NCSC PHP Redesign

NSCS PHP Redesign

NSCS PHP Redesign
Generated: 13-May-2019

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Person Characteristics I ................................................................................................... 3
Police Ask-All Items ......................................................................................................... 9
Community Measures .................................................................................................... 12
Victimization Screener ................................................................................................... 18
Vehicle Theft ................................................................................................................ 19
Vehicle Part Theft .......................................................................................................... 26
Theft ........................................................................................................................... 33
Break-In ...................................................................................................................... 42
Vandalism .................................................................................................................... 50
Attack .......................................................................................................................... 58
Unwanted Sexual Contact............................................................................................... 67
Catch-All ...................................................................................................................... 75
Crime Incident Report (Adults and Youth) ........................................................................ 76
Series Crimes ............................................................................................................... 80
What Happened: Module SV – Unwanted Sexual Contact.................................................... 82
What Happened: Module A – Attack/Threatened Attack ...................................................... 89
Consequences I: Injury .................................................................................................. 96
What Happened: Module MV – Motor Vehicle Theft/Parts Theft/Attempted Theft ................. 101
What Happened: Module B – Break-ins .......................................................................... 104
What Happened: Module T – Theft ................................................................................ 106
What Happened: Module V – Vandalism ......................................................................... 112
Location Series ........................................................................................................... 114
Presence Series .......................................................................................................... 121
Victim-Offender Relationship ........................................................................................ 123
Offender Characteristics ............................................................................................... 136
Self-Protection ............................................................................................................ 144
Hate Crimes ............................................................................................................... 150
Police Involvement Series ............................................................................................ 153
Workplace Violence Series ............................................................................................ 168
Consequences II: Socio-emotional Problems ................................................................... 173
Consequences III: Economic Consequences .................................................................... 178
Property Damage ........................................................................................................ 182
Lost Work and Wages .................................................................................................. 185
Victim Services (VS) Series .......................................................................................... 188
Narrative.................................................................................................................... 199
Person Characteristics II .............................................................................................. 200
Household Characteristics II ......................................................................................... 213
Closing ...................................................................................................................... 216

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Person Characteristics I
Box ID:

PC_START

Load variables used for routing in this instrument:
CONDITION – (2 = Interviewer Administered; 3 = Self-Administered)
UT_AGE – age of respondent
UT_RESP_GENDER – respondent's gender (1 = Male; 2 = Female; 3 = Other)
UT_HHR – household respondent (1 = Yes; 2 = No)
UT_HHM_KIDAGE_A – number of children in the household
UT_ASKALL – Ask All section to be asked (1 = Police; 2 = Community)
SOLO_HHM – lives alone (1 = Yes; 2 = No)
SVERSION – interleaving condition (1 = Interleaf; 2 = Non-interleaf)
RSTUDENT – regular student (1 = Yes; 2 = No)
CSTUDENT – college/campus student (1 = Yes; 2 = No)
PC3a – apartment dweller (1 = Apartment; 2 = No)
RECORDING – Consent to Record flag (1 = Yes; 2 = No)
GLOBAL – Question not asked will return NULL in the data. Missing responses for questions that
are asked will return -9 in the data. Missing responses take the path of "No" response unless
otherwise noted in the routing instructions. If not a Yes/No question format, respondents route
to the next question or programming box unless otherwise noted in the routing instructions.
Box ID:

PC_BOX0A

IF CONDITION = 2, GO TO MODE. ELSE, GO TO PC_BOX1.
Question ID:

MODE

INTERVIEWER: IS THIS AN IN-PERSON INTERVIEW OR A TELEPHONE INTERVIEW?
1

IN PERSON

2

TELEPHONE

ASK Description: Respondents who completed the interviewer-administered questionnaire.
ASK Specification: IF CONDITION = 2.
Question ID:

PROXY

TYPE OF INTERVIEW
0

RESPONDENT INTERVIEW

GO TO PC_BOX0B

1

PROXY INTERVIEW

GO TO PROXYREASON

ASK Description: Respondents who completed the interviewer-administered questionnaire.
ASK Specification: IF CONDITION = 2.
PROGRAM: If PROXY != 0, 1, display error message in red and bold "REQUIRED QUESTION".
User should not be permitted to leave PROXY blank.

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Question ID:

PROXYREASON

ENTER THE REASON FOR THE PROXY INTERVIEW:
1

PROXY PERSON IS 12-13 YEARS OLD AND PARENT
REFUSED PERMISSION FOR SELF-INTERVIEW

2

PROXY PERSON IS PHYSICALLY/MENTALLY
UNABLE TO ANSWER

3

PROXY PERSON IS TEMPORARILY ABSENT AND
WON'T RETURN BEFORE CLOSEOUT

ASK Description: Proxy respondents who completed the interviewer-administered questionnaire.
ASK Specification: IF CONDITION = 2 AND PROXY = 1.
PROGRAM: If PROXYREASON != 1,2,3 display error message in red and bold "REQUIRED
QUESTION". User should not be permitted to leave PROXYREASON blank.
Box ID:

PC_BOX0B

IF CONDITION = 2 AND MODE = 1 and RECORDING = 1 (YES), GO TO CONFRECORD.
ELSE, GO TO PC_BOX1.

Question ID:

CONFRECORD

You've consented to participate in this interview as well as to have the interview recorded for
quality control purposes. I am going to turn on the recording now and ask you to confirm that
permission to record.
[START RECORDING. THEN STATE:]
Today's date is [STATE: LOCAL DATE and TIME including AM/PM]. To confirm, you have given
your permission to record this interview for quality control purposes. Is that correct?
1

CONTINUE

GO TO PC_BOX1

2

STOP RECORDING

GO TO PC_RECORD2

ASK Description: Respondents who completed the interviewer-administered questionnaire inperson and consented to record their interview.
ASK Specification: IF CONDITION = 2 AND MODE = 1 AND RECORDING = 1.
Question ID:

PC_RECORD2

[STOP RECORDING. THEN STATE:]
That's fine. The interview will not be recorded.
ASK Description: Respondents who did not give permission to record the interview.
ASK Specification: IF CONFRECORD = 2.

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Box ID:

PC_BOX1

IF UT_HHR = 1 and CONDITION = 2, GO TO PC1_INTRO.
ELSE, GO TO PC1_PREINTRO.

Question ID:

PC1_PREINTRO

Thank you for participating in the National Survey of Crime and Safety sponsored by the Bureau
of Justice Statistics at the US Department of Justice.{ READ AS NEEDED:} The survey
questions asks for information about people's perceptions of community safety, their local
police, and their experiences with victimization and crime in the past year. The results will be
used to help improve the way the government measures crime.
{On each screen, you will be asked about experiences that have happened to you recently. Click
on your answer or type in an answer, and then click the NEXT button to continue to the next
screen. You can skip any question you don't know the answer to or prefer not to answer by
leaving the question blank and clicking the NEXT button.
If you need to change an answer, you can click the PREVIOUS button to go back to an earlier
screen. Do not click the "Back" button in your browser.}
ASK Description: Respondents who are completing the self-administered questionnaire or non
household respondents who are completing the interviewer-administered questionnaire.
ASK Specification: IF CONDITION = 3 OR (CONDITION = 2 AND UT_HHR != 1).
Question ID:

PC1_INTRO

{I want to remind you that you can skip any question you don't know the answer to or prefer
not to answer.} {Next/First} are some questions just about you.
Question ID:

PC1

How long have you lived at this address?
1

|__|__| Years

2

|__|__| If less than one year, enter the number of
months

ASK Description: All respondents.
PROGRAM: Allow entry for both months and years. Allow 2 digits for each field.
CREATE THE FOLLOING DERIVED VARIABLE:
PC1_YEARS:
PC1_YEARS = 0;
IF PC1_YR != -9, SET PC1_YEARS = PC1_YEARS + PC1_YR;
IF PC1_MO != -9, SET PC1_YEARS = PC1_YEARS + PC1_MO / 12;

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Box ID:

PC_BOX2

IF Respondent did not report the number of months or number of years they have lived at their
address, GO TO PC2.
ELSE, respondent has been at the address for less than 1 year, GO TO PC3.
ELSE, respondent has been at the address for less than 5 years, GO TO PC4.
ELSE, GO TO BOX PC_BOX3.

IF PC1_YR = -9 AND PC1_MO = -9, GO TO PC2.
ELSE, IF PC1_YEARS < 1, GO TO PC3.
ELSE, IF PC1_YEARS < 5, GO TO PC4.
ELSE, GO TO BOX PC_BOX3.

Question ID:

PC2

Have you lived at this address. . .
1

Less than 6 months

GO TO PC3

2

At least 6 months, but less than 1 year

GO TO PC3

3

At least 1 year, but less than 5 years

GO TO PC4

4

5 years or more

GO TO PC5

ASK Description: Respondents who did not report the number of months or number of years
they have lived at their address.
ASK Specification: IF PC1_YR = -9 AND PC1_MO = -9.
Question ID:

PC3

Have you been homeless or without a regular place to stay at any time in the past 12 months,
that is, since {DATE 12 MONTHS AGO}?
1

Yes

2

No

ASK Description: Respondents who have lived at their address for less than one year or did not
report how long they have lived at their current address.
ASK Specification: IF ((PC1_YR != -9 OR PC1_MO != -9) AND PC1_YEARS < 1) OR (PC1_YR = 9 AND PC1_MO = -9 AND PC2 = 1, 2, -9).

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Question ID:

PC4

How many times have you moved in the past 5 years, that is, since {CURRENT MONTH AND
CURRENT YEAR MINUS 5}?
1

|__|__|

ASK Description: Respondents who have lived at their address for less than 5 years or did not
report how long they have lived at their address.
ASK Specification: IF ((PC1_YR != -9 OR PC1_MO != -9) AND PC1_YEARS < 5) OR (PC1_YR = 9 AND PC1_MO = -9 AND PC2 = 1, 2, 3, -9).
PROGRAM: Allow 2 digits.
Box ID:

PC_BOX3

IF respondent's age >= 16 (UT_AGE >= 16), GO TO PC5.
ELSE, GO TO PC_BOX4.

Question ID:

PC5

In the past 7 days, did you have a job or work at a business? Do not include volunteer work or
work around the house.
1

Yes

GO TO PC6A

2

No

GO TO PC6

ASK Description: Respondents who are 16 years or older.
ASK Specification: IF UT_AGE >= 16.
Question ID:

PC6

AT ANY TIME during the past 12 months, that is, since {DATE 12 MONTHS AGO}, did you have
a job or work at a business?
1

Yes

GO TO PC6a

2

No

GO TO PC_BOX4

ASK Description: Respondents who are 16 years or older and did not have a job or work at a
business in the past 7 days.
ASK Specification: IF UT_AGE >= 16 AND PC5 = 2, -9.
Question ID:

PC6A

Have you worked at this same job for all of the past 12 months?
1

Yes

GO TO PC_BOX4

2

No

GO TO PC7

ASK Description: Respondents who are 16 years or older and have had a job or worked at a
business in the past 12 months.
ASK Specification: IF UT_AGE >= 16 AND (PC5 = 1 OR (PC5 = 2, -9 AND PC6 = 1)).

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Question ID:

PC7

At any time in the past 12 months, have you been unemployed?
1

Yes

2

No

ASK Description: Respondents who are 16 years or older and had a job or worked at a business
in the past 12 months and have not worked the same job for all of the past 12 months.
ASK Specification: IF UT_AGE >= 16 AND (PC5 = 1 OR (PC5 = 2, -9 AND PC6 = 1)) AND PC6A
= 2, -9.
Box ID:

PC_BOX4

If UT_ASKALL=1, GO TO PQ_START.
If UT_ASKALL=2, GO TO CA_START.

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Police Ask-All Items
Box ID:

PQ_START

Programmer note: If UT_ASKALL = 1, GO TO PQ_BOX1. ELSE, GO TO CA_START.
Box ID:

PQ_BOX1

For PQ1a-b, display a ‘Yes' and ‘No' column with options for each response category.
Question ID:

PQ1

Next are some questions about experiences you may have had with the police in your area
during the past 12 months, that is, since {DATE 12 MONTHS AGO}. Please include experiences
with police officers, sheriff's deputies, state troopers, or school resource officers, but not with
guards or other security personnel who are not part of the police.
1

During the past 12 months, have you contacted
the police in your area to report a crime,
disturbance or suspicious activity?

2

During the past 12 months, have you contacted
the police in your area to report something else,
such as a traffic accident or medical emergency?

ASK Description: Respondents who were selected to answer questions about the police in their
area.
ASK Specification: IF UT_ASKALL = 1.
Box ID:

PQ_BOX2

For PQ2a-c, display a ‘Yes' and ‘No' column with options for each response category.
Question ID:

PQ2

During the past 12 months, that is, since {DATE 12 MONTHS AGO} have you…
1

been stopped by the police when you were driving
or when you were a passenger in a motor vehicle?

2

been stopped or approached by the police for
some other reason?

3

been at a community meeting, neighborhood
watch, or other activities where the police took
part?

ASK Description: Respondents who were selected to answer questions about the police in their
area.
ASK Specification: IF UT_ASKALL = 1.

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Question ID:

PQ3a

The next questions ask for your views of the police in your area{ even though you may not have
had direct contact with them recently}.
Please draw on everything you know about them and give your best judgments when you
respond to these questions.
How respectfully do you think the police in your area treat people?
1

Very respectfully

2

Somewhat respectfully

3

Neither respectfully nor disrespectfully

4

Somewhat disrespectfully

5

Very disrespectfully

ASK Description: Respondents who were selected to answer questions about the police in their
area.
ASK Specification: IF UT_ASKALL = 1.
Question ID:

PQ3b

In your opinion, how much time and attention do the police in your area give to what people
have to say?
1

A great deal of time

2

A lot of time

3

A moderate amount of time

4

A little time

5

No time at all

ASK Description: Respondents who were selected to answer questions about the police in their
area.
ASK Specification: IF UT_ASKALL = 1.
Question ID:

PQ3c

In your opinion, how fairly do the police in your area treat people?
1

Very fairly

2

Somewhat fairly

3

Neither fairly nor unfairly

4

Somewhat unfairly

5

Very unfairly

ASK Description: Respondents who were selected to answer questions about the police in their
area.
ASK Specification: IF UT_ASKALL = 1.

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Question ID:

PQ3d

How effective are the police at preventing crime in your area?
1

Very effective

2

Somewhat effective

3

Neither effective nor ineffective

4

Somewhat ineffective

5

Very ineffective

ASK Description: Respondents who were selected to answer questions about the police in their
area.
ASK Specification: IF UT_ASKALL = 1.
Question ID:

PQ3e

How much do you trust the police in your area?
1

Trust completely

2

Somewhat trust

3

Neither trust nor distrust

4

Somewhat distrust

5

Distrust completely

ASK Description: Respondents who were selected to answer questions about the police in their
area.
ASK Specification: IF UT_ASKALL = 1.
Question ID:

PQ3f

Taking everything into account, how would you rate the job the police in your area are doing?
1

A very good job

2

A somewhat good job

3

Neither a good nor a bad job

4

A somewhat bad job

5

A very bad job

ASK Description: Respondents who were selected to answer questions about the police in their
area.
ASK Specification: IF UT_ASKALL = 1.

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Community Measures
Box ID:

CA_START

Programmer note: If UT_ASKALL = 2, GO TO CA1_INTRO. ELSE, GO TO S_INTRO_2.
Question ID:

CA1_INTRO

Next are some questions about your local area.
ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.
Box ID:

CA_BOX1

Display questions CA1a through CA1d using the expanded stem-leaf screen. The introduction
text from CA1a is the stem. Show all leaves on the screen at once.
Question ID:

CA1a

How worried are you about {each of the following:/. . .}
Being mugged or robbed in your local area?
1

Extremely worried

2

Very worried

3

Somewhat or moderately worried

4

Slightly worried

5

Not at all worried

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.
Question ID:

CA1b

{(How worried are you about) being/Being} threatened or attacked in your local area?
1

Extremely worried

2

Very worried

3

Somewhat or moderately worried

4

Slightly worried

5

Not at all worried

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.

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Question ID:

CA1c

{(How worried are you about) having/Having} something stolen from inside your home?
1

Extremely worried

2

Very worried

3

Somewhat or moderately worried

4

Slightly worried

5

Not at all worried

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.
Question ID:

CA1d

{(How worried are you about) having/Having} something stolen from your porch, lawn, garage,
or other part of your property?
1

Extremely worried

2

Very worried

3

Somewhat or moderately worried

4

Slightly worried

5

Not at all worried

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.
Question ID:

CA_1

Is there any place within a mile of your home where you would be afraid to walk alone at night?
1

Yes

2

No

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.

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Question ID:

CA2

How often does concern about crime prevent you from doing things you would like to do?
1

Every day

2

Several times a week

3

Several times a month

4

Once a month or less

5

Never

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.
Box ID:

CA_BOX2

Display questions CA3a through CA3d using the expanded stem-leaf screen. The introduction
text from CA3a is the stem. Show all leaves on the screen at once.
Question ID:

CA3a

In your local area, how common a problem is {. . ./each of the following:}
Vandalism, graffiti or other deliberate damage to property
1

Extremely common

2

Very common

3

Somewhat or moderately common

4

Not too common

5

Not common at all

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.
Question ID:

CA3b

People being drunk or rowdy in public places
1

Extremely common

2

Very common

3

Somewhat or moderately common

4

Not too common

5

Not common at all

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.

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Question ID:

CA3c

Burned, abandoned or boarded-up buildings
1

Extremely common

2

Very common

3

Somewhat or moderately common

4

Not too common

5

Not common at all

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.
Question ID:

CA3d

People using or dealing drugs illegally
1

Extremely common

2

Very common

3

Somewhat or moderately common

4

Not too common

5

Not common at all

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.
Question ID:

CA4

If children or teenagers in your local area were skipping school and hanging out on a street
corner, how likely is it that any of your neighbors would do something about it?
1

Very likely

2

Somewhat likely

3

Neither likely nor unlikely

4

Somewhat unlikely

5

Very unlikely

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.

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Question ID:

CA5

If children or teenagers were damaging others' property, how likely is it any of your neighbors
would do something about it?
1

Very likely

2

Somewhat likely

3

Neither likely nor unlikely

4

Somewhat unlikely

5

Very unlikely

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.
Question ID:

CA6

If there was a crime in your local area, how likely is it that any of your neighbors would call the
police?
1

Very likely

2

Somewhat likely

3

Neither likely nor unlikely

4

Somewhat unlikely

5

Very unlikely

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.
Box ID:

CA_BOX3

Display questions CA7a and CA7b using the expanded stem-leaf screen. The introduction text
from CA7a is the stem. Show all leaves on the screen at once.

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Question ID:

CA7a

Please {tell me/mark} how much you agree or disagree with each of the following statements
about your local area.
People around here are willing to help their neighbors.
1

Strongly agree

2

Somewhat agree

3

Neither agree nor disagree

4

Somewhat disagree

5

Strongly disagree

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.
Question ID:

CA7b

People in this local area can be trusted.
1

Strongly agree

2

Somewhat agree

3

Neither agree nor disagree

4

Somewhat disagree

5

Strongly disagree

ASK Description: Respondents who were selected to answer questions about their local area.
ASK Specification: IF UT_ASKALL = 2.

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Victimization Screener
Question ID:

S_INTRO_2

The next questions{ will} ask about things that may have happened to you in the past 12
months, that is, since {TODAY'S DATE ONE YEAR AGO}. The questions will cover theft,{ breakins, vandalism,} physical attacks, and unwanted sexual contact.
ASK Description: All respondents.
PROGRAM: ROUTING INSTRUCTIONS: If UT_HHR = 1 (household respondent), go to S_01. Else,
go to S_03.

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Vehicle Theft
Question ID:

S_01

At any point in the past 12 months, have you or someone you live with owned a car, van, truck,
motorcycle, or other motor vehicle?
1

Yes

2

No

ASK Description: Household respondents.
ASK Specification: If UT_HHR = 1.
PROGRAM: ROUTING INSTRUCTIONS: If S_01 = 1,-9, go to S_01A. Else, go to S_03.
Question ID:

S_01A

How many motor vehicles have you or someone you live with owned over the past 12 months?
Please include any that are no longer owned by you or someone you live with.
1

Number of motor vehicles: |_ _|

ASK Description: Respondents who have owned or lived with someone who owned a car, van,
truck, motorcycle, or other motor vehicle in the past 12 months or who did not indicate they
have owned or lived with someone who owned a car, van, truck, motorcycle, or other motor
vehicle in the past 12 months.
ASK Specification: IF S_01 = 1,-9.
PROGRAM: ROUTING INSTRUCTIONS: If S_01A = 0, -9, go to S_03.
Else go to S_01BOX1.
Box ID:

S_01BOX1

For S_01B, display a ‘Yes' and ‘No' column with options for each response category.
Question ID:

S_01B

These first questions ask just about vehicle theft. In the past 12 months …
1

{Did anyone steal the vehicle or use it without
permission?/Did anyone steal any of these vehicles
or use it without permission?}

2

Did anyone TRY to steal {the vehicle/any of these
vehicles} but not actually steal it?

ASK Description: Respondents who have owned or lived with someone who owned a car, van,
truck, motorcycle, or other motor vehicle in the past 12 months.
ASK Specification: IF S_01 = 1 and S_01A > 0.
PROGRAM: ROUTING INSTRUCTIONS: If S_01B1 = 1 or S_01B2 = 1, go to S_01C1. Else, go to
S_02.

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Question ID:

S_01C1

In the past 12 months, how many times {was a vehicle stolen or used without permission/did
someone try to steal a vehicle/was a vehicle stolen or used without permission or did someone
try to steal a vehicle}?
1

Once

2

Two or more times {How many times: |_ _|}

ASK Description: Respondents who had a vehicle stolen, used without permission, or was
attempted stolen in the past 12 months.
ASK Specification: IF S_01 = 1 AND (S_01B1 = 1 OR S_01B2 = 1).
PROGRAM: ROUTING INSTRUCTIONS: If S_01C1 = -9 or (S_01C1 = 2 and S_01C1_NUM = -9),
go to S_01C1A.
Else, if S_01C1 = 2 and S_01C1_NUM >= 4, go to S_01C2.
Else, if S_01C1 = 2 and S_01C1_NUM = 2, 3, go to S_01D_INTRO.
Else, if S_01C1 = 1 or (S_01C1 = 2 and S_01C1_NUM = 1), go to S_01BOX2.
Else, go to S_02.
Question ID:

S_01C1A

You did not enter how many times this happened in the past 12 months. Please select one of the
following.
1

I really meant to answer

2

I don't know the answer

ASK Description: Respondents who had a vehicle stolen, used without permission, or was
attempted stolen in the past 12 months and did not enter how many times this happened in the
past 12 months.
ASK Specification: IF S_01 = 1 AND (S_01B1 = 1 OR S_01B2 = 1) AND (S_01C1 = -9 OR
(S_01C1 = 2 AND S_01C1_NUM = -9)).
PROGRAM: If S_01C1A = 2, -9, set S_MV = 1 and create 1 CIR.
ROUTING INSTRUCTIONS: If S_01C1A = 1, go to S_01C1.
Else, go to S_01BOX2.
Question ID:

S_01C2

Do you recall enough details about each incident to be able to distinguish them from each other?
1

Yes

2

No

GO TO S_01BOX2

ASK Description: Respondents who had a vehicle stolen, used without permission, or was
attempted stolen in the past 12 months and reported four or more vehicle theft incidents in the
past 12 months.
ASK Specification: IF S_01 = 1 AND (S_01B1 = 1 OR S_01B2 = 1) AND S_01C1 = 2 AND
S_01C1_NUM >= 4.
PROGRAM: If S_01C2 = 2, set SERIES = 1.

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Question ID:

S_01D_INTRO

{I will ask/On the next screens, you are going to be asked} about {each of these/the four most
recent} incidents, starting with the most recent{ time this happened. Please click NEXT to
continue.}
ASK Description: Respondents who had a vehicle stolen, used without permission, or was
attempted stolen in the past 12 months and reported less than four vehicle theft incidents in the
last 12 months or reported four or more vehicle theft incidents in the past 12 months and
recalled enough details about each incident to be able to distinguish them from each other.
ASK Specification: IF S_01 = 1 AND (S_01B1 = 1 OR S_01B2 = 1) AND S_01C1 = 2 AND
(S_01C1_NUM = 2, 3 OR (S_01C1_NUM >= 4 AND S_01C2 = 1)).
Box ID:

S_01BOX2

If S_01C1 = 2 and (S_01C1_NUM = 2, 3 or (S_01C1_NUM >= 4 and S_01C2 = 1)), repeat
S_01D through S_01G up to 4 times for each vehicle theft incident reported in S_01C1_NUM.
Ask all items from S_01D through S_01G (as appropriate) for most recent incident, then move
to next most recent incident, and so on.
Else, if S_01C1 = 1 or S_01C1_NUM = 1 or (S_01C1_NUM >= 4 and S_01C2 = 2) or S_01C1A
= 2, -9, ask only about most recent incident in S_01D.

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Question ID:

S_01D

{You said that someone{ stole a vehicle or used it without permission}{ or}{ tried to steal a
vehicle} {FILL ANSWER FROM S_01C1} times in the past 12 months.} In what month did the
{MOST RECENT/SECOND MOST RECENT/THIRD MOST RECENT/FOURTH MOST RECENT}
incident happen? If you don't remember the exact month, please give your best estimate.
1

Before {CURRENT MONTH MINUS 12}

2

{CURRENT MONTH MINUS 12}

3

{CURRENT MONTH MINUS 11}

4

{CURRENT MONTH MINUS 10}

5

{CURRENT MONTH MINUS 9}

6

{CURRENT MONTH MINUS 8}

7

{CURRENT MONTH MINUS 7}

8

{CURRENT MONTH MINUS 6}

9

{CURRENT MONTH MINUS 5}

10

{CURRENT MONTH MINUS 4}

11

{CURRENT MONTH MINUS 3}

12

{CURRENT MONTH MINUS 2}

13

{CURRENT MONTH MINUS 1}

14

{CURRENT MONTH}

ASK Description: Respondents who had a vehicle stolen or used without permission or had a
vehicle that someone attempted to steal once in the past 12 months or did not know how many
times this incident happened in the past 12 months.
ASK Specification: IF (S_01B1 = 1 OR S_01B2 = 1) AND (S_01C1 = 1 OR (S_01C1 = 2 AND
S_01C1_NUM >= 1) OR S_01C1A = 2, -9).
PROGRAM: ROUTING INSTRUCTIONS: If DATE PROVIDED IN S_01D IS CURRENT MONTH
MINUS 12 OR S_01D = -9, go to S_01D1.
Else, if DATE PROVIDED IN S_01D IS CURRENT MONTH MINUS 6, go to S_01D2.
Else, if DATE PROVIDED IN S_01D IS BEFORE CURRENT MONTH MINUS 12, go to S_02.
Else, go to S_01BOX3.

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Question ID:

S_01D1

Did this incident happen before, after, or on {12-MO ANCHORDATE}?
1

It happened before {12-MO ANCHORDATE}

2

It happened after or on {12-MO ANCHORDATE}

3

I don't know when it happened / can't remember

ASK Description: Respondents who had a vehicle stolen or used without permission or had a
vehicle that someone attempted to steal but did not provide a date when this happened or said
it happened 12 months ago.
ASK Specification: IF DATE PROVIDED IN S_01D IS CURRENT MONTH MINUS 12 OR S_01D = 9.
PROGRAM: ROUTING INSTRUCTIONS: If S_01D = -9 and S_01D1 = 2, go to S01D2.
Else, if DATE PROVIDED IN S_01D IS CURRENT MONTH MINUS 12 and S_01D1 = 2, go to
S_01BOX3.
Else, if S_01D1 = 3, -9, go to S_01BOX5.
Else, if S_01D1 = 1, go to S_02.
Question ID:

S_01D2

Did this incident happen before, after, or on {6-MO ANCHORDATE}?
1

It happened before {6-MO ANCHORDATE}

2

It happened after or on {6-MO ANCHORDATE}

3

I don't know

ASK Description: Respondents who had a vehicle stolen or used without permission or had a
vehicle that someone attempted to steal 6 months ago or on or after 12 months ago.
ASK Specification: IF DATE PROVIDED IN S_01D IS CURRENT MONTH MINUS 6 OR (S_01D = -9
AND S_01D1 = 2).
Box ID:

S_01BOX3

For each incident that happened within the past 12 months, set S_MV = 1.
If interleaving condition, go to S_01E.
Else, go to S_01BOX5.

IF DATE PROVIDED IN S_01D IS WITHIN THE PAST 12 MONTHS OR S_01D1 = 2, set S_MV = 1.
If SVERSION = 1, go to S_01E.
Else, go to S_01BOX5.

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Question ID:

S_01E

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/S_01D: MONTH, YEAR} incident when someone{ stole a vehicle or used it without
permission}{ or}{ tried to steal a vehicle}, was anything stolen from the vehicle, such as a cell
phone, money, or anything else in the vehicle?
1

Yes

2

No

ASK Description: Respondents who had a vehicle stolen or used without permission or had a
vehicle that someone attempted to steal in the past 12 months or did not know how many times
this incident happened in the past 12 months.
ASK Specification: IF SVERSION = 1 AND (S_01C1 = 1 OR S_01C1_NUM >= 1 OR S_01C1A =
2, -9) AND (DATE PROVIDED IN S_01D IS WITHIN THE PAST 12 MONTHS OR S_01D1 = 2).
PROGRAM: If S_01E = 1, set S_T=1.
Question ID:

S_01F

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/S_01D: MONTH, YEAR} incident when someone{ stole a vehicle or used it without
permission}{ or}{ tried to steal a vehicle}, were you physically attacked, or threatened with a
weapon during this incident?
1

Yes

GO TO S_01G

2

No

GO TO S_01BOX5

ASK Description: Respondents who had a vehicle stolen or used without permission or had a
vehicle that someone attempted to steal in the past 12 months or did not know how many times
this incident happened in the past 12 months.
ASK Specification: IF SVERSION = 1 AND (S_01C1 = 1 OR S_01C1_NUM >= 1 OR S_01C1A =
2, -9) AND (DATE PROVIDED IN S_01D IS WITHIN THE PAST 12 MONTHS OR S_01D1 = 2).
PROGRAM: If S_01F = 1, set S_ATA=1.

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Question ID:

S_01G

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/S_01D: MONTH, YEAR} incident when someone{ stole a vehicle or used it without
permission}{ or}{ tried to steal a vehicle}, did anyone have, or try to have, sexual contact with
you that you DID NOT CONSENT TO and that YOU DID NOT WANT to happen?
1

Yes

2

No

ASK Description: Respondents who had a vehicle stolen or used without permission or had a
vehicle that someone attempted to steal in the past 12 months or did not know how many times
this incident happened in the past 12 months and were physically attacked, or threatened with a
weapon during this incident.
ASK Specification: IF SVERSION = 1 AND (S_01C1 = 1 OR S_01C1_NUM >= 1 OR S_01C1A =
2, -9) AND (DATE PROVIDED IN S_01D IS WITHIN THE PAST 12 MONTHS OR S_01D1 = 2) AND
S_01F = 1.
PROGRAM: If S_01G = 1, set S_SA=1.
Box ID:

S_01BOX5

If data has been collected for the four most recent dates in S_01D where N = S_01C1_NUM, go
to S_02.
Else, go to S_01D for incident (N+1).

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Vehicle Part Theft
Box ID:

S_02BOX1

For S_02A, display ‘Yes' and ‘No' columns with options for each response category.
Question ID:

S_02A

In the past 12 months …
1

Did anyone steal any vehicle parts such as a tire,
car stereo, GPS, hubcap, or battery from {the
vehicle/any of these vehicles}?

2

Did anyone steal any gas from {the vehicle/any of
these vehicles}?

3

Did anyone TRY to steal vehicle parts from {the
vehicle/any of these vehicles}?

ASK Description: Household respondents who have owned or lived with someone who owned a
car, van, truck, motorcycle, or other motor vehicle in the past 12 months and reported whether
or not someone stole a vehicle or used it without permission or attempted to steal a vehicle.
ASK Specification: IF UT_HHR = 1 AND S_01 = 1 AND (S_01B1 = 1, 2 OR S_01B2 = 1, 2).
PROGRAM: ROUTING INSTRUCTIONS: If S_02A1 =1 or S_02A2 = 1 or S_02A3 = 1, go to
S_02B1. Else, go to S_03.
Question ID:

S_02B1

{Thinking about the times when someone stole or tried to steal vehicle parts or gas,}How many
times did {this happen/any of these things happen} in the past 12 months?
1

Once

2

Two or more times {How many times: |_ _|}

ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts.
ASK Specification: IF S_02A1 = 1 OR S_02A2 = 1 OR S_02A3 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If S_02B1 = -9 or (S_02B1 = 2 and S_02B1_NUM = -9),
go to S_02B1A.
Else, if S_02B1 = 2 and S_02B1_NUM >= 4, go to S_02B2.
Else, if S_02B1 = 2 and S_02B1_NUM = 2, 3, go to S_02C_INTRO.
Else, if S_02B1 = 1 or (S_02B1 = 2 and S_02B1_NUM = 1), go to S_02BOX2.
Else, go to S_03.

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Question ID:

S_02B1A

You did not enter how many times this happened in the past 12 months. Please select one of the
following.
1

I really meant to answer

2

I don't know the answer

ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts and did not enter how many times this happened in the
past 12 months.
ASK Specification: IF (S_02A1 = 1 OR S_02A2 = 1 OR S_02A3 = 1) AND (S_02B1 = -9 OR
(S_02B1 = 2 AND S_02B1_NUM = -9)).
PROGRAM: If S_02B1A = 2, -9, set S_MVP = 1 and create 1 CIR.
ROUTING INSTRUCTIONS: If S_02B1A = 1, go to S_02B1.
Else, go to S_02BOX2.
Question ID:

S_02B2

Do you recall enough details about each incident to be able to distinguish them from each other?
1

Yes

2

No

ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts four or more times in the last 12 months.
ASK Specification: IF S_02B1 = 2 AND S_02B1_NUM >= 4.
PROGRAM: If S_02B2 = 2, set SERIES = 1.
ROUTING INSTRUCTIONS: If S_02B2 = 1, go to S_02C_INTRO.
Else, go to S_02BOX2.
Question ID:

S_02C_INTRO

{I will ask/On the next screens, you are going to be asked} about {each of these/the four most
recent} incidents, starting with the most recent{ time this happened. Please click NEXT to
continue.}
ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts two or more times in the last 12 months and recalled
enough details about each incident to be able to distinguish them from each other.
ASK Specification: IF (S_02B1 = 2 AND S_02B1_NUM >= 4 AND S_02B2 = 1) OR (S_02B1 = 2
AND S_02B1_NUM = 2, 3).

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Box ID:

S_02BOX2

If S_02B1 = 2 and (S_02B1_NUM = 2, 3 or (S_02B1_NUM >= 4 and S_02B2 = 1)), repeat
S_02C through S_02G up to four most recent dates in S_02C where N = S_02B1_NUM. Ask all
items from S_02C through S_02G (as appropriate) for most recent incident, then move to next
most recent incident, and so on.
Else, if S_02B1 = 1 or (S_02B1 = 2 and (S_02B1_NUM = 1 or (S_02B1_NUM >= 4 and
S_02B2 = 2))) OR S_02B1A = 2, -9, ask only about most recent incident in S_02C.

Question ID:

S_02C

{You said that someone {stole} {or} {tried to steal} vehicle parts or gas {FILL ANSWER FROM
S_02B1 times} in the past 12 months.} In what month did the {MOST RECENT/SECOND MOST
RECENT/THIRD MOST RECENT/FOURTH MOST RECENT} incident happen? If you don't
remember the exact month, please give your best estimate.
1

Before {CURRENT MONTH MINUS 12}

2

{CURRENT MONTH MINUS 12}

3

{CURRENT MONTH MINUS 11}

4

{CURRENT MONTH MINUS 10}

5

{CURRENT MONTH MINUS 9}

6

{CURRENT MONTH MINUS 8}

7

{CURRENT MONTH MINUS 7}

8

{CURRENT MONTH MINUS 6}

9

{CURRENT MONTH MINUS 5}

10

{CURRENT MONTH MINUS 4}

11

{CURRENT MONTH MINUS 3}

12

{CURRENT MONTH MINUS 2}

13

{CURRENT MONTH MINUS 1}

14

{CURRENT MONTH}

ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts two or more times in the last 12 months and recalled
enough details about each incident to be able to distinguish them from each other or did not
know how many times this incident happened in the past 12 months.
ASK Specification: IF (S_02A1 = 1 OR S_02A2 = 1 OR S_02A3 = 1) AND (S_02B1 = 1 OR
(S_02B1 = 2 AND S_02B1_NUM >= 1) OR S_02B1A = 2, -9).
PROGRAM: ROUTING INSTRUCTIONS: If DATE PROVIDED IN S_02C IS CURRENT MONTH MINUS
12 OR S_02C = -9, go to S_02C1.
Else, if DATE PROVIDED IN S_02C IS CURRENT MONTH MINUS 6, go to S_02C2.
Else, if DATE PROVIDED IN S_02C IS BEFORE CURRENT MONTH MINUS 12, go to S_03.
Else, go to S_02BOX2B.

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Question ID:

S_02C1

Did this incident happen before, after, or on {12-MO ANCHORDATE}?
1

It happened before {12-MO ANCHORDATE}

2

It happened after or on {12-MO ANCHORDATE}

3

I don't know when it happened / can't remember

ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts a year or more ago.
ASK Specification: FOR S_02C1: IF DATE PROVIDED IN S_02C IS CURRENT MONTH MINUS 12
OR S_02C = -9.
PROGRAM: ROUTING INSTRUCTIONS: If S_02C = -9 and S_02C1 = 2, go to S_02C2.
Else, if DATE PROVIDED IN S_02C IS CURRENT MONTH MINUS 12 and S_02C1 = 2, go to
S_02BOX2B.
Else, if S_02C1 = 3, -9, go to S_02BOX5.
Else, if S_02C1 = 1, go to S_03.
Question ID:

S_02C2

Did this incident happen before, after, or on {6-MO ANCHORDATE}?
1

It happened before {6-MO ANCHORDATE}

2

It happened after or on {6-MO ANCHORDATE}

3

I don't know

ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts six months ago.
ASK Specification: IF DATE PROVIDED IN S_02C IS CURRENT MONTH MINUS 6 OR (S_02C = -9
AND S_02C1 = 2).
PROGRAM: ROUTING INSTRUCTIONS: If S_02C = -9 AND S_02C1 = 2 AND S_02C2 = 3, -9, go
to S_02BOX5.
Else, go to S_02BOX2B.
Box ID:

S_02BOX2B

Respondents who had any vehicle parts or gas stolen from their vehicle or someone tried to
steal vehicle parts in the past 12 months and the MONTH/YEAR of the current incident matches
the MONTH/YEAR of any previously reported incidents, or no date was provided for the current
incident and the current incident was confirmed to have happened on or after anchor date and
there are any previously reported incidents for which a date was not collected that were
confirmed to have happened on or after anchor date, go to S_02DD2.
Else, go to box S_02BOX3.

