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Instrument 4: Follow-Up Survey for Your Money, Your Goals users
Thank you for completing this survey as part of our evaluation of this training on Your
Money, Your Goals. Please note that the Bureau intends to keep your responses private to the
extent permitted by law, and when survey results are reported none of your answers will be
connected to your organization.
Your organization/agency: ______________________________________
1) Since being trained in the use of Your Money, Your Goals…
# of Clients
With how many of the people you serve have you discussed financial
information?
With how many of the people you serve have you used tools and resources
from Your Money, Your Goals?
How many of them have you referred to other financial resources (such as
credit counselors, free tax preparation, financial coaching, etc.)?
2) Do you think Your Money, Your Goals has affected your interactions with the people you serve?
Yes, it has affected them a lot
Yes, it has affected them some
Yes, it has affected them a little
No, it has not affected my interactions with clients
2b) Please explain your answer to this question.
__________________________________________________________________________________
__________________________________________________________________________________
3) How confident are you in your ability to…
Very
Confident
Confident
Somewhat
Confident
Not at All
Confident
Understand core financial management topics,
such as budgeting, saving, and setting financial
goals?
Discuss core financial management topics with the
people you serve?
Assess individuals’ financial condition or situation?
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OMB Control Number: 3170-0038
Expiration Date: XX/XX/20XX
Very
Confident
Confident
Somewhat
Confident
Not at All
Confident
Get help if you or the people you serve have
questions about financial issues?
Refer people to community resources such as
credit-debt counseling and tax filing assistance?
Know where to go for unbiased information or
help in working with the people you serve?
Help people manage their financial challenges?
Provide the right financial content at the right time
in the context of your work with individuals?
Access and use tools and materials from the
Consumer Financial Protection Bureau (CFPB)
through its consumer website?
4) How well do these statements describe you or your situation?
Part 1
This statement describes me
I could handle a major unexpected
expense
I am securing my financial future
Because of my money situation, I feel
like I will never have the things I want in
life
I can enjoy life because of the way I’m
managing my money
I am just getting by financially
I am concerned that the money I have
or will save won’t last
Completely
Very Well
Somewhat
Very
Little
Not at
all
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OMB Control Number: 3170-0038
Expiration Date: XX/XX/20XX
Part 2: How often does this statement apply to you?
This statement applies to me
7. Giving a gift for a wedding, birthday
or other occasion would put a strain on
my finances for the month
8. I have money left over at the end of
the month
9. I am behind with my finances
10.My finances control my life
Always
Often
Sometimes
Rarely
Never
Part 3: Tell us about yourself.
How old are you?
18-61
62+
Page 3
5) Your Money, Your Goals includes a variety of tools and information on a number of different topics. In your work, how useful have you
found each of the following tools and resources?
With how many people have you
used this tool?
How useful did you and your clients find this tool?
Very
Useful
Useful
Somewhat
Useful
Not at All
Useful
Introduction
Tool 1—Financial Empowerment
Checklist
______ people
None
______ people
None
Tool 1—Goal-Setting Tool
______ people
None
Tool 2 – Planning for Life Events and
Large Purchases
______ people
None
Tool 3 – Buying a car
______ people
None
Tool 1—Savings Plan
______ people
None
Tool 2—Saving and Benefits:
Understanding Asset Limits
______ people
None
Tool 3—Finding a Safe Place for
Savings
______ people
None
Tool 4 – Increasing your income
through tax credits
______ people
None
Introduction: Assessing the Situation
Tool 1—My money picture
Module 1: Setting Goals
Module 2: Saving for Emergencies,
Bills, and Goals
Page 4
With how many people have you
used this tool?
How useful did you and your clients find this tool?
