem z Amerykańskiego Biura Spisu Ludności. Czy ktoś
tutaj mówi po angielsku I czy mógłby nam pomóc? Jeżeli nie, proszę podać
mi swój numer telefonu, pod którym można skontaktować się z Państwem
po polsku.

07. Polski/Polish

Здравствуйте! Я представляю Бюро переписи населения Соединенных
Штатов. Присутствует ли здесь кто-нибудь, кто говорит по-английски
и мог бы нам помочь? Если нет, то, пожалуйста, дайте нам свой номер
телефона, чтобы при необходимости наш сотрудник мог с вами
поговорить по-русски.

08. Pусский/Russian

Xin chào, tôi là nhân viên của Cục Thống Kê Dân Số Hoa Kỳ. Ở đây hiện
có ai biết nói tiếng Anh và có thể giúp chúng tôi không? Nếu không xin vui
long cho biết số điện thoại của quý vị. Chúng tôi có thể liên lạc với quý vị
bằng tiếng Việt.

09. Tiếng Việt /
Vietnamese

CE-305 (4-1-2017)

57

U.S. Department of Commerce
Economics and Statistics Administration
U.S. Census Bureau


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