IF (DATE PROVIDED IN S_02C IS WITHIN THE PAST 12 MONTHS AND S_02C MATCHES A DATE
PROVIDED IN S_01D) OR (S_02C = -9 AND S_02C1 = 2 AND (S_01D = -9 AND S_01D1 = 2
FOR ANY INCIDENT IN S_01D)), GO TO S_02DD2.
ELSE, GO TO S_02BOX3.

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Question ID:

S_02DD2

Is this incident part of any other incident you have already mentioned?
1

Yes

GO TO S_02DD3

2

No

GO TO S_02BOX3

ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts in the past 12 months and the MONTH/YEAR of the current
incident matches the MONTH/YEAR of any previously reported incidents, or no date was
provided for the current incident and the current incident was confirmed to have happened on or
after anchor date and there are any previously reported incidents for which a date was not
collected that were confirmed to have happened on or after anchor date.
ASK Specification: IF (DATE PROVIDED IN S_02C IS WITHIN THE PAST 12 MONTHS AND S_02C
MATCHES A DATE PROVIDED IN S_01D) OR (S_02C = -9 AND S_02C1 = 2 AND (S_01D = -9
AND S_01D1 = 2 FOR ANY INCIDENT IN S_01D)).
Question ID:

S_02DD3

Which incident was this part of?
0

{Incident 1}

1

{Incident 2}

2

{Incident 3}

3

{Incident 4}

-8

This is a separate incident

ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts that occurred as part of another incident.
ASK Specification: IF S_02DD2 = 1.
Box ID:

S_02BOX3

If S_02DD3 = 0, 1, 2, 3, set S_MVP = 1 for the incident selected in S_02DD3.
Else, if DATE PROVIDED IN S_02C IS WITHIN THE PAST 12 MONTHS or S_02C1 = 2 AND
(S_02DD2 != 1 OR S_02DD3 = -8, -9), set S_MVP = 1.
ROUTING INSTRUCTIONS: If SVERSION = 1 AND (S_02DD2 != 1 OR S_02DD3 = -8, -9), go to
S_02E.
Else, go to S_02BOX5.

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Question ID:

S_02E

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/MONTH, YEAR} incident in which someone {stole}{ or}{tried to steal vehicle parts or
gas}, other than the vehicle parts or gas, was anything else stolen from the vehicle, such as a
cell phone, money, or anything else in the vehicle?
1

Yes

2

No

ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts at least once in the past 12 months or did not know how
many times this incident happened in the past 12 months.
ASK Specification: IF SVERSION = 1 AND (S_02A1 = 1 OR S_02A2 = 1 OR S_02A3 = 1) AND
(S_02B1 = 1 OR (S_02B1 = 2 AND S_02B1_NUM >= 1) OR S_02B1A = 2, -9) AND (DATE
PROVIDED IN S_02C IS WITHIN THE PAST 12 MONTHS OR S_02C1 = 2) AND (S_02DD2 != 1
OR S_02DD3 = -8, -9).
PROGRAM: If S_02E = 1, set S_T = 1.
Question ID:

S_02F

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/MONTH, YEAR} incident in which someone {stole}{ or}{tried to steal vehicle parts or
gas}, were you physically attacked, or threatened with a weapon during this incident?
1

Yes

GO TO S_02G

2

No

GO TO S_02BOX5

ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts at least once in the past 12 months or did not know how
many times this incident happened in the past 12 months.
ASK Specification: IF SVERSION = 1 AND (S_02A1 = 1 OR S_02A2 = 1 OR S_02A3 = 1) AND
(S_02B1 = 1 OR (S_02B1 = 2 AND S_02B1_NUM >= 1) OR S_02B1A = 2, -9) AND (DATE
PROVIDED IN S_02C IS WITHIN THE PAST 12 MONTHS OR S_02C1 = 2) AND (S_02DD2 != 1
OR S_02DD3 = -8, -9).
PROGRAM: If S_02F = 1, set S_ATA = 1.

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Question ID:

S_02G

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/MONTH, YEAR} incident in which someone {stole}{ or}{tried to steal vehicle parts or
gas}, did anyone have, or try to have, sexual contact with you that you DID NOT CONSENT TO
and that YOU DID NOT WANT to happen as part of this incident?
1

Yes

2

No

ASK Description: Respondents who had any vehicle parts or gas stolen from their vehicle or
someone tried to steal vehicle parts at least once in the past 12 months or did not know how
many times this incident happened in the past 12 months and were physically attacked, or
threatened with a weapon during this incident.
ASK Specification: IF SVERSION = 1 AND (S_02A1 = 1 OR S_02A2 = 1 OR S_02A3 = 1) AND
(S_02B1 = 1 OR (S_02B1 = 2 AND S_02B1_NUM >= 1) OR S_02B1A = 2, -9) AND (DATE
PROVIDED IN S_02C IS WITHIN THE PAST 12 MONTHS OR S_02C1 = 2) AND (S_02DD2 != 1
OR S_02DD3 = -8, -9) AND S_02F = 1.
PROGRAM: If S_02G = 1, set S_SA = 1.
Box ID:

S_02BOX5

If data has been collected for the four most recent dates in S_02C where N = S_02B1_NUM, go
to S_03.
Else, go to S_02C for incident (N+1).

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Theft
Box ID:

S_03BOX1

For S_03, display ‘Yes' and ‘No' columns with options for each response category.
Question ID:

S_03A

The {next }questions {below }ask about different things that might have been stolen from you.
This may have happened to you while you were at home,{ at work or} school, or somewhere
else.
{Other than the thefts or attempted thefts you have mentioned already, in/In} the past 12
months did anyone…
1

Steal something that you carry, like a cell phone,
money, a wallet, purse, or backpack?

2

Steal something that you wear, like clothing,
jewelry, or shoes?

3

Steal something in your home, like a TV,
computer, tools, or guns?

4

Steal something from your porch, lawn, garage, or
other part of your property, such as a bicycle,
garden hose or lawn furniture?

5

Steal something out of a vehicle, such as a
package or groceries?

6

{Steal something belonging to the children who
live here?}

7

Steal anything else that belongs to you, including
things that were stolen from you at work or at
school?

ASK Description: All respondents.
Question ID:

S_03B

{Other than what you have already mentioned,} In the past 12 months, did anyone TRY to steal
anything that belongs to you {or the children who live with you}, but not actually steal it?
1

Yes

2

No

ASK Description: All respondents
Box ID:

S_03BOX2

If S_03A1 = 1 or S_03A2 = 1 or S_03A3 = 1 or S_03A4 = 1 or S_03A5 = 1 or S_03A6 = 1 or
S_03A7 = 1 or S_03B = 1, go to S_03C1. Else, go to S_04.

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Question ID:

S_03C1

{You just said yes to more than one of these questions about theft. Altogether,} How many
times did someone{ steal}{ or}{ try to steal} something in the past 12 months?
1

Once

2

Two or more times {How many times: |_ _|}

ASK Description: Respondents who had something stolen or attempted stolen from them.
ASK Specification: IF S_03A1 = 1 OR S_03A2 = 1 OR S_03A3 = 1 OR S_03A4 = 1 OR S_03A5
= 1 OR S_03A6 = 1 OR S_03A7 = 1 OR S_03B = 1.
PROGRAM: ROUTING INSTRUCTIONS: If S_03C1 = -9 OR (S_03C1 = 2 AND S_03C1_NUM = 9), go to S_03C1A.
Else, if S_03C1 = 2 and S_03C1_NUM >= 4, go to S_03C2.
Else, if S_03C1 = 2 and S_03C1_NUM = 2, 3, go to S_03D_INTRO.
Else, if S_03C1 = 1 or (S_03C1 = 2 and S_03C1_NUM = 1), go to S_03BOX2.
Else, go to S_04.
Question ID:

S_03C1A

You did not enter how many times this happened in the past 12 months. Please select one of the
following.
1

I really meant to answer

2

I don't know the answer

ASK Description: Respondents who had something stolen or attempted stolen from them and
did not enter how many times this happened in the past 12 months.
ASK Specification: IF (S_03A1 = 1 OR S_03A2 = 1 OR S_03A3 = 1 OR S_03A4 = 1 OR S_03A5
= 1 OR S_03A6 = 1 OR S_03A7 = 1 OR S_03B = 1) AND (S_03C1 = -9 OR (S_03C1 = 2 AND
S_03C1_NUM = -9)).
PROGRAM: If S_03C1A = 2, -9, create 1 CIR.
ROUTING INSTRUCTIONS: If S_03C1A = 1, go to S_03C1.
Else, go to S_03BOX2A.
Question ID:

S_03C2

Do you recall enough details about each incident to be able to distinguish them from each other?
1

Yes

2

No

ASK Description: Respondents who had something stolen from them four or more times in the
past 12 months.
ASK Specification: IF S_03C1 = 2 AND S_03C1_NUM >= 4.
PROGRAM: If S_03C2 = 2, set SERIES = 1
ROUTING INSTRUCTIONS: If S_03C2 = 2, go to S_03BOX2.
Else, go to S_03D_INTRO.

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Question ID:

S_03D_INTRO

{I will ask/On the next screens, you are going to be asked} about {each of these/the four most
recent} incidents, starting with the most recent{ time this happened. Please click NEXT to
continue.}
ASK Description: Respondents who had something stolen or attempted stolen from them more
than once in the past 12 months.
ASK Specification: IF (S_03C1 = 2 AND S_03C1_NUM = 2, 3) OR (S_03C1 = 2 AND
S_03C1_NUM >= 4 AND S_03C2 = 1).
Box ID:

S_03BOX2A

If S_03C1 = 2 and (S_03C1_NUM = 2, 3 or (S_03C1_NUM >= 4 and S_03C2 = 1)), repeat
S_03D through S_03G for up to four most recent dates in S_03C1 where N = S_03C1_NUM. Ask
all items from S_03D through S_04G (as appropriate) for most recent incident, then move to
next most recent incident, and so on.
Else, if S_03C1 = 1 or (S_03C1 = 2 and (S_03C1_NUM = 1 or (S_03C1_NUM >= 4 and S_03C2
= 2) or S_03C1A = 2, -9, ask only about most recent incident in S_03D.

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Question ID:

S_03D

{You said that someone { stole}{ or}{ tried to steal} something {FILL ANSWER FROM S_01C1
times} in the past 12 months.} In what month did the {MOST RECENT/SECOND MOST
RECENT/THIRD MOST RECENT/FOURTH MOST RECENT} incident happen? If you don't
remember the exact month, please give your best estimate.
1

Before {CURRENT MONTH MINUS 12}

2

{CURRENT MONTH MINUS 12}

3

{CURRENT MONTH MINUS 11}

4

{CURRENT MONTH MINUS 10}

5

{CURRENT MONTH MINUS 9}

6

{CURRENT MONTH MINUS 8}

7

{CURRENT MONTH MINUS 7}

8

{CURRENT MONTH MINUS 6}

9

{CURRENT MONTH MINUS 5}

10

{CURRENT MONTH MINUS 4}

11

{CURRENT MONTH MINUS 3}

12

{CURRENT MONTH MINUS 2}

13

{CURRENT MONTH MINUS 1}

14

{CURRENT MONTH}

ASK Description: Respondent had something stolen or attempted stolen from them in the past
12 months or did not know how many times this incident happened in the past 12 months.
ASK Specification: IF (S_03A1 = 1 OR S_03A2 = 1 OR S_03A3 = 1 OR S_03A4 = 1 OR S_03A5
= 1 OR S_03A6 = 1 OR S_03A7 = 1 OR S_03B = 1) AND (S_03C1 = 1 OR (S_03C1 = 2 AND
S_03C1_NUM >= 1) OR S_03C1A = 2, -9).
PROGRAM: ROUTING INSTRUCTIONS: If DATE PROVIDED IN S_03D IS CURRENT MONTH
MINUS 12 OR S_03D = -9, go to S_03D1.
Else, if DATE PROVIDED IN S_03D IS CURRENT MONTH MINUS 6, go to S_03D2.
Else, if UT_HHR = 1 and DATE PROVIDED IN S_03D IS BEFORE CURRENT MONTH MINUS 12, go
to S_04.
Else, if DATE PROVIDED IN S_03D IS BEFORE CURRENT MONTH MINUS 12, go to S_06.
Else, go to S_03BOX2B.

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Question ID:

S_03D1

Did this incident happen before, after, or on {12-MO ANCHORDATE}?
1

It happened before {12-MO ANCHORDATE}

2

It happened after or on {12-MO ANCHORDATE}

3

I don't know when it happened / can't remember

ASK Description: Respondents who had something stolen or attempted stolen from them 12
months ago or did not report the month and year that this incident occurred.
ASK Specification: IF DATE PROVIDED IN S_03D IS CURRENT MONTH MINUS 12 OR S_03D = 9.
PROGRAM: ROUTING INSTRUCTIONS: If S_03D = -9 and S_03D1 = 2, go to S_03D2.
Else, if DATE PROVIDED IN S_03D IS CURRENT MONTH MINUS 12 and S_03D1 = 2, go to
S_03BOX2B.
Else, if S_03D1 = 3, -9, go to S_03BOX5.
Else, if UT_HHR = 1 and S_03D1 = 1, go to S_04.
Else, go to S_06.
Question ID:

S_03D2

Did this incident happen before, after, or on {6-MO ANCHORDATE}?
1

It happened before {6-MO ANCHORDATE}

2

It happened after or on {6-MO ANCHORDATE}

3

I don't know

ASK Description: Respondents who had something stolen from them six months ago or did not
report the month and year of the incident and confirmed it happened in the past 12 months.
ASK Specification: IF DATE PROVIDED IN S_03D IS CURRENT MONTH MINUS 6 OR (S_03D = -9
AND S_03D1 = 2).
PROGRAM: ROUTING INSTRUCTIONS: If S_03D = -9 AND S_03D1 = 2 AND S_03D2 = 3, -9, go
to S_03BOX5.
Else, go to S_03BOX2B.

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Box ID:

S_03BOX2B

Respondents who had something stolen from them in the past 12 months and the MONTH/YEAR
of the current incident matches the MONTH/YEAR of any previously reported incidents, or no
date was provided for the current incident and the current incident was confirmed to have
happened on or after anchor date and there are any previously reported incident for which a
date was not collected that were confirmed to have happened on or after anchor date, go to
S_03DD2.
Else, respondents who reported anyone tried to steal anything that belongs to them but did not
actually steal it and someone stole something from them in the past 12 months, go to S_03AT.
Else, go to S_03BOX3.

IF (DATE PROVIDED IN S_03D IS WITHIN THE PAST 12 MONTHS AND (S_03D MATCHES A
DATE PROVIDED IN S_01D OR S_02C)) OR (S_03D = -9 AND S_03D1 = 2 AND ((S_01D = -9
AND S_01D1 = 2 FOR ANY INCIDENT IN S_01D) OR (S_02C = -9 AND S_02C1 = 2 FOR ANY
INCIDENT IN S_02C))), GO TO S_03DD2.
ELSE, IF S_03B = 1, -9 AND (S_03A1 = 1 OR S_03A2 = 1 OR S_03A3 = 1 OR S_03A4 = 1 OR
S_03A5 = 1 OR S_03A6 = 1 OR S_03A7 = 1) AND (DATE PROVIDED IN S_03D IS WITHIN THE
PAST 12 MONTHS OR (DATE PROVIDED IN S_03D IS CURRENT MONTH MINUS 12 OR S_03D =
-9 AND S_03D1 = 2), GO TO S_03AT.
ELSE, GO TO S_03BOX3.

Question ID:

S_03DD2

Is this incident part of any other incident you have already mentioned?
1

Yes

2

No

ASK Description: Respondents who had something stolen or attempted stolen in the past 12
months and the MONTH/YEAR of the current incident matches the MONTH/YEAR of any
previously reported incidents, or no date was provided for the current incident and the current
incident was confirmed to have happened on or after anchor date and there are any previously
reported incident for which a date was not collected.
ASK Specification: IF (DATE PROVIDED IN S_03D IS WITHIN THE PAST 12 MONTHS AND S_03D
MATCHES A DATE PROVIDED IN S_01D OR S_02C) OR (S_03D = -9 AND S_03D1 = 2 AND
((S_01D = -9 AND S_01D1 = 2 FOR ANY INCIDENT IN S_01D) OR (S_02C = -9 AND S_02C1 =
2 FOR ANY INCIDENT IN S_02C))).
PROGRAM: ROUTING INSTRUCTIONS: IF S_03DD2 = 1, GO TO S_03DD3.
ELSE, IF S_03B = 1, -9 AND (S_03A1 = 1 OR S_03A2 = 1 OR S_03A3 = 1 OR S_03A4 = 1 OR
S_03A5 = 1 OR S_03A6 = 1 OR S_03A7 = 1) AND (DATE PROVIDED IN S_03D IS WITHIN THE
PAST 12 MONTHS OR (DATE PROVIDED IN S_03D IS CURRENT MONTH MINUS 12 OR S_03D =
-9 AND S_03D1 = 2), GO TO S_03AT.
ELSE, GO TO S_03BOX3.

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Question ID:

S_03DD3

Which incident was this part of?
0

{Incident 1}

1

{Incident 2}

2

{Incident 3}

3

{Incident 4}

4

{Incident 5}

5

{Incident 6}

6

{Incident 7}

7

{Incident 8}

-8

This is a separate incident

ASK Description: Respondents who had something stolen from them as part of another incident.
ASK Specification: IF S_03DD2 = 1.
PROGRAM: IF S_03DD3 != -8, -9 AND S_03A1 != 1 AND S_03A2 != 1 AND S_03A3 != 1 AND
S_03A4 != 1 AND S_03A5 != 1 AND S_03A6 != 1 AND S_03A7 != 1 AND S_03B = 1, SET
S_AT = 1 FOR THE INCIDENT SELECTED IN S_03DD3.
ELSE, IF S_03DD3 != -8, -9, SET S_T = 1 FOR THE INCIDENT SELECTED IN S_03DD3.
ROUTING INSTRUCTIONS: IF S_03B = 1, -9 AND (S_03A1 = 1 OR S_03A2 = 1 OR S_03A3 = 1
OR S_03A4 = 1 OR S_03A5 = 1 OR S_03A6 = 1 OR S_03A7 = 1) AND (DATE PROVIDED IN
S_03D IS WITHIN THE PAST 12 MONTHS OR (DATE PROVIDED IN S_03D IS CURRENT MONTH
MINUS 12 OR S_03D = -9 AND S_03D1 = 2)) AND S_03DD3 = -8, -9, GO TO S_03AT.
Else, go to S_03BOX3.
Question ID:

S_03AT

You said someone stole or tried to steal something from you during {this/the} incident
{MONTH/in the past 12 months}. Did the offender actually steal something or did they only TRY
to steal something?
1

The offender actually stole something

2

The offender only tried to steal something

ASK Description: Respondents who reported anyone tried to steal anything that belongs to them
but did not actually steal it and someone stole something from them in the past 12 months.
ASK Specification: IF S_03B = 1, -9 AND (S_03A1 = 1 OR S_03A2 = 1 OR S_03A3 = 1 OR
S_03A4 = 1 OR S_03A5 = 1 OR S_03A6 = 1 OR S_03A7 = 1) AND (DATE PROVIDED IN S_03D
IS WITHIN THE PAST 12 MONTHS OR (DATE PROVIDED IN S_03D IS CURRENT MONTH MINUS
12 OR S_03D = -9 AND S_03D1 = 2)) AND (S_03DD2 != 1 OR S_03DD3 = -8, -9).

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Box ID:

S_03BOX3

If (DATE PROVIDED IN S_03D IS WITHIN THE PAST 12 MONTHS OR S_03D1 = 2) AND
S_03DD3 = 0, 1, 2, 3, 4, 5, 6, 7, set S_T = 1 for the incident selected in S_03DD3.
Else, if (DATE PROVIDED IN S_03D IS WITHIN THE PAST 12 MONTHS OR S_03D1 = 2) AND
((S_03B != 1 AND (S_03A1 = 1 OR S_03A2 = 1 OR S_03A3 = 1 OR S_03A4 = 1 OR S_03A5 =
1 OR S_03A6 = 1 OR S_03A7 = 1)) OR S_03AT = 1) AND (S_03DD2 != 1 OR S_03DD3 = -8, 9), set S_T = 1.
Else, if (DATE PROVIDED IN S_03D IS WITHIN THE PAST 12 MONTHS OR S_03D1 = 2) AND
((S_03B = 1 AND (S_03A1 != 1 AND S_03A2 != 1 AND S_03A3 != 1 AND S_03A4 != 1 AND
S_03A5 != 1 AND S_03A6 != 1 AND S_03A7 != 1)) OR S_03AT = 2) AND (S_03DD2 != 1 OR
S_03DD3 = -8, -9), set S_AT = 1.
ROUTING INSTRUCTIONS: If SVERSION = 1 AND (S_03DD2 != 1 OR S_03DD3 = -8, -9), go to
S_03E.
Else, go to S_03BOX5.

Question ID:

S_03E

Still thinking about this {most recent/second most recent/third most recent/fourth most recent/
S_03D: MONTH, YEAR} incident when someone {stole}{ or}{ tried to steal} something, did
anyone break in, or try to break in, to your home or another building on your property as part of
this incident?
1

Yes

2

No

ASK Description: Respondents who had something stolen or someone tried to steal from them in
the past 12 months or did not know how many times this incident happened in the past 12
months.
ASK Specification: IF SVERSION = 1 AND (S_03A1 = 1 OR S_03A2 = 1 OR S_03A3 = 1 OR
S_03A4 = 1 OR S_03A5 = 1 OR S_03A6 = 1 OR S_03A7 = 1 OR S_03B = 1) AND (S_03C1 = 1
OR (S_03C1 = 2 AND S_03C1_NUM >= 1) OR S_03C1A = 2, -9) AND (DATE PROVIDED IN
S_03D IS WITHIN THE PAST 12 MONTHS OR S_03D1 = 2) AND (S_03DD2 != 1 AND S_03DD3
= -8, -9).
PROGRAM: If S_03E = 1, set S_BI = 1.

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Question ID:

S_03F

Still thinking about this {most recent/second most recent/third most recent/fourth most recent/
S_03D: MONTH, YEAR} incident when someone {stole}{ or}{ tried to steal} something, were
you physically attacked, or threatened with a weapon, during this incident?
1

Yes

GO TO S_03G

2

No

GO TO S_03BOX5

ASK Description: Respondents who had something stolen or someone tried to steal from them in
the past 12 months or did not know how many times this incident happened in the past 12
months.
ASK Specification: IF SVERSION = 1 AND (S_03A1 = 1 OR S_03A2 = 1 OR S_03A3 = 1 OR
S_03A4 = 1 OR S_03A5 = 1 OR S_03A6 = 1 OR S_03A7 = 1 OR S_03B = 1) AND (S_03C1 = 1
OR (S_03C1 = 2 AND S_03C1_NUM >= 1) OR S_03C1A = 2, -9) AND (DATE PROVIDED IN
S_03D IS WITHIN THE PAST 12 MONTHS OR S_03D1 = 2) AND (S_03DD2 != 1 AND S_03DD3
= -8, -9).
PROGRAM: If S_03F = 1, set S_ATA = 1.
Question ID:

S_03G

Still thinking about this {most recent/second most recent/third most recent/fourth most recent/
S_03D: MONTH, YEAR} incident when someone {stole}{ or}{ tried to steal} something, did
anyone have, or try to have, sexual contact with you that you DID NOT CONSENT TO and that
YOU DID NOT WANT to happen as part of this incident?
1

Yes

2

No

ASK Description: Respondents who had something stolen or someone tried to steal from them in
the past 12 months or did not know how many times this incident happened in the past 12
months and were physically attacked, or threatened with a weapon, during this incident.
ASK Specification: IF SVERSION = 1 AND (S_03A1 = 1 OR S_03A2 = 1 OR S_03A3 = 1 OR
S_03A4 = 1 OR S_03A5 = 1 OR S_03A6 = 1 OR S_03A7 = 1 OR S_03B = 1) AND (S_03C1 = 1
OR (S_03C1 = 2 AND S_03C1_NUM >= 1) OR S_03C1A = 2, -9) AND (DATE PROVIDED IN
S_03D IS WITHIN THE PAST 12 MONTHS OR S_03D1 = 2) AND (S_03DD2 != 1 AND S_03DD3
= -8, -9) AND S_03F = 1.
PROGRAM: If S_03G = 1, set S_SA = 1.
Box ID:

S_03BOX5

If data has been collected for the four most recent dates in S_03D where N = S_03C1_NUM, go
to S_04.
Else, go to S_03D for incident (N+1).

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Break-In
Box ID:

S_04START

ROUTING INSTRUCTIONS: IF UT_HHR = 1, go to S_04BOX1. Else, GO TO S_06
Box ID:

S_04BOX1

For S_04A1 through S_04A3, display a ‘Yes' and ‘No' column with options for each response
category.
Question ID:

S_04A

The next few questions ask about break-ins. {Other than break-in(s) you have mentioned
already, } in the past 12 months, did anyone…
1

Break in or try to break into your home by forcing
a door or window, pushing past someone,
jimmying a lock, cutting a screen, or coming
through an open door or window?

2

Break in or try to break into your garage, shed, or
storage room?

3

Break in or try to break into a hotel or motel room
or vacation home where you were staying?

ASK Description: All household respondents.
ASK Specification: IF UT_HHR = 1.
PROGRAM: ROUTING INSTRUCTIONS: If S_04A1 = 1 or S_04A2 = 1 or S_04A3 = 1, go to
S_04B1. Else, go to S_05.
Question ID:

S_04B1

How many times did someone break in or try to break in during the past 12 months?
1

Once

2

Two or more times {How many times: |_ _|}

ASK Description: Respondents who reported a break-in or attempted break-in in the past 12
months.
ASK Specification: IF S_04A1 = 1 OR S_04A2 = 1 OR S_04A3 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If S_04B1 = -9 OR (S_04B1 = 2 AND S_04B1_NUM = 9), go to S_04B1A.
Else, if S_04B1 = 1 or (S_04B1 = 2 and S_04B1_NUM = 1), go to S_04 BOX1.
Else, if S_04B1 = 2 and S_04B1_NUM = 2, 3, go to S_04C_INTRO.
Else, if S_04B1 = 2 and S_04B1_NUM >= 4, go to S_04B2.

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Question ID:

S_04B1A

You did not enter how many times this happened in the past 12 months. Please select one of the
following.
1

I really meant to answer

2

I don't know the answer

ASK Description: Respondents who reported a break-in or attempted break-in in the past 12
months and did not enter how many times this happened in the past 12 months.
ASK Specification: IF (S_04A1 = 1 OR S_04A2 = 1 OR S_04A3 = 1) AND (S_04B1 = -9 OR
(S_04B1 = 2 AND S_04B1_NUM = -9)).
PROGRAM: If S_04B1A = 2, -9, set S_BI = 1 and create 1 CIR.
ROUTING INSTRUCTIONS: If S_04B1A = 1, go to S_04B1.
Else, go to S_04BOX2.
Question ID:

S_04B2

Do you recall enough details about each incident to be able to distinguish them from each other?
1

Yes

2

No

ASK Description: Respondents who reported a break-in or attempted break-in four or more
times in the last 12 months.
ASK Specification: IF S_04B1 = 2 AND S_04B1_NUM >= 4.
PROGRAM: If S_04B2, set SERIES = 1.
ROUTING INSTRUCTIONS: If S_04B2 = 2, go to S_04C. Else, go to S_04C_INTRO.
Question ID:

S_04C_INTRO

{I will ask/On the next screens, you are going to be asked} about {each of these/the four most
recent} incidents, starting with the most recent{ time this happened. Please click NEXT to
continue.}
ASK Description: Respondents who reported a break-in or attempted break-in more than once in
the last 12 months.
ASK Specification: IF S_04B1 = 2 AND (S_04B1_NUM = 2, 3 OR (S_04B1 = 2 AND
S_04B1_NUM >= 4 AND S_04B2 = 1)).
Box ID:

S_04BOX2

If S_04B1 = 2 and (S_04B1_NUM = 2, 3 or (S_04B1_NUM >= 4 and S_04B2 = 1), repeat
S_04C through S_04G for up to four most recent dates in S_04C where N = S_04B1_NUM. Ask
all items from S_04C through S_041G (as appropriate) for most recent incident, then move to
next most recent incident, and so on.
Else, if S_04B1 = 1 or (S_04B1 = 2 and (S_04B1_NUM = 1 or (S_04B1_NUM >= 4 and S_04B2
= 2))) or S_04B1A = 2, -9, ask only about most recent incident in S_04C.

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Question ID:

S_04C

{You said that someone broke in or tried to break in {FILL ANSWER FROM S_04B1 times} in the
past 12 months.} In what month did the {MOST RECENT/SECOND MOST RECENT/THIRD MOST
RECENT/FOURTH MOST RECENT} incident happen? If you don't remember the exact month,
please give your best estimate.
1

Before {CURRENT MONTH MINUS 12}

2

{CURRENT MONTH MINUS 12}

3

{CURRENT MONTH MINUS 11}

4

{CURRENT MONTH MINUS 10}

5

{CURRENT MONTH MINUS 9}

6

{CURRENT MONTH MINUS 8}

7

{CURRENT MONTH MINUS 7}

8

{CURRENT MONTH MINUS 6}

9

{CURRENT MONTH MINUS 5}

10

{CURRENT MONTH MINUS 4}

11

{CURRENT MONTH MINUS 3}

12

{CURRENT MONTH MINUS 2}

13

{CURRENT MONTH MINUS 1}

14

{CURRENT MONTH}

ASK Description: Respondents who reported a break-in or attempted break-in in the last 12
months or did not know how many times this incident happened in the past 12 months.
ASK Specification: IF (S_04A1 = 1 OR S_04A2 = 1 OR S_04A3 = 1) AND (S_04B1 = 1 OR
(S_04B1 = 2 AND S_04B1_NUM >= 1) OR S_04B1A = 2, -9).
PROGRAM: ROUTING INSTRUCTIONS: If DATE PROVIDED IN S_04C IS CURRENT MONTH MINUS
12 OR S_04C = -9, go to S_04C1.
Else, if DATE PROVIDED IN S_04C IS CURRENT MONTH MINUS 6, go to S_04C2.
Else, if DATE PROVIDED IN S_04C IS BEFORE CURRENT MONTH MINUS 12, go to S_05.
Else, go to S_04BOX2B.

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Question ID:

S_04C1

Did this incident happen before, after, or on {12-MO ANCHORDATE}?
1

It happened before {12-MO ANCHORDATE}

2

It happened after or on {12-MO ANCHORDATE}

3

I don't know when it happened / can't remember

ASK Description: Respondents who reported a break-in or attempted break-in 12 months ago or
did not report the month and year that this incident occurred.
ASK Specification: IF DATE PROVIDED IN S_04C IS CURRENT MONTH MINUS 12 OR S_04C = 9.
PROGRAM: ROUTING INSTRUCTIONS: If S_04C = -9 and S_04C1 = 2, go to S_04C2.
Else, if DATE PROVIDED IN S_04C IS CURRENT MONTH MINUS 12 and S_04C1 = 2, go to
S_04BOX2B.
Else, if S_04C1 = 3, -9, go to S_04BOX5.
Else, go to S_05.
Question ID:

S_04C2

Did this incident happen before, after, or on {6-MO ANCHORDATE}?
1

It happened before {6-MO ANCHORDATE}

2

It happened after or on {6-MO ANCHORDATE}

3

I don't know

ASK Description: Respondents who reported a break-in or attempted break-in six months ago or
did not report the month and year of the incident and confirmed it happened in the past 12
months.
ASK Specification: IF DATE PROVIDED IN S_04C IS CURRENT MONTH MINUS 6 OR (S_04C = -9
AND S_04C1 = 2).
PROGRAM: ROUTING INSTRUCTIONS: If S_04C = -9 AND S_04C1 = 2 AND S_04C2 = 3, -9, go
to S_04BOX5.
Else, go to S_04BOX2B.

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Box ID:

S_04BOX2B

Respondents who reported a break-in or attempted break-in in the past 12 months and the
MONTH/YEAR of the current incident matches the MONTH/YEAR of any previously reported
incidents, or no date was provided for the current incident and the current incident was
confirmed to have happened on or after anchor date and there are any previously reported
incidents for which a date was not that were confirmed to have happened on or after anchor
date, go to S_04DD2.
Else, go to S_04BOX3.

IF (DATE PROVIDED IN S_04C IS WITHIN THE PAST 12 MONTHS AND (S_04C MATCHES A DATE
PROVIDED IN S_01D OR S_02C OR S_03D)) OR (S_04C = -9 AND S_04C1 = 2 AND ((S_01D =
-9 AND S_01D1 = 2 FOR ANY INCIDENT IN S_01D) OR (S_02C = -9 AND S_02C1 = 2 FOR ANY
INCIDENT IN S_02C) OR (S_03D = -9 AND S_03D1 = 2 FOR ANY INCIDENT IN S_03D))), GO
TO S_04DD2.
ELSE, GO TO S_04BOX3.

Question ID:

S_04DD2

Is this incident part of any other incident you have already mentioned?
1

Yes

GO TO S_04DD3

2

No

GO TO S_04BOX3

ASK Description: Respondents who reported a break-in or attempted break-in in the past 12
months and the MONTH/YEAR of the current incident matches the MONTH/YEAR of any
previously reported incidents, or no date was provided for the current incident and the current
incident was confirmed to have happened on or after anchor date and there are any previously
reported incidents for which a date was not that were confirmed to have happened on or after
anchor date.
ASK Specification: IF (DATE PROVIDED IN S_04C IS WITHIN THE PAST 12 MONTHS AND
(S_04C MATCHES A DATE PROVIDED IN S_01D OR S_02C OR S_03D)) OR (S_04C = -9 AND
S_04C1 = 2 AND ((S_01D = -9 AND S_01D1 = 2 FOR ANY INCIDENT IN S_01D) OR (S_02C = 9 AND S_02C1 = 2 FOR ANY INCIDENT IN S_02C) OR (S_03D = -9 AND S_03D1 = 2 FOR ANY
INCIDENT IN S_03D))).

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Question ID:

S_04DD3

Which incident was this part of?
0

{Incident 1}

1

{Incident 2}

2

{Incident 3}

3

{Incident 4}

4

{Incident 5}

5

{Incident 6}

6

{Incident 7}

7

{Incident 8}

8

{Incident 9}

9

{Incident 10}

10

{Incident 11}

11

{Incident 12}

-8

This is a separate incident

ASK Description: Respondents who reported a break-in or attempted break-in that was part of
another incident.
ASK Specification: IF S_04DD2 = 1.
Box ID:

S_04BOX3

If (DATE PROVIDED IN S_04C IS WITHIN THE PAST 12 MONTHS OR S_04C1 = 2) AND
S_04DD3 = 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, set S_BI for the incident selected in S_04DD3.
Else, if DATE PROVIDED IN S_04C IS WITHIN THE PAST 12 MONTHS OR S_04C1 = 2 AND
(S_04DD2 != 1 OR S_04DD3 = -8, -9), set S_BI = 1.
ROUTING INSTRUCTIONS: If SVERSION = 1 AND (S_04DD2 != 1 OR S_04DD3 = -8, -9), go to
S_04E.
Else, go to S_04BOX5.

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Question ID:

S_04E

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/S_04C: MONTH, YEAR} incident when someone broke in or tried to break in, was
anything stolen as part of this incident?
1

Yes

2

No

ASK Description: Respondents who reported a break-in or attempted break-in in the past 12
months or did not know how many times this incident happened in the past 12 months.
ASK Specification: IF SVERSION = 1 AND (S_04A1 = 1 OR S_04A2 = 1 OR S_04A3 = 1) AND
(S_04B1 = 1 OR (S_04B1 = 2 AND S_04B1_NUM >= 1) OR S_04B1A = 2, -9) AND (DATE
PROVIDED IN S_04C IS WITHIN THE PAST 12 MONTHS OR S_04C1 = 2) AND (S_04DD2 != 1
OR S_04DD3 = -8, -9).
PROGRAM: If S_04E = 1, set S_T = 1.
Question ID:

S_04F

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/S_04C: MONTH, YEAR} incident when someone broke in or tried to break in, were you
physically attacked, or threatened with a weapon, during this incident?
1

Yes

GO TO S_04G

2

No

GO TO S_04BOX5

ASK Description: Respondents who reported a break-in or attempted break-in in the past 12
months or did not know how many times this incident happened in the past 12 months.
ASK Specification: IF SVERSION = 1 AND (S_04A1 = 1 OR S_04A2 = 1 OR S_04A3 = 1) AND
(S_04B1 = 1 OR (S_04B1 = 2 AND S_04B1_NUM >= 1) OR S_04B1A = 2, -9) AND (DATE
PROVIDED IN S_04C IS WITHIN THE PAST 12 MONTHS OR S_04C1 = 2) AND (S_04DD2 != 1
OR S_04DD3 = -8, -9).
PROGRAM: If S_04F = 1, set S_ATA = 1.

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Question ID:

S_04G

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/S_04C: MONTH, YEAR} incident when someone broke in or tried to break in, did anyone
have, or try to have, sexual contact with you that you DID NOT CONSENT TO and that YOU DID
NOT WANT to happen as part of this incident?
1

Yes

2

No

ASK Description: Respondents who reported a break-in or attempted break-in in the past 12
months or did not know how many times this incident happened in the past 12 months and were
physically attacked, or threatened with a weapon, during this incident.
ASK Specification: IF SVERSION = 1 AND (S_04A1 = 1 OR S_04A2 = 1 OR S_04A3 = 1) AND
(S_04B1 = 1 OR (S_04B1 = 2 AND S_04B1_NUM >= 1) OR S_04B1A = 2, -9) AND (DATE
PROVIDED IN S_04C IS WITHIN THE PAST 12 MONTHS OR S_04C1 = 2) AND (S_04DD2 != 1
OR S_04DD3 = -8, -9) AND S_04F = 1.
PROGRAM: If S_04G = 1, set S_SA = 1.
Box ID:

S_04BOX5

If data has been collected for the four most recent dates in S_04C where N = S_04B1_NUM, go
to S_05.
Else, go to S_04C for incident (N+1).