Very
Useful
Useful
Somewhat
Useful
Not at All
Useful
Module 3: Tracking and Managing
Income and Benefits
Tool 1—Income and Resource
Tracker
______ people
None
Tool 2—Ways to receive income and
benefits: Know your options
______ people
None
Tool 2—Ways to increase income
and resources
______ people
None
Tool 1—Spending Tracker
______ people
None
Tool 2—Bill Calendar
______ people
None
Tool 3 – Ways to pay bills: Know
your options
______ people
None
Tool 3—Strategies for cutting
expenses
______ people
None
Tool 4—When Cash is Short—
Prioritizing Bills and Planning
Spending
______ people
None
Tool 1—Cash Flow Budget
______ people
None
Tool 2—Cash Flow Calendar
______ people
None
Module 4: Paying Bills and Other
Expenses
Module 5: Getting through the Month
Page 5
With how many people have you
used this tool?
Tool 3—Improving Cash Flow
Checklist
How useful did you and your clients find this tool?
Very
Useful
Useful
Somewhat
Useful
Not at All
Useful
______ people
None
Tool 1—Debt Worksheet
______ people
None
Tool 2—Debt-to-Income Worksheet
______ people
None
Tool 3—Reducing Debt Worksheet
______ people
None
Tool 4—Repaying Student Loans
______ people
None
Tool 5—When Debt Collectors Call
______ people
None
Tool 1—Getting Your Credit Reports
and Scores
______ people
None
Tool 2—Credit Report Review
Checklist
______ people
None
Tool 3—Improving Credit Reports
and Scores
______ people
None
Tool 4 – Keeping records to show
you’ve paid your bills
______ people
None
Module 6: Dealing with Debt
Module 7: Understanding Credit
Reports and Scores
Module 8: Money services, cards,
accounts, and loans: Finding what
works for you
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With how many people have you
used this tool?
How useful did you and your clients find this tool?
Very
Useful
Useful
Somewhat
Useful
Not at All
Useful
Tool 1— Know your options:
Money services, cards, accounts,
and loans
______ people
None
Tool 2— Ask questions: Choosing
where to get what you need
______ people
None
Tool 3— Money services and
banking basics
______ people
None
Tool 4—Opening an Account
Checklist
______ people
None
Tool 5 - Money transfers and
remittances: What you need to
know
______ people
None
Tool 1—Submitting a Complaint to
the CFPB
______ people
None
Tool 2—Protecting Your Identity
______ people
None
Tool 3—Red Flags
______ people
None
Tool 4—Learning More about
Consumer Protection
______ people
None
Module 14: Protecting Your Money
Privacy Notice
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Information you provide in response to this survey will help the survey sponsor the Consumer Financial Protection Bureau (“CFPB”) evaluate the
effectiveness of the Your Money, Your Goals toolkit, and to assess the scope of partner organizations’ use of the toolkit.
The CFPB will not obtain or access any information that directly identifies respondents, and any answers or comments you provide will not be tied to
you individually. The agency will only obtain and access de-identified results and aggregated analyses of those results. Any directly identifying
information will only be used by ICF International (survey facilitator) and partner organizations to facilitate distribution and collection of surveys and
survey responses. Survey responses will not be shared and will be kept private except as required by law.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and 1022, codified at 12 U.S.C. §§ 5493 and 5512.
Your participation is voluntary, and you may withdraw participation at any time.
Paperwork Reduction Act
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of
information unless it displays a valid OMB control number. The OMB control number for this collection is 3170-XXXX. It expires on XX/XX/20XX. The
time required to complete this information collection is estimated to average approximately 25 minutes per response, including the time for reviewing
any instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. The obligation to respond to this collection of information is voluntary. Comments regarding this collection of information, including the
estimated response time, suggestions for improving the usefulness of the information, or suggestions for reducing the burden to respond to this
collection should be submitted to Bureau at the Consumer Financial Protection Bureau (Attention: PRA Office), 1700 G Street NW, Washington, DC
20552, or by email to PRA_CFPB_PRA@cfpb.gov.
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| File Type | application/pdf |
| Author | Mike Long |
| File Modified | 2016-07-20 |
| File Created | 2016-07-20 |