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Vandalism
Question ID:

S_05A1

Vandalism is when someone deliberately damages or destroys something belonging to you.
Examples are breaking windows, slashing tires, or painting graffiti on walls. In the past 12
months, has anyone vandalized your home, car, or something else that belongs to you or
someone else living here?
1

Yes

2

No

ASK Description: All household respondents.
ASK Specification: IF UT_HHR = 1.
Question ID:

S_05A2

In the past 12 months, did someone deliberately injure or kill an animal, such as a pet or
livestock, that belonged to you or someone you live with?
1

Yes

2

No

ASK Description: All household respondents.
ASK Specification: IF UT_HHR = 1.
PROGRAM: ROUTING INSTRUCTIONS: If S_05A1 = 1 or S_05A2 = 1, go to S_05B1.
Else, go to S_06A.
Question ID:

S_05B1

In the past 12 months, how many times did someone vandalize something that belonged to you
or someone you live with?
{Please also count times when an animal was injured or killed.}
1

Once

2

Two or more times {How many times: |_ _|}

ASK Description: Respondents who had their home, car, or something else vandalized or had an
animal deliberately injured or killed in the past 12 months.
ASK Specification: IF S_05A1 = 1 OR S_05A2 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If S_05B1 = -9 OR (S_05B1 = 2 AND S_05B1_NUM = 9), go to S_05B1A.
Else, if S_05B1 = 2 and S_05B1_NUM = 2, 3, go to S_05C_INTRO.
Else, if S_05B1 = 2 and S_05B1_NUM >= 4, go to S_05B2.
Else, if S_05B1 = 1 or (S_05B1 = 2 and S_05B1_NUM = 1), go to S_05BOX1.

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Question ID:

S_05B1A

You did not enter how many times this happened in the past 12 months. Please select one of the
following.
1

I really meant to answer

2

I don't know the answer

ASK Description: Respondents who had their home, car, or something else vandalized or had an
animal deliberately injured or killed in the past 12 months and did not enter how many times
this happened in the past 12 months.
ASK Specification: IF (S_05A1 = 1 OR S_05A2 = 1) AND (S_05B1 = -9 OR (S_05B1 = 2 AND
S_05B1_NUM = -9)).
PROGRAM: If S_05B1A = 2, -9, set S_V = 1 and create 1 CIR.
ROUTING INSTRUCTIONS: If S_05B1A = 1, go to S_05B1.
Else, go to S_05BOX1.
Question ID:

S_05B2

Do you recall enough details about each incident to be able to distinguish them from each other?
1

Yes

2

No

ASK Description: Respondents who had their home, car, or something else vandalized or had an
animal deliberately injured or killed four or more times in the past 12 months.
ASK Specification: IF S_05B1 = 2 AND S_05B1_NUM >= 4.
PROGRAM: If S_05B2 = 2, set SERIES = 1.
ROUTING INSTRUCTIONS: If S_05B2 = 2, go to S_05BOX1.
Else, go to S_05C_INTRO.
Question ID:

S_05C_INTRO

{I will ask/On the next screens, you are going to be asked} about {each of these/the four most
recent} incidents, starting with the most recent{ time this happened. Please click NEXT to
continue.}
ASK Description: Respondents who had their home, car, or something else vandalized or had an
animal deliberately injured or killed more than once within the last 12 months.
ASK Specification: IF (S_05B1 = 2 AND S_05B1_NUM = 2, 3) OR (S_05B1 = 2 AND
S_05B1_NUM >= 4 AND S_05B2 = 1).
Box ID:

S_05BOX1

If S_05B1 = 2 and (S_05B1_NUM = 2, 3 or (S_05B1_NUM >= 4 and S_05B2 = 1), repeat
S_05C through S_05G for up to four most recent dates in S_05C where N = S_05B1_NUM. Ask
all items from S_05C through S_05G (as appropriate) for most recent incident, then move to
next most recent incident, and so on.
Else, if S_05B1 = 1 or (S_05B1 = 2 and (S_05B1_NUM = 1 or (S_05B1_NUM >= 4 and S_05B2
= 2))) or S_05B1A = 2, -9, ask only about most recent incident in S_05C.

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Question ID:

S_05C

{You said that {something was vandalized}{ and}{ someone deliberately injured or killed an
animal} {FILL ANSWER FROM S_05B1 times} in the past 12 months.} In what month did the
{MOST RECENT/SECOND MOST RECENT/THIRD MOST RECENT/FOURTH MOST RECENT}
incident happen? If you don't remember the exact month, please give your best estimate.
1

Before {CURRENT MONTH MINUS 12}

2

{CURRENT MONTH MINUS 12}

3

{CURRENT MONTH MINUS 11}

4

{CURRENT MONTH MINUS 10}

5

{CURRENT MONTH MINUS 9}

6

{CURRENT MONTH MINUS 8}

7

{CURRENT MONTH MINUS 7}

8

{CURRENT MONTH MINUS 6}

9

{CURRENT MONTH MINUS 5}

10

{CURRENT MONTH MINUS 4}

11

{CURRENT MONTH MINUS 3}

12

{CURRENT MONTH MINUS 2}

13

{CURRENT MONTH MINUS 1}

14

{CURRENT MONTH}

ASK Description: Respondents who had their home, car, or something else vandalized or had an
animal deliberately injured or killed in the past 12 months or did not know how many times this
incident happened in the past 12 months.
ASK Specification: IF (S_05A1 = 1 OR S_05A2 = 1) AND (S_05B1 = 1 OR (S_05B1 = 2 AND
S_05B1_NUM >= 1) OR S_05B1A = 2, -9).
PROGRAM: ROUTING INSTRUCTIONS: If DATE PROVIDED IN S_05C IS CURRENT MONTH MINUS
12 OR S_05C = -9, go to S_05C1.
Else, if DATE PROVIDED IN S_05C IS CURRENT MONTH MINUS 6, go to S_05C2.
Else, if DATE PROVIDED IN S_05C IS BEFORE CURRENT MONTH MINUS 12, go to S_06.
Else, go to S_05BOX2B.

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Question ID:

S_05C1

Did this incident happen before, after, or on {12-MO ANCHORDATE}?
1

It happened before {12-MO ANCHORDATE}

2

It happened after or on {12-MO ANCHORDATE}

3

I don't know when it happened / can't remember

ASK Description: Respondents who had something vandalized or had an animal deliberately
injured or killed 12 months ago or did not report the month and year of the incident.
ASK Specification: IF DATE PROVIDED IN S_05C IS CURRENT MONTH MINUS 12 OR S_05C = 9.
PROGRAM: ROUTING INSTRUCTIONS: If S_05C = -9 and S_05C1 = 2, go to S_05C2.
Else, if DATE PROVIDED IN S_05C IS CURRENT MONTH MINUS 12 and S_05C1 = 2, go to
S_05BOX2B.
Else, if S_05C1 = 3, -9, go to S_05BOX5.
Else, go to S_06.
Question ID:

S_05C2

Did this incident happen before, after, or on {6-MO ANCHORDATE}?
1

It happened before {6-MO ANCHORDATE}

2

It happened after or on {6-MO ANCHORDATE}

3

I don't know

ASK Description: Respondents who had something vandalized or had an animal deliberately
injured or killed six months ago or did not report the month and year of the incident and
confirmed it happened in the past 12 months.
ASK Specification: IF DATE PROVIDED IN S_05C IS CURRENT MONTH MINUS 6 OR (S_05C = -9
AND S_05C1 = 2).
PROGRAM: ROUTING INSTRUCTIONS: If S_05C = -9 AND S_05C1 = 2 AND S_05C2 = 3, -9, go
to S_05BOX5.
Else, go to S_05BOX2B.

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Box ID:

S_05BOX2B

Respondents who had their home, car, or something else vandalized or had an animal
deliberately injured or killed in the past 12 months and the MONTH/YEAR of the current incident
matches the MONTH/YEAR of any previously reported incidents, or no date was provided for the
current incident and the current incident was confirmed to have happened on or after anchor
date and there are any previously reported incidents for which a date was not collected that
were confirmed to have happened on or after anchor date, go to S_05DD2.
Else, go to S_05BOX3.

IF (DATE PROVIDED IN S_05C IS WITHIN THE PAST 12 MONTHS AND (S_05C MATCHES A DATE
PROVIDED IN S_01D OR S_02C OR S_03D OR S_04C)) OR (S_05C = -9 AND S_05C1 = 2 AND
((S_01D = -9 AND S_01D1 = 2 FOR ANY INCIDENT IN S_01D) OR (S_02C = -9 AND S_02C1 =
2 FOR ANY INCIDENT IN S_02C) OR (S_03D = -9 AND S_03D1 = 2 FOR ANY INCIDENT IN
S_03D) OR (S_04C = -9 AND S_04C1 = 2 FOR ANY INCIDENT IN S_04C)), GO TO S_05DD2.
ELSE, GO TO S_05BOX3.

Question ID:

S_05DD2

Is this incident part of any other incident you have already mentioned?
1

Yes

GO TO S_05DD3

2

No

GO TO S_05BOX3

ASK Description: Respondents who had their home, car, or something else vandalized or had an
animal deliberately injured or killed in the past 12 months and the MONTH/YEAR of the current
incident matches the MONTH/YEAR of any previously reported incidents, or no date was
provided for the current incident and the current incident was confirmed to have happened on or
after anchor date and there are any previously reported incidents for which a date was not
collected that were confirmed to have happened on or after anchor date.
ASK Specification: IF (DATE PROVIDED IN S_05C IS WITHIN THE PAST 12 MONTHS AND S_05C
MATCHES A DATE PROVIDED IN S_01D OR S_02C OR S_03D OR S_04C) OR (S_05C = -9 AND
S_05C1 = 2 AND ((S_01D = -9 AND S_01D1 = 2 FOR ANY INCIDENT IN S_01D) OR (S_02C = 9 AND S_02C1 = 2 FOR ANY INCIDENT IN S_02C) OR (S_03D = -9 AND S_03D1 = 2 FOR ANY
INCIDENT IN S_03D) OR (S_04C = -9 AND S_04C1 = 2 FOR ANY INCIDENT IN S_04C))).

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Question ID:

S_05DD3

Which incident was this part of?
0

{Incident 1}

1

{Incident 2}

2

{Incident 3}

3

{Incident 4}

4

{Incident 5}

5

{Incident 6}

6

{Incident 7}

7

{Incident 8}

8

{Incident 9}

9

{Incident 10}

10

{Incident 11}

11

{Incident 12}

12

{Incident 13}

13

{Incident 14}

14

{Incident 15}

15

{Incident 16}

-8

This is a separate incident

ASK Description: Respondents who had something vandalized or had an animal deliberately
injured or killed that was part of another incident.
ASK Specification: IF S_05DD2 = 1.
Box ID:

S_05BOX3

IF (DATE PROVIDED IN S_05C IS WITHIN THE PAST 12 MONTHS OR S_05C1 = 2) AND
S_05DD3 = 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, set S_V = 1 for the incident
selected in S_05DD3.
Else, if (DATE PROVIDED IN S_05C IS WITHIN THE PAST 12 MONTHS OR S_05C1 = 2) AND
(S_05DD2 != 1 OR S_05DD3 = -8, -9), set S_V = 1.
ROUTING INSTRUCTIONS: If SVERSION = 1 AND (S_05DD2 != 1 OR S_05DD3 = -8, -9), go to
S_05E.
Else, go to S_05BOX5.

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Question ID:

S_05E

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/S_05C: MONTH, YEAR} incident when {something was vandalized}{ or}{ someone
deliberately injured or killed an animal}, was anything stolen as part of the incident?
1

Yes

2

No

ASK Description: Respondents who had something vandalized or had an animal deliberately
injured or killed in the past 12 months or did not know how many times this incident happened
in the past 12 months.
ASK Specification: IF SVERSION = 1 AND (S_05A1 = 1 OR S_05A2 = 1) AND (S_05B1 = 1 OR
(S_05B1 = 2 AND S_05B1_NUM >= 1) OR S_05B1A = 2, -9) AND (DATE PROVIDED IN S_05C
IS WITHIN THE PAST 12 MONTHS OR S_05C1 = 2) AND (S_05DD2 != 1 OR S_05DD3 = -8, -9).
PROGRAM: If S_05E = 1, set S_T = 1.
Question ID:

S_05F

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/S_05C: MONTH, YEAR} incident when {something was vandalized}{ or}{ someone
deliberately injured or killed an animal}, were you physically attacked, or threatened with a
weapon, during this incident?
1

Yes

GO TO S_05G

2

No

GO TO S_05BOX5

ASK Description: Respondents who had something vandalized or had an animal deliberately
injured or killed in the past 12 months or did not know how many times this incident happened
in the past 12 months.
ASK Specification: IF SVERSION = 1 AND (S_05A1 = 1 OR S_05A2 = 1) AND (S_05B1 = 1 OR
(S_05B1 = 2 AND S_05B1_NUM >= 1) OR S_05B1A = 2, -9) AND (DATE PROVIDED IN S_05C
IS WITHIN THE PAST 12 MONTHS OR S_05C1 = 2) AND (S_05DD2 != 1 OR S_05DD3 = -8, -9).
PROGRAM: If S_05F = 1, set S_ATA = 1.

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Question ID:

S_05G

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/S_05C: MONTH, YEAR} incident when {something was vandalized}{ or}{ someone
deliberately injured or killed an animal}, did anyone have, or try to have, sexual contact with
you that you DID NOT CONSENT TO and that YOU DID NOT WANT to happen as part of this
incident?
1

Yes

2

No

ASK Description: Respondents who had something vandalized or had an animal deliberately
injured or killed in the past 12 months or did not know how many times this incident happened
in the past 12 months and were physically attacked, or threatened with a weapon, during this
incident.
ASK Specification: IF SVERSION = 1 AND (S_05A1 = 1 OR S_05A2 = 1) AND (S_05B1 = 1 OR
(S_05B1 = 2 AND S_05B1_NUM >= 1) OR S_05B1A = 2, -9) AND (DATE PROVIDED IN S_05C
IS WITHIN THE PAST 12 MONTHS OR S_05C1 = 2) AND (S_05DD2 != 1 OR S_05DD3 = -8, -9)
AND S_05F = 1.
PROGRAM: If S_05G = 1, set S_SA = 1.
Box ID:

S_05BOX5

If data has been collected for the four most recent dates in S_05C where N = S_05B1_NUM, go
to S_06.
Else, go to S_05C for incident (N+1).

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Attack
Box ID:

S_06

For S_06A1 through S_06A5, display ‘Yes' and ‘No' columns with options for each response
category.
Question ID:

S_06A

The next few questions ask about any physical attacks against you personally. These may have
happened at your home or while you were{ at work,} at school, or away from home.
{Other than the attacks or threatened attacks you have already mentioned, in/In} the past 12
months, did anyone attack or try to attack you…
1

With a weapon, such as a gun or knife

2

With something else used as a weapon, like a
baseball bat, scissors, or a stick?

3

By throwing something at you, such as a rock or
bottle?

4

By hitting, slapping, grabbing, kicking, punching,
or choking you?

5

In the past 12 months, did anyone attack or try to
attack you or use force against you in any other
way? Please mention it even if you are not certain
it was a crime.

ASK Description: All respondents.
Question ID:

S_06A6

In the past 12 months, did anyone THREATEN to attack you, but not actually do it? {Do not
include incidents you have already mentioned.}
1

Yes

2

No

ASK Description: All respondents.

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Question ID:

S_06A8

People sometimes don't think of attacks by someone they know, like {a current or former
spouse or partner/a boyfriend or girlfriend}, someone {at work or at school/at school}, a friend,
a family member, a neighbor, or any other person you've met or known.
{Other than what you have already mentioned,} In the past 12 months, has anyone you know
used any kind of physical force against you? Examples are if someone you know choked you,
slapped you, hit you, attacked you with a weapon, or otherwise physically hurt you.
1

Yes

2

No

ASK Description: All respondents.
Box ID:

S_06BOX2

If S_06A1 = 1 or S_06A2 = 1 or S_06A3 = 1 or S_06A4 = 1 or S_06A5 = 1 or S_06A6 = 1 or
S_06A8 = 1, go to S_06B1.
Else, go to S_07.
Question ID:

S_06B1

{You just said yes to more than one of these questions about physical attacks. Altogether,} In
the past 12 months, how many times did someone {attack you or try to attack you}{ or}{
threaten to attack you}?
1

Once

2

Two or more times {How many times: |_ _|}

ASK Description: Respondents who reported they were attacked or someone tried to attack
them or were threatened with attack in the past 12 months.
ASK Specification: IF S_06A1 = 1 OR S_06A2 = 1 OR S_06A3 = 1 OR S_06A4 = 1 OR S_06A5
= 1 OR S_06A6 = 1 OR S_06A8 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If S_06B1 = -9 OR (S_06B1 = 2 AND S_06B1_NUM = 9), go to S_06B1A.
Else, if S_06B1 = 2 and S_06B1_NUM >= 4, go to S_06B2.
Else, if S_06B1 = 2 and S_06B1_NUM = 2, 3, go to S_06C_INTRO.
Else, if S_06B1 = 1 or (S_06B1 = 2 and S_06B1_NUM = 1), go to S_06C.

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Question ID:

S_06B1A

You did not enter how many times this happened in the past 12 months. Please select one of the
following.
1

I really meant to answer

2

I don't know the answer

ASK Description: Respondents who reported they were attacked or someone tried to attack
them or were threatened with attack in the past 12 months and did not enter how many times
this happened the past 12 months.
ASK Specification: IF (S_06A1 = 1 OR S_06A2 = 1 OR S_06A3 = 1 OR S_06A4 = 1 OR S_06A5
= 1 OR S_06A6 = 1 OR S_06A8 = 1) AND (S_06B1 = -9 OR (S_06B1 = 2 AND S_06B1_NUM =
-9)).
PROGRAM: If (S_06A1 = 1 OR S_06A2 = 1 OR S_06A3 = 1 OR S_06A4 = 1 OR S_06A5 = 1 OR
S_06A8 = 1) AND S_06B1A = 2, -9, set S_A = 1 and create 1 CIR.
ROUTING INSTRUCTIONS: If S_06B1A = 1, go to S_06B1.
Else, go to S_06BOX3.
Question ID:

S_06B2

Do you recall enough details about each incident to be able to distinguish them from each other?
1

Yes

2

No

ASK Description: Respondents who were attacked or someone tried to attack or were
threatened with attack four or more times in the past 12 months.
ASK Specification: IF S_06B1 = 2 AND S_06B1_NUM >= 4.
PROGRAM: If S_06B2 = 2, set SERIES = 1.
ROUTING INSTRUCTIONS: If S_06B2 = 2, go to S_06C.
Else, go to S_06C_INTRO.
Question ID:

S_06C_INTRO

{I will ask/On the next screens, you are going to be asked} about {each of these/the four most
recent} incidents, starting with the most recent{ time this happened. Please click NEXT to
continue.}
ASK Description: Respondents who were attacked or someone tried to attack or were
threatened with attack more than once in the past 12 months.
ASK Specification: IF (S_06B1 = 2 and S_06B1_NUM = 2, 3) OR (S_06B1 = 2 AND
S_06B1_NUM >= 4 AND S_06B2 = 1).

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Box ID:

S_06BOX3

If S_06B1 = 2 and (S_06B1_NUM = 2, 3 or (S_06B1_NUM >= 4 and S_06B2 = 1), repeat
S_06C through S_06F for up to four most recent dates in S_06C where N = S_06B1_NUM. Ask
all items from S_06C through S_06F (as appropriate) for most recent incident, then move to
next most recent incident, and so on.
Else, if S_06B1 = 1 or (S_06B1 = 2 and (S_06B1_NUM = 1 or (S_06B1_NUM >= 4 and S_06B2
= 2))) or S_06B1A = 2, -9, ask only about most recent incident in S_06C.

Question ID:

S_06C

{You said that {someone attacked you or tried to attack you}{ and}{ someone threatened to
attack you} {FILL ANSWER FROM S_06B1 times} in the past 12 months.} When did the {MOST
RECENT/SECOND MOST RECENT/THIRD MOST RECENT/FOURTH MOST RECENT} incident
happen? If you don't remember the exact month, please give your best estimate.
1

Before {CURRENT MONTH MINUS 12}

2

{CURRENT MONTH MINUS 12}

3

{CURRENT MONTH MINUS 11}

4

{CURRENT MONTH MINUS 10}

5

{CURRENT MONTH MINUS 9}

6

{CURRENT MONTH MINUS 8}

7

{CURRENT MONTH MINUS 7}

8

{CURRENT MONTH MINUS 6}

9

{CURRENT MONTH MINUS 5}

10

{CURRENT MONTH MINUS 4}

11

{CURRENT MONTH MINUS 3}

12

{CURRENT MONTH MINUS 2}

13

{CURRENT MONTH MINUS 1}

14

{CURRENT MONTH}

ASK Description: Respondents who were attacked or someone tried to attack or were
threatened with attack in the past 12 months or did not know how many times this incident
happened in the past 12 months.
ASK Specification: IF (S_06A1 = 1 OR S_06A2 = 1 OR S_06A3 = 1 OR S_06A4 = 1 OR S_06A5
= 1 OR S_06A6 = 1 OR S_06A8 = 1) AND (S_06B1 = 1 OR (S_06B1 = 2 AND S_06B1_NUM >=
1) OR S_06B1A = 2, -9).
PROGRAM: ROUTING INSTRUCTIONS: If DATE PROVIDED IN S_06C IS CURRENT MONTH MINUS
12 OR S_06C = -9, go to S_06C1.
Else, if DATE PROVIDED IN S_06C IS CURRENT MONTH MINUS 6, go to S_06C2.
Else, if DATE PROVIDED IN S_06C IS BEFORE CURRENT MONTH MINUS 12, go to S_07.
Else, go to S_06BOX3B.

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Question ID:

S_06C1

Did this incident happen before, after, or on {12-MO ANCHORDATE}?
1

It happened before {12-MO ANCHORDATE}

2

It happened after or on {12-MO ANCHORDATE}

3

I don't know when it happened / can't remember

ASK Description: Respondents who were attacked or someone tried to attack or were
threatened with attack in the past 12 months.
ASK Specification: IF DATE PROVIDED IN S_06C IS CURRENT MONTH MINUS 12 OR S_06C = 9.
PROGRAM: ROUTING INSTRUCTIONS: If S_06C = -9 and S_06C1 = 2, go to S_06C2.
Else, if DATE PROVIDED IN S_06C IS CURRENT MONTH MINUS 12 and S_06C1 = 2, go to
S_06BOX3B.
Else, if S_06C1 = 3, -9, go to S_06BOX5.
Else, go to S_07.
Question ID:

S_06C2

Did this incident happen before, after, or on {6-MO ANCHORDATE}?
1

It happened before {6-MO ANCHORDATE}

2

It happened after or on {6-MO ANCHORDATE}

3

I don't know

ASK Description: Respondents who were attacked or someone tried to attack or were
threatened with attack six months ago or did not report the month and year of the incident and
confirmed it happened in the past 12 months.
ASK Specification: IF DATE PROVIDED IN S_06C IS CURRENT MONTH MINUS 6 OR (S_06C = -9
AND S_06C1 = 2).
PROGRAM: ROUTING INSTRUCTIONS: If S_06C = -9 AND S_06C1 = 2 AND S_06C2 = 3, -9, go
to S_06BOX5.
Else, go to S_06BOX3B.

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Box ID:

S_06BOX3B

Respondents who were attacked or someone tried to attack or were threatened with attack in
the past 12 months and the MONTH/YEAR of the current incident matches the MONTH/YEAR of
any previously reported incidents, or no date was provided for the current incident and the
current incident was confirmed to have happened on or after anchor date and there are any
previously reported incidents for which a date was not collected that were confirmed to have
happened on or after anchor date, go to S_06DD2.
Else, go to S_06BOX3C.

IF (DATE PROVIDED IN S_06C IS WITHIN THE PAST 12 MONTHS AND (S_06C MATCHES A DATE
PROVIDED IN S_01D OR S_02C OR S_03D OR S_04C OR S_05C)) OR S_06C = -9 AND S_06C1
= 2 AND ((S_01D = -9 AND S_01D1 = 2 FOR ANY INCIDENT IN S_01D) OR (S_02C = -9 AND
S_02C1 = 2 FOR ANY INCIDENT IN S_02C) OR (S_03D = -9 AND S_03D1 = 2 FOR ANY
INCIDENT IN S_03D) OR (S_04C = -9 AND S_04C1 = 2 FOR ANY INCIDENT IN S_04C) OR
(S_05C = -9 AND S_05C1 = 2 FOR ANY INCIDENT IN S_05C)), GO TO S_06DD2.
ELSE, GO TO S_06BOX3C.

Question ID:

S_06DD2

Is this incident part of any other incident you have already mentioned?
1

Yes

GO TO S_06DD3

2

No

GO TO S_06BOX3C

ASK Description: Respondents who were attacked or someone tried to attack or were
threatened with attack in the past 12 months and the MONTH/YEAR of the current incident
matches the MONTH/YEAR of any previously reported incidents, or no date was provided for the
current incident and the current incident was confirmed to have happened on or after anchor
date and there are any previously reported incidents for which a date was not collected that
were confirmed to have happened on or after anchor date.
ASK Specification: IF (DATE PROVIDED IN S_06C IS WITHIN THE PAST 12 MONTHS AND S_06C
MATCHES A DATE PROVIDED IN S_01D OR S_02C OR S_03D OR S_04C OR S_05C) OR (S_06C
= -9 AND S_06C1 = 2 AND ((S_01D = -9 AND S_01D1 = 2 FOR ANY INCIDENT IN S_01D) OR
(S_02C = -9 AND S_02C1 = 2 FOR ANY INCIDENT IN S_02C) OR (S_03D = -9 AND S_03D1 = 2
FOR ANY INCIDENT IN S_03D) OR (S_04C = -9 AND S_04C1 = 2 FOR ANY INCIDENT IN S_04C)
OR (S_05C = -9 AND S_05C1 = 2 FOR ANY INCIDENT IN S_05C))).

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Question ID:

S_06DD3

Which incident was this part of?
0

{Incident 1}

1

{Incident 2}

2

{Incident 3}

3

{Incident 4}

4

{Incident 5}

5

{Incident 6}

6

{Incident 7}

7

{Incident 8}

8

{Incident 9}

9

{Incident 10}

10

{Incident 11}

11

{Incident 12}

12

{Incident 13}

13

{Incident 14}

14

{Incident 15}

15

{Incident 16}

16

{Incident 17}

17

{Incident 18}

18

{Incident 19}

19

{Incident 20}

-8

This is a separate incident

ASK Description: Respondents who were attacked or someone tried to attack or were
threatened with attack that was part of another incident.
ASK Specification: IF S_06DD2 = 1.
Box ID:

S_06BOX3C

IF (DATE PROVIDED IN S_06C IS WITHIN THE PAST 12 MONTHS OR S_06C1 = 2) AND
S_06DD3 = 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, set S_ATA = 1 for
the incident selected in S_06DD3.
Else, if (DATE PROVIDED IN S_06C IS WITHIN THE PAST 12 MONTHS OR S_06C1 = 2), set
S_ATA = 1.

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Box ID:

S_06BOX4

Respondents who were attacked or someone tried to attack and were threatened with attack in
the past 12 months, go to S_06D.
Else, respondents who were threatened with attack but not actually attacked or attempted to be
attacked in the past 12 months, go to S_06E.
Else, respondents who were attacked or someone tried to attack or were threatened with attack
face to face in the last 12 months, go to S_06F.
Else, go to S_06BOX5.

IF S_06A6 = 1 AND (S_06A1 = 1 OR S_06A2 = 1 OR S_06A3 = 1 OR S_06A4 = 1 OR S_06A5 =
1) AND (S_06B1 = 1 OR (S_06B1 = 2 AND S_06B1_NUM >= 1)) AND (DATE PROVIDED IN
S_06C IS WITHIN THE PAST 12 MONTHS OR S_06C1 = 2) AND (S_06DD2 != 1 OR S_06DD3 =
-8, -9), GO TO S_06D.
ELSE, IF S_06A6 = 1 AND S_06A1 != 1 AND S_06A2 != 1 AND S_06A3 != 1 AND S_06A4 != 1
AND S_06A5 != 1 AND (S_06B1 = 1 OR (S_06B1 = 2 AND S_06B1_NUM >= 1)) AND (DATE
PROVIDED IN S_06C IS WITHIN THE PAST 12 MONTHS OR S_06C1 = 2) AND (S_06DD2 != 1
OR S_06DD3 = -8, -9), GO TO S_06E.
ELSE, IF SVERSION = 1 AND (S_06A1 = 1 OR S_06A2 = 1 OR S_06A3 = 1 OR S_06A4 = 1 OR
S_06A5 = 1 OR S_06A6 = 1 OR S_06A8 = 1) AND (S_06B1 = 1 OR (S_06B1 = 2 AND
S_06B1_NUM >= 1)) AND (DATE PROVIDED IN S_06C IS WITHIN THE PAST 12 MONTHS OR
S_06C1 = 2) AND (S_06DD2 != 1 OR S_06DD3 = -8, -9), GO TO S_06F.
ELSE, GO TO S_06BOX5.

Question ID:

S_06D

In this {most recent/second most recent/third most recent/fourth most recent} incident, did
someone actually attack or try to attack you, OR did they threaten to attack you?
1

Attacked / Tried to attack

2

Threatened to attack

ASK Description: Respondents who were attacked or someone tried to attack and were
threatened with attack in the past 12 months.
ASK Specification: IF S_06A6 = 1 AND (S_06A1 = 1 OR S_06A2 = 1 OR S_06A3 = 1 OR
S_06A4 = 1 OR S_06A5 = 1) AND (S_06B1 = 1 OR (S_06B1 = 2 AND S_06B1_NUM >= 1))
AND (DATE PROVIDED IN S_06C IS WITHIN THE PAST 12 MONTHS OR S_06C1 = 2) AND
(S_06DD2 != 1 OR S_06DD3 = -8, -9).
PROGRAM: If S_06D = 1, set S_A = 1.
ROUTING INSTRUCTIONS: If S_06D = 2, go to S_06E.
Else, IF SVERSION = 1 AND (S_06A1 = 1 OR S_06A2 = 1 OR S_06A3 = 1 OR S_06A4 = 1 OR
S_06A5 = 1 OR S_06A6 = 1 OR S_06A8 = 1) AND (S_06B1 = 1 OR (S_06B1 = 2 AND
S_06B1_NUM >= 1)) AND (DATE PROVIDED IN S_06C IS WITHIN THE PAST 12 MONTHS OR
S_06C1 = 2) AND (S_06DD2 != 1 OR S_06DD3 = -8, -9), go to S_06F.
Else, go to S_06BOX5.

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Question ID:

S_06E

How were you threatened? (Mark all that apply.)
1

Face to face

2

By phone or text

3

Online (email or social media)

4

Some other way Specify: ______

ASK Description: Respondents who were threatened with attack but not actually attacked or
attempted to be attacked in the past 12 months or did not know how many times this incident
happened in the past 12 months.
ASK Specification: IF ((S_06A6 = 1 AND (S_06A1 != 1 AND S_06A2 != 1 AND S_06A3 != 1
AND S_06A4 != 1 AND S_06A5 != 1)) OR S_06D = 2) AND (S_06B1 = 1 OR (S_06B1 = 2 AND
S_06B1_NUM >= 1) OR S_06B1A = 2, -9) AND (DATE PROVIDED IN S_06C IS WITHIN THE
PAST 12 MONTHS OR S_06C1 = 2) AND (S_06DD2 != 1 OR S_06DD3 = -8, -9).
PROGRAM: Display text box and allow 250 character text response.
If S_06E = 1, set S_TA = 1.
ROUTING INSTRUCTIONS: If SVERSION = 1 AND S_06E = 1, go to S_06F.
Else, go to S_06BOX5.
Question ID:

S_06F

Still thinking about this {most recent/second most recent/third most recent/fourth most
recent/S_06C: MONTH, YEAR} incident when {someone attacked you or tried to attack you}{
or}{ someone threatened to attack you}, did anyone have, or try to have, sexual contact with
you that you DID NOT CONSENT TO and that YOU DID NOT WANT to happen as part of this
incident?
1

Yes

2

No

ASK Description: Respondents who were attacked or someone tried to attack or were
threatened with attack in the last 12 months or did not know how many times this incident
happened in the past 12 months.
ASK Specification: IF SVERSION = 1 AND (S_06A1 = 1 OR S_06A2 = 1 OR S_06A3 = 1 OR
S_06A4 = 1 OR S_06A5 = 1 OR S_06A6 = 1 OR S_06A8 = 1) AND (S_06B1 = 1 OR (S_06B1 =
2 AND S_06B1_NUM >= 1) OR S_06B1A = 2, -9) AND (DATE PROVIDED IN S_06C IS WITHIN
THE PAST 12 MONTHS OR S_06C1 = 2) AND (S_06DD2 != 1 OR S_06DD3 = -8, -9).
PROGRAM: If S_06F = 1, set S_SA = 1.
Box ID:

S_06BOX5

If data has been collected for the four most recent dates in S_06C where N = S_06B1_NUM, go
to S_07BOX1.
Else, go to S_06C for incident (N+1).

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Unwanted Sexual Contact
Box ID:

S_07BOX1

For S_07A1 through S_07A4, display ‘Yes' and ‘No' columns with options for each response
category.
Question ID:

S_07A

The next questions are about any sexual contact in the past 12 months that you DID NOT
CONSENT TO and that YOU DID NOT WANT to happen. The information you provide is
confidential.
{Sexual contact includes touching of your sexual body parts, or any type of sexual penetration
with a body part or object. It also includes making you touch or penetrate someone else. This
could have been done by someone you knew well, someone you casually knew, or a stranger
and can happen to both men and women./Sexual contact includes someone touching your
private parts, unwanted sex, or making you do these kinds of things to them. This could have
been done by someone you know well, someone you casually know, or a stranger and can
happen to both boys and girls.}
{Other than the unwanted sexual contact you have already mentioned,} in the past 12 months…
1

Did anyone touch, grab, or kiss your {sexual body
parts against your will/private parts when you
didn't want them to} - or TRY to do this?

2

Did anyone force you to have sexual contact by
holding you down with his or her body, pinning
your arms, hitting or kicking you, or using some
other type of force - or TRY to do this?

3

Did anyone threaten to physically hurt you or
someone close to you if you did not have sexual
contact?

4

Did anyone have sexual contact with you - or try
to have sexual contact with you - while you were
passed out, unconscious, asleep, or unable to
consent because you were drunk or high?

ASK Description: All respondents.
PROGRAM: ROUTING INSTRUCTIONS: If S_07A1 = 1 or S_07A2 = 1 or S_07A3 = 1 or S_07A4
= 1, go to S_07B1.
Else, go to S_08.

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Question ID:

S_07B1

In the past 12 months, how many times did someone have or try to have these types of sexual
contact with you?
1

Once

2

Two or more times {How many times: |_ _|}

ASK Description: Respondents who had unwanted sexual contact in the past 12 months.
ASK Specification: IF S_07A1 = 1 OR S_07A2 = 1 OR S_07A3 = 1 OR S_07A4 = 1 OR S_07Y1
= 1 OR S_07Y2 = 1 OR S_07Y3 = 1 OR S_07Y4 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If S_07B1 = -9 OR (S_07B1 = 2 AND S_07B1_NUM = 9), go to S_07B1A.
Else, if S_07B1 = 2 and S_07B1_NUM >= 4, go to S_07B2.
Else, if S_07B1 = 2 and S_07B1_NUM = 2, 3, go to S_07C_INTRO.
Else, if S_07B1 = 1 or (S_07B1 = 2 and S_07B1_NUM = 1), go to S_07C.
Question ID:

S_07B1A

You did not enter how many times this happened in the past 12 months. Please select one of the
following.
1

I really meant to answer

2

I don't know the answer

ASK Description: Respondents who had unwanted sexual contact in the past 12 months and did
not enter how many times this happened the past 12 months.
ASK Specification: IF (S_07A1 = 1 OR S_07A2 = 1 OR S_07A3 = 1 OR S_07A4 = 1 OR S_07Y1
= 1 OR S_07Y2 = 1 OR S_07Y3 = 1 OR S_07Y4 = 1) AND (S_07B1 = -9 OR (S_07B1 = 2 AND
S_07B1_NUM = -9)).
PROGRAM: If S_07B1A = 2, -9, set S_SA = 1 and create 1 CIR.
ROUTING INSTRUCTIONS: If S_07B1A = 1, go to S_07B1.
Else, go to S_07BOX3.
Question ID:

S_07B2

Do you recall enough details about each incident to be able to distinguish them from each other?
1

Yes

2

No

ASK Description: Respondents who had unwanted sexual contact four or more times in the past
12 months.
ASK Specification: IF S_07B1 = 2 AND S_07B1_NUM >= 4.
PROGRAM: If S_07B2 = 2, set SERIES = 1.
ROUTING INSTRUCTIONS: If S_07B2 = 2, go to S_07C.
Else, go to S_07C_INTRO.

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Question ID:

S_07C_INTRO

{I will ask/On the next screens, you are going to be asked} about {each of these/the four most
recent} incidents, starting with the most recent{ time this happened. Please click NEXT to
continue.}
ASK Description: Respondents who had unwanted sexual contact more than once in the past 12
months.
ASK Specification: IF (S_07B1 = 2 AND S_07B1_NUM = 2, 3) OR (S_07B1 = 2 AND
S_07B1_NUM >= 4 AND S_07B2 = 1).
Box ID:

S_07BOX3

If S_07B1 = 2 and (S_07B1_NUM = 2, 3 or (S_07B1_NUM >= 4 and S_07B2 = 1)), repeat
S_07C through S_07DD2 for up to four most recent dates in S_07C where N = S_07B1_NUM.
Ask all items from S_07C through S_07DD2 (as appropriate) for most recent incident, then
move to next most recent incident, and so on.
Else, if S_06B1 = 1 or (S_06B1 = 2 and (S_06B1_NUM = 1 or (S_06B1_NUM >= 4 and S_07B2
= 2))) or S_06B1A = 2, -9, ask only about most recent incident in S_07C.

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Question ID:

S_07C

{You said that someone had, or tried to have these types of sexual contact with you {FILL
ANSWER FROM S_07B1 times} in the past 12 months.} In what month did the {MOST
RECENT/SECOND MOST RECENT/THIRD MOST RECENT/FOURTH MOST RECENT} incident
happen? If you don't remember the exact month, please give your best estimate.
1

Before {CURRENT MONTH MINUS 12}

2

{CURRENT MONTH MINUS 12}

3

{CURRENT MONTH MINUS 11}

4

{CURRENT MONTH MINUS 10}

5

{CURRENT MONTH MINUS 9}

6

{CURRENT MONTH MINUS 8}

7

{CURRENT MONTH MINUS 7}

8

{CURRENT MONTH MINUS 6}

9

{CURRENT MONTH MINUS 5}

10

{CURRENT MONTH MINUS 4}

11

{CURRENT MONTH MINUS 3}

12

{CURRENT MONTH MINUS 2}

13

{CURRENT MONTH MINUS 1}

14

{CURRENT MONTH}

ASK Description: Respondents who had unwanted sexual contact in the past 12 months or did
not know how many times this incident happened in the past 12 months.
ASK Specification: IF (S_07A1 = 1 OR S_07A2 = 1 OR S_07A3 = 1 OR S_07A4 = 1 OR S_07Y1
= 1 OR S_07Y2 = 1 OR S_07Y3 = 1 OR S_07Y4 = 1) AND (S_07B1 = 1 OR (S_07B1 = 2 AND
S_07B1_NUM >= 1) OR S_07B1A = 2, -9).
PROGRAM: ROUTING INSTRUCTIONS: If DATE PROVIDED IN S_07C IS CURRENT MONTH MINUS
12 OR S_07C = -9, go to S_07C1.
Else, if DATE PROVIDED IN S_07C IS CURRENT MONTH MINUS 6, go to S_07C2.
Else, if DATE PROVIDED IN S_07C IS BEFORE CURRENT MONTH MINUS 12, go to S_08.
Else, go to S_07BOX3B.

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Question ID:

S_07C1

Did this incident happen before, after, or on {12-MO ANCHORDATE}?
1

It happened before {12-MO ANCHORDATE}

2

It happened after or on {12-MO ANCHORDATE}

3

I don't know when it happened / can't remember

ASK Description: Respondents who had unwanted sexual contact 12 months ago or did not
report when they had unwanted sexual contact.
ASK Specification: IF DATE PROVIDED IN S_07C IS CURRENT MONTH MINUS 12 OR S_07C = 9.
PROGRAM: ROUTING INSTRUCTIONS: If S_07C = -9 and S_07C1 = 2, go to S_07C2.
Else, if DATE PROVIDED IN S_07C IS CURRENT MONTH MINUS 12 and S_07C1 = 2, go to
S_07BOX3B.
Else, if S_07C1 = 3, -9, go to S_07BOX4.
Else, go to S_08.
Question ID:

S_07C2

Did this incident happen before, after, or on {6-MO ANCHORDATE}?
1

It happened before {6-MO ANCHORDATE}

2

It happened after or on {6-MO ANCHORDATE}

3

I don't know

ASK Description: Respondents who had unwanted sexual contact six months ago or did not
report the month and year of the incident and confirmed it happened in the past 12 months.
ASK Specification: IF DATE PROVIDED IN S_07C IS CURRENT MONTH MINUS 6 OR (S_07C = -9
AND S_07C1 = 2).
PROGRAM: ROUTING INSTRUCTIONS: If S_07C = -9 AND S_07C1 = 2 AND S_07C2 = 3, -9, go
to S_07BOX4.
Else, go to S_07BOX3B.

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Box ID:

S_07BOX3B

Respondents who had unwanted sexual contact in the past 12 months and the MONTH/YEAR of
the current incident matches the MONTH/YEAR of any previously reported incidents, or no date
was provided for the current incident and the current incident was confirmed to have happened
on or after anchor date and there are any previously reported incidents for which a date was not
collected that were confirmed to have happened on or after anchor date, go to S_07DD2.
Else, go to S_07BOX4.

IF (DATE PROVIDED IN S_07C IS WITHIN THE PAST 12 MONTHS AND (S_07C MATCHES A DATE
PROVIDED IN S_01D OR S_02C OR S_03D OR S_04C OR S_05C OR S_06C)) OR (S_07C = -9
AND S_07C1 = 2 AND ((S_01D = -9 AND S_01D1 = 2 FOR ANY INCIDENT IN S_01D) OR
(S_02C = -9 AND S_02C1 = 2 FOR ANY INCIDENT IN S_02C) OR (S_03D = -9 AND S_03D1 = 2
FOR ANY INCIDENT IN S_03D) OR (S_04C = -9 AND S_04C1 = 2 FOR ANY INCIDENT IN S_04C)
OR (S_05C = -9 AND S_05C1 = 2 FOR ANY INCIDENT IN S_05C) OR (S_06C = -9 AND S_06C1
= 2 FOR ANY INCIDENT IN S_06C))), GO TO S_07DD2.
ELSE, GO TO S_07BOX4.

Question ID:

S_07DD2

Is this incident part of any other incident you have already mentioned?
1

Yes

GO TO S_07DD3

2

No

GO TO S_07BOX4

ASK Description: Respondents who had unwanted sexual contact in the past 12 months and the
MONTH/YEAR of the current incident matches the MONTH/YEAR of any previously reported
incidents, or no date was provided for the current incident and the current incident was
confirmed to have happened on or after anchor date and there are any previously reported
incidents for which a date was not collected that were confirmed to have happened on or after
anchor date.
ASK Specification: IF (DATE PROVIDED IN S_07C IS WITHIN THE PAST 12 MONTHS AND
(S_07C MATCHES A DATE PROVIDED IN S_01D OR S_02C OR S_03D OR S_04C OR S_05C OR
S_06C)) OR (S_07C = -9 AND S_07C1 = 2 AND ((S_01D = -9 AND S_01D1 = 2 FOR ANY
INCIDENT IN S_01D) OR (S_02C = -9 AND S_02C1 = 2 FOR ANY INCIDENT IN S_02C) OR
(S_03D = -9 AND S_03D1 = 2 FOR ANY INCIDENT IN S_03D) OR (S_04C = -9 AND S_04C1 = 2
FOR ANY INCIDENT IN S_04C) OR (S_05C = -9 AND S_05C1 = 2 FOR ANY INCIDENT IN S_05C)
OR (S_06C = -9 AND S_06C1 = 2 FOR ANY INCIDENT IN S_06C))).

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Question ID:

S_07DD3

Which incident was this part of?
0

{Incident 1}

1

{Incident 2}

2

{Incident 3}

3

{Incident 4}

4

{Incident 5}

5

{Incident 6}

6

{Incident 7}

7

{Incident 8}

8

{Incident 9}

9

{Incident 10}

10

{Incident 11}

11

{Incident 12}

12

{Incident 13}

13

{Incident 14}

14

{Incident 15}

15

{Incident 16}

16

{Incident 17}

17

{Incident 18}

18

{Incident 19}

19

{Incident 20}

20

{Incident 21}

21

{Incident 22}

22

{Incident 23}

23

{Incident 24}

-8

This is a separate incident

ASK Description: Respondents who had unwanted sexual contact that was part of another
incident.
ASK Specification: IF S_07DD2 = 1.

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Box ID:

S_07BOX4

IF (DATE PROVIDED IN S_07C IS WITHIN THE PAST 12 MONTHS OR S_07C1 = 2) AND
S_07DD3 = 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23,
set S_SA = 1 for the incident selected in S_07DD3.
ELSE, IF (DATE PROVIDED IN S_07C IS WITHIN THE PAST 12 MONTHS OR S_07C1 = 2) AND
(S_07DD2 != 1 OR S_07DD3 = -8, -9), set S_SA = 1.
If data has been collected for the four most recent dates in S_07C where N = S_07B1_NUM, go
to S_08.
Else, go to S_07C for incident (N+1).

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Catch-All
Question ID:

S_08

To make sure this survey has captured everything that has happened to you, is there anything
else that you might think of as a crime that happened to you, personally, in the past 12 months,
that is, since {DATE 12 MONTHS AGO} that you haven't mentioned? It could be something you
called the police about, or something you didn't consider reporting to the police.
1

Yes

2

No

ASK Description: All respondents.
PROGRAM: ROUTING INSTRUCTIONS: If S_08 = 1, go to S_08a.
Else, go to CIR_START.
Question ID:

S_08a

Please describe what else happened to you since {ANCHOR DATE}.
1

OPEN-ENDED VERBATIM RESPONSE FOR
PURPOSES OF FIELD TEST

ASK Description: Respondents who have another crime to report that has happened to them
within the last 12 months.
ASK Specification: IF S_08 = 1.
PROGRAM: Allow 1000 characters for text response.

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Crime Incident Report (Adults and Youth)
Box ID:

CIR_START

PROGRAMMER NOTE: BEGIN CIR LOOP (CIR_START through NA_BOX3). Prioritize most serious
incident first, then the most recent incident within most serious. If some incidents with dates are
provided and others are missing a date, prioritize those with a date first. CONTINUE LOOPING
THROUGH CIRs UNTIL ALL INCIDENTS HAVE BEEN ASKED ABOUT.
PRIORITIZATION OF SERIOUSNESS
S_SA – Unwanted sexual contact
S_A – Attack
S_ATA – Attack or threatened attack
S_TA – Threatened Attack
S_BI – Break in
S_MV – Motor vehicle theft
S_T – Theft
S_MVP – Motor vehicle part or gas theft
S_V - Vandalism
NOTE: IF S_AT IS THE ONLY FLAG SET FOR AN INCIDENT, ONLY NARRATIVE WILL BE
COLLECTED. AN INCIDENT REPORTED IN S_08A, DOES NOT QUALIFY FOR A CIR.
ROUTING INSTRUCTIONS: If no CIR exists, go to PC9_INTRO. Else, go to IN1.
Display text on each screen in CIR for this incident in bold, including month/year and short text
description of screener item: Display format - Incident: April, 2018 ⇒ { D escrip tion }
Display Description as follows and use comma separators and "or" as needed:
If S_MV = 1, display "Motor vehicle theft or attempted theft".
If S_MVP = 1, display "Motor vehicle parts or gas theft or attempted theft".
If S_ATA = 1 and S_A != 1 and S_TA != 1, display "An attack, attempted attack, or threatened
attack".
If S_A = 1 and S_TA != 1 and S_ATA != 1, display "An attack or attempted attack".
If S_TA = 1 and S_A != 1 and S_ATA != 1, display "Threatened attack".
If S_A = 1 and S_TA = 1 and S_ATA != 1, display "An attack or threatened attack".
If S_T = 1, display "Theft".
If S_AT = 1, display "Attempted theft".
If S_BI = 1, display "Break-in".
If S_V = 1, display "Vandalism".
If S_SA = 1, display "Unwanted sexual contact".

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Question ID:

IN1

The next questions are about the incident in {MONTH/YEAR} that involved: {DESCRIPTION OF
INCIDENT FEATURES BASED ON CRIME FLAGS}
{If you don't recall particular details, or don't want to answer, you can skip any question by
letting me know./The heading at the top of the screen will help remind you of the incident that
the next questions ask about.
If you don't recall particular details, or don't want to answer, you can skip any questions by
clicking the NEXT button.}
ASK Description: All respondents who reported an incident.
ASK Specification: IF (S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_AT = 1 OR S_BI = 1 OR S_V
= 1 OR (S_A = 1 OR S_TA = 1 OR S_ATA = 1) OR S_SA = 1).
Box ID:

CIR_BOX1

If SVERSION = 1 and S_AT = 1 and S_SA != 1 and S_A != 1 and S_TA != 1 and S_ATA != 1
and S_BI != 1 and S_T != 1 and S_MV != 1 and S_MVP != 1 and S_V != 1, go to NA_BOX1.
Else if SVERSION = 1, go to CIRINTRO.
Else, go to CIR_BOX1B.

Box ID:

CIR_BOX1B

For CIR2A – CIR2H, display ‘Yes' and ‘No' columns with options for each response category.

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Question ID:

CIR2

Just to confirm, did any of the following other things also happen as part of this incident
{MONTH/YEAR OF INCIDENT}?
1

{Someone stole or tried to steal a vehicle}

2

{Someone stole or tried to steal vehicle parts or
gas}

3

{Someone stole something{ else}}

4

{Someone tried to steal something{ else} but did
not steal it}

5

{Someone broke in, or tried to break in to your
property}

6

{Someone vandalized something of yours}

7

{Someone attacked or threatened to attack you}

8

{Someone had or tried to have sexual contact with
you that you did not agree to and did not want to
happen}

ASK Description: All respondents who reported an incident.
ASK Specification: IF SVERSION != 1 AND (S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_AT = 1
OR S_BI = 1 OR S_V = 1 OR S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1).
PROGRAM: If CIR2A = 1, set S_MV = 1.
If CIR2B = 1, set S_MVP = 1.
If CIR2C = 1, set S_T = 1.
If CIR2D = 1, set S_AT = 1.
If CIR2E = 1, set S_BI = 1.
If CIR2F = 1, set S_V = 1.
If CIR2G = 1, set S_ATA = 1.
If CIR2H = 1, set S_SA = 1.

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Box ID:

CIR_BOX2

Programmer note: Refresh headers after setting new flags in CIR2.
Display text on each screen in CIR for this incident in bold, including month/year and short text
description of screener item: Display format - Incident: April, 2018 ⇒ { D escrip tion }
Display Description as follows and use comma separators and "or" as needed:
If S_MV = 1, display "Motor vehicle theft or attempted theft".
If S_MVP = 1, display "Motor vehicle parts or gas theft or attempted theft".
If S_ATA = 1 and S_A != 1 and S_TA != 1, display "An attack, attempted attack, or threatened
attack".
If S_A = 1 and S_TA != 1 and S_ATA != 1, display "An attack or attempted attack".
If S_TA = 1 and S_A != 1 and S_ATA != 1, display "Threatened attack".
If S_A = 1 and S_TA = 1 and S_ATA != 1, display "An attack or threatened attack".
If S_T = 1, display "Theft".
If S_AT = 1, display "Attempted theft".
If S_BI = 1, display "Break-in".
If S_V = 1, display "Vandalism".
If S_SA = 1, display "Unwanted sexual contact".
ROUTING INSTRUCTIONS:
If SVERSION = 2 and S_AT = 1 and S_SA != 1 and S_A != 1 and S_TA != 1 and S_ATA != 1
and S_BI != 1 and S_T != 1 and S_MV != 1 and S_MVP != 1 and S_V != 1, go to NA_BOX1.
Else if SVERSION = 2, GO TO CIRINTRO.

Question ID:

CIRINTRO

Some of the next questions will refer to the "offender(s)," which means the person or people
who did this to you.
ASK Description: All respondents who reported an incident.
ASK Specification: IF S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_AT = 1 OR S_BI = 1 OR S_V
= 1 OR (S_A = 1 OR S_TA = 1 OR S_ATA = 1) OR S_SA = 1.

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Series Crimes
Box ID:

SC_START

If SERIES = 1 FOR THIS INCIDENT, ASK SC1.
Else, go to SC_BOX1.
Question ID:

SC1

Earlier, you said this type of thing happened to you more than once in the past 12 months.
{Did all of these incidents happen in the same place, did some of them happen in the same
place, or did they all happen in different places?/Did all, some, or none of these incidents
happen in the same place?}
1

All in the same place

2

Some in the same place

3

All in different places

ASK Description: Respondents who reported this type of incident more than once in the past 12
months.
ASK Specification: IF SERIES = 1.
Question ID:

SC2

Were all of these incidents {done by the same offender, were some of them done by the same
offender, or were they all done by different offenders/, some of them, or none of them done by
the same offender(s)}?
1

All by same offender

2

Some by same offender

3

{All by different offenders/None by same offender}

ASK Description: Respondents who reported this type of incident more than once in the past 12
months.
ASK Specification: IF SERIES = 1.
Question ID:

SC3

The rest of the questions will now ask you to focus on the most recent time this happened{, in
{MONTH/YEAR}}.
ASK Description: Respondents who reported this type of incident more than once in the past 12
months.
ASK Specification: IF SERIES = 1.

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Box ID:

SC_BOX1

If this incident involved unwanted sexual contact, go to SA_START.
Else, if this incident involved an attack or threatened attack with or without a weapon, go to
A_START.
Else, if this incident involved theft or attempted theft of a motor vehicle, go to MV_START.
Else, if this incident involved a break-in or attempted break-in, go to BI_START.
Else, if this incident involved theft, go to T_START.
Else, if this incident did not involve theft or attempted theft of a motor vehicle but involved theft
or attempted theft of a motor vehicle parts or gas, go to MV_START.
Else, if this incident involved vandalized property, go to V_START.

IF S_SA = 1, GO TO SA_START.
ELSE, IF S_A = 1 OR S_TA = 1 OR S_ATA = 1, GO TO A_START.
ELSE, IF S_MV = 1, GO TO MV_START.
ELSE, IF S_BI = 1, GO TO BI_START.
ELSE, IF S_T = 1, GO TO T_START.
ELSE, IF S_MV != 1 AND S_MVP = 1, GO TO MV_START.
ELSE, IF S_V = 1, GO TO V_START.

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What Happened: Module SV – Unwanted Sexual
Contact
Box ID:

SA_START

Respondents with S_SA = 1 are asked this module.
Question ID:

PNSA1a

Earlier, you said someone had or tried to have unwanted sexual contact with you during the
incident {in {MONTH/YEAR}/in the past 12 months}.
These questions are about what specific things you did not want to happen during the incident.
It may seem like you've already answered these questions, but we want to understand clearly
what happened. Some of the language is explicit; it's important that the questions be asked
this way so that you understand what we mean.
ASK Description: Respondents who reported unwanted sexual contact in this incident.
ASK Specification: IF S_SA = 1.
Question ID:

SA_0

In this incident, did someone have unwanted sexual contact with you, such as touching,
groping, or penetration, including making you do these things to them?
1

Yes

2

No

ASK Description: Respondents who reported unwanted sexual contact in this incident.
ASK Specification: IF S_SA = 1.
PROGRAM: ROUTING INSTRUCTIONS: If SA_0 = 1, go to SA_1.
Else, if SA_0 = 2, go to SA_BOX3.
Else, go to A_START.
Box ID:

SA_BOX1

For SA_1A – SA_1D, display ‘Yes' and ‘No' columns with options for each response category.

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Question ID:

SA_1

In this particular incident, …
1

Did you have unwanted vaginal sex{ with a
woman}?

2

Did you have unwanted oral or anal sex? ({READ
IF NEEDED: }Oral sex means that someone put
their mouth or tongue on a vagina, anus or penis.
Anal sex is a man or boy putting his penis in
someone else's anus.)

3

Was there unwanted penetration of sexual body
parts with a finger or object?

4

Was there unwanted sexual contact, such as
touching or kissing of sexual body parts, or
grabbing, fondling, or rubbing up against you in a
sexual way?

ASK Description: Respondents who reported unwanted sexual contact in this incident.
ASK Specification: IF SA_0 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If SA_1A = 1 or SA_1B = 1 or SA_1C = 1 or SA_1D = 1,
go to SA_1F.
Else, go to SA_BOX2B.
Question ID:

SA_1F

You said that there was {unwanted vaginal sex}{,} {unwanted oral or anal sex}{,} {unwanted
penetration with a finger or object} {and} {unwanted sexual touching} that you did not want to
happen. Did the offender penetrate or touch your sexual body parts, were you forced to
penetrate or touch the offender's sexual body parts, or did both happen?
1

The offender penetrated or touched you

2

You were forced to penetrate or touch the offender

3

Both

ASK Description: Respondents who reported any unwanted vaginal, oral or anal sex, unwanted
penetration with a finger or object, or unwanted sexual touching as part of this incident.
ASK Specification: IF SA_1A = 1 OR SA_1B = 1 OR SA_1C = 1 OR SA_1D = 1.
Box ID:

SA_BOX2

For SA_2A – SA_2D, display ‘Yes' and ‘No' columns with options for each response category.

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Question ID:

SA_2

During {this/the} incident…
1

Did the offender use physical force, such as
holding or pinning you, hitting or kicking you, or
using a weapon?

2

Did the offender threaten to physically hurt you or
someone close to you?

3

Were you blacked out, unconscious, or asleep?

4

Were you unable to consent because you were too
drunk or high?

ASK Description: Respondents who reported any unwanted vaginal, oral or anal sex, unwanted
penetration with a finger or object, or unwanted kissing or sexual touching as part of this
incident.
ASK Specification: IF SA_1A = 1 OR SA_1B = 1 OR SA_1C = 1 OR SA_1D = 1.
PROGRAM: ROUTING INSTRUCTIONS: If (SA_1A = 1 or SA_1B = 1 or SA_1C = 1) and (SA_2A
= 2, -9 and SA_2B = 2, -9 and SA_2C = 2, -9 and SA_2D = 2, -9), go to SA_2F.
Else, if (SA_1A = 1 or SA_1B = 1 or SA_1C = 1) and (SA_2A = 1 or SA_2B = 1 or SA_2C = 1 or
SA_2D = 1), go to A_START.
Else, if SA_1D = 1 and SA_2A = 2, -9 and SA_2B = 2, -9 and SA_2C = 2, -9, go to SA_2E.
Else, go to SA_BOX3.
Question ID:

SA_2E

During {this/the} incident, did the offender forcibly touch or kiss your sexual body parts, or
forcibly touch, grab, fondle, or rub up against you in a sexual way?
1

Yes

2

No

ASK Description: Respondents who reported unwanted kissing or sexual touching, without force
or threats, while conscious.
ASK Specification: IF SA_1A = 2, -9 AND SA_1B = 2, -9 AND SA_1C = 2, -9 AND SA_1D = 1.
PROGRAM: ROUTING INSTRUCTIONS: If SA_2A = 2, -9 and SA_2B = 2, -9 and SA_2C = 2, -9
and SA_2D = 2, -9 and SA_2E = 2, -9, go to SA_2F.
Else, go to SA_BOX2B.

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Question ID:

SA_2F

Did the offender use some other type of pressure, such as threatening to cause financial or
other problems for you, threatening to break up with you, threatening to hurt your reputation,
or promising rewards?
1

Yes

2

No

ASK Description: Respondents who reported unwanted kissing or sexual touching, without force.
ASK Specification: IF (SA_1A = 1 OR SA_1B = 1 OR SA_1C = 1 OR SA_1D = 1) AND SA_2A =
2, -9 AND SA_2B = 2, -9 AND SA_2C = 2, -9 AND SA_2D = 2, -9 AND SA_2E != 1.
Box ID:

SA_BOX2B

Respondents who reported unwanted vaginal sex, unwanted oral sex, or unwanted penetration
of sexual body parts with a finger or object in this incident, go to A_START.Else, go to
SA_BOX3.
IF SA_1A = 1 or SA_1B = 1 or SA_1C = 1, go to A_START.Else, go to SA_BOX3.
Box ID:

SA_BOX3

For SA_3A – SA_3D, display ‘Yes' and ‘No' columns with options for each response category.

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Question ID:

SA_3

Did the offender physically TRY to do, or make you do, any of the following, BUT NOT ACTUALLY
DO IT?
1

{Have vaginal sex{ with a woman}{?}}

2

{Did the offender physically try to, or make you,
have oral or anal sex?/Have oral or anal sex}
{({READ IF NEEDED: }Oral sex means that
someone put their mouth or tongue on a vagina,
anus or penis. Anal sex is a man or boy putting his
penis in someone else's anus.)}

3

{Did the offender physically try to sexually
penetrate you with a finger or object or make you
penetrate them with your finger or an
object?/Sexually penetrate you with a finger or
object or make you penetrate them with your
finger or an object}

4

{Did the offender physically try to, or make you,
touch or kiss sexual body parts?/Touch or kiss
sexual body parts}

ASK Description: Respondents who reported that someone did not have unwanted sexual
contact with them as part of this incident, or reported the incident did not involve unwanted
vaginal sex, unwanted oral or anal sex, or unwanted penetration of sexual body parts with a
finger or object.
ASK Specification: IF SA_0 = 2 OR (SA_1A != 1 AND SA_1B != 1 AND SA_1C != 1).
PROGRAM: ROUTING INSTRUCTIONS: If SA_3A = 1 or SA_3B = 1 or SA_3C = 1, go to
SA_BOX4.
Else, go to SA_3E.
Question ID:

SA_3E

Did the offender verbally THREATEN to have vaginal sex, have oral or anal sex, or have sexual
penetration with a finger or object when you did not want it to happen?
1

Yes

2

No

ASK Description: Respondents who did NOT report that the offender tried to perform unwanted
vaginal sex, oral or anal sex, or penetration with finger or object.
ASK Specification: IF SA_3A = 2, -9 AND SA_3B = 2, -9 AND SA_3C = 2, -9.
PROGRAM: ROUTING INSTRUCTIONS: IF SA_3D = 2, -9 AND SA_3E = 2, -9, GO TO SA_3F.
ELSE, GO TO SA_BOX4.

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Question ID:

SA_3F

Did the offender threaten to, or threaten to make you, touch or kiss sexual body parts when you
did not want it to happen?
1

Yes

2

No

ASK Description: Respondents who did NOT report that the offender tried to perform unwanted
vaginal sex, oral or anal sex, penetration with finger or object, or groping/touching and did not
report a verbal threat of penetration.
ASK Specification: IF SA_3A = 2, -9 AND SA_3B = 2, -9 AND SA_3C = 2, -9 AND SA_3D = 2, -9
AND SA_3E = 2, -9.
PROGRAM: ROUTING INSTRUCTIONS: IF SA_3F = 2, -9 GO TO SA_4D.
ELSE, GO TO SA_BOX4.
Box ID:

SA_BOX4

For SA_4A_a - SA_4A_c, display ‘Yes' and ‘No' columns with options for each response category.
Question ID:

SA_4A

You said that the offender {tried to/threatened to} have unwanted sexual contact with you
when you did not want it to happen.
1

Did the offender use physical force, such as
holding or pinning you, hitting or kicking you, or
using a weapon, in doing this?

2

Did the offender threaten to physically hurt you or
someone close to you?

3

Did the offender {try/threaten} to do it while you
were blacked out, asleep, unconscious, or unable
to consent because you were high on alcohol or
drugs?

ASK Description: Respondents who reported the offender tried or threatened unwanted vaginal
sex, oral or anal sex, penetration with finger or object, or kissing or sexual touching.
ASK Specification: IF SA_3A = 1 OR SA_3B = 1 OR SA_3C = 1 OR SA_3D = 1 OR SA_3E = 1
OR SA_3F = 1.
PROGRAM: ROUTING INSTRUCTIONS: If SA_3E = 1 or SA_3F = 1 or (SA_4a_b = 1 and
SA_4A_a != 1 and SA_4A_c != 1), go to SA_4C.
Else, if SA_4A_a = 2, -9 and SA_4A_b = 2, -9 and SA_4A_c = 2, -9, go to SA_4D.
Else, go to A_START.

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Question ID:

SA_4C

At the time, how likely did you think it was that the offender would actually act on their threat
during {this/the} incident?
1

Very likely

2

Somewhat likely

3

Somewhat unlikely

4

Very unlikely

ASK Description: Respondents who reported the offender threatened unwanted vaginal sex, oral
or anal sex, penetration with finger or object, or kissing or sexual touching and threatened to
hurt someone but did not use physical force or try to do it when the respondent was unable to
consent.
ASK Specification: IF SA_3E = 1 OR SA_3F = 1 OR (SA_4A_b = 1 and SA_4A_a != 1 and
SA_4A_c != 1).
Question ID:

SA_4Ca

Were you threatened face to face, by phone or text, online (such as by email or social media),
or in some other way? (Mark all that apply.)
1

Face to face

2

By phone or text

3

Online (email or social media)

4

Some other way

ASK Description: Respondents who reported the offender threatened unwanted vaginal sex, oral
or anal sex, penetration with finger or object, or kissing or sexual touching and threatened to
hurt someone but did not use physical force or try when the respondent was unable to consent.
ASK Specification: IF SA_3E = 1 OR SA_3F = 1 OR (SA_4A_b = 1 AND SA_4A_a = 2, -9 AND
SA_4A_c = 2, -9).
PROGRAM: ROUTING INSTRUCTIONS:
If SA_4Ca1 != 1 and S_A != 1 and S_TA != 1 and S_ATA = 1 and S_MV != 1 and S_MVP != 1
and S_T != 1 and S_AT != 1 and S_BI != 1 and S_V != 1, go to NA_BOX1.
Else, go to A_START.
Question ID:

SA_4D

How did the offender [try/threaten] to do something to you?
1

TEXT RESPONSE ________________________

ASK Description: Respondents who did not report or refused to report whether the offender
threatened to touch or kiss sexual body parts or threatened unwanted vaginal sex, oral or anal
sex, penetration with finger or object, or kissing or sexual touching without using physical force,
threatening to hurt someone, or try when the respondent was unable to consent.
ASK Specification: IF SA_3F = 2, -9 OR (SA_4A_a = 2, -9 AND SA_4A_b = 2, -9 AND SA_4A_c
= 2, -9).
PROGRAM: Display text field, max character length = 1000.

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What Happened: Module A – Attack/Threatened
Attack
Box ID:

A_START

Respondents with S_A = 1 or S_TA = 1 or S_ATA = 1 or S_SA=1 are asked this module.
ROUTING INSTRUCTIONS: IF S_SA=1, GO TO SA11.
ELSE IF S_06D = NULL AND (S_TA= 1 OR S_ATA = 1), go to A0.
Else, go to A1.

Question ID:

A0

Did someone actually attack you, try to attack you, or threaten to attack you during this
incident?
1

Attacked / Tried to attack

2

Threatened to attack

ASK Description: Respondents who reported being attacked, with or without a weapon, or
threatened with attack, and did not report unwanted sexual contact for this incident.
ASK Specification: IF S_06D = NULL AND (S_TA = 1 OR S_ATA = 1).
PROGRAM: If A0 = 1, set S_A = 1.
ROUTING INSTRUCTIONS: If A0 = 2, go to A8. Else, if A0 = 1, go to A1.
Else, go to CI_START.
Question ID:

A8

{Were you threatened face to face, by phone or text, online (such as by email or social media),
or in some other way/How were you threatened}? (Mark all that apply.)
1

Face to face

2

By phone or text

3

Online (email or social media)

4

Some other way Specify:_____

ASK Description: Respondents who reported being threatened with attack, with or without a
weapon, or threatened with attack, or reported unwanted sexual contact for this incident.
ASK Specification: IF A0 = 2.
PROGRAM: Display text box and allow 250 character text response.
If A8a = 1, set S_TA = 1.
ROUTING INSTRUCTIONS: If A8a = 1, go to A1.
Else, If A8a !=1 and (S_MV != 1 and S_MVP != 1 and S_T != 1 and S_BI != 1 and S_V != 1),
go to NA_BOX1.
Else, go to CI_START.

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Question ID:

SA11

The next questions ask whether a weapon was used during this incident.
ASK Description: Respondents who reported unwanted sexual contact as part of this incident.
ASK Specification: IF S_SA = 1.
Question ID:

A1

{You said someone {attacked or tried to attack you}{threatened to attack you} during
{this/the} incident {in {MONTH}/{in the past 12 months}.} {Just to confirm, did/Did} the
offender(s) have a weapon such as a gun or knife, or something to use as a weapon, such as a
baseball bat, scissors, or a stick?
1

Yes

2

No

ASK Description: Respondents who reported being attacked or threatened with attack or
unwanted sexual contact as part of this incident.
ASK Specification: IF A0 = 1 OR A8a = 1 OR S_SA=1.
PROGRAM: ROUTING INSTRUCTIONS: If A1 = 1, go to A2.
Else if A1 != 1 and (SA_2A = 1 or SA_2E = 1 or SA_4A_a = 1), go to A_BOX3.
Else if S_SA=1 and (S_T = 1 or S_AT = 1), go to CI_START.
Else if S_SA=1 and S_T != 1 and S_AT != 1, go to A10.
Else, go to A3.
Question ID:

A2

What was the weapon? (Mark all that apply.)
1

A GUN

2

A KNIFE

3

SOME OTHER SHARP OBJECT, SUCH AS SCISSORS
OR AN AXE

4

A BLUNT OBJECT, SUCH AS A ROCK OR BAT

5

SOMETHING ELSE - Specify - ______

ASK Description: Respondents who reported being attacked or threatened with attack with a
weapon.
ASK Specification: IF A1 = 1.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If A2_1 = 1, go to A2a.
Else if A2_2 = 1 or A2_3 = 1, go to A_BOX2.
Else if (SA_2A !=1 and SA_2E != 1 and SA_4A_a != 1 and S_A !=1 and S_TA !=1) and (S_T =
1 or S_AT = 1), go to CI_START.
Else if (SA_2A !=1 and SA_2E != 1 and SA_4A_a != 1 and S_A !=1 and S_TA !=1) and S_T !=
1 and S_AT != 1, go to A10.
Else, go to A3.

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Question ID:

A2a

Was it a handgun or some other kind of gun, such as a rifle or shotgun?
1

Hand gun/pistol/revolver

2

Some other kind of gun/rifle/shotgun

ASK Description: Respondents who reported being attacked or threatened with attack with a
gun.
ASK Specification: IF A2_1 = 1.
Box ID:

A_BOX1

For A2b_a – A2b_d, display ‘Yes' and ‘No' columns with options for each response category.
Question ID:

A2b

Did the offender(s):
1

Shoot you

2

Shoot at you, but miss

3

Hit you with the gun

4

Show you a gun or point a gun at you

ASK Description: Respondents who reported being attacked or threatened with attack with a
gun.
ASK Specification: IF A2_1 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If (A2b_a = 1 or A2b_c = 1) and (S_T = 1 or S_AT = 1),
go to CI_START.
Else if (A2b_a = 1 or A2b_c = 1) and S_T != 1 and S_AT != 1, go to A10.
Else if A2_2 = 1 or A2_3 = 1, go to A_BOX2.
Else if (SA_2A != 1 and SA_2E != 1 and SA_4A_a != 1 and S_A != 1 and S_TA != 1) and (S_T
= 1 or S_AT = 1), go to CI_START.
Else if (SA_2A != 1 and SA_2E != 1 and SA_4A_a != 1 and S_A != 1 and S_TA != 1) and S_T
!= 1 and S_AT != 1, go to A10.
Else, go to A3.
Box ID:

A_BOX2

For A2c_a – A2c_b, display ‘Yes' and ‘No' columns with options for each response category.

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Question ID:

A2c

You said the offender(s) had a knife or other sharp object. Did the offender(s):
1

Stab or cut you?

2

Try to stab or cut you?

ASK Description: Respondents who reported being attacked or threatened with attack with a
weapon that was not a gun.
ASK Specification: IF A2_2 = 1 or A2_3 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If A2c_a = 1 and (S_T = 1 or S_AT = 1), go to
CI_START.
Else if A2c_a = 1 and S_T != 1 and S_AT != 1, go to A10.
Else if SA_2A = 1 or SA_2E = 1 or SA_4A_a = 1, go to A_BOX3.
Else if (SA_2A !=1 and SA_2E != 1 and SA_4A_a != 1 and S_A !=1 and S_TA !=1) and (S_T =
1 or S_AT = 1), go to CI_START.
Else if (SA_2A != 1 and SA_2E != 1 and SA_4A_a != 1 and S_A != 1 and S_TA != 1) and S_T
!= 1 and S_AT != 1, go to A10.
Else, go to A3.
Question ID:

A3

{In addition to trying to {shoot}/{stab or cut} you, did the offender(s) hit you, grab you, knock
you down or attack you in any other way?/Did the offender(s) hit you, grab you, knock you
down or attack you in any way?}
1

Yes

2

No

ASK Description: Respondents who reported being attacked or threatened with attack, with or
without a weapon.
ASK Specification: IF (A0 = 1 OR A8a = 1) AND A2b_a != 1 AND A2b_c != 1 AND A2c_a != 1.
PROGRAM: ROUTING INSTRUCTIONS: If A3 = 1, go to A_BOX3.
Else, if A3 = 2 and (A2b_b = 1 or A2c_b = 1) and (S_T = 1 or S_AT = 1), go to CI_START.
Else, if A3 = 2 and (A2b_b = 1 or A2c_b = 1) and S_T != 1 and S_AT != 1, go to A10.
Else, go to A4.
Question ID:

A4

Did the offender(s) TRY to hit you, grab you, knock you down or try to attack you in any way?
1

Yes

GO TO A7

2

No

GO TO A5

ASK Description: Respondents who reported being attacked or threatened with attack and not
being hit, grabbed, or knocked to the ground.
ASK Specification: IF A3 = 2 AND (A2b_b != 1 AND A2c_b != 1).

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Question ID:

A5

Did the offender(s) THREATEN to hit you, grab you, knock you down or threaten to attack you in
any way?
1

Yes

GO TO A7

2

No

GO TO A6

ASK Description: Respondents who reported being attacked or threatened with attack and the
offender(s) not trying to hit, grab, or knock the respondent to the ground.
ASK Specification: IF A4 = 2.
Question ID:

A6

What did the offender do? {Anything else?} (Mark all that apply.)
1

Took something without your permission

2

Tried to or threatened to take something

3

Argued with you or used abusive language

4

Broke in or tried to break in to your home

5

Broke in or tried to break in to your vehicle

6

Damaged or destroyed your property

7

Something else ______________

ASK Description: Respondents who reported being attacked or threatened with attack and the
offender(s) not threatening to hit, grab, or knock the respondent to the ground.
ASK Specification: IF A5 = 2.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If (S_T = 1 or S_AT = 1), go to CI_START.
Else if S_T != 1 and S_AT != 1, go to A10.

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Question ID:

A7

{Did/How did} the offender(s) TRY or THREATEN to attack you{ by.../?} (Mark all that apply.)
1

Saying they would attack or kill you

2

{Threatening you with a weapon}

3

{Trying to attack you with a weapon other than
gun, knife or sharp object}}

4

Throwing something at you

5

Following you or surrounding you

6

Trying to choke you

7

Trying to hit, slap, knock down, grab, hold, trip,
jump, or push you

8

Something else ________________

ASK Description: Respondents who reported being attacked or threatened with attack.
ASK Specification: IF A4 = 1 OR A5 = 1.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If (S_T= 1 or S_AT= 1), go to CI_START.
Else if S_T != 1 and S_AT != 1, go to A10.
Box ID:

A_BOX3

For A9A - A9G, display ‘Yes' and ‘No' columns with options for each response category.

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Question ID:

A9

{Earlier you said the offender used physical force{ and had a weapon} during the incident.} Did
the offender(s) {also} do any of the following?
1

Hit you, slap you, or knock you down

2

Grab, hold, trip, jump, or push you

3

Hit you with an object other than a gun

4

Throw something at you

5

Choke you

6

Do something else to attack you? Specify:
_________________

ASK Description: Respondent reported being attacked, with or without a weapon, or used force
in having or trying to have sexual contact with them.
ASK Specification: IF (A2b_a != 1 AND A2b_c != 1 AND A2c_a != 1) AND ((SA_2A = 1 OR
SA_2E = 1 OR SA_4A_a = 1) OR ((A2_2 = 1 OR A2_3 = 1) AND A2c_a != 1 AND (SA_2A = 1
OR SA_2E = 1 OR SA_4A_a = 1)) OR A3 = 1).
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If (S_T= 1 or S_AT= 1), go to CI_START.
Else if S_T != 1 and S_AT != 1, go to A10.
Question ID:

A10

Did the offender steal or try to steal something that belonged to you during {this/the} incident?
1

Yes, stole something

2

Yes, tried to steal something

3

No

ASK Description: Respondents with a sexual attack, attack, attempted attack, or face-to-face
threatened attack who did not already report a theft or attempted theft.
ASK Specification: IF (S_A = 1 OR S_ATA = 1 OR S_TA = 1 OR S_SA = 1) AND (S_T != 1 AND
S_AT != 1)
PROGRAM: If A10 = 1, set S_T = 1. If A10 = 2, set S_AT = 1.

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Consequences I: Injury
Box ID:

CI_START

Respondents with S_A = 1 or S_TA = 1 or S_ATA = 1 or S_SA = 1 are asked this module.
Question ID:

CI_INTRO

{The next questions ask/This section asks} about any injuries you may have had during this
incident.
ASK Description: Respondents who reported being attacked or someone tried to have unwanted
sexual contact with them.
ASK Specification: IF S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1.
Question ID:

CI1

During {this/the} incident, {besides being} {shot} {and/or} {stabbed}, were you physically
injured in any {other} way? Injuries include things such as bruises, black eyes, cuts, broken
bones or more serious injuries.
1

Yes

2

No

ASK Description: Respondents who reported being attacked or someone tried to have unwanted
sexual contact with them.
ASK Specification: IF S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1.
PROGRAM: ROUTING INSTRUCTIONS: IF CI1 = 1, go to CI_BOX0.
Else, go to CI_BOX1.
Box ID:

CI_BOX0

Go to CI2.

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Question ID:

CI2

{How were you injured? Any other injury?/Were you injured in any of these ways?} (Mark all
that apply.)
1

Broken or cracked bones

2

Broken nose

3

Dislocated joints

4

A concussion

5

Knocked unconscious

6

{Injury from sexual intercourse, such as to vagina
or anus}

7

{Other internal injuries, such as internal bleeding
or damage to internal organs}

8

Some other way Specify:
_____________________

ASK Description: Respondents who reported being injured during the incident.
ASK Specification: IF CI1 = 1.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If CI2_8 = 1 or (CI2_1 = -9 and CI2_2 = -9 and CI2_3 = -9 and
CI2_4 = -9 and CI2_5 = -9 and CI2_6 = -9 and CI2_7 = -9 and CI2_8 = -9), go to CI2a.
Else, if 12 <= UT_AGE <= 55 and CI1 = 1 and (A3 = 1 or SA_1A = 1 or SA_1B = 1 or SA_1C =
1 or SA_1D = 1 or SA_1E = 1), go to CI3.
Else, go to CI6.
Question ID:

CI2a

Were you injured in any of these other ways? (Mark all that apply.)
1

Bruising, swelling, welts, black eye

2

Bite mark or bite wound

3

Cuts or scratches

4

Sore muscles, sprains, strains, pulls

5

Burns

6

Nose bleed or bloody lip

7

Broken, chipped, or lost teeth

8

Other (specify) ______________________

ASK Description: Respondents who reported being injured during the incident and reported
being injured in some other way.
ASK Specification: IF CI1 = 1 AND (CI2_8 = 1 OR (CI2_1 = -9 AND CI2_2 = -9 AND CI2_3 = -9
AND CI2_4 = -9 AND CI2_5 = -9 AND CI2_6 = -9 AND CI2_7 = -9 AND CI2_8 = -9)).
PROGRAM: Display text box and allow 250 character text response.

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Question ID:

CI3

Did you face any other physical consequences as a result of this victimization?
1

Yes (Specify) ______

2

No

ASK Description: Respondents who reported being injured during the incident and reported
being injured in some other way.
ASK Specification: IF CI1 = 1 AND (CI2_8 = 1 OR (CI2_1 = -9 AND CI2_2 = -9 AND CI2_3 = -9
AND CI2_4 = -9 AND CI2_5 = -9 AND CI2_6 = -9 AND CI2_7 = -9 AND CI2_8 = -9)).
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If UT_RESP_GENDER = 2 and 12 <= UT_AGE <= 55 and CI1 = 1
and (A3 = 1 or SA_1A = 1 or SA_1B = 1 or SA_1C = 1 or SA_1D = 1 or SA_1E = 1), go to
CI3a.
Else, go to CI6.
Question ID:

CI3a

Were you pregnant at the time?
1

Yes

2

No

ASK Description: Female respondents between ages 12 and 55 who reported being attacked or
unwanted sexual contact.
ASK Specification: IF UT_RESP_GENDER = 2 AND 12 <= UT_AGE <= 55 and CI1 = 1 and (A3 =
1 or SA_1A = 1 or SA_1B = 1 or SA_1C = 1 or SA_1D = 1 or SA_1E = 1).
Question ID:

CI6

Did you receive any care from a medical or dental professional as a result of {this/the} incident?
1

Yes

GO TO CI7

2

No

GO TO CI_BOX1

ASK Description: Respondents who reported being injured during this incident.
ASK Specification: IF CI1 = 1.
Question ID:

CI7

Did you receive this care at the location where the incident happened, somewhere else, or both?
1

Only where the incident happened

GO TO CI_BOX1

2

Only somewhere else

GO TO CI7a

3

Both

GO TO CI7a

ASK Description: Respondents who reported they received care from a medical or dental
professional as a result of this incident.
ASK Specification: IF CI6 = 1.

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Question ID:

CI7a

Where did you receive this care? (Mark all that apply.)
1

AT YOUR HOME OR THE HOME OF A RELATIVE,
FRIEND, OR NEIGHBOR

2

AT A HOSPITAL EMERGENCY ROOM ER) OR AN
EMERGENCY CLINIC

3

AT SOME OTHER KIND OF MEDICAL OR DENTAL
PLACE

4

SOMEWHERE ELSE (specify) ______

ASK Description: Respondents who reported they received care from a medical or dental
professional somewhere other than where the incident took place.
ASK Specification: IF CI7 = 2, 3.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If CI7aB = 1 or CI7aC = 1 or CI7aD = 1, go to CI8.
Else, go to CI_BOX1.
Question ID:

CI8

Did you stay overnight in the hospital?
1

Yes

2

No

ASK Description: Respondents who reported they received care for the incident at a hospital
emergency room or clinic, or some other kind of medical/dental place, or somewhere else.
ASK Specification: IF CI7aB = 1 OR CI7aC = 1 OR CI7aD = 1.
PROGRAM: ROUTING INSTRUCTIONS: IF CI8 = 1, go to CI9.
Else, if CI6 = 1, go to CI10.
Else, go to CI_BOX1.
Question ID:

CI9

How many nights did you stay in the hospital?
1

|__|__| nights

ASK Description: Respondents who stayed overnight at the hospital.
ASK Specification: IF CI8 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If CI6 = 1, go to CI10.
Else, go to CI_BOX1.

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Question ID:

CI10

Have you had any out–of–pocket expenses for your medical or dental care that you do not
expect to get paid back from insurance or some other source?
1

Yes

GO TO CI11

2

No

GO TO CI_BOX1

3

Don't know

GO TO CI_BOX1

ASK Description: Respondents who received care for the incident and stayed at the hospital
overnight.
ASK Specification: IF CI6 = 1 AND CI8 = 1.
Question ID:

CI11

How much were these out-of-pocket expenses?
1

Less than $100

2

$100 to less than $500

3

$500 to less than $1000

4

$1000 to less than $5000

5

$5000 or more

ASK Description: Respondents who reported out of pocket expenses for this incident.
ASK Specification: IF CI10 = 1.
Box ID:

CI_BOX1

If this incident involved theft or attempted theft of a motor vehicle, go to MV_START.
Else, if this incident involved a break-in or attempted break-in, go to BI_START.
Else, if this incident involved theft or attempted theft, go to T_START.
Else, if this incident did not involve theft or attempted theft of a motor vehicle but involved theft
or attempted theft of motor vehicle parts or gas, go to MV_START.
Else, if this incident involved vandalized property, go to V_START.

IF S_MV
ELSE, IF
ELSE, IF
ELSE, IF
ELSE, IF

= 1, GO TO MV_START.
S_BI = 1, GO TO BI_START.
S_T = 1 OR S_AT = 1, GO TO T_START.
S_MV != 1 AND S_MVP = 1, GO TO MV_START.
S_V = 1, GO TO V_START.

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What Happened: Module MV – Motor Vehicle
Theft/Parts Theft/Attempted Theft
Box ID:

MV_START

Respondents with S_MV = 1 or S_MVP = 1 are asked this module.
If S_MV = 1 and (S_01B1 = 1 and S_01B2 = 1), go to MV1a.
Else, if S_MV = 1, go to MV2a.
Else, if S_MVP = 1 and (S_02A1 = 1 OR S_02A2 = 1) and S_02A3 = 1, go to MV1b.
Else, if S_MVP = 1, go to MV2b.
Else, go to MV_BOX1.

Question ID:

MV1a

You said someone stole or tried to steal a vehicle or used it without permission during {this/the}
incident{ in {MONTH}}. Did the offender(s) actually take the vehicle?
1

Yes

2

No

ASK Description: Respondents who reported someone stole or tried to steal a vehicle.
ASK Specification: IF S_MV = 1 AND (S_01B1 = 1 AND S_01B2 = 1).
PROGRAM: ROUTING INSTRUCTIONS: If MV1a = -9, go to MV_BOX1.
Question ID:

MV2a

{You said someone {stole a vehicle or used it without permission/tried to steal a vehicle} during
{this/the} incident{ in {MONTH}}.} Who did the vehicle belong to?
1

You

2

Someone else you live with

3

Both you and someone else you live with

4

Someone you don't live with

5

Other ____________________

ASK Description: Respondents who reported someone stole or tried to steal a vehicle.
ASK Specification: IF S_MV = 1 OR MV1a = 1, 2.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS:
If S_MVP = 2 and (S_02A1 = 1 or S_02A2 = 1) and S_02A3 = 1, go to MV1b.
Else, if S_MVP = 2, go to MV2b.
Else, if S_MV = 1 and MV1a != 2, go to MV3.
Else, go to MV_BOX1.

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Question ID:

MV1b

You said someone stole or tried to steal vehicle parts or gas during {this/the} incident{ in
{MONTH}}. Did the offender(s) actually take any vehicle parts or gas?
1

Yes

2

No

ASK Description: Respondents who reported someone stole or tried to steal vehicle parts.
ASK Specification: IF S_MVP = 1 AND (S_02A1 = 1 OR S_02A2 = 1) AND S_02A3 = 1.
Question ID:

MV2b

{You said someone stole or tried to steal vehicle parts or gas during {this/the} incident{ in
{MONTH}}.} Who did the vehicle parts or gas belong to?
1

You

2

Someone else you live with

3

Both you and someone else you live with

4

Someone you don't live with

5

Other _____

ASK Description: Respondents who reported someone stole or tried to steal vehicle parts.
ASK Specification: IF S_MVP = 1.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS:
If S_MV = 1 and (MV1a = 1 or MV1a = NULL (was not asked)), go to MV3.
Else, go to MV_BOX1.
Question ID:

MV3

Did anyone ever tell the offender(s) they could use the vehicle?
1

Yes

GO TO MV4

2

No

GO TO MV_BOX1

ASK Description: Respondents who reported someone stole or tried to steal a vehicle and did
not report the vehicle was not actually stolen or refuse to report whether or not the vehicle was
actually stolen.
ASK Specification: IF S_MV = 1 AND MV1a != 2,-9.

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Question ID:

MV4

Did the offender(s) return the vehicle?
1

Yes

2

No

ASK Description: Respondents who reported anyone told the offender they could use the
vehicle.
ASK Specification: IF MV3 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If MV4 = 1 and S_MV = 1 and S_MVP != 1 and S_T != 1
and S_BI != 1 and S_V != 1 and S_A != 1 and S_TA != 1 and S_ATA != 1 and S_SA != 1, go to
NA_BOX1.
Else, go to MV_BOX1.
Box ID:

MV_BOX1

If this incident involved a break-in or attempted break-in and the break in module has not yet
been completed, go to BI_START.
Else, if this incident involved theft and the theft module has not yet been completed, go to
T_START.
Else, if this incident involved vandalized property, go to V_START.
Else, go to LO_INTRO.

IF S_BI = 1 AND BI1a = NULL, GO TO BI_START.
ELSE, IF S_T = 1 AND T2a_1 = NULL, GO TO T_START.
ELSE, IF S_V = 1, GO TO V_START.
ELSE, GO TO LO_INTRO.

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What Happened: Module B – Break-ins
Box ID:

BI_START

Respondents with S_BI = 1 are asked this module.

Box ID:

BI_BOX1

For BI1a – BI1f, display ‘Yes' and ‘No' columns with options for each response category.
Question ID:

BI1

You said someone broke in or tried to break in during {this/the} incident{ in {MONTH}}. Did
someone break in or try to break into any of the following during this incident?
1

Your home?

2

A garage, shed, or other detached building on your
property?

3

A second home or vacation home?

4

A hotel or motel room where you or someone you
live with was staying?

5

A car or motor vehicle?

6

Some other place? Specify:
____________________

ASK Description: Respondents who reported a break-in.
ASK Specification: IF S_BI = 1.
PROGRAM: ROUTING INSTRUCTIONS: If BI1a = 1 OR BI1b = 1 OR BI1c = 1 OR BI1d = 1 OR
BI1f = 1, go to BI2.
Else, go to BI_BOX2.
Question ID:

BI2

{Excluding the motor vehicle, did/Did} the offender(s) actually get inside {any of these places}?
1

Yes

2

No

ASK Description: Respondents who reported a break-in of something other than a motor vehicle.
ASK Specification: IF BI1a = 1 OR BI1b = 1 OR BI1c = 1 OR BI1d = 1 OR BI1f = 1.

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Question ID:

BI3

Were there any signs that the offender(s) got in or tried to get in by force? Signs of force
include things like broken locks or windows.
1

Yes

GO TO BI4

2

No

GO TO BI_BOX2

ASK Description: Respondents who reported a break-in of something other than a motor vehicle.
ASK Specification: IF BI1a = 1 OR BI1b = 1 OR BI1c = 1 OR BI1d = 1 OR BI1f = 1.
Question ID:

BI4

What were these signs?{ Anything else?} (Mark all that apply.)
1

A window was damaged

2

A window screen was damaged or removed

3

A lock on a window was damaged or tampered
with

4

There was some other damage to a window

5

A door was damaged

6

A screen door was damaged or removed

7

A lock or a door handle was damaged or tampered
with

8

There was some other damage to a door

9

Something else ____________________

ASK Description: Respondents who reported a break-in with signs of force.
ASK Specification: IF BI3 = 1.
PROGRAM: Display text box and allow 250 character text response.
Box ID:

BI_BOX2

If this incident involved theft, go to T_START.
Else, if this incident did not involve theft or attempted theft of a motor vehicle but involved theft
or attempted theft of a motor vehicle parts or gas, go to MV_START.
Else, if this incident involved vandalized property, go to V_START.
Else, go to LO_INTRO.

IF S_T = 1, GO TO T_START.
ELSE, IF S_MV != 1 AND S_MVP = 1, GO TO MV_START.
ELSE, IF S_V = 1, GO TO V_START.
ELSE, GO TO LO_INTRO.

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What Happened: Module T – Theft
Box ID:

T_START

Respondents with S_T = 1 are asked this module.

Box ID:

T_BOX1A

Go to T2a.

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Question ID:

T2a

You said someone stole something from you during {this/the} incident{ in {MONTH}}. What
was stolen?{ Anything else?} (Mark all that apply.)
1

{CASH}

2

{CREDIT CARDS, A CHECK, OR BANK CARDS}

3

{A PURSE OR WALLET}

4

{A BACKPACK, BRIEFCASE, OR LUGGAGE}

5

{A CELL PHONE}

6

{A TABLET, A LAPTOP, OR OTHER PERSONAL
ELECTRONICS}

7

{CLOTHING, FURS, OR SHOES}

8

{JEWELRY, A WATCH, OR KEYS}

9

{A TV, A COMPUTER, OR APPLIANCES}

10

{OTHER HOME FURNISHINGS, SUCH AS CHINA OR
RUGS}

11

{A HANDGUN OR OTHER FIREARM}

12

{TOOLS, MACHINES, OR OFFICE EQUIPMENT}

13

{A BICYCLE OR BICYCLE PARTS}

14

{A GARDEN HOSE OR LAWN FURNITURE}

15

{TOYS, OR SPORTS AND RECREATION
EQUIPMENT}

16

{SOMETHING YOU KEPT IN YOUR VEHICLE, SUCH
AS A GPS DEVICE OR A PHONE CHARGER}

17

{A PACKAGE OR GROCERIES}

18

SOMETHING ELSE

ASK Description: Respondents who reported someone stole something.
ASK Specification: IF S_T = 1.
PROGRAM: ROUTING INSTRUCTIONS:
If T2a_18 = 1, go to T2b.
Else, if T2a_1 = 1 or T2a_3 = 1, go to T_BOX3.
Else, go to T4.

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Question ID:

T2b

You said someone stole or tried to steal something else from you during {this/the} incident{ in
{MONTH}}. What was stolen? (Mark all that apply.)
1

{CASH}

2

{CREDIT CARDS, CHECK, BANK CARDS}

3

{PURSE/WALLET}

4

{BACKPACK, BRIEFCASE, LUGGAGE}

5

{CELL PHONE}

6

{OTHER PERSONAL AND PORTABLE
ELECTRONICS}

7

{CLOTHING, FURS, SHOES}

8

{JEWELRY, WATCH, KEYS}

9

{TV, COMPUTER, APPLIANCES}

10

{OTHER HOME FURNISHINGS (SILVER, CHINA,
ART OBJECTS, FURNITURE, RUGS, ETC.)}

11

{HANDGUN OR OTHER FIREARM}

12

{TOOLS, MACHINES, OFFICE EQUIPMENT}

13

{BICYCLE OR PARTS}

14

{GARDEN HOSE OR LAWN FURNITURE}

15

{TOYS, SPORTS, RECREATION EQUIPMENT}

16

{UNATTACHED MOTOR VEHICLE ACCESSORIES
(GPS DEVICE, PHONE CHARGERS, ETC.)}

17

{A PACKAGE OR GROCERIES}

18

SOMETHING ELSE Specify: _______

ASK Description: Respondents who reported someone stole something else.
ASK Specification: IF T2a_18 = 1.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If T2a_1 = 1 or T2a_3 = 1 or T2b_1 = 1 or T2b_3 = 1, go to
T_BOX3.
Else, go to T4.
Box ID:

T_BOX3

If respondent is less than 18 years old, go to T3a.
If respondent is 18 years old or older, go to T3b.

If UT_AGE < 18, go to T3a.
If UT_AGE >= 18, go to T3b.

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Question ID:

T3a

How much cash was taken? {READ RESPONSES UNTIL R SAYS YES.}
1

Less than 10 dollars

2

$10 or more, but less than $20

3

$20 or more, but less than $30

4

$30 or more, but less than $50

5

$50 or more

ASK Description: Respondents who are less than 18 years old and reported cash or a
wallet/purse was stolen.
ASK Specification: IF UT_AGE < 18 and (T2a_1 = 1 OR T2a_3 = 1 OR T2b_1 = 1 OR T2b_3 = 1
OR T2c_1 = 1 OR T2c_3 = 1).
Question ID:

T3b

How much cash was taken? {READ RESPONSES UNTIL R SAYS YES.}
1

Less than 10 dollars

2

$10 or more, but less than $50

3

$50 or more, but less than $200

4

$200 or more, but less than $500

5

$500 or more, but less than $1,000

6

$1,000 or more

ASK Description: Respondents who are 18 years old or older and reported cash or a wallet/purse
was stolen.
ASK Specification: IF UT_AGE >= 18 and (T2a_1 = 1 OR T2a_3 = 1 OR T2b_1 = 1 OR T2b_3 =
1 OR T2c_1 = 1 OR T2c_3 = 1).

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Question ID:

T4

Who did the stolen property or money belong to?
1

{RESPONDENT/You}

2

{SOMEONE RESPONDENT LIVES WITH/Someone
else you live with}

3

{BOTH RESPONDENT AND SOMEONE ELSE S/HE
LIVES WITH/Both you and someone else you live
with}

4

{SOMEONE RESPONDENT DOESN'T LIVE
WITH/Someone you don't live with}

5

{OTHER/OTHER Specify: _____}

ASK Description: Respondents who reported someone stole or tried to steal something.
ASK Specification: IF S_T = 1 or S_AT = 1.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If T4 = 4 and S_SA != 1 and S_A != 1 and S_MV != 1 and S_MVP !=
1 and S_TA != 1 and S_ATA != 1 and S_V != 1 and S_BI != 1, go to NA_BOX1.
Else, if T4 != 4 and (T2a_1 = 1 or T2a_3 = 1 or T2a_5 = 1 or T2b_1 = 1 or T2b_3 = 1 or T2b_5
= 1 or T2c_1 = 1 or T2c_3 = 1 or T2c_5 = 1), go to T5.
Else, if T4 != 4, go to T6.
Else, go to T_BOX2.
Question ID:

T5

Was the {cash} {or} {purse or wallet} {or} {cell phone} on your person, such as in a pocket or
being held?
1

Yes

2

No

ASK Description: Respondents who reported cash, a purse or wallet, or cell phone stolen.
ASK Specification: IF T4 != 4 AND (T2a_1 = 1 OR T2a_3 = 1 OR T2a_5 = 1 or T2b_1 = 1 or
T2b_3 = 1 or T2b_5 = 1 or T2c_1 = 1 or T2c_3 = 1 or T2c_5 = 1).
Question ID:

T6

Was there anything {else} the offender(s) took directly from you, such as from your pocket or
hands, or something that you were wearing?
1

Yes

2

No

ASK Description: Respondents who reported someone stole something that does belong the
respondent or someone the respondent live with.
ASK Specification: IF T4 != 4.

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Box ID:

T_BOX2

If this incident did not involve theft or attempted theft of a motor vehicle but involved theft or
attempted theft of a motor vehicle parts or gas, go to MV_START.
Else, if this incident involved vandalized property, go to V_START.
Else, go to LO_INTRO.

IF S_MV != 1 AND S_MVP = 1, GO TO MV_START.
ELSE, IF S_V = 1, GO TO V_START.
ELSE, GO TO LO_INTRO.

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What Happened: Module V – Vandalism
Box ID:

V_START

Respondents with S_V = 1 (but no other screener flags = 1) are asked this module.
ROUTING INSTRUCTIONS: If S_V = 1 and S_A != 1 and S_TA != 1 and S_T != 1 and S_BI != 1
and S_SA != 1 and S_MV != 1 and S_MVP != 1 AND S_05A1 = 1, go to V1.
Else, if S_V = 1 and S_A != 1 and S_TA != 1 and S_T != 1 and S_BI != 1 and S_SA != 1 and
S_MV != 1 and S_MVP != 1 AND SOLO_HHM != 1, go to V3.
Else, go to LO_INTRO.

Question ID:

V1

You said someone damaged or destroyed your property during {this/the} incident{ in
{MONTH}}. What kind of property did the offender damage or destroy?{ Anything else?}(Mark
all that apply.)
1

A vehicle (including parts)

2

Something inside your home or apartment

3

A mailbox

4

Something outside of your home or apartment,
such as doors, windows, or walls

5

Fences, walls, gates or items in a garden

6

A garage, shed, greenhouse or other structure on
your property

7

An animal such as a pet or livestock

8

Other ________________________

ASK Description: Respondents who reported their property was damaged or destroyed and did
not report any other incident type.
ASK Specification: IF S_V = 1 and S_A != 1 and S_TA != 1 and S_T != 1 and S_BI != 1 and
S_SA != 1 and S_MV != 1 and S_MVP != 1 AND S_05A1 = 1.
PROGRAM: Display text box and allow 250 character text response.

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Question ID:

V2

What kind of damage did the offender do? (Mark all that apply.)
1

Broke glass, such as a window or mirror

2

Defaced something, such as painting graffiti, or
keyed a car

3

Burned something

4

Drove into or ran over something with a vehicle

5

Broke or destroyed something else

6

{Injured or killed animals}

7

Other _______________

ASK Description: Respondents who reported their property was damaged or destroyed and did
not report any other incident type.
ASK Specification: IF S_V = 1 and S_A != 1 and S_TA != 1 and S_T != 1 and S_BI != 1 and
S_SA != 1 and S_MV != 1 and S_MVP != 1 AND S_05A1 = 1.
PROGRAM: Display text box and allow 250 character text response.
Question ID:

V3

{You said someone injured or killed an animal during {this/the} incident{ in {MONTH}}.} Did
the offender attack or threaten anyone (else) who was living with you during {this/the}
incident?
1

Yes

2

No

ASK Description: Respondents who reported their property was damaged or destroyed or
someone injured or killed an animal and did not report any other incident type and is not in a
single person household.
ASK Specification: IF S_V = 1 and S_A != 1 and S_TA != 1 and S_T != 1 and S_BI != 1 and
S_SA != 1 and S_MV != 1 and S_MVP != 1 AND S_05A1 != 1 AND SOLO_HHM != 1.
Question ID:

V4

Did the offender steal or try to steal something that belonged to anyone (else) who lived with
you during {this/the} incident?
1

Yes

2

No

ASK Description: Respondents who reported their property was damaged or destroyed or
someone injured or killed an animal and did not report any other incident type and is not in a
single person household.
ASK Specification: IF S_V = 1 and S_A != 1 and S_TA != 1 and S_T != 1 and S_BI != 1 and
S_SA != 1 and S_MV != 1 and S_MVP != 1 AND S_05A1 != 1 AND SOLO_HHM != 1.

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Location Series
Question ID:

LO_INTRO

The next questions ask about when and where {this/the} incident{ in {MONTH}} took place.
ASK Description: Respondents who reported an incident.
ASK Specification: IF S_MV = 1 or S_MVP = 1 or S_T = 1 or S_BI = 1 or S_V = 1 or S_A = 1 or
S_TA = 1 or S_ATA = 1 or S_SA = 1.
Question ID:

LO_T

About what time did the incident happen?
1

After 6am - 12 noon

2

After 12 noon - 3pm

3

After 3pm - 6pm

4

After 6pm - 9pm

5

After 9pm - midnight

6

After 12 midnight - 6am

7

During the day, but don't know what time

8

During the night, but don't know what time

9

Don't know whether day or night

ASK Description: Respondents who reported an incident.
ASK Specification: IF S_MV = 1 or S_MVP = 1 or S_T = 1 or S_BI = 1 or S_V = 1 or S_A = 1 or
S_TA = 1 or S_ATA = 1 or S_SA = 1.
Box ID:

LO_BOX1

Respondents who have lived at their current address less than 6 months, at least 6 months, but
less than 1 year, or did not report how long they have lived at their current address, go to
CIR1A.
Else, go to LO_BOX2.

If PC2 = 1, 2, -9 or PC1_YR < 1, go to CIR1A.
Else, go to LO_BOX2.

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Question ID:

CIR1A

Did this incident happen while you were living at your current address, or before you moved to
this address?
1

While living at current address

2

Before moving to this address

ASK Description: Respondents who have lived at their current address less 6 months, at least 6
months, but less than 1 year, or did not report how long they have lived at their current
address.
ASK Specification: IF PC2 = 1, 2, -9 or PC1_YR < 1.
Box ID:

LO_BOX2

Respondents who reported a break in at a second home, a hotel or motel room, or some other
place, go to LO_BOX4.
Else, respondents who reported someone broke into or vandalized their vehicle, go to LO_1.
Else, go to LO_BOX3.
If BI1c = 1 or BI1d = 1 or BI1f = 1, go to LO_BOX4.
Else, if BI1e = 1 or V1_1 = 1 or S_MV = 1 or S_MVP = 1, go to LO_1.
Else, go to LO_BOX3.
Question ID:

LO_1

Where was the vehicle when this happened?{ (READ UNTIL RESPONDENT PICKS ONE)}
1

On your property, such as your driveway or garage

2

{In your building's garage or parking lot}

3

In some other garage or parking lot

4

On the street near where you live

5

On the street but not near where you live

6

Somewhere else

ASK Description: Respondents who reported someone broke into or vandalized their vehicle.
ASK Specification: IF BI1e = 1 OR V1_1 = 1 OR S_MV = 1 OR S_MVP = 1.
Box ID:

LO_BOX3

If (LO_1 = 1, 2, 4 and CIR1A = 2) or LO_1 = 3, 5, 6, go to LO_BOX4.
Else, if LO_1 = 1, 2, 4, go to PR_INTRO.
Else, if S_MV != 1 and S_MVP != 1 and (S_T = 1 or S_BI = 1 or S_V = 1 or S_A = 1 or S_TA =
1 or S_ATA = 1 or S_SA = 1), go to LO_3.
Else, go to PR_INTRO.

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Question ID:

LO_3

Where did {this/the} incident happen?
1

Inside your home

2

{In a common area where you live, such as a
stairwell, hallway, or storage area}

3

On your porch, lawn, garage, or other part of
{your/your building's} property

4

Inside somewhere else where you were staying
overnight or longer

5

{At your place of work}

6

{At school, on school property, or on a school bus}

7

{In a campus building such as a classroom or a
lab}

8

Somewhere else

ASK Description: Respondents whose incident does not involve theft of a motor vehicle or theft
of motor vehicle parts.
ASK Specification: IF S_MV != 1 AND S_MVP != 1 AND (S_T = 1 or S_BI = 1 or S_V = 1 or S_A
= 1 or S_TA = 1 or S_ATA = 1 or S_SA = 1).
Box ID:

LO_BOX4

If LO_3 = 1, 2, 3 and CIR1A = 2, go to LO1_1.
Else, if LO_3 = 1, 2, 3 and CSTUDENT = 1, go to LO_5a.
Else, if LO_3 = 1, 2, 3, go to PR_INTRO.
Else, go to LO1_1.

Question ID:

LO1_1

Did this happen in the city, town or village where you live (now)?
1

Yes

2

No

ASK Description: Respondents who reported this incident occurred outside of their home or
vehicle.
ASK Specification: If (LO_3 = 1, 2, 3 and CIR1A = 2) OR LO_3 != 1, 2, 3.

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Box ID:

LO_BOX5

If LO1_1 = 1 and LO_1 = 1, 2, 3, 4 and CSTUDENT = 1, go to LO_5a.
Else, if LO1_1 = 1 and (LO_1 = 1, 2, 3, 4 or LO_3 = 1, 2, 3, 5), go to LO8.
Else, if LO1_1 = 1 and LO_3 = 6, go to LO_BOX7.
Else, if LO1_1 = 1 and LO_3 = 4, 8, go to LO2.
Else, if LO1_1 = 1 and LO_3 = 7, go to LO_5a.
Else, go to LO1_1a.

Question ID:

LO1_1a

Did this happen in the U.S. or in another country?
1

In the U.S.

GO TO LO1_1b

2

In another country

GO TO PR_INTRO

ASK Description: Respondents who reported this incident did not happen in their home town.
ASK Specification: IF LO1_1 != 1.
Question ID:

LO1_1b

Did this happen on an American Indian Reservation or on American Indian Lands?
1

Yes

2

No

ASK Description: Respondents who reported the incident occurred within the U.S.
ASK Specification: IF LO1_1a = 1.
Box ID:

LO_BOX6

If LO_1 = 1, 2, 3, 4 and CSTUDENT = 1, go to LO_5a.
Else, if LO_1 = 1, 2, 3, 4 or LO_3 = 1, 2, 3, 5, go to LO8.
Else, if LO_3 = 6, go to LO3.
Else, go to LO2.

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Question ID:

LO2

Which of the following BEST describes where this happened . . . { READ UNTIL RESPONDENT
PICKS ONE.}
1

At, in, or near someone else's home

2

At a business, such as a store, restaurant, bar, or
office building

3

At a public building, such as a hospital or library

4

In a parking lot or garage

5

In an open area, on the street, or on public
transportation

6

Or somewhere else? (specify) ______

ASK Description: Respondents who reported this incident did not happen at home or at school.
ASK Specification: IF LO_1 != 1, 2, 3, 4 AND LO_3 != 1, 2, 3, 5, 6.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If LO2 = 2, go to LO2e.
Else, if (12 <= UT_AGE = 18 or CSTUDENT = 1) and LO_3 != 6, 7, go to LO_4.
Else, go to LO_BOX7.
Question ID:

LO_4

Did {this/the} incident occur when you were on the way to or from school?
1

Yes

GO TO LO8

2

No

GO TO LO8

ASK Description: Respondents who are aged 12 to 18 or are a student and reported this incident
did not happen at school or on campus.
ASK Specification: IF LO_1 != 1, 2, 3, 4 AND LO_3 != 1, 2, 3, 5, 6, 7 AND (12 <= UT_AGE = 18
OR CSTUDENT = 1).

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Question ID:

LO_2e

At what type of a business did {this/the} incident happen?
1

A restaurant, bar, nightclub

GO TO LO8

2

A bank

GO TO LO8

3

A gas station

GO TO LO8

4

A store or shopping mall

GO TO LO8

5

An office

GO TO LO8

6

A factory or warehouse

GO TO LO8

7

Other (specify) _______

GO TO LO8

ASK Description: Respondents who reported this incident happened at a business.
ASK Specification: IF LO2 = 2.
PROGRAM: Display text box and allow 250 character text response.
Box ID:

LO_BOX7

If LO_3 = 6 and S_MV != 1, go to LO3.
Else, go to LO8.
Question ID:

LO3

You said this happened at school. Did this happen inside a school building or somewhere else on
school property (school parking area, play area, school bus, etc)?
1

Inside a school building

GO TO LO4

2

On school property outside the school building
(school parking area, play area, school bus, etc.)

GO TO LO8

3

Other (specify) _______

GO TO LO8

ASK Description: Respondents who reported this incident happened at school and did not
involve a motor vehicle theft.
ASK Specification: IF S_MV != 1 AND LO_3 = 6.
PROGRAM: Display text box and allow 250 character text response.
Question ID:

LO4

Was it your school?
1

Yes

GO TO LO8

2

No

GO TO LO8

ASK Description: Respondents who reported the incident occurred inside a school building.
ASK Specification: IF LO3 = 1.

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Question ID:

LO_5a

Did this happen on a college or university campus?
1

Yes

2

No

ASK Description: Respondents who are students and reported their vehicle was broken into or
vandalized on their property, in their building's garage or parking lot, in some other garage or
parking lot, or on the street where they live or reported the incident occurred in their home, in a
common area, or on their property.
ASK Specification: IF CSTUDENT = 1 AND (LO_1 = 1, 2, 3, 4 OR LO_3 = 1, 2, 3).
PROGRAM: ROUTING INSTRUCTIONS: If LO_5a = 1, go to LO_5.
Else, if (LO_3 = 1, 2, 3 and CIR1A = 2) or LO_3 != 1, 2, 3, go to LO8.
Else, go to PR_BOX1.
Question ID:

LO_5

Where did this happen?
1

In or on the property of a residence hall or dorm

2

In or on the property of a fraternity or sorority
house

3

In or on the property of other residential housing
around the university

4

Somewhere else on campus

ASK Description: Respondents who reported this incident occurred on a college or university
campus.
ASK Specification: IF CSTUDENT = 1 AND (LO_1 = 1, 2, 3, 4 OR LO_3 = 1, 2, 3) AND LO_5a =
1.
Question ID:

LO8

How far from your home was it . . .
1

A mile or less

2

More than a mile up to five miles

3

More than 5 miles up to fifty miles

4

More than 50 miles

ASK Description: Respondents who reported this incident occurred outside of their home or
vehicle.
ASK Specification: IF (LO_3 = 1, 2, 3 and CIR1A = 2) OR LO_3 != 1, 2, 3.

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Presence Series
Box ID:

PR_BOX1

Respondents who reported an incident that involved unwanted sexual contact or an attack of
any kind, go to VO_INTRO.
Else, go to PR_INTRO.

If S_SA = 1 or S_A = 1 or S_AT = 1 or S_ATA = 1, go to VO_INTRO.
Else, go to PR_INTRO.

Question ID:

PR_INTRO

The next questions ask about who was there when {this/the} incident{ in {MONTH}} took
place.
ASK Description: Respondents who did not report an incident that involved unwanted sexual
contact or an attack of any kind.
ASK Specification: IF S_SA != 1 AND S_A != 1 AND S_AT != 1 AND S_ATA != 1.
Question ID:

PR1

Did you{ or anyone you live with} see, hear, or have any contact with the offender(s) as the
incident was happening?
1

Yes

2

No

ASK Description: Respondents who did not report an incident that involved unwanted sexual
contact or an attack of any kind.
ASK Specification: IF S_SA != 1 AND S_A != 1 AND S_AT != 1 AND S_ATA != 1.
PROGRAM: ROUTING INSTRUCTIONS: If PR1 = 1 and SOLO_HHM != 1, go to PR2.
Else, go to VO_INTRO.

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Question ID:

PR2

Who saw, heard, or had contact with the offender(s) as the incident was happening? (Mark all
that apply.)
1

{RESPONDENT/You}

2

{ONLY SOMEONE RESPONDENT LIVES
WITH/Someone you live with}

3

{SOMEONE RESPONDENT DOES NOT LIVE
WITH/Someone you do not live with}

ASK Description: Respondents who reported anyone in their household saw, heard, or had any
contact with the offender(s) as the incident was happening.
ASK Specification: IF PR1 = 1 AND SOLO_HHM != 1.
PROGRAM: ROUTING INSTRUCTIONS: IF PR2a = 1, go to PR3.
Else, go to VO_INTRO.
Question ID:

PR3

Did the offender(s) have a weapon such as a gun or knife, or something to use as a weapon,
such as a baseball bat, scissors, or a stick?
1

Yes

2

No

ASK Description: Respondents who reported that they saw, heard, or had contact with the
offender(s) as the incident was happening.
ASK Specification: IF PR2a = 1.

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Victim-Offender Relationship
Question ID:

VO_INTRO

This section asks what you know about the offender(s).
ASK Description: Respondents who reported an incident.
ASK Specification: IF S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1 OR S_V = 1 OR S_A =
1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1.
Question ID:

VO1

{To the best of your knowledge, was/Was} the incident committed by only one or by more than
one offender?
1

One

2

More than one

3

{Don't know}

ASK Description: Respondents who reported an incident.
ASK Specification: IF S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1 OR S_V = 1 OR S_A =
1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1.
PROGRAM: ROUTING INSTRUCTIONS: If VO1 = -9, go to VO1a.
Else, if VO1 = 3, go to VO2.
Else, go to VO1b.
Question ID:

VO1a

To the best of your knowledge, was the incident committed by only one or by more than one
offender?
1

One

2

More than one

3

Don't know

ASK Description: Respondents who did not answer whether the incident was committed by only
one or by more than one offender.
ASK Specification: IF VO1 = -9.
PROGRAM: ROUTING INSTRUCTIONS: If VO1a = 3,-9, go to VO2.
Else, go to VO1b.

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Question ID:

VO1b

Do you know who {the offender was/the offenders were}?
1

Yes

2

No

ASK Description: Respondents who reported there were one or more offender(s).
ASK Specification: IF VO1 = 1, 2 OR VO1a = 1, 2.
PROGRAM: ROUTING INSTRUCTIONS: If VO1b = 2, go to VO2.
Else, go to VO_BOX1.
Question ID:

VO2

Do you know anything about {the offender/any of the offenders}, such as whether they were
young or old, male or female, etc.?
1

Yes

2

No

ASK Description: Respondents who reported an incident.
ASK Specification: IF S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1 OR S_V = 1 OR S_A =
1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1.
PROGRAM: ROUTING INSTRUCTIONS: If VO2 = 1, go to VO_BOX1.
Else, if VO2 = 2,-9, go to OC_BOX1.
Box ID:

VO_BOX1

IF S_A = 1 or S_TA = 1 or S_ATA = 1 or S_SA = 1, go to VO_BOX2.
Else, go to VO3.

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Question ID:

VO3

{How did you learn what you know about the offender{s}?/How did you find out who the
{offender was/offenders were}?} (Mark all that apply.)
1

You saw or heard the offender(s)

2

Someone you live with saw or heard the
offender(s)

3

Someone else saw or heard the offender(s)

4

You figured it out yourself

5

The police told you

6

The offender(s) admitted it

7

The offender(s) had threatened to do it, or had
done it before

8

{The stolen item(s) were found on the offender(s)
or at the offender(s) home}

9

Other - specify ___________

ASK Description: Respondents who reported they know something about the offender(s) and did
not report an attack, threatened attack, attack with a weapon, or unwanted sexual contact as
part of this incident.
ASK Specification: IF VO2 = 1 AND S_A != 1 AND S_TA != 1 AND S_ATA != 1 AND S_SA != 1.
PROGRAM: Display text box and allow 250 character text response.
Box ID:

VO_BOX2

If VO1 = 1 or VO1a = 1, go to VO6.
If VO1 = 2 or VO1a = 2, go to VO14.
Else, go to Offender Characteristics module, OC_BOX1.

Question ID:

VO6

Was the offender someone you knew, even slightly, or a complete stranger?
1

Someone you knew

GO TO VO8

2

Complete stranger

GO TO VO7

ASK Description: Respondents who reported there was one offender and know something about
the offender.
ASK Specification: IF (VO1 = 1 OR VO1a = 1) AND VO2 = 1.

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Question ID:

VO7

Would you be able to recognize the offender if you saw him/her?
1

Yes

GO TO VO9

2

Not sure (possibly)

GO TO VO9

3

No

GO TO VO11

ASK Description: Respondents who reported there was one offender and know something about
the offender and the offender was a complete stranger.
ASK Specification: IF (VO1 = 1 OR VO1a = 1) AND VO2 = 1 AND VO6 = 2.
Question ID:

VO8

Was the offender someone you knew by sight only, a casual acquaintance, or someone you
knew well?
1

Knew by sight only

2

Someone you knew, but not well

3

Someone you knew well

ASK Description: Respondents who reported there was one offender and know something about
the offender and the offender was someone they knew.
ASK Specification: IF (VO1 = 1 OR VO1a = 1) AND VO2 = 1 AND VO6 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If VO8 = 1, -9, go to VO9.
Else, if VO8 = 2, 3, go to VO_BOX2A.
Question ID:

VO9

Did you know how the offender might be found, for instance, where he/she lived, worked, went
to school, or spent time?
1

Yes

2

No

ASK Description: All Respondents.
PROGRAM: ROUTING INSTRUCTIONS: Go to VO11.
Box ID:

VO_BOX2A

Go to VO10.

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Question ID:

VO10

At the time of the incident, {which of the following BEST describes }how {did }you
{know/knew} the offender?{ For example, was the offender a friend, cousin, etc.?}
1

{A spouse or ex-spouse}

2

Someone you were romantically involved with,
dating, or casually seeing at the time of the
incident

3

{An ex-boyfriend, ex-girlfriend,{ former
fiancé(e),} or someone you were no longer dating
or seeing}

4

A relative

5

Someone else

ASK Description: Respondents who reported the offender was a casual acquaintance or someone
they knew well.
ASK Specification: IF VO8 = 2, 3.
PROGRAM: ROUTING INSTRUCTIONS: If VO10 = -9, go to VO13. Else, go to VO10a.

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Question ID:

VO10a

Specifically, how did you know the offender at the time of the incident?
1

{A HUSBAND OR WIFE}

2

{AN EX-HUSBAND OR EX-WIFE}

3

{A LIVE-IN PARTNER}

4

{A FIANCÉ(E)}

5

{A BOYFRIEND, GIRLFRIEND, OR DATING
PARTNER}

6

{SOMEONE YOU WERE CASUALLY SEEING}

7

{AN EX-BOYFRIEND, EX-GIRLFRIEND, OR FORMER
FIANCÉ(E)/AN EX-BOYFRIEND OR EXGIRLFRIEND}

8

{SOMEONE YOU WERE NO LONGER DATING OR
SEEING}

9

{A PARENT OR STEP-PARENT}

10

{A CHILD OR STEP-CHILD}

11

{A BROTHER, SISTER, STEP-BROTHER, OR STEPSISTER}

12

{SOME OTHER RELATIVE ___________}

13

{A FRIEND OR EX-FRIEND}

14

{AN ACQUAINTANCE OR A FRIEND OF A FRIEND}

15

{A ROOMMATE OR BOARDER}

16

{A SCHOOLMATE}

17

{A NEIGHBOR}

18

{A CUSTOMER OR CLIENT}

19

{A PATIENT}

20

{A SUPERVISOR OR FORMER SUPERVISOR}

21

{AN EMPLOYEE OR CO-WORKER OR FORMER
EMPLOYEE OR CO-WORKER}

22

{A TEACHER OR SCHOOL STAFF}

23

{SOME OTHER NON-RELATIVE___________}

ASK Description: Respondents who reported the offender was a casual acquaintance or someone
they knew well.
ASK Specification: IF VO8 = 2, 3 AND VO10 != -9.
PROGRAM: Display text boxes and allow 250 character text response.
ROUTING INSTRUCTIONS: If VO10a = 3, 15, go to VO13.
Else, go to VO12.

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Question ID:

VO11

What was your connection, if any, to this person?
1

A friend of a friend

2

A schoolmate

3

A neighbor

4

{A customer or client}

5

{A patient}

6

{Someone who worked at the same place as you}

7

A teacher or school staff

8

Other - specify ___________

9

A stranger/or someone of whom you have no
knowledge

ASK Description: Respondents who reported the offender was a complete stranger or knew the
offender by sight only.
ASK Specification: IF VO6 = 2 OR VO8 = 1.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: Go to OC_BOX1.
Question ID:

VO12

Had you ever lived with this person?
1

Yes

GO TO VO13

2

No

GO TO OC_BOX1

ASK Description: Respondents who reported the offender was someone other than a live-in
partner or roommate or boarder.
ASK Specification: IF VO8 = 2, 3 AND VO10a != 3, 15.
Question ID:

VO13

Were you living with this person at the time of {this/the} incident {in {MONTH/YEAR}}?
1

Yes

GO TO OC_BOX1

2

No

GO TO OC_BOX1

ASK Description: Respondents who reported the offender was a live-in partner, roommate, or
boarder of have ever lived with the offender.
ASK Specification: IF VO10a = 3, 15 OR VO12 = 1.

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Question ID:

VO14

How many offenders were there?
1

|__|__|

ASK Description: Respondents who reported there were two or more offenders and know
something about the offender(s).
ASK Specification: IF (VO1 = 2 OR VO1a = 2) AND VO2 = 1.
PROGRAM: Display checkbox with label "Don't know number of offenders" below numeric field.
Allow user to only allow entering in the numeric field or selecting the checkbox, not both.
Question ID:

VO15

Were any of the offenders someone you knew, even slightly, or were all of them complete
strangers?
1

At least one was someone you knew

2

All were complete strangers

ASK Description: Respondents who reported there were two or more offenders and know
something about the offender(s).
ASK Specification: IF (VO1 = 2 OR VO1a = 2) AND VO2 = 1.
PROGRAM: If VO15 = 1, go to VO17.
Else, if VO15 = 2,-9, go to VO16.
Question ID:

VO16

Would you be able to recognize any of them if you saw them?
1

Yes

GO TO VO18

2

Not sure (possibly)

GO TO VO18

3

No

GO TO VO_BOX3

ASK Description: Respondents who reported that all of the offenders were complete strangers or
did not report whether they knew any of the offenders or not.
ASK Specification: IF VO15 = 2, -9.

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Question ID:

VO17

Were any of the offenders someone you knew by sight only, someone you knew, but not well, or
someone you knew well? (Mark all that apply.)
1

Knew by sight only

2

Knew, but not well

3

Someone you knew well

ASK Description: Respondents who reported at least one of the offenders was someone they
knew.
ASK Specification: IF VO15 = 1.
PROGRAM: ROUTING INSTRUCTIONS: If (VO17_1 = 1 and VO17_2 != 1 and VO17_3 != 1) or
(VO17_1 = -9 and VO17_2 = -9 and VO17_3 = -9), go to VO18.
Else, if VO17_2 = 1 or VO17_3 = 1, go to VO_BOX2B.
Question ID:

VO18

Did you know how any of the offenders might be found, for instance, where they lived, worked,
went to school, or spent time?
1

Yes

2

No

ASK Description: Respondents who would be able to or possibly be able to recognize any of the
offenders if they saw them or only knew the offenders by sight only or did not report whether
they knew any of the offenders by sight only, knew any of the offenders but not well, or any of
the offenders were someone they knew well.
ASK Specification: IF VO16 = 1, 2 OR (VO17_1 = 1 AND VO17_2 != 1 AND VO17_3 != 1) OR
(VO17_1 = -9 AND VO17_2 = -9 AND VO17_3 = -9).
PROGRAM: ROUTING INSTRUCTIONS: Go to VO_BOX3.
Box ID:

VO_BOX2B

Go to VO19.

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Question ID:

VO19

At the time of the incident, did you know any of the offenders in any way of the following ways?
1

{A spouse or ex-spouse}

2

Someone you were romantically involved with,
dating, or casually seeing at the time of the
incident, but not a spouse or ex-spouse

3

An ex-boyfriend, ex-girlfriend, former fiancé(e), or
someone you were no longer dating or seeing

4

A relative

5

Someone else

ASK Description: Respondents who reported that any of the offenders were someone they knew,
but not well or were someone they knew well.
ASK Specification: IF VO17_2 = 1 OR VO17_3 = 1.

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Question ID:

VO19a

Specifically, how did you know them? (Mark all that apply.)
1

{A HUSBAND OR WIFE}

2

{AN EX-HUSBAND OR EX-WIFE}

3

{A LIVE-IN PARTNER}

4

{A FIANCÉ(E)}

5

{A BOYFRIEND, GIRLFRIEND, OR DATING
PARTNER}

6

{SOMEONE YOU WERE CASUALLY SEEING}

7

{AN EX-BOYFRIEND, EX-GIRLFRIEND, OR FORMER
FIANCÉ(E)/AN EX-BOYFRIEND OR EXGIRLFRIEND}

8

{SOMEONE YOU WERE NO LONGER DATING OR
SEEING}

9

{A PARENT OR STEP-PARENT}

10

{A CHILD OR STEP-CHILD}

11

{A BROTHER, SISTER, STEP-BROTHER, OR STEPSISTER}

12

{SOME OTHER RELATIVE ___________}

13

{A FRIEND OR EX-FRIEND}

14

{AN ACQUAINTANCE OR A FRIEND OF A FRIEND}

15

{A ROOMMATE OR BOARDER}

16

{A SCHOOLMATE}

17

{A NEIGHBOR}

18

{A CUSTOMER OR CLIENT}

19

{A PATIENT}

20

{A SUPERVISOR OR FORMER SUPERVISOR}

21

{AN EMPLOYEE OR CO-WORKER OR FORMER
EMPLOYEE OR CO-WORKER}

22

{A TEACHER OR SCHOOL STAFF}

23

{SOME OTHER NON-RELATIVE___________}

ASK Description: Respondents who reported that any of the offenders were someone they knew,
but not well or were someone they knew well.
ASK Specification: IF VO17_2 = 1 OR VO17_3 = 1.
PROGRAM: Display text boxes and allow 250 character text response.
ROUTING INSTRUCTIONS: If VO19a_3 = 1 OR VO19a_15 = 1, go to VO22.
Else, go to VO21.

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Box ID:

VO_BOX3

If VO15 = 1 or (VO17_1 = 1 and VO17_2 != 1 and VO17_3 != 1), go to VO20.
Else, go to OC_BOX1.

Question ID:

VO20

What was your connection, if any, to the offender(s)? (Mark all that apply.)
1

A friend of a friend

2

A schoolmate

3

A neighbor

4

{A customer or client}

5

{A patient}

6

{Someone who worked at the same place as you}

7

A teacher or school staff

8

Other - specify _________

9

A stranger/or someone of whom you have no
knowledge

ASK Description: Respondents who reported at least one of the offenders were someone they
knew or knew any of the offenders by sight only.
ASK Specification: IF VO15 = 1 OR (VO17_1 = 1 AND VO17_2 != 1 AND VO17_3 != 1).
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: Go to OC_BOX1.
Question ID:

VO21

Had you ever lived with any of them?
1

Yes

GO TO VO22

2

No

GO TO OC_BOX1

ASK Description: Respondents who reported that any of the offenders were someone they knew,
but not well or were someone they knew well and that none of the offenders were a live-in
partner, roommate, or boarder.
ASK Specification: IF (VO17_2 = 1 OR VO17_3 = 1) AND VO19a_3 != 1 AND VO19a_15 != 1.
Question ID:

VO22

Were you living with any of them at the time of {this/the} incident?
1

Yes

2

No

ASK Description: Respondents who have ever lived with any of the offenders.
ASK Specification: IF VO19a = 3, 15 OR VO21 = 1.

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Offender Characteristics
Box ID:

OC_BOX1

Respondents who reported the crime was committed by only one offender, go to OCINTRO.
Else, respondents who reported the crime was committed by more than one offender, go to
OCINTRO_MULT.
Else, respondents who saw, heard, or had contact with the offender(s) as the incident was
happening or someone the respondent does not live with had contact with the offender(s) as the
incident was happening, go to OCINTRO.
Else, respondents who did not know or did not report how many offenders the crime was
committed by but knew something about the offender(s), go to OCINTRO.Else, go to SP_BOX1.
IF VO1 = 1 OR VO1a = 1, GO TO OCINTRO.
ELSE, IF VO1 = 2 OR VO1a = 2, GO TO OCINTRO_MULT.
ELSE, IF PR2a = 1 OR PR2c = 1, GO TO OCINTRO.
ELSE, IF VO1 = 3, -9 AND VO2 = 1, GO TO OCINTRO.ELSE, GO TO SP_BOX1.
Question ID:

OCINTRO

This section asks for details about the offender.
ASK Description: Respondents who reported the crime was committed by only one offender, or
respondents who saw, heard, or had contact with the offender(s) as the incident was happening
or someone the respondent does not live with had contact with the offender(s) as the incident
was happening, or respondents who did not know or did not report how many offenders the
crime was committed by but knew something about the offender(s).
ASK Specification: IF VO1 = 1 OR VO1a = 1 OR (VO1 != 2 AND VO1a != 2 AND (PR2a = 1 OR
PR2c = 1 OR (VO1 = 3, -9 AND VO2 = 1))).
Question ID:

OC1

Was the offender male or female?
1

Male

2

Female

3

{Don't know}

ASK Description: Respondents who reported the crime was committed by only one offender, or
respondents who saw, heard, or had contact with the offender(s) as the incident was happening
or someone the respondent does not live with had contact with the offender(s) as the incident
was happening, or respondents who did not know or did not report how many offenders the
crime was committed by but knew something about the offender(s).
ASK Specification: IF VO1 = 1 OR VO1a = 1 OR (VO1 != 2 AND VO1a != 2 AND (PR2a = 1 OR
PR2c = 1 OR (VO1 = 3, -9 AND VO2 = 1))).

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Question ID:

OC2

How old would you say the offender was?{ (USE CATEGORIES AS PROBES IF NEEDED.)}
1

Under 18

2

18 to 24

3

25 to 34

4

35 to 54

5

55 or older

6

{Don't know}

ASK Description: Respondents who reported the crime was committed by only one offender, or
respondents who saw, heard, or had contact with the offender(s) as the incident was happening
or someone the respondent does not live with had contact with the offender(s) as the incident
was happening, or respondents who did not know or did not report how many offenders the
crime was committed by but knew something about the offender(s).
ASK Specification: IF VO1 = 1 OR VO1a = 1 OR (VO1 != 2 AND VO1a != 2 AND (PR2a = 1 OR
PR2c = 1 OR (VO1 = 3, -9 AND VO2 = 1))).
PROGRAM: ROUTING INSTRUCTIONS: IF OC2 = 1, GO TO OC2a.
ELSE, GO TO OC3.
Question ID:

OC2a

Would you say the offender was…
1

Under 12

2

12 to 14

3

15 to 17

4

{Don't know}

ASK Description: Respondents who reported the offender was under 18 years old.
ASK Specification: IF OC2 = 1.
Question ID:

OC3

Was the offender Hispanic or Latino?
1

Yes

2

No

3

{Don't know}

ASK Description: Respondents who reported the crime was committed by only one offender, or
respondents who saw, heard, or had contact with the offender(s) as the incident was happening
or someone the respondent does not live with had contact with the offender(s) as the incident
was happening, or respondents who did not know or did not report how many offenders the
crime was committed by but knew something about the offender(s).
ASK Specification: IF VO1 = 1 OR VO1a = 1 OR (VO1 != 2 AND VO1a != 2 AND (PR2a = 1 OR
PR2c = 1 OR (VO1 = 3, -9 AND VO2 = 1))).

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Question ID:

OC4

What race or races was the offender? You may select more than one. (Mark all that apply.)
1

White

2

Black or African American

3

American Indian or Alaska Native

4

Asian

5

Native Hawaiian or Other Pacific Islander

6

{Don't know}

ASK Description: Respondents who reported the crime was committed by only one offender, or
respondents who saw, heard, or had contact with the offender(s) as the incident was happening
or someone the respondent does not live with had contact with the offender(s) as the incident
was happening, or respondents who did not know or did not report how many offenders the
crime was committed by but knew something about the offender(s).
ASK Specification: IF VO1 = 1 OR VO1a = 1 OR (VO1 != 2 AND VO1a != 2 AND (PR2a = 1 OR
PR2c = 1 OR (VO1 = 3, -9 AND VO2 = 1))).
Question ID:

OC5

Was the offender a member of a street gang, or don't you know?
1

Yes

2

No

3

Don't know

ASK Description: Respondents who reported the crime was committed by only one offender, or
respondents who saw, heard, or had contact with the offender(s) as the incident was happening
or someone the respondent does not live with had contact with the offender(s) as the incident
was happening, or respondents who did not know or did not report how many offenders the
crime was committed by but knew something about the offender(s).
ASK Specification: IF VO1 = 1 OR VO1a = 1 OR (VO1 != 2 AND VO1a != 2 AND (PR2a = 1 OR
PR2c = 1 OR (VO1 = 3, -9 AND VO2 = 1))).
Question ID:

OC6

Was the offender drinking or on drugs at the time of the incident{, or don't you know}?
1

Yes, the offender was drinking or on drugs

GO TO SP_BOX1

2

No, the offender was not drinking or on drugs

GO TO SP_BOX1

3

Don't know

GO TO SP_BOX1

ASK Description: All Respondents.

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Question ID:

OCINTRO_MULT

This section asks for more details about the offenders.
ASK Description: Respondents who reported the crime was committed by more than one
offender.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2).
Question ID:

OC9

Were the offenders male or female?
1

All were male

2

All were female

3

They were both male and female

4

{Don't know}

ASK Description: Respondents who reported the crime was committed by more than one
offender.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2).
PROGRAM: ROUTING INSTRUCTIONS: If OC9 = 1, 2 or VO14 = 2, go to OC11.
ELSE, GO TO OC10.
Question ID:

OC10

Were most of the offenders male or were most of them female?
1

Most were male

2

Most were female

3

They were evenly divided

4

{Don't know}

ASK Description: Respondents who reported the crime was committed by more than one
offender and did not report the offenders were all one gender and did not report there were two
offenders.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2) AND OC9 != 1, 2
AND VO14 != 2.

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Question ID:

OC11

How old would you say the youngest was?{ (USE CATEGORIES AS PROBES IF NEEDED.)}
1

Under 18

2

18 to 24

3

25 to 34

4

35 to 54

5

55 or older

6

{Don't know}

ASK Description: Respondents who reported the crime was committed by more than one
offender.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2).
PROGRAM: ROUTING INSTRUCTIONS: IF OC11 = 1, GO TO OC11A.
ELSE, GO TO OC12.
Question ID:

OC11a

Would you say the youngest offender was…
1

Under 12

2

12 to 14

3

15 to 17

4

{Don't know}

ASK Description: Respondents who reported the crime was committed by more than one
offender and reported the youngest offender was under the age of 18.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2) AND OC11 = 1.

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Question ID:

OC12

How old would you say the oldest was?{ (USE CATEGORIES AS PROBES IF NEEDED.)}
1

Under 18

2

18 to 24

3

25 to 34

4

35 to 54

5

55 or older

6

{Don't know}

ASK Description: Respondents who reported the crime was committed by more than one
offender.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2).
PROGRAM: ROUTING INSTRUCTIONS: IF OC12 = 1, GO TO OC12A.
ELSE, GO TO OC13.
Question ID:

OC12a

Would you say the oldest offender was…
1

Under 12

2

12 to 14

3

15 to 17

4

{Don't know}

ASK Description: Respondents who reported the crime was committed by more than one
offender and reported the oldest offender was under the age of 18.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2) AND OC12 = 1.
Question ID:

OC13

Were any of the offenders Hispanic or Latino?
1

Yes

GO TO OC14

2

No

GO TO OC15

3

{Don't know}

GO TO OC15

ASK Description: Respondents who reported the crime was committed by more than one
offender.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2).

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Question ID:

OC14

Were most of the offenders Hispanic, non-Hispanic, or were roughly an equal number Hispanic
and non-Hispanic?
1

Most of the offenders were Hispanic

2

Most of the offenders were non-Hispanic

3

A roughly equal number were Hispanic and nonHispanic

4

{Don't know}

ASK Description: Respondents who reported the crime was committed by more than one
offender and reported any of the offenders were Hispanic or Latino.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2) AND OC14 = 1.
Question ID:

OC15

Were the offenders… (Mark all that apply.)
1

White?

2

Black or African American?

3

American Indian or Alaska Native?

4

Asian?

5

Native Hawaiian or Other Pacific Islander?

6

{Don't know}

ASK Description: Respondents who reported the crime was committed by more than one
offender.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2).
PROGRAM: ROUTING INSTRUCTIONS: IF 2 OR MORE ARE SELECTED FROM OC15_1, OC15_2,
OC15_3, OC15_4, OR OC15_5, GO TO OC16.
ELSE, GO TO OC17.

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Question ID:

OC16

What race were most of the offenders?
1

{MOST WERE WHITE}

2

{MOST WERE BLACK OR AFRICAN AMERICAN}

3

{MOST WERE AMERICAN INDIAN OR ALASKA
NATIVE}

4

{MOST WERE ASIAN}

5

{MOST WERE NATIVE HAWAIIAN OR OTHER
PACIFIC ISLANDER}

6

ROUGHLY EQUAL NUMBERS OF TWO OR MORE
RACES

7

{DON'T KNOW}

ASK Description: Respondents who reported one or more of the offenders were at least two of
the following: white, black or African American, Asian, Native Hawaiian or other Pacific islander,
or American Indian or Alaska native.
ASK Specification: IF 2 OR MORE ARE SELECTED FROM OC15_1, OC15_2, OC15_3, OC15_4, OR
OC15_5.
Question ID:

OC17

Were any of the offenders a member of a street gang, or don't you know?
1

Yes (a member of a street gang)

2

No (not a member of a street gang)

3

Don't know (if a member of a street gang)

ASK Description: Respondents who reported the crime was committed by more than one
offender.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2).
Question ID:

OC18

Were any of the offenders drinking or on drugs at the time of the incident{, or don't you know}?
1

Yes, some or all of the offenders were drinking or
on drugs

2

No, none were drinking or on drugs

3

Don't know

ASK Description: Respondents who reported the crime was committed by more than one
offender.
ASK Specification: IF VO1 != 1 AND VO1a != 1 AND (VO1 = 2 OR VO1a = 2).

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Self-Protection
Box ID:

SP_BOX1

GLOBAL – IF VO1=1, USE "OFFENDER" IN THIS SERIES. IF VO1=2, USE "OFFENDERS".
If the crime involved an attack of any kind or unwanted sexual contact or the respondent had
contact with the offender(s) as the incident was happening, go to SPINTRO.Else, go to HC2.
If S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1 or PR2a = 1, go to SPINTRO.Else, go to
HC2.
Question ID:

SPINTRO

These next questions are about what you did when {this/the} incident{ in {MONTH}} occurred.
People may react differently to certain situations and there's not a wrong or right way to react.
Everyone is different and every situation is different.
ASK Description: Respondents who reported the crime involved an attack of any kind or
unwanted sexual contact or the respondent had contact with the offender(s) as the incident was
happening.
ASK Specification: IF S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1 OR PR2a = 1.
Question ID:

SP1

Which of the following describes how you reacted during the incident? (Mark all that apply.)
1

Did you do what the person told you to do?

2

Did you not do anything, freeze or not move?

3

Did you do something or try to do something to
protect yourself or your belongings?

4

Did you do or try to do something else during the
incident?

ASK Description: Respondents who reported the crime involved an attack of any kind or
unwanted sexual contact or the respondent had contact with the offender(s) as the incident was
happening.
ASK Specification: IF S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1 OR PR2a = 1.
PROGRAM: ROUTING INSTRUCTIONS: If SP1_3 = 1 or SP1_4 = 1, go to SP2.
Else, go to SP_BOX3.

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Question ID:

SP2

You said that you took some action during the incident. What did you do?{ Anything else?}
(Mark all that apply.)
1

You threatened or attacked the offender{s}

2

You ducked or tried to avoid the offender{s}

3

You chased or warned the offender{s} off

4

You argued, reasoned, or pleaded with the
offender{s}

5

You got away or tried to get away, hid, or locked a
door

6

You called the police or a guard

7

You tried to get someone else's attention

8

You held onto your belongings

9

You stalled or distracted the offender{s}

10

Something else

ASK Description: Respondents who reacted during the incident by doing something to protect
themselves or their belongings or tried to do something else during the incident.
ASK Specification: IF SP1_3 = 1 or SP1_4 = 1.
PROGRAM: If SP2_1 = 1, go to SP2A.
Else, go to SP_BOX2.
Question ID:

SP2A

What did you do to attack or threaten the offender{s}? (Mark all that apply.)
1

You attacked the offender{s} with a gun or fired a
gun

2

You attacked the offender{s} with another weapon

3

You hit, kicked, or attacked the offender{s} in
some other way

4

You threatened the offender{s} with a gun

5

You threatened the offender{s} with another
weapon

6

You threatened the offender{s} in some other way

7

Something else ______________

ASK Description: Respondents who took action during the incident by threatening or attacking
the offender(s).
ASK Specification: IF SP2_1 = 1.
PROGRAM: Display text box and allow 250 character text response.

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Box ID:

SP_BOX2

If SP2_10 = 1, go to SP2b.
Else, go to SP_BOX3.
Question ID:

SP2b

What other actions did you take during the incident?
1

TEXT RESPONSE

ASK Description: Respondents who took action during the incident by doing something else.
ASK Specification: IF SP2_10 = 1.
PROGRAM: DISPLAY TEXT FIELD, MAX CHARACTER LENGTH = 256.
Box ID:

SP_BOX3

Respondents who were physically injured in any way during the incident, go to SP3A.
Else, go to SP3B.
If CI1 = 1, GO TO SP3A.
Else, go to SP3B.
Question ID:

SP3A

Did you {take that action/take any of these actions} {before you were injured, after you were
injured, or at the same time you were injured?/…} (Mark all that apply.)
1

Before you were injured

2

After you were injured

3

At the same time you were injured

ASK Description: Respondents who reported the crime involved an attack of any kind or
unwanted sexual contact or the respondent had contact with the offender(s) as the incident was
happening and were physically injured in any way during the incident.
ASK Specification: IF (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1 OR PR2a = 1) AND
CI1 = 1.
Question ID:

SP3b

Overall, do you think that what you did helped the situation, made it worse, or had no impact?
1

Helped the situation

2

Made the situation worse

3

Had no impact on the situation

ASK Description: Respondents who reported the crime involved an attack of any kind or
unwanted sexual contact or the respondent had contact with the offender(s) as the incident was
happening.
ASK Specification: IF S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1 OR PR2a = 1.

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Box ID:

SP_BOX4

Respondents who reported someone else saw, heard, or had contact with the offender(s), go to
SP5.Else, go to SP4.
If PR2b = 1 OR PR2c = 1, go to SP5.Else, go to SP4.
Question ID:

SP4

Besides you and the offender{s}, was anyone ELSE present during the incident? (Only include
those ages 12 or older)?
1

Yes

GO TO SP5

2

No

GO TO HC2

ASK Description: Respondents who reported the crime involved an attack of any kind or
unwanted sexual contact and did not report that someone else saw, heard, or had contact with
the offender(s).
ASK Specification: IF (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1) AND PR2b != 1 AND
PR2c != 1.
Question ID:

SP5

Did anyone else do or try to do anything to help you while the incident was going on?
1

Yes

GO TO SP6

2

No

GO TO SP_BOX5

ASK Description: Respondents who reported the crime involved an attack of any kind or
unwanted sexual contact or the respondent had contact with the offender(s) as the incident was
happening or reported someone other than themselves and the offender(s) were present during
the incident.
ASK Specification: IF S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1 OR PR2a = 1 OR SP4 =
1.
Question ID:

SP6

Who took these actions? (Mark all that apply.)
1

Someone who was with you

2

Someone who was with the offender{s}

3

Someone else

ASK Description: Respondents who reported that someone else did or tried to do anything to
help them while the incident was going on.
ASK Specification: IF SP6 = 1.

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Question ID:

SP7

What did the person or people try to do to help you? (Mark all that apply.)
1

They attacked or tried to attack the offender{s}

2

They defended you or your property without
physically attacking the offender{s}

3

They chased or warned off the offender{s}

4

They argued, reasoned, pleaded or bargained with
the offender{s}

5

They tried to get help

6

They did something else (specify) ______

ASK Description: Respondents who reported that someone else did or tried to do anything to
help them while the incident was going on.
ASK Specification: IF SP6 = 1.
PROGRAM: Display text box and allow 250 character text response.
Question ID:

SP8

Overall, did the actions of this person or people help the situation, make it worse, or have no
impact?
1

Helped the situation

2

Made the situation worse

3

Had no impact on the situation

ASK Description: Respondents who reported that someone else did or tried to do anything to
help them while the incident was going on.
ASK Specification: IF SP6 = 1.
Box ID:

SP_BOX5

If PR2b = 1 or PR2c = 1 or SP4 = 1, GO TO SP9.Else, go to HC2.
Question ID:

SP9

{Not including the offender{s}, were/Were} anyone who was there during the incident under
the age of 12?
1

Yes

2

No

ASK Description: Respondents who reported the crime involved an attack of any kind or
unwanted sexual contact and reported that someone else saw, heard, or had contact with the
offender(s).
ASK Specification: IF (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1) AND (PR2b = 1 OR
PR2c = 1 OR SP4 = 1).

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Question ID:

SP9a

Not counting yourself, {or }the offender{s}{, or children under 12}, were any other people
harmed, threatened with harm, or have any belongings taken or damaged in {this/the}
incident?
1

Yes {How many? |__|__|}

2

No

ASK Description: Respondents who reported the crime involved an attack of any kind or
unwanted sexual contact and reported that someone else saw, heard, or had contact with the
offender(s).
ASK Specification: IF (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1) AND (PR2b = 1 OR
PR2c = 1 OR SP4 = 1).
PROGRAM: If SP9a = 1, display "How many?" and an open response field. Allow 2 digits.
ROUTING INSTRUCTIONS: If SP9a = 1, go to SP10.
Else, if SP9a = 2, -9, go HC2.
Question ID:

SP10

{Of these {SP9A_NUM} people, how many of them live with you now?/Thinking just about the
other persons who were present during the incident who were harmed, threatened with harm,
or had property taken or damaged … How many of these persons live with you now? (Do not
include yourself, the offender{s} or children under 12 years of age.)}
1

|__|__|

ASK Description: Respondents who reported that someone other than themselves were harmed,
threatened with harm, or had belongings taken or damaged in this incident.
ASK Specification: IF SP9a = 1.
PROGRAM: Allow 2 digits.

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Hate Crimes
Question ID:

HC2

A hate crime is a crime of prejudice or bigotry that occurs when an offender targets someone
because of one or more of their characteristics or religious beliefs, such as:
-

Race
Religion
Ethnic background or national origin
A disability
Sex
Sexual orientation or gender identity

This could happen even if the offender falsely thinks you have certain characteristics or religious
beliefs.
Do you think that this was a hate crime targeted at you?
1

Yes

GO TO HC_BOX1

2

No

GO TO HC3

ASK Description: Respondents who reported an incident.
ASK Specification: IF S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1 OR S_V = 1 OR S_A =
1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1.
Box ID:

HC_BOX1

For HC2a_1 – HC2a_6, display a ‘Yes' and ‘No' column with options for each response category.

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Question ID:

HC2a

Do you think prejudice or bigotry towards any of the following was a reason you were targeted,
even if the offender falsely thought something about you?
1

Because of your race?

2

Because of your religion?

3

Because of your ethnic background or national
origin?

4

Because of any disability you may have?

5

Because of your sex?

6

Because of your sexual orientation or gender
identity - by this we mean gay, lesbian, bisexual,
straight, transgender, or gender non-conforming?

ASK Description: Respondents who suspect that this incident was a hate crime targeted at
them.
ASK Specification: IF HC2 = 1.
PROGRAM: ROUTING INSTRUCTIONS: Go to HC4.
Question ID:

HC3

Do you think this was a hate crime targeted at any of the people you spend time with?
1

Yes

GO TO HC4

2

No

GO TO PI_INTRO

ASK Description: Respondents who do not suspect that this incident was a hate crime targeted
at them.
ASK Specification: IF HC2 = 2.
Question ID:

HC4

Did the offender(s) say something, write something, or leave something behind at the crime
scene that made you think it was a hate crime?
1

Yes

GO TO HC_BOX2

2

No

GO TO PI_INTRO

ASK Description: Respondents who suspect that this incident was a hate crime targeted at them
or any of the people they spend time with.
ASK Specification: IF HC2 = 1 OR (HC2 = 2 AND HC3 = 1).
Box ID:

HC_BOX2

For HC5a – HC5g, display a ‘Yes' and ‘No' column with options for each response category.

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Question ID:

HC5

Did any of the following things happen?
1

The offender(s) used hurtful or abusive language
referring to your sex, religion, race or ethnicity,
sexual orientation or gender identity, or a disability

2

There was something at the scene, such as a
swastika or a burning cross, that made you think
this was a hate crime

3

The police told you that this was a hate crime

4

From what you know, the offender(s) had
committed similar hate crimes in the past

5

The incident happened around a holiday, event, or
place commonly associated with a specific group

6

Other hate crimes had occurred in your local area
or neighborhood

7

Something else happened that would suggest it
was a hate crime Specify: ______________

ASK Description: Respondents who reported the offenders said, wrote, or left anything behind at
the crime scene that suggested the incident was a hate crime.
ASK Specification: IF HC4 = 1.
PROGRAM: Display text box and allow 250 character text response.

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Police Involvement Series
Question ID:

PI_INTRO

The next questions ask about whether the police got involved in {this/the} incident{ in
{MONTH}}.
ASK Description: Respondents who reported an incident.
ASK Specification: IF S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1 OR S_V = 1 OR S_A =
1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1.
Question ID:

PI1

Did the police find out about {this/the} incident?
1

Yes

2

No

ASK Description: Respondents who reported an incident.
ASK Specification: IF S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1 OR S_V = 1 OR S_A =
1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1.
PROGRAM: ROUTING INSTRUCTIONS: If PI1 = 1, go to PI4.
Else, if PI1 = 2, go to PI2a.
Else, go to PI24.

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Question ID:

PI2a

Why did you decide not to contact the police? (Mark all that apply.)
1

You didn't think it was important enough to report

2

You didn't think the police would do anything
about it

3

You weren't sure who did it

4

It was too personal to report

5

{You told a parent or other adult relative}

6

You took care of it yourself

7

You reported it to an official other than the police

8

You didn't think the police would believe you

9

You didn't want to get into trouble with the police

10

You didn't want the offender to get in trouble or
face harsh consequences

11

You were worried the offender might get back at
you

12

You weren't sure it was a crime

13

Some other reason

ASK Description: Respondents who reported the police did not find out about this incident.
ASK Specification: IF PI1 = 2.
PROGRAM: ROUTING INSTRUCTIONS: If PI2a_13 = 1, go to PI2b.
Else, go to PI_BOX1.
Question ID:

PI2b

What was the other reason why you did not contact the police? (Mark all that apply.)
1

You didn't trust the police

2

You didn't find out until it was too late to report

3

It would have been too much trouble to report it

4

You thought someone else would contact the police

5

Some other reason ____________

ASK Description: Respondents who reported the police did not find out about this incident for
some other reason.
ASK Specification: IF PI2a_13 = 1.
PROGRAM: Display text box and allow 250 character text response.

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Box ID:

PI_BOX1

If more than one reason marked in PI2a and PI2b (excluding PI2a_13), go to PI3.
Else, respondents who reported the incident happened at school, on school property, or on a
school bus and reported the incident to an official other than police, go to PI2C.
Else, respondents who reported the incident happened at school, on school property, or on a
school bus and did not report the incident to an official other than police, go to PI16a.
Else, go to PI17.

IF PI2a[_1/…/_12] = 1 OR PI2b[_1/…/_5] = 1 FOR TWO OR MORE REASONS, go to PI3.
Else, if PI2a_7 = 1 and LO_3 = 6, go to PI2C.
Else, if PI2a_7 != 1 AND LO_3 = 6, go to PI16a.
Else, go to PI17.

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Question ID:

PI3

Which of these would you say was the most important reason why you did not contact the
police?
1

{You didn't think it was important enough to
report}

2

{You didn't think the police would do anything
about it}

3

{You weren't sure who did it}

4

{It was too personal to report}

5

{You told a parent or other adult relative}

6

{You took care of it yourself}

7

{You reported it to an official other than the
police}

8

{You didn't think the police would believe you}

9

{You didn't want to get into trouble with the
police}

10

{You didn't want the offender to get in trouble or
face harsh consequences}

11

{You were worried the offender might get back at
you}

12

{You weren't sure it was a crime}

13

{You didn't trust the police}

14

{You didn't find out until it was too late to report}

15

{It would have been too much trouble to report it}

16

{You thought someone else would contact the
police}

17

{FILL DISPLAY FROM PI2b_5_SPECIFY}

18

NO ONE REASON IS MOST IMPORTANT

ASK Description: Respondents who reported the police did not find out about this incident for
multiple reasons.
ASK Specification: IF PI2a[_1/…/_12] = 1 OR PI2b[_1/…/_5] = 1 FOR TWO OR MORE REASONS.
PROGRAM: ROUTING INSTRUCTIONS: If PI2a_7 = 1 and LO_3=6, go to PI2c.
Else, if PI2a_7 != 1 and LO_3 = 6, go to PI16a.
Else, go to PI17.

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Question ID:

PI2c

Did you report the incident to a school official or School Resource Officer?
1

Yes

2

No

GO TO PI17

ASK Description: Respondents who reported the incident happened at school, on school
property, or on a school bus and reported the incident to an official other than police.
ASK Specification: If LO_3 = 6 and PI2a_7 = 1.
Question ID:

PI2d

Why did you decide not to contact a school official or School Resource Officer?{ Any other
reasons?} (Mark all that apply.)
1

You didn't think it was important enough to report

2

You didn't think the official or school resource
officer would do anything about it

3

You weren't sure who did it

4

It was too personal to report

5

You took care of it yourself

6

You didn't think the police would believe you

7

You didn't want to get into trouble

8

You didn't want the offender or his/her family to
get in trouble or face harsh consequences

9

You were worried the offender might get back at
you

10

You weren't sure it was a crime

11

Some other reason

ASK Description: Respondents who reported the incident happened at school, on school
property, or on a school bus and reported the incident to an official other than police and did not
report the incident to a school official or School Resource Officer.
ASK Specification: If LO_3 = 6 and PI2a_7 = 1 AND PI2c = 2.
PROGRAM: ROUTING INSTRUCTIONS: GO TO PI17.

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Question ID:

PI4

Who informed the police? If more than one person, choose the first response that applies.
1

You informed the police yourself

2

Someone you live with

3

{A school employee or School Resource Officer}

4

Someone such as a security guard or a building
manager

5

The police were at scene

7

Someone else told the police {Who?/Specify:}
______

ASK Description: Respondents who reported the police found out about the incident.
ASK Specification: IF PI1 = 1.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If HC2 = 1 or HC3 = 1, go to PI16b.
Else if PI4 = 1, 2, 3, 4, 7, go to PI5.
Else if PI4 = 5 or -9, go to PI17.
Question ID:

PI16b

Did you tell the police that you believe the incident was a hate crime?
1

Yes

2

No

ASK Description: Respondents who reported the police found out about the incident and suspect
that this incident was a hate crime targeted at them or any of the people they spend time with.
ASK Specification: IF PI1 = 1 AND (HC2 = 1 OR HC3 = 1).
PROGRAM: ROUTING INSTRUCTIONS: If PI4 = 1, 2, 3, 4, 7, go to PI5.
Else if PI4 = 5 or -9, go to PI17.

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Question ID:

PI5

How did {you first/they} notify the police?
1

{You/They} called the police

2

{You/They} approached an officer or police car

3

{You/They} went to the police station

4

{You/They} used the internet or a social media
app

5

Some other way - specify ______

6

{Don't Know}

ASK Description: Respondents who reported the police found out about the incident through the
respondent, someone they live with, a school employee or School Resource Officer, a security
guard or building manager, or someone else.
ASK Specification: IF PI4 = 1, 2, 3, 4, 7.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: If PI5 = 1, 2, 3, go to PI9.
If PI5 = 4, 5, 6, go to PI_BOX2.
Question ID:

PI9

Which of the following BEST describes when the police were first contacted?{ (READ
RESPONSES UNTIL R SAYS YES.)}
1

While the incident was happening

2

Within 10 minutes after the incident occurred

3

Within an hour after the incident occurred

4

Within 24 hours of the incident

5

Longer than a day after the incident occurred

ASK Description: Respondents who reported the police were notified by phone call, approaching
an officer, or by going to the police station.
ASK Specification: IF PI5 = 1, 2, 3.
Box ID:

PI_BOX2

IF PI5 = 1, 4, 5, GO TO PI_BOX2A.
ELSE, GO TO PI_BOX3.
Box ID:

PI_BOX2A

Go to PI10.

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Question ID:

PI10

What did the police do when they found out about the incident? (Mark all that apply.)
1

Come to you

2

Tell you to go to a police station

3

Take a report over the phone

4

Deal with it through the mail

5

Deal with it through the Internet or a social media
app

6

Something else____________

7

{IF R VOLUNTEERS: THE POLICE DID
NOTHING/The police did nothing}

ASK Description: Respondents who reported the police were contacted by phone, using the
internet or social media app, or some other way.
ASK Specification: IF PI5 = 1, 4, 5.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: Go to PI_BOX3.
Box ID:

PI_BOX3

Respondents who reported the police came to them when they found out about the incident, go
to PI13.
Else, respondents who gave the police a report over the phone, go to PI11.
Else, go to PI_BOX4.
If PI10_1 = 1, go to PI13.
Else, if PI10_3 = 1, go to PI11.
Else, go to PI_BOX4.
Question ID:

PI11

How satisfied were you with how the phone report was taken{ . . ./?}
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

6

{Or do you not have an opinion?/Don't know}

ASK Description: Respondents who gave the police a report over the phone.
ASK Specification: IF PI10_3 = 1.

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Box ID:

PI_BOX4

Respondents who reported the police told them to go to a police station, or took a report over
the phone, or dealt with it through the mail, or dealt with it through the internet or social media
app, or did something else, or did nothing, go to PI12.
Else, go to PI_BOX6.
If PI10_2 = 1 OR PI10_3 = 1 OR PI10_4 = 1 OR PI10_5 = 1 OR PI10_6 = 1 OR PI10_7 = 1, go
to PI12.
Else, go to PI_BOX6.
Question ID:

PI12

Do you think the police should have come to you when they were contacted?
1

Yes

2

No

ASK Description: Respondents who reported the police told them to go to a police station, or
took a report over the phone, or dealt with it through the mail, or dealt with it through the
internet or social media app, or did something else, or did nothing.
ASK Specification: IF PI10_2 = 1 OR PI10_3 = 1 OR PI10_4 = 1 OR PI10_5 = 1 OR PI10_6 = 1
OR PI10_7= 1.
PROGRAM: Go to PI17.
Question ID:

PI13

How satisfied were you with the time it took the police to get to you after they were contacted?
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

6

{Don't Know Or do you not have an opinion?/Don't
Know}

ASK Description: Respondents who reported the police came to them when they found out about
incident.
ASK Specification: IF PI10_1 = 1.

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Box ID:

PI_BOX5

Respondents who reported the police came to them when they found out about incident and
reported that the police were not already at the scene and the police were not contacted by
approaching an officer or police car, go to PI14.
Else, go to PI_BOX5A.
IF PI10_1 = 1 AND PI4 != 5 AND PI5 != 2, GO TO PI14.
Else, go to PI_BOX5A.
Question ID:

PI14

Had the police told {you/the person who contacted them} how long it would take them to get
there?
1

Yes

2

No

3

{Don't know}

ASK Description: Respondents who reported the police came to them when they found out about
incident and reported that the police were not already at the scene and the police were not
contacted by approaching an officer or police car.
ASK Specification: IF PI10_1 = 1 AND PI4 != 5 AND PI5 != 2.
Box ID:

PI_BOX5A

Go to PI15.
Question ID:

PI15

{What did/Did} the police do{ any of the following} while they were there?{ Anything else?}
(Mark all that apply.)
1

They asked you questions about what happened

2

They questioned other witnesses or suspects

3

They looked around

4

They took evidence, such as fingerprints

5

They made a list of what was taken

6

They promised to watch over the crime scene

7

They promised to investigate

8

They made one or more arrests

9

They did not do any of these things

ASK Description: Respondents who reported the police came to them when they found out about
incident.
ASK Specification: IF PI10_1 = 1.

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Question ID:

PI16

Did the police do any of the following other things while they were there? (Mark all that apply.)
1

They calmed people down

2

They resolved the conflict

3

They gave advice about insurance

4

They gave information about your rights as a
victim

5

They gave information about services that could
help you as a victim

6

They contacted victim services on your behalf

7

They contacted emergency medical services

8

They did something else to help Specify: _____

9

{RECORD IF VOLUNTEERED: }They did not do
anything {else} to help

ASK Description: Respondents who reported the police came to them when they found out about
incident.
ASK Specification: IF PI10_1 = 1.
PROGRAM: Display text box and allow 250 character text response.
Box ID:

PI_BOX6

Respondents who reported the incident happened at school, on school property, or on a school
bus and did not report the incident to an official other than police, go to PI16a.
Else, go to PI17.

If PI2a_7 != 1 and LO_3 = 6, go to PI16a.
Else go to PI17.

Question ID:

PI16a

Did anyone report the incident to a school official or School Resource Officer (SRO)?
1

Yes

2

No

ASK Description: Respondents who reported the incident happened at school, on school
property, or on a school bus and did not report the incident to an official other than police.
ASK Specification: IF PI2a_7 != 1 AND LO_3 = 6.

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Question ID:

PI17

Did you (or anyone you live with) have any later contact with the police about the incident?
1

Yes

2

No

ASK Description: Respondents who reported whether or not the police found out about the
incident.
ASK Specification: IF PI1 = 1, 2.
PROGRAM: ROUTING INSTRUCTIONS: If PI17 = 1, go to PI18.
Else, if PI17 = 2 and PI1 = 1, go to PI20.
Else, go to PI24.
Question ID:

PI18

Thinking about these later contacts, did the police get in touch with you or did you get in touch
with them?
1

Police contacted you (or someone else you live
with)

2

You (or someone else you live with) contacted the
police

3

BOTH

ASK Description: Respondents who reported they or anyone they live with had any later contact
with the police about the incident.
ASK Specification: IF PI17 = 1.

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Question ID:

PI19

What did the police do to follow up on {this/the} incident?{ Anything else?} (Mark all that
apply.)
1

They took a report on what happened

2

They questioned other witnesses or suspects

3

They watched over or promised to watch over the
crime scene

4

{They got some or all of your belongings back}

5

They made one or more arrests

6

They stayed in touch

7

They contacted victim services on your behalf

8

They did something else (specify) ________

9

They did not do anything to your knowledge

ASK Description: Respondents who reported they or anyone they live with had any later contact
with the police about the incident.
ASK Specification: IF PI17 = 1.
PROGRAM: Display text box and allow 250 character text response.
Question ID:

PI20

Next are some questions about how you feel the police handled {this/the} incident. If more
than one officer was involved, please think about how you would rate them as a group.
How respectfully did the police treat you?
1

Very respectfully

2

Somewhat respectfully

3

Neither respectfully or disrespectfully

4

Somewhat disrespectfully

5

Very disrespectfully

6

{Does not apply}

ASK Description: Respondents who reported they or anyone they live with had any later contact
with the police about the incident or reported they or anyone they live with did not have any
later contact with the police but the police did find out about the incident.
ASK Specification: IF PI17 = 1 OR (PI17 = 2 AND PI1 = 1).

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Question ID:

PI21

How satisfied were you with the amount of time the police gave you to tell your story?
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

6

{Does not apply}

ASK Description: Respondents who reported they or anyone they live with had any later contact
with the police about the incident or reported they or anyone they live with did not have any
later contact with the police but the police did find out about the incident.
ASK Specification: IF PI17 = 1 OR (PI17 = 2 AND PI1 = 1).
Question ID:

PI22

How satisfied were you that the police did everything they could . . .
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who reported they or anyone they live with had any later contact
with the police about the incident or reported they or anyone they live with did not have any
later contact with the police but the police did find out about the incident.
ASK Specification: IF PI17 = 1 OR (PI17 = 2 AND PI1 = 1).
Question ID:

PI23

Taking the whole experience into account, how effectively did the police handle the incident?
1

Very effectively

2

Somewhat effectively

3

Neither effectively nor ineffectively

4

Somewhat ineffectively

5

Very ineffectively

ASK Description: Respondents who reported they or anyone they live with had any later contact
with the police about the incident or they or anyone they live with did not have any later contact
with the police but the police did find out about the incident.
ASK Specification: IF PI17 = 1 OR (PI17 = 2 AND PI1 = 1).

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Question ID:

PI24

At the time, did you consider this incident to be a crime?
1

Yes

2

No

ASK Description: Respondents who did not report whether or not the police found out about the
incident or they or anyone they live with did not have any later contact with the police and the
police found out about the incident.
ASK Specification: IF PI1 = -9 OR (PI17 = 2 AND PI1 = 2).
Question ID:

PI25

Now, looking back, do you consider this incident to be a crime?
1

Yes

2

No

ASK Description: Respondents who did not report whether or not the police found out about the
incident or they or anyone they live with did not have any later contact with the police and the
police found out about the incident.
ASK Specification: IF PI1 = -9 OR (PI17 = 2 AND PI1 = 2).

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Workplace Violence Series
Box ID:

WV_BOX1

Respondents who had a job or worked at a business in the past 7 days or past 12 months and
reported this incident involved an attack, threatened attack, attack with a weapon, or unwanted
sexual contact, go to WV1.
Else, go to CS1.

If (PC5 = 1 or PC6 = 1) and (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1), go to WV1.
Else, go to CS1.

Question ID:

WV1

Did {this/the} incident occur while you were working or on duty?
1

Yes

2

No

GO TO WV_BOX3

ASK Description: Respondents who had a job or worked at a business in the past 7 days or past
12 months and reported this incident involved an attack, threatened attack, attack with a
weapon, or unwanted sexual contact.
ASK Specification: IF (PC5 = 1 OR PC6 = 1) AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
S_SA = 1).
Box ID:

WV_BOX2

Respondents who reported the incident did not occur on their own property, inside their home,
or at their place of work, go to WV2.
Else, go to CS1.

IF LO_1 != 1 AND LO_3 != 1, 3, 5, go to WV2.
Else, go to CS1.

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Question ID:

WV2

Did {this/the} incident happen when you were on your way to or from work?
1

Yes

2

No

ASK Description: Respondents who had a job or worked at a business in the past 7 days or past
12 months and reported this incident involved an attack, threatened attack, attack with a
weapon, or unwanted sexual contact and reported the incident did not occur on their own
property, inside their home, or at their place of work.
ASK Specification: IF (PC5 = 1 OR PC6 = 1) AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
S_SA = 1) AND LO_1 != 1 AND LO_3 != 1, 3, 5.
Box ID:

WV_BOX3

Respondents who reported the incident occurred at their place of work or reported the incident
occurred while they were working or on duty or reported the incident happened on when they
were on their way to or from work, go to WV3.
Else, go to CS1.

IF LO_3 = 5 or WV1 = 1 or WV2 = 1, GO TO WV3.
ELSE, GO TO CS1.

Question ID:

WV3

The next questions are about the job you had at the time of {this/the} incident. Were you
employed by . . .
1

A private company, business, or individual for
wages

2

The Federal government

3

A State, county, or local government

4

Yourself (self-employed) in your own business,
professional practice, or farm

5

A private not-for-profit, tax-exempt, or charitable
organization?

ASK Description: Respondents who had a job or worked at a business in the past 7 days or past
12 months and reported this incident involved an attack, threatened attack, attack with a
weapon, or unwanted sexual contact and reported the incident occurred at their place of work or
reported the incident occurred while they were working or on duty or reported the incident
happened on when they were on their way to or from work.
ASK Specification: IF (PC5 = 1 OR PC6 = 1) AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
S_SA = 1) AND (LO_3 = 5 OR WV1 = 1 OR WV2 = 1).

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Question ID:

WV5

What is the name of the (company/government agency/business/non-profit organization) where
you were working at the time of {this/the} incident? Remember, all answers to this survey are
confidential, and you may skip any question that you don't want to answer.
1

TEXT RESPONSE

ASK Description: Respondents who had a job or worked at a business in the past 7 days or past
12 months and reported this incident involved an attack, threatened attack, attack with a
weapon, or unwanted sexual contact and reported the incident occurred at their place of work or
reported the incident occurred while they were working or on duty or reported the incident
happened on when they were on their way to or from work.
ASK Specification: IF (PC5 = 1 OR PC6 = 1) AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
S_SA = 1) AND (LO_3 = 5 OR WV1 = 1 OR WV2 = 1).
PROGRAM: DISPLAY TEXT FIELD, MAX CHARACTER LENGTH = 1000.
Question ID:

WV6

What kind of business or industry is this? What do they make or do where you were working at
the time of {this/the} incident?
1

TEXT RESPONSE

ASK Description: Respondents who had a job or worked at a business in the past 7 days or past
12 months and reported this incident involved an attack, threatened attack, attack with a
weapon, or unwanted sexual contact and reported the incident occurred at their place of work or
reported the incident occurred while they were working or on duty or reported the incident
happened on when they were on their way to or from work.
ASK Specification: IF (PC5 = 1 OR PC6 = 1) AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
S_SA = 1) AND (LO_3 = 5 OR WV1 = 1 OR WV2 = 1).
PROGRAM: DISPLAY TEXT FIELD, MAX CHARACTER LENGTH = 1000.

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Question ID:

WV7

{Is this mainly…/Which of these categories best describes the business or industry?}{ TURN
LAPTOP SCREEN TO RESPONDENT/ READ UNTIL RESPONSE PROVIDED.}
1

Agriculture

2

Forestry

3

Construction

4

Healthcare and Social Assistance

5

Manufacturing

6

Mining

7

Oil and Gas Extraction

8

Public Safety

9

Services

10

Transportation

11

Warehousing

12

Utilities

13

Retail trade

14

Wholesale trade

15

Something else Specify: _____________

ASK Description: Respondents who had a job or worked at a business in the past 7 days or past
12 months and reported this incident involved an attack, threatened attack, attack with a
weapon, or unwanted sexual contact and reported the incident occurred at their place of work or
reported the incident occurred while they were working or on duty or reported the incident
happened on when they were on their way to or from work.
ASK Specification: IF (PC5 = 1 OR PC6 = 1) AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
S_SA = 1) AND (LO_3 = 5 OR WV1 = 1 OR WV2 = 1).
PROGRAM: Display text box and allow 250 character text response.

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Question ID:

WV8

What kind of work were you doing at this job at the time of {this/the} incident, that is, what
was your occupation? (For example: registered nurse, personnel manager, supervisor of order
department, secretary, accountant)
1

TEXT RESPONSE

ASK Description: Respondents who had a job or worked at a business in the past 7 days or past
12 months and reported this incident involved an attack, threatened attack, attack with a
weapon, or unwanted sexual contact and reported the incident occurred at their place of work or
reported the incident occurred while they were working or on duty or reported the incident
happened on when they were on their way to or from work.
ASK Specification: IF (PC5 = 1 OR PC6 = 1) AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
S_SA = 1) AND (LO_3 = 5 OR WV1 = 1 OR WV2 = 1).
PROGRAM: DISPLAY TEXT FIELD, MAX CHARACTER LENGTH = 1000.
Question ID:

WV9

What were your usual activities or duties at this job? (For example: patient care, directing hiring
policies, supervising order clerks, typing and filing, reconciling financial records)
1

TEXT RESPONSE

ASK Description: Respondents who had a job or worked at a business in the past 7 days or past
12 months and reported this incident involved an attack, threatened attack, attack with a
weapon, or unwanted sexual contact and reported the incident occurred at their place of work or
reported the incident occurred while they were working or on duty or reported the incident
happened on when they were on their way to or from work.
ASK Specification: IF (PC5 = 1 OR PC6 = 1) AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
S_SA = 1) AND (LO_3 = 5 OR WV1 = 1 OR WV2 = 1).
PROGRAM: DISPLAY TEXT FIELD, MAX CHARACTER LENGTH = 1000.

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Consequences II: Socio-emotional Problems
Question ID:

CS1

Being a victim of crime affects people in different ways. The next questions are about how
{this/the} incident may have affected you.
Did {this/the} incident lead you to have serious problems with your{ job or} schoolwork, or
trouble with people{ at work or} at school?
1

Yes

2

No

ASK Description: Respondents who reported an incident.
ASK Specification: IF S_MV = 1 or S_MVP = 1 or S_T = 1 or S_BI = 1 or S_V = 1 or S_A = 1 or
S_TA = 1 or S_ATA = 1 or S_SA = 1.
Question ID:

CS2

Did {this/the} incident lead you to have serious problems with family members or friends, such
as having more arguments with them, losing trust in them, or feeling more distant from them?
1

Yes

2

No

ASK Description: Respondents who reported an incident.
ASK Specification: IF S_MV = 1 or S_MVP = 1 or S_T = 1 or S_BI = 1 or S_V = 1 or S_A = 1 or
S_TA = 1 or S_ATA = 1 or S_SA = 1.
Question ID:

CS3

How upsetting has {this/the} incident been to you?
1

Not at all upsetting

2

Mildly upsetting

3

Moderately upsetting

4

Severely upsetting

ASK Description: Respondents who reported an incident.
ASK Specification: IF S_MV = 1 or S_MVP = 1 or S_T = 1 or S_BI = 1 or S_V = 1 or S_A = 1 or
S_TA = 1 or S_ATA = 1 or S_SA = 1.
Box ID:

CS_BOX1

Respondents who had serious problems with their job or schoolwork, or trouble with people at
work or school, or had serious problems with family members or friends, or reported this
incident was moderately upsetting or severely upsetting to them, go to CS_BOX2.Else, go to
CE_BOX1.
If CS1 = 1 or CS2 = 1 or CS3 = 3, 4, go to CS_BOX2.Else, go to CE_BOX1.

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Box ID:

CS_BOX2

Display questions CS4_A through CS4_H using the expanded stem-leaf screen. The introduction
text from CS4_A is the stem. Show all leaves on the screen at once.
Question ID:

CS4_A

{I am going to read/Here is} a list of things you may have felt because of the incident. For
each, please {tell me/mark} whether you didn't feel this way at all, you felt this way for less
than a month, or you felt this way for a month or longer.
Angry
1

Didn't feel this way

2

Yes, for less than 1 month

3

Yes, for 1 month or more

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.
Question ID:

CS4_B

Shocked
1

Didn't feel this way

2

Yes, for less than 1 month

3

Yes, for 1 month or more

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.
Question ID:

CS4_C

Fearful
1

Didn't feel this way

2

Yes, for less than 1 month

3

Yes, for 1 month or more

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.

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Question ID:

CS4_D

Depressed
1

Didn't feel this way

2

Yes, for less than 1 month

3

Yes, for 1 month or more

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.
Question ID:

CS4_E

Anxious or panicked
1

Didn't feel this way

2

Yes, for less than 1 month

3

Yes, for 1 month or more

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.
Question ID:

CS4_F

Less confident
1

Didn't feel this way

2

Yes, for less than 1 month

3

Yes, for 1 month or more

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.

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Question ID:

CS4_G

Sad
1

Didn't feel this way

2

Yes, for less than 1 month

3

Yes, for 1 month or more

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.
Question ID:

CS4_H

Annoyed
1

Didn't feel this way

2

Yes, for less than 1 month

3

Yes, for 1 month or more

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.
Question ID:

CS5a

Did you have difficulty sleeping because of the incident?
1

No

2

Yes, for less than one month

3

Yes, for one month or more

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.

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Question ID:

CS6

Have you talked to a psychologist, psychiatrist, counselor, or other mental health professional
about {this/the} incident?
1

Yes

GO TO CS7

2

No

GO TO CE_BOX1

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.
Question ID:

CS7

Did you have any out–of–pocket expenses for your mental health care, that is, expenses that
you do not expect to get paid back from insurance or some other source?
1

Yes

GO TO CS8

2

No

GO TO CE_BOX1

3

Don't know

GO TO CE_BOX1

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.
Question ID:

CS8

How much were these out-of-pocket expenses?{ READ CATEGORIES AS NEEDED.}
1

Less than $100

2

$100 to less than $500

3

$500 to less than $1000

4

$1000 to less than $5000

5

$5000 or more

ASK Description: Respondents who had serious problems with their job or schoolwork, or trouble
with people at work or school, or had serious problems with family members or friends, or
reported this incident was moderately upsetting or severely upsetting to them.
ASK Specification: IF CS1 = 1 OR CS2 = 1 OR CS3 = 3, 4.

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Consequences III: Economic Consequences
Box ID:

CE_BOX1

Respondents who confirmed their vehicle was actually stolen as part of this incident, go to CE1.
Else, respondents who had anything stolen as part of this incident or had vehicle parts or gas
stolen during the incident, go to CE5.
Else, respondents who reported someone vandalized their home, car, or something else that
belongs to them or someone they live with or someone killed an animal that belonged to them
as part of this incident, go to CE13.
Else, go to CE_BOX5.
If MV1a = 1, go to CE1.
Else, if S_T = 1 or MV1b = 1, go to CE5.
Else, if S_V = 1, go to CE13.
Else, go to CE_BOX5.
Question ID:

CE1

What would you estimate was the value of the vehicle that was stolen or taken without
permission?{ READ CATEGORIES AS NEEDED.}
1

Less than $500

2

$500 to less than $1,000

3

$1,000 to less than $5,000

4

$5,000 to less than $10,000

5

$10,000 or more

ASK Description: Respondents who confirmed their vehicle was actually stolen as part of this
incident.
ASK Specification: IF MV1a = 1.
Question ID:

CE2

Did you get the vehicle back?
1

Yes

GO TO CE3

2

No

GO TO CE_BOX2

ASK Description: Respondents who confirmed their vehicle was actually stolen as part of this
incident.
ASK Specification: IF MV1a = 1.

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Question ID:

CE3

Was the vehicle damaged in any way?
1

Yes, it was damaged beyond repair

2

Yes, there was some damage

3

No, there was no damage

ASK Description: Respondents who confirmed their vehicle was actually stolen as part of this
incident and got the vehicle back.
ASK Specification: IF MV1a = 1 AND CE2 = 1
Box ID:

CE_BOX2

Respondents who reported anything was stolen from their vehicle, go to CE4.
Else, go to CE_BOX3.
If S_01E = 1, go to CE4.
Else, go to CE_BOX3.
Question ID:

CE4

Earlier you said some items were stolen along with the vehicle. What was the value of these
other items, including the value of anything you got back?{ READ CATEGORIES AS NEEDED.}
1

Less than $25

2

$25 to less than $50

3

$50 to less than $100

4

$100 to less than $500

5

$500 or more

ASK Description: Respondents who confirmed their vehicle was actually stolen as part of this
incident and reported anything was stolen from their vehicle .
ASK Specification: IF MV1a = 1 AND S_01E = 1
PROGRAM: ROUTING INSTRUCTIONS: Go to CE_BOX4.
Box ID:

CE_BOX3

Respondents who had anything stolen as part of this incident or had vehicle parts or gas stolen
during the incident and did not actually have their vehicle stolen, go to CE5.
If (S_T = 1 or MV1b = 1) and MV1a != 1, GO TO CE5.
Else, go to CE_BOX4.

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Question ID:

CE5

(Including cash) what would you estimate was the total value of the stolen items, including the
value of anything you got back?{ READ CATEGORIES AS NEEDED.}
1

Less than $25

2

$25 to less than $50

3

$50 to less than $100

4

$100 to less than $500

5

$500 to less than $1,000

6

$1,000 or more

ASK Description: Respondents who had anything stolen as part of this incident or had vehicle
parts or gas stolen during the incident and did not actually have their vehicle stolen
ASK Specification: IF (S_T = 1 OR MV1b = 1) AND MV1a != 1.
Box ID:

CE_BOX4

Respondents who reported their vehicle was actually stolen or reported the offender(s) actually
took vehicle parts or gas or reported the offender actually stole something or had anything
stolen as part of this incident, go to CE6.
Else, go to CE_BOX5.
IF MV1a = 1 OR MV1b = 1 OR S_03AT = 1 OR S_T = 1, GO TO CE6.
Else, go to CE_BOX5.
Question ID:

CE6

{Apart from the stolen vehicle did/Did} you get any of the stolen {money }{or } {items }back?
1

Yes, you got all of it back

GO TO CE_BOX5

2

Yes, you got some of it back

GO TO CE7

3

No, you got none of it back

GO TO CE_BOX5

ASK Description: Respondents who reported their vehicle was actually stolen or reported the
offender(s) actually took vehicle parts or gas or reported the offender actually stole something
or had anything stolen as part of this incident.
ASK Specification: IF MV1a = 1 OR MV1b = 1 OR S_03AT = 1 OR S_T = 1.

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Question ID:

CE7

{Apart from the cost of the vehicle, what/ What} would you estimate was the total value of the
{ other} items you got back?{ READ CATEGORIES AS NEEDED.}
1

Less than $25

2

$25 to less than $50

3

$50 to less than $100

4

$100 to less than $500

5

$500 to less than $1,000

6

$1,000 or more

ASK Description: Respondents who got any of their stolen money or items back.
ASK Specification: IF CE6 = 2.

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Property Damage
Box ID:

CE_BOX5

Respondents who did not report someone vandalized their home, car, or something else that
belongs to them or someone they live with or someone killed an animal that belonged to them
as part of this incident, go to CE8.
Else, go to CE13.
If S_V != 1, go to CE8.
Else, go to CE13.
Question ID:

CE8

{Other than any stolen property was/Was} anything that belonged to you or someone you live
with damaged or destroyed in {this/the} incident?
1

Yes

GO TO CE9

2

No

GO TO CE_BOX9

ASK Description: Respondents who reported an incident that did not involve someone
vandalizing their home, car, or something else that belongs to them or someone they live with
or someone killing an animal that belonged to them.
ASK Specification: IF S_V != 1 AND (S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1 OR S_A
= 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1).
Question ID:

CE9

What was damaged or destroyed{ other than any stolen property}?{ Anything else?} (Mark all
that apply.)
1

A vehicle (including parts)

2

Something inside your home or apartment

3

A mailbox

4

Something outside of your home or apartment,
such as doors, windows, or walls

5

Fences, walls, gates or items in a garden

6

A garage, shed, greenhouse or other structure on
your property

7

An animal such as a pet or livestock

8

Other Specify __________________

ASK Description: Respondents who had anything that belonged to them or someone they live
with was damaged or destroyed in this incident.
ASK Specification: IF CE8 = 1.
PROGRAM: Display text box and allow 250 character text response.

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Box ID:

CE_BOX6

Respondents who had a vehicle damaged or destroyed during this incident, go to CE10.
Else, go to CE_BOX7.
If CE9_1 = 1, go to CE10.
Else, go to CE_BOX7.
Question ID:

CE10

Was any of the damage a result of the offender trying to get into the vehicle?
1

Yes

2

No

ASK Description: Respondents who had a vehicle damaged or destroyed during this incident.
ASK Specification: IF CE9_1 = 1.
Box ID:

CE_BOX7

Respondents who had a mailbox or something outside of their home damaged or destroyed
during this incident, go to CE11.
Else, go to CE_BOX8.
If CE9_3 = 1 or CE9_4 = 1, go to CE11.
Else, go to CE_BOX8.
Question ID:

CE11

Was any of the damage to your house or apartment a result of the offender trying to get inside?
1

Yes

2

No

ASK Description: Respondents who had a mailbox or something outside of their home damaged
or destroyed during this incident
ASK Specification: IF CE9_3 = 1 OR CE9_4 = 1.
Box ID:

CE_BOX8

Respondents who had a garage, shed, greenhouse or other structure on their property damaged
or destroyed during this incident, go to CE12.
Else, go to CE13.
If CE9_6 = 1, go to CE12.
Else, go to CE13.

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Question ID:

CE12

Was any of the damage to your garage, shed, greenhouse or other structure on your property a
result of the offender trying to get into the structure?
1

Yes

2

No

ASK Description: Respondents who had a garage, shed, greenhouse or other structure on their
property damaged or destroyed during this incident.
ASK Specification: IF CE9_6 = 1.
Question ID:

CE13

{Excluding any costs you have already mentioned, what/What} was the total value of the
damage done{ in this vandalism}? If you don't know the exact amount, please give your best
estimate.{ READ CATEGORIES AS NEEDED.}
1

Less than $100

2

$100 to less than $500

3

$500 to less than $1,000

4

$1,000 to less than $5,000

5

$5,000 or more

ASK Description: Respondents who reported someone vandalized their home, car, or something
else that belongs to them or someone they live with or someone killed an animal that belonged
to them as part of this incident or had anything that belonged to them or someone they live with
was damaged or destroyed in this incident.
ASK Specification: IF S_V = 1 OR CE8 = 1.
Question ID:

CE14

Did you need to stay somewhere else or move to a new home as a result of {this/the} incident?
1

Yes

2

No

ASK Description: Respondents who reported someone vandalized their home, car, or something
else that belongs to them or someone they live with or someone killed an animal that belonged
to them as part of this incident or had anything that belonged to them or someone they live with
was damaged or destroyed in this incident.
ASK Specification: IF S_V = 1 OR CE8 = 1.

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Lost Work and Wages
Box ID:

CE_BOX9

Respondents who had a job or worked at a business at any time in the past 12 months or are a
regular student or are a college/campus student, go to CE15.
Else, go to VS_BOX1.

If PC5 = 1 OR PC6 = 1 or RStudent = 1 or CStudent = 1, go to CE15.
Else, go to VS_BOX1.

Question ID:

CE15

Have you taken any time off from work or school because of {this/the} incident?
1

Yes, time off from work

GO TO CE16

2

Yes, time off from school

GO TO CE16

3

Yes, time off from both work and school

GO TO CE16

4

No

GO TO VS_BOX1

ASK Description: Respondents who had a job or worked at a business at any time in the past 12
months or are a regular student or are a college/campus student.
ASK Specification: IF PC5 = 1 OR PC6 = 1 or RStudent = 1 or CStudent = 1.
Question ID:

CE16

How many days did you take off work or school?{ READ CATEGORIES AS NEEDED.}
1

Less than one day

2

1 or 2 days

3

3 days to less than one full week

4

1 full week to less than a month

5

A month or more

ASK Description: Respondents who had a job or worked at a business at any time in the past 12
months or are a regular student or are a college/campus student and have taken any time off
from work or school because of the incident.
ASK Specification: IF (PC5 = 1 OR PC6 = 1 or RStudent = 1 or CStudent = 1) AND CE15 = 1, 2,
3.
PROGRAM: If CE15 = 1 or 3, go to CE17.
Else, go to CE19.

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Question ID:

CE17

Did you lose any pay for the time you took off?
1

Yes

GO TO CE18

2

No

GO TO CE19

ASK Description: Respondents who had a job or worked at a business at any time in the past 12
months or are a regular student or are a college/campus student and have taken any time off
from work because of the incident.
ASK Specification: IF (PC5 = 1 OR PC6 = 1 or RStudent = 1 or CStudent = 1) AND CE15 = 1, 3.
Question ID:

CE18

About how much pay did you lose?{ READ CATEGORIES AS NEEDED.}
1

Less than $100

2

$100 to less than $500

3

$500 to less than $1000

4

$1000 or more

ASK Description: Respondents who had a job or worked at a business at any time in the past 12
months or are a regular student or are a college/campus student and have taken any time off
from work because of the incident and lost pay for the time they took off.
ASK Specification: IF (PC5 = 1 OR PC6 = 1 or RStudent = 1 or CStudent = 1) AND CE15 = 1, 3
AND CE17 = 1.
Question ID:

CE19

Did you lose your job or have to give up work, or withdraw from school as a result of {this/the}
incident?
1

Yes

GO TO VS_BOX1

2

No

GO TO CE19A

ASK Description: Respondents who had a job or worked at a business at any time in the past 12
months or are a regular student or are a college/campus student and have taken any time off
from work or school because of the incident.
ASK Specification: IF (PC5 = 1 OR PC6 = 1 or RStudent = 1 or CStudent = 1) AND CE15 = 1, 2,
3.

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Question ID:

CE19a

Did you have to change your job or school as a result of {this/the} incident?
1

Yes

2

No

ASK Description: Respondents who had a job or worked at a business at any time in the past 12
months or are a regular student or are a college/campus student and have taken any time off
from work or school because of the incident and lost their job or had to give up work, or
withdraw from school as a result of this incident.
ASK Specification: IF (PC5 = 1 OR PC6 = 1 or RStudent = 1 or CStudent = 1) AND CE15 = 1, 2,
3 AND CE19 = 1.

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Victim Services (VS) Series
Box ID:

VS_BOX1

Respondents who are completing their first CIR and reported an attack, threatened attack, or
attack with a weapon as part of this incident, or had unwanted vaginal sex, oral sex, anal sex,
sexual penetration with a finger or object in their vagina or anus or in the offender's vagina or
anus, or sexual touching and the offender used physical force, threatened to hurt them or
someone close to them, they were blacked out, unconscious or asleep, or unable to consent
because they were too drunk or high, or used force to touch them in a sexual way, or reported
the incident was severely upsetting to them, go to VS_intro.
IF THIS IS THE FIRST CIR AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR ((SA_1a = 1 OR
SA_1b = 1 or SA_1c = 1 OR SA_1d = 1) AND (SA_2a = 1 OR SA_2b = 1 OR SA_2c = 1 OR
SA_2d = 1 OR SA_2e = 1)) OR CS3 = 4), go to VS_intro.
Else, go to NA_BOX1.

Question ID:

VS_intro

The next questions ask about any help you might have gotten after {this/the} incident{ in
{MONTH}} took place.
ASK Description: Respondents who are completing their first CIR and reported an attack,
threatened attack, or attack with a weapon as part of this incident, or had unwanted vaginal
sex, oral sex, anal sex, sexual penetration with a finger or object in their vagina or anus or in
the offender's vagina or anus, or sexual touching and the offender used physical force,
threatened to hurt them or someone close to them, they were blacked out, unconscious or
asleep, or unable to consent because they were too drunk or high, or used force to touch them
in a sexual way, or reported the incident was severely upsetting to them.
ASK Specification: IF THIS IS THE FIRST CIR AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
((SA_1a = 1 OR SA_1b = 1 or SA_1c = 1 OR SA_1d = 1) AND (SA_2a = 1 OR SA_2b = 1 OR
SA_2c = 1 OR SA_2d = 1 OR SA_2e = 1)) OR CS3 = 4).
Question ID:

VS1A

Have you told any family, friends, co-workers{, classmates} or neighbors about the incident?
1

Yes

2

No

ASK Description: Respondents who are completing their first CIR and reported an attack,
threatened attack, or attack with a weapon as part of this incident, or had unwanted vaginal
sex, oral sex, anal sex, sexual penetration with a finger or object in their vagina or anus or in
the offender's vagina or anus, or sexual touching and the offender used physical force,
threatened to hurt them or someone close to them, they were blacked out, unconscious or
asleep, or unable to consent because they were too drunk or high, or used force to touch them
in a sexual way, or reported the incident was severely upsetting to them.
ASK Specification: IF THIS IS THE FIRST CIR AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
((SA_1a = 1 OR SA_1b = 1 or SA_1c = 1 OR SA_1d = 1) AND (SA_2a = 1 OR SA_2b = 1 OR
SA_2c = 1 OR SA_2d = 1 OR SA_2e = 1)) OR CS3 = 4).

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Question ID:

VS1B

{Other than{ the police or} family/friends have/Have} you told anyone in the following
positions about the incident who you thought might be able to help you? (Mark all that apply.)
1

{Teacher, school counselor or school
administrator}

2

{Employer, supervisor, or human resources
personnel}

3

Medical or mental health professional

4

Representative of a religious or community
organization

5

Security guard or personnel, other than the police

6

Other (specify) ____

7

No, have not told anyone in any of these positions.

ASK Description: Respondents who are completing their first CIR and reported an attack,
threatened attack, or attack with a weapon as part of this incident, or had unwanted vaginal
sex, oral sex, anal sex, sexual penetration with a finger or object in their vagina or anus or in
the offender's vagina or anus, or sexual touching and the offender used physical force,
threatened to hurt them or someone close to them, they were blacked out, unconscious or
asleep, or unable to consent because they were too drunk or high, or used force to touch them
in a sexual way, or reported the incident was severely upsetting to them.
ASK Specification: IF THIS IS THE FIRST CIR AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
((SA_1a = 1 OR SA_1b = 1 or SA_1c = 1 OR SA_1d = 1) AND (SA_2a = 1 OR SA_2b = 1 OR
SA_2c = 1 OR SA_2d = 1 OR SA_2e = 1)) OR CS3 = 4).
PROGRAM: Display text box and allow 250 character text response.
Box ID:

VS_BOX2

For VS2A – VS2K, display a ‘Yes' and ‘No' column with options for each response category.
Display VS2A-G in one screen and VS2H-K on the next screen.

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Question ID:

VS2

Besides any help you might have gotten from friends or family, have you received the following
kinds of services because of the incident?
1

Hotline, helpline, or crisis line intervention?

2

{Counseling, therapy, support groups, or help
from a mental health provider?}

3

{Help or advocacy with medical care or medical
exams, including accompanying you to a medical
exam?}

4

{Sexual assault exam by a doctor, nurse or other
medical professional?}

5

Free or low cost legal services from an attorney?

6

Help with the legal process, such as with police
interviews, preparing for or going to court, or
enforcement of your rights?

7

Help filing for a restraining, protection, or nocontact order?

8

{Help applying for victim compensation?}

9

{Short term or emergency financial assistance?}

10

{Housing, shelter or safehouse services?}

11

{Any other help or services because of the
incident? ________________}

ASK Description: Respondents who are completing their first CIR and reported an attack,
threatened attack, or attack with a weapon as part of this incident, or had unwanted vaginal
sex, oral sex, anal sex, sexual penetration with a finger or object in their vagina or anus or in
the offender's vagina or anus, or sexual touching and the offender used physical force,
threatened to hurt them or someone close to them, they were blacked out, unconscious or
asleep, or unable to consent because they were too drunk or high, or used force to touch them
in a sexual way, or reported the incident was severely upsetting to them.
ASK Specification: IF THIS IS THE FIRST CIR AND (S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR
((SA_1a = 1 OR SA_1b = 1 or SA_1c = 1 OR SA_1d = 1) AND (SA_2a = 1 OR SA_2b = 1 OR
SA_2c = 1 OR SA_2d = 1 OR SA_2e = 1)) OR CS3 = 4).
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: IF VS2A = 1 OR VS2B = 1 OR VS2C = 1 OR VS2D = 1 OR VS2E = 1
OR VS2F = 1 OR VS2G = 1 OR VS2H = 1 OR VS2I = 1 OR VS2J = 1 OR VS2K = 1, GO TO
VS_BOX3.
ELSE, GO TO VS4.

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Box ID:

VS_BOX3

Display questions VS3A through VS3K using the expanded stem-leaf screen. The introduction
text from VS3A is the stem. Show all leaves on the screen at once.
If VS2A = 1, display VS3A.
If VS2B = 1, display VS3B.
If VS2C = 1, display VS3C.
If VS2D = 1, display VS3D.
If VS2E = 1, display VS3E.
If VS2F = 1, display VS3F.
If VS2G = 1, display VS3G.
If VS2H = 1, display VS3H.
If VS2I = 1, display VS3I.
If VS2J = 1, display VS3J.
If VS2K = 1, display VS3K.

Question ID:

VS3A

How satisfied were you with...
Hotline, helpline, or crisis line intervention
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who received professional help from a hotline, helpline, or crisis
line intervention.
ASK Specification: IF VS2A = 1.
Question ID:

VS3B

Counseling, therapy, support groups, or help from a mental health provider
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who received professional help from counseling, therapy, support
groups, or help from a mental health provider.
ASK Specification: IF VS2B = 1.

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Question ID:

VS3C

Help or advocacy with medical care or medical exams, including accompanying you to a medical
exam
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who received professional help or advocacy with medical care or
medical exams.
ASK Specification: IF VS2C = 1.
Question ID:

VS3D

Sexual assault exam by a doctor, nurse or other medical professional
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who received professional help from a sexual assault exam by a
doctor, nurse or other medical professional.
ASK Specification: IF VS2D = 1.
Question ID:

VS3E

Free or low cost legal services from an attorney
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who received professional help from free or low cost legal
services from an attorney.
ASK Specification: IF VS2E = 1.

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Question ID:

VS3F

Help with the legal process, such as with police interviews, preparing for or going to court, or
enforcement of your rights
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who received professional help with the legal process, such as
with police interviews, preparing for court, or going to court.
ASK Specification: IF VS2F = 1.
Question ID:

VS3G

Help filing for a restraining, protection, or no-contact order
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who received professional help getting a restraining, protection,
or no-contact order.
ASK Specification: IF VS2G = 1.
Question ID:

VS3H

Help applying for victim compensation
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who received professional help applying for victim compensation.
ASK Specification: IF VS2H = 1.

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Question ID:

VS3I

Short term or emergency financial assistance
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who received professional help from short term or emergency
financial assistance.
ASK Specification: IF VS2I = 1.
Question ID:

VS3J

Housing, shelter or safehouse services
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who received professional help from housing, shelter or
safehouse services.
ASK Specification: IF VS2J = 1.
Question ID:

VS3K

Any other help or services you received
1

Completely satisfied

2

Mostly satisfied

3

Equally satisfied and dissatisfied

4

Mostly dissatisfied

5

Completely dissatisfied

ASK Description: Respondents who received professional help from any other services.
ASK Specification: IF VS2K = 1.

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Box ID:

VS_BOX4

Respondents who did not receive or refused to report if they received professional services from
a hotline, helpline, or crisis line intervention; counseling, therapy, support groups, or help from
a mental health provider; help or advocacy with medical care or medical exams, including
accompanying you to a medical exam; sexual assault exam by a doctor, nurse or other medical
professional; free or low cost legal services from an attorney; help with the legal process, such
as with police interviews, preparing for or going to court, or enforcement of your rights; help
applying for victim compensation; help filing for a restraining, protection, or no-contact order;
short term or emergency financial assistance; or housing, or shelter or safehouse services, go to
VS4.
Else, go to NA_BOX1.

IF VS2A = 2, -9 OR VS2B = 2, -9 OR VS2C = 2, -9 OR VS2D = 2, -9 OR VS2E = 2, -9 OR VS2F
= 2, -9 OR VS2G = 2, -9 OR VS2H = 2, -9 OR VS2I = 2, -9 OR VS2J = 2, -9, GO TO VS4.
ELSE, GO TO NA_BOX1.

Question ID:

VS4

Were there any types of services that you TRIED to get BUT WERE UNABLE TO GET?
1

Yes

GO TO VS5

2

No

GO TO VS7

ASK Description: Respondents who did not receive or refused to report if they received
professional services from a hotline, helpline, or crisis line intervention; counseling, therapy,
support groups, or help from a mental health provider; help or advocacy with medical care or
medical exams, including accompanying you to a medical exam; sexual assault exam by a
doctor, nurse or other medical professional; free or low cost legal services from an attorney;
help with the legal process, such as with police interviews, preparing for or going to court, or
enforcement of your rights; help applying for victim compensation; help filing for a restraining,
protection, or no-contact order; short term or emergency financial assistance; housing, or
shelter or safehouse services.
ASK Specification: IF VS2A = 2, -9 OR VS2B = 2, -9 OR VS2C = 2, -9 OR VS2D = 2, -9 OR
VS2E = 2, -9 OR VS2F = 2, -9 OR VS2G = 2, -9 OR VS2H = 2, -9 OR VS2I = 2, -9 OR VS2J = 2,
-9.

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Question ID:

VS5

Which {of the following }services did you TRY to get BUT WERE UNABLE TO GET?{ READ
CATEGORIES AS NEEDED.} (Mark all that apply.)
1

{Hotline, helpline, or crisis line intervention}

2

{Counseling, therapy, support groups, or help
from a mental health provider}

3

{Help or advocacy with medical care or medical
exams, including accompanying you to a medical
exam}

4

{Sexual assault exam by a doctor, nurse or other
medical professional}

5

{Free or low cost legal services from an attorney}

6

{Help with the legal process, such as with police
interviews, preparing for or going to court, or
enforcement of your rights}

7

{Help filing for a restraining, protection, or nocontact order}

8

{Help applying for victim compensation}

9

{Short term or emergency financial assistance}

10

{Housing, shelter or safehouse services}

11

Any other help or service because of the incident
Specify: ________________

ASK Description: Respondents who tried but were unable to get help from any type of service.
ASK Specification: IF VS4 = 1.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: IF VS5A = 1 OR VS5B = 1 OR VS5C = 1 OR VS5D = 1 OR VS5E = 1
OR VS5F = 1 OR VS5G = 1 OR VS5H = 1 OR VS5I = 1 OR VS5J = 1 OR VS5K = 1, GO TO
VS_BOX5.
Else, go to NA_BOX1.
Box ID:

VS_BOX5

For VS6A-VS6I, display a ‘Yes' and ‘No' column with options for each response category.

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Question ID:

VS6

Were any of the following reasons why you didn't actually get the services you needed after the
incident?
1

The services you needed were not available in your
area?

2

Program was full, or there was a long wait list

3

You did not think you were eligible for services, or
you were told you were not eligible?

4

You did not have transportation{ or childcare}?

5

You could not take time off work or school?

6

The services were not available in your language?

7

You didn't want to get the offender in trouble or
face harsh consequences?

8

You were worried about the consequences for
yourself or your family?

9

Some other reason? (Specify)___________

ASK Description: Respondents who were unable to receive help from a hotline, helpline, or crisis
line intervention; counseling, therapy, support groups, or help from a mental health provider;
help or advocacy with medical care or medical exams, including accompanying you to a medical
exam; sexual assault exam by a doctor, nurse or other medical professional; free or low cost
legal services from an attorney; help with the legal process, such as with police interviews,
preparing for or going to court, or enforcement of your rights; help applying for victim
compensation; help filing for a restraining, protection, or no-contact order; short term or
emergency financial assistance; housing, or shelter or safehouse services.
ASK Specification: IF VS5A = 1 OR VS5B = 1 OR VS5C = 1 OR VS5D = 1 OR VS5E = 1 OR VS5F
= 1 OR VS5G = 1 OR VS5H = 1 OR VS5I = 1 OR VS5J = 1 OR VS5K = 1.
PROGRAM: Display text box and allow 250 character text response.
ROUTING INSTRUCTIONS: GO TO NA_BOX1.
Question ID:

VS7

You said you didn't try to get any services. Did you want any services?
1

Yes

GO TO VS_BOX6

2

No

GO TO NA_BOX1

ASK Description: Respondents who reported there were not any services that they tried but
were unable to get.
ASK Specification: IF VS4 = 2.
Box ID:

VS_BOX6

For VS8A – VS8H, display a ‘Yes' and ‘No' column with options for each response category.

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Question ID:

VS8

Please indicate whether or not each of the following were reasons why you did not try to get any
services. (Mark all that apply.)
1

You did not know what help or services were
available

2

You did not think you were eligible for services, or
you were told you were not eligible

3

You did not have transportation{ or childcare}

4

You could not take time off work or school

5

You didn't want to get the offender in trouble or
face harsh consequences

6

You were worried about the consequences for
yourself or your family

7

You did not feel services were appropriate to meet
your needs

8

Some other reason (Specify) _______________

ASK Description: Respondents who reported there were not any services that they tried but
were unable to get and they wanted any services.
ASK Specification: IF VS4 = 2 AND VS7 = 1.
PROGRAM: Display text box and allow 250 character text response.

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Narrative
Box ID:

NA_BOX1

Respondents completing the interviewer-administered questionnaire, go to N1.
Else, respondents completing the self-administered questionnaire, go to NARR.
If CONDITION = 2, GO TO N1.
Else if CONDITION = 3, GO TO NARR.
Question ID:

NARR

Thank you for providing this information about the incident{ in {MONTH}}. On the next screen,
you will be asked to describe the incident in your own words. Remember that you can skip any
question, including this one, if you don't recall particular details, or don't want to answer.
ASK Description: Respondents completing the self-administered questionnaire.
ASK Specification: IF CONDITION = 3.
Question ID:

N1

{Thank you for telling me about the incident{ in {MONTH}}. Would you mind describing the
incident for me in your own words? Remember that you can skip any question, including this
one, if you don't want to answer, or you don't recall particular details.} {Also remember that we
are recording this interview, so I won't need to type in what you have to say./Since the audio
recording is off, please be patient as I type in your answer.}{To check that the survey questions
have captured what happened in this incident, please describe the incident in your own words.
Depending on your situation, this might include who did it, where it occurred, what was taken,
whether you were injured or any other details you feel are important to understand what
happened.}
1

TEXT RESPONSE

ASK Description: All respondents.
PROGRAM: DISPLAY TEXT FIELD, MAX CHARACTER LENGTH = 4000.
Box ID:

NA_BOX3

END OF CIR LOOP
If data has been collected for all incidents reported, go to PC9_INTRO.
Else, go to CIR1 for next incident loop.

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Person Characteristics II
Question ID:

PC9_INTRO

The next questions ask about you. Remember all answers to this survey are confidential.
ASK Description: All respondents.
Box ID:

PC2_BOX1

Respondents who did not indicate they have a job or work at a business in the past 7 days, GO
TO PC9.
Else, go to PC2_BOX2.

IF PC5 = 2, GO TO PC9.
ELSE, GO TO PC2_BOX2.

Question ID:

PC9

Earlier you said you did not have a job or business last week. During the past 4 WEEKS, have
you been ACTIVELY looking for work?
1

Yes

2

No

ASK Description: Respondents who did not indicate they had a job or work at a business in the
past 7 days.
ASK Specification: IF PC5 = 2.
Box ID:

PC2_BOX2

Respondents who indicated they had a job or work at a business in the past 12 months, GO TO
PC10.
Else, go to PC2_BOX3.
IF PC6 = 1, GO TO PC10.
ELSE, GO TO PC2_BOX3.

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Question ID:

PC10

Earlier you said you had a job or worked at a business at some time in the past 12 months. Did
that (job/work) last 2 consecutive weeks or more?
1

Yes

GO TO PC11

2

No

GO TO PC_INTRO2

ASK Description: Respondents who indicated they have a job or work at a business in the past
12 months.
ASK Specification: IF PC6 = 1.
Question ID:

PC11

When did that job end?
1

DATE FIELD

ASK Description: Respondents who indicated they had a job or work at a business in the past 12
months and the job/work lasted 2 consecutive weeks or more.
ASK Specification: IF PC6 = 1 AND PC10 = 1.
PROGRAM: Show Text Field for DATE, format MM/DD/YYYY. Numeric response only.
LOGIC CHECK: Hard check – date entered > current date.
Box ID:

PC2_BOX3

Respondents who had a job or worked at a business in the past 7 days or past 12 months and
reported any incident that involved an attack, threatened attack, attack with a weapon, or
unwanted sexual contact and reported the incident occurred at their place of work or reported
the incident occurred while they were working or on duty or reported the incident happened on
when they were on their way to or from work, GO TO PC11A.
ELSE, go to PC2_BOX4.

IF (PC5 = 1 OR PC6 = 1) AND THE FOLLOWING IS TRUE FOR ANY CIR: (S_A = 1 OR S_TA = 1
OR S_ATA = 1 OR S_SA = 1) AND (LO_3 = 5 OR WV1 = 1 OR WV2 = 1) AND (WV3 != -9 OR
WV5 != -9 OR WV6 != -9 OR WV7 != -9 OR WV8 != -9 OR WV != -9), go to PC11A.
Else, go to PC2_BOX4.

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Question ID:

PC11a

Earlier you said that an incident happened while you were at work. Have you changed your job
since then?
1

Yes

GO TO PC12

2

No

GO TO PC_INTRO2

ASK Description: Respondents who provided any details about any incident that happened at
work or on the way to or from work.
ASK Specification: IF (PC5 = 1 OR PC6 = 1) AND THE FOLLOWING IS TRUE FOR ANY CIR: (S_A
= 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1) AND (LO_3 = 5 OR WV1 = 1 OR WV2 = 1) AND
(WV3 != -9 OR WV5 != -9 OR WV6 != -9 OR WV7 != -9 OR WV8 != -9 OR WV != -9).
Box ID:

PC2_BOX4

Respondents who indicated they had changed jobs since the incident, GO TO PC_INTRO2.
Respondents who indicated they had a job or work at a business in the past 7 days or the
job/work in the past 12 months lasted 2 consecutive weeks or more, GO TO PC12.
Else, GO TO PC_INTRO2.

IF PC11a = 2, GO TO PC_INTRO2.
ELSE, IF PC5 = 1 OR PC10 = 1, GO TO PC12.
ELSE, GO TO PC_INTRO2.

Question ID:

PC12

{Earlier you said you had a job or worked at a business last week. }The next questions are
about your {current main/most recent} job. {Are/Were} you employed by . . .
1

A private company, business, or individual for
wages,

GO TO PC14

2

{The }Federal government,{ or}

GO TO PC14

3

A state, county, or local government,

GO TO PC14

4

{Self-employed/Yourself (self-employed)} in your
own business, professional practice, or farm, or

GO TO PC14

5

{Employed by a/A} private not-for-profit, taxexempt, or charitable organization?

GO TO PC14

ASK Description: Respondents who indicated they had a job or work at a business in the past 7
days or the job/work in the past 12 months lasted 2 consecutive weeks or more.
ASK Specification: IF PC5 = 1 OR PC10 = 1.

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Question ID:

PC14

What is the name of the (company/government agency/business/non-profit organization) for
which you worked? Remember, all answers to this survey are confidential, and you may skip
any question that you don't want to answer.
1

TEXT RESPONSE

ASK Description: Respondents who indicated they had a job or work at a business in the past 7
days or the job/work in the past 12 months lasted 2 consecutive weeks or more.
ASK Specification: IF PC5 = 1 OR PC10 = 1.
PROGRAM: DISPLAY TEXT FIELD, MAX CHARACTER LENGTH = 200.
Question ID:

PC15

What kind of business or industry is this? What do they make or do?
1

TEXT RESPONSE

ASK Description: Respondents who indicated they had a job or work at a business in the past 7
days or the job/work in the past 12 months lasted 2 consecutive weeks or more.
ASK Specification: IF PC5 = 1 OR PC10 = 1.
PROGRAM: DISPLAY TEXT FIELD, MAX CHARACTER LENGTH = 200.

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Question ID:

PC16

{Is this mainly…? TURN LAPTOP AROUND SO R CAN SEE LIST./Which of these categories best
describes the business or industry?}
1

Agriculture

2

Forestry

3

Construction

4

Healthcare and Social Assistance

5

Manufacturing

6

Mining

7

Oil and Gas Extraction

8

Public Safety

9

Services

10

Transportation

11

Warehousing

12

Utilities

13

Retail trade

14

Wholesale trade

15

Something else Specify: _______

ASK Description: Respondents who indicated they had a job or work at a business in the past 7
days or the job/work in the past 12 months lasted 2 consecutive weeks or more.
ASK Specification: IF PC5 = 1 OR PC10 = 1.
Question ID:

PC17

What kind of work {do/did} you do, that is, what {is/was} your occupation? (For example:
registered nurse, personnel manager, supervisor of order department, secretary, accountant)
1

TEXT RESPONSE

ASK Description: Respondents who indicated they had a job or work at a business in the past 7
days or the job/work in the past 12 months lasted 2 consecutive weeks or more.
ASK Specification: IF PC5 = 1 OR PC10 = 1.
PROGRAM: DISPLAY TEXT FIELD, MAX CHARACTER LENGTH = 200.

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Question ID:

PC18

What {are/were} your usual activities or duties at this job? (For example: patient care, directing
hiring policies, supervising order clerks, typing and filing, reconciling financial records)
1

TEXT RESPONSE

ASK Description: Respondents who indicated they had a job or work at a business in the past 7
days or the job/work in the past 12 months lasted 2 consecutive weeks or more.
ASK Specification: IF PC5 = 1 OR PC10 = 1.
PROGRAM: DISPLAY TEXT FIELD, MAX CHARACTER LENGTH = 200.
Question ID:

PC_INTRO2

The next questions ask about any health conditions, impairments, or disabilities you may have.
ASK Description: All respondents.
Question ID:

PC19

Are you deaf or do you have serious difficulty hearing?
1

Yes

2

No

ASK Description: All respondents.
Question ID:

PC20

Are you blind or do you have serious difficulty seeing even when wearing glasses?
1

Yes

2

No

ASK Description: All respondents.
Box ID:

PC2_BOX5

For PC21 - PC23, display a ‘Yes' and ‘No' column with options for each response category.
Question ID:

PC21

Because of a physical, mental, or emotional condition, do you have serious difficulty:
1

. . . concentrating, remembering or making
decisions?

2

. . . walking or climbing stairs?

3

. . . dressing or bathing?

ASK Description: All respondents.

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Box ID:

PC2_BOX6

IF UT_AGE >= 16, GO TO PC24.
Else, GO TO PC2_BOX6AA.

Question ID:

PC24

Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone
such as visiting a doctor's office or shopping?
1

Yes

2

No

ASK Description: Respondents age 16 or older.
ASK Specification: IF UT_AGE >= 16.
Box ID:

PC2_BOX6AA

IF PC19 = 1 OR PC20 = 1 OR PC21 = 1 OR PC22 = 1 OR PC23 = 1 OR PC24 = 1, GO TO PC24A.
Else, GO TO PC25_INTRO.
Question ID:

PC24A

Do you consider yourself to be disabled?
1

Yes

2

No

ASK Description: Respondents who are deaf or have serious difficulty hearing, blind or have
serious difficulty seeing even when wearing glasses, because of a physical, mental, or emotional
condition have serious difficulty concentrating, remembering or making decisions, walking or
climbing stairs, dressing or bathing, or because of a physical, mental, or emotional condition
have difficulty doing errands alone such as visiting a doctor's office or shopping.
ASK Specification: IF PC19 = 1 OR PC20 = 1 OR PC21 = 1 OR PC22 = 1 OR PC23 = 1 OR PC24
= 1.
Question ID:

PC25_INTRO

The next questions are about your background.
ASK Description: All respondents.
Question ID:

PC25

Are you Hispanic or {Latino/Latina}?
1

Yes

2

No

ASK Description: All respondents.

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Question ID:

PC26

Which one or more of the following would you say is your race? Select one or more.
1

White

2

Black or African American

3

American Indian or Alaska Native

4

Asian

5

Native Hawaiian or Other Pacific Islander

ASK Description: All respondents.
PROGRAM: ROUTING INSTRUCTIONS: IF PC25 = 1 AND ((PC26_1 = 1 AND PC26_2 != 1 AND
PC26_3 != 1 AND PC26_4 != 1 AND PC26_5 != 1) OR (PC26_1 != 1 AND PC26_2 = 1 AND
PC26_3 != 1 AND PC26_4 != 1 AND PC26_5 != 1) OR (PC26_1 != 1 AND PC26_2 != 1 AND
PC26_3 = 1 AND PC26_4 != 1 AND PC26_5 != 1) OR (PC26_1 != 1 AND PC26_2 != 1 AND
PC26_3 != 1 AND PC26_4 = 1 AND PC26_5 != 1) OR (PC26_1 != 1 AND PC26_2 != 1 AND
PC26_3 != 1 AND PC26_4 != 1 AND PC26_5 = 1)), go to PC26a. Else, go to PC2_BOX7.
Question ID:

PC26a

Do you primarily consider yourself to be Hispanic, or {response from PC26}, or both equally?
1

Hispanic

2

{response from PC26}

3

Both equally

ASK Description: Respondents who are Hispanic and say they are only one race.
ASK Specification: IF PC25 = 1 AND ((PC26_1 = 1 AND PC26_2 != 1 AND PC26_3 != 1 AND
PC26_4 != 1 AND PC26_5 != 1) OR (PC26_1 != 1 AND PC26_2 = 1 AND PC26_3 != 1 AND
PC26_4 != 1 AND PC26_5 != 1) OR (PC26_1 != 1 AND PC26_2 != 1 AND PC26_3 = 1 AND
PC26_4 != 1 AND PC26_5 != 1) OR (PC26_1 != 1 AND PC26_2 != 1 AND PC26_3 != 1 AND
PC26_4 = 1 AND PC26_5 != 1) OR (PC26_1 != 1 AND PC26_2 != 1 AND PC26_3 != 1 AND
PC26_4 != 1 AND PC26_5 = 1)).
Box ID:

PC2_BOX7

Respondents who are over 16 years of age, go to PC27.
Else, go to PC_BOX10.

IF UT_AGE >= 16, GO TO PC27.
Else, GO TO PC2_BOX10.

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Question ID:

PC27

Are you now . . .
1

Married

2

Widowed

3

Divorced

4

Separated, or

5

Never married

ASK Description: Respondents over 16 years of age.
ASK Specification: IF UT_AGE >= 16.
Box ID:

PC2_BOX8

Respondents who are over 16 years of age and are now married, go to PC28.
Else, go to PC2_BOX9.

IF UT_AGE >= 16 AND PC27 = 1, GO TO PC28.
ELSE, GO TO PC2_BOX9.

Question ID:

PC28

Is your spouse living with you?
1

Yes

GO TO PC2_BOX10

2

No

GO TO PC2_BOX10

ASK Description: Respondents who are over 16 years of age and are now married.
ASK Specification: IF UT_AGE >= 16 AND PC27 = 1.
Box ID:

PC2_BOX9

Respondents who are over 16 years of age and live with another adult and are not married, go
to PC29.
Else, go to PC2_BOX10.

IF UT_AGE >= 16 AND SOLO_HHM != 1 AND PC27 != 1, GO TO PC29.
Else, GO TO PC2_BOX10.

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Question ID:

PC29

Do you live with a boyfriend, girlfriend, or partner?
1

Yes

2

No

ASK Description: Respondents who are over 16 years of age and live with another adult and are
not married.
ASK Specification: IF UT_AGE >= 16 AND SOLO_HHM != 1 AND PC27 != 1.
Box ID:

PC2_BOX10

The questions about sexual orientation and gender identity will be asked of VICTIMS age 16 and
older (victim defined as R was asked to complete at least one CIR). If Male, go to PC30. If
Female or Other, go to PC31.
Else, go to PC35.
IF UT_AGE >=16 AND (S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1 OR S_V = 1 OR S_A
= 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1 AND UT_RESP_GENDER = 1, GO TO PC30.
ELSE, IF UT_AGE >=16 AND (S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1 OR S_V = 1
OR S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1 AND UT_RESP_GENDER != 1, GO TO
PC31.
ELSE, GO TO PC35.
Question ID:

PC30

Which of the following BEST represents how you think of yourself?
1

Gay

GO TO PC32

2

Straight, that is, not gay

GO TO PC32

3

Bisexual

GO TO PC32

4

Something else (Specify: _______)

GO TO PC32

5

Refused

GO TO PC32

6

Don't know

GO TO PC32

ASK Description: Respondents who are 16 years or older and completed a CIR and are male.
ASK Specification: IF UT_AGE >= 16 AND (S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1
OR S_V = 1 OR S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1) AND UT_RESP_GENDER =
1.
PROGRAM: Display text box and allow 128 character text response.

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Question ID:

PC31

Which of the following BEST represents how you think of yourself?
1

Lesbian or gay

2

Straight, that is, not lesbian or gay

3

Bisexual

4

Something else (Specify: _______)

5

Refused

6

Don't know

ASK Description: Respondents who are 16 years or older and completed a CIR and are female.
ASK Specification: IF UT_AGE >= 16 AND (S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1
OR S_V = 1 OR S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1) AND UT_RESP_GENDER !=
1
PROGRAM: Display text box and allow 128 character text response.
Question ID:

PC32

What sex was recorded on your original birth certificate?
1

Male

2

Female

3

Refused

4

Don't know

ASK Description: Respondents who are 16 years or older and completed a CIR.
ASK Specification: IF UT_AGE >= 16 AND (S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1
OR S_V = 1 OR S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1).
Question ID:

PC33

Do you currently describe yourself as male, female, or transgender?
1

Male

2

Female

3

Transgender

4

None of these (SPECIFY) ________________

5

Refused

6

I don't know the answer

ASK Description: Respondents who are 16 years or older and completed a CIR.
ASK Specification: IF UT_AGE >= 16 AND (S_MV = 1 OR S_MVP = 1 OR S_T = 1 OR S_BI = 1
OR S_V = 1 OR S_A = 1 OR S_TA = 1 OR S_ATA = 1 OR S_SA = 1).
PROGRAM: Display text box and allow 250 character text response.

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Box ID:

PC2_BOX11

Respondents who reported their sex on their birth certificate was male or female and currently
describe themselves as male, female, or transgender and currently describe themselves as
something different than the sex recorded on their original birth certificate, go to PC34.
Else, go to PC35.
If PC32 = 1, 2 AND PC33 = 1, 2, 3 AND PC32 != PC33, go to PC34.
Else, go to PC35.
Question ID:

PC34

Just to confirm, your sex recorded at birth was {INSERT RESPONSE FROM PC32} and you now
describe yourself as {INSERT RESPONSE FROM PC33}. Is that correct?
1

Yes

2

No

-7

Refused

-8

Don't know

GO TO PC32

ASK Description: Respondents who reported their sex on their birth certificate was male or
female and currently describe themselves as male, female, or transgender and currently
describe themselves as something different than the sex recorded on their original birth
certificate.
ASK Specification: If PC32 = 1, 2 AND PC33 = 1, 2, 3 AND PC32 != PC33.
Question ID:

PC35

Are you a citizen of the United States? That is, were you born in the United States, born in a
U.S. territory, born of U.S. citizen parents, or did you become a citizen of the U.S. through
naturalization?
1

Yes, born in the United States

2

Yes, born in Puerto Rico, Guam, the U.S. Virgin
Islands, or Northern Marianas

3

Yes, born abroad of U.S. citizen parent or parents

4

Yes, U.S. citizen by naturalization

5

No, not a U.S. citizen

ASK Description: All respondents.
Box ID:

PC2_BOX12

Respondents who are 18 years or older, go to PC36.
Else, go to HHC2_BOX1.
If UT_AGE >=18, go to PC36.
Else, go to HHC2_BOX1.

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Question ID:

PC36

Have you ever served on active duty in the U. S. Armed Forces, Reserves, or National Guard?
1

NEVER SERVED IN THE MILITARY

GO TO HHC2_BOX1

2

ONLY ON ACTIVE DUTY FOR TRAINING IN THE
RESERVES OR NATIONAL GUARD

GO TO HHC2_BOX1

3

Now on active duty

4

On active duty in the past, but not now

ASK Description: Respondents who are 18 years or older.
ASK Specification: IF UT_AGE >= 18.
Question ID:

PC37

When did you serve on active duty in the U.S. Armed Forces?{ READ CATEGORIES AS
NEEDED.} (Mark all that apply, even if just for part of the time period.)
1

September 2001 or later

2

August 1990 to August 2001 (including Persian
Gulf War)

3

May 1975 to July 1990

4

Vietnam Era (August 1964 to April 1975)

5

February 1955 to July 1964

6

Korean War (July 1950 to January 1955)

7

January 1947 to June 1950

8

World War II (December 1941 to December 1946)

9

November 1941 or earlier

ASK Description: Respondents who are 18 years or older and are now on active duty or were on
active duty in the past but not now.
ASK Specification: IF UT_AGE >= 18 AND PC36 = 3, 4.

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Household Characteristics II
Box ID:

HHC2_BOX1

Household Respondents, go to H26a.
Else, go to ALL_END.

If UT_HHR = 1, go to H26a.
Else, go to ALL_END.

Question ID:

H26a

Thinking about all of the people who lived in your household in the past 12 months, {was
your/which category represents the} TOTAL combined income{ less than $30,000, or $30,000
or more}? This includes money from jobs, net income from business, farm or rent, pensions,
dividends, interest, Social Security payments, and any other money income received by the
people in this household who are 14 years of age or older.
1

Less than $30,000

2

$30,000 or more

ASK Description: Household respondents.
ASK Specification: IF UT_HHR = 1.
PROGRAM: ROUTING INSTRUCTIONS: IF H26a = 1, GO TO H26B1.
ELSE, IF H26a = 2, GO TO H26B2.
ELSE, GO TO H27.

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Question ID:

H26B1

Was the total combined income in your household…{ READ CATEGORIES UNTIL RESPONDENT
SAYS YES.}
1

Less than $5,000

2

$5,000 to $7,499

3

$7,500 to $9,999

4

$10,000 to $12,499

5

$12,500 to $14,999

6

$15,000 to $17,499

7

$17,500 to $19,999

8

$20,000 to $24,999

9

$25,000 to $29,999

ASK Description: Household respondents whose combined total household income is less than
$30,000.
ASK Specification: IF UT_HHR = 1 AND H26a = 1.
PROGRAM: ROUTING INSTRUCTIONS: GO TO H27.
Question ID:

H26B2

Was the total combined income in your household…{ READ CATEGORIES UNTIL RESPONDENT
SAYS YES.}
1

$30,000 to $34,999

2

$35,000 to $39,999

3

$40,000 to $49,999

4

$50,000 to $74,999

5

$75,000 to $99,999

6

$100,000 to $149,999

7

$150,000 to $199,999

8

$200,000 or more

ASK Description: Household respondents whose combined total household income is $30,000 or
more.
ASK Specification: IF UT_HHR = 1 AND H26a = 2.

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Question ID:

H27

At any time during the past 12 months, did anyone who lives with you receive any kind of
welfare or public assistance from a state or local welfare office – any food or housing benefits,
welfare-to-work assistance, emergency help, or anything like that?
1

Yes

2

No

ASK Description: Household respondents.
ASK Specification: IF UT_HHR = 1.
Question ID:

H28

How often do you worry that your total income (for everyone who lives there) will not be
enough to meet your expenses and bills?
1

Almost all the time

2

Often

3

Once in a while

4

Hardly ever

5

Never

ASK Description: Household respondents.
ASK Specification: IF UT_HHR = 1.

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Closing
Question ID:

ALL_END

{PLEASE CLICK ON THE SUBMIT BUTTON TO FINALIZE THE INTERVIEW/If you have any
questions or concerns about participating in the survey, please contact NSCS Survey Support at
1-855-849-6119. You can also email any questions or concerns to NSCS@westat.com.
Thank you for participating in this study. We realize that some of the topics covered are quite
personal and can be difficult to think and talk about. We appreciate your willingness to be a
part of this study and want you to know that we recognize the important contribution you have
made. Sometimes when people have participated in a study like this, they realize that they are
interested in following up on some of the issues that they have been asked about in the study
with someone who is professionally trained to deal with these kinds of issues.
On the next screen you will see a list of the toll-free numbers of resources that you can use now
or in the future if you want to speak further with someone.}
ASK Description: All respondents.
Question ID:

SUBMITTED

{PLEASE CLOSE THIS WINDOW AND GO BACK TO THE IMS/You can reach the National
Domestic Violence Hotline at 1-800-799-SAFE. You can reach the National Center for Victims of
Crime at 1-202-467-8700. You can reach the National Child Abuse Hotline at 1-800-4-A-CHILD.
You can reach Victim Connect at 1-855-4-VICTIM.
That completes the survey. Thank you for your participation.
Please close your browser or the current tab to exit the survey.}
ASK Description: All respondents.
PROGRAM: ROUTING INSTRUCTIONS: If CONDITION = 2, close module and return to the IMS.
If CONDITION = 3, close module.

216