Form 1 Draft Questions

Small Business Pulse Survey

Phase 2 Draft Questions for Cognitive Interviews

6.23.20

First screen (PRA/PA statements):

The U.S. Census Bureau is required by law to protect your information. The Census Bureau is not permitted to publicly release your responses in a way that could identify you. We are conducting this voluntary interview under the authority of Title 13, United States Code, Sections 131 and 182. Federal law protects your privacy and keeps your answers confidential (Title 13, United States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your data.

We estimate that completing this interview will take 30-45 minutes on average. Send comments regarding this estimate or any other aspect of this interview, including suggestions for reducing the time it takes to complete this interview to adrm.pra@census.gov. This collection has been approved by the Office of Management and Budget (OMB). This eight-digit OMB approval number, 0607-0725, confirms this approval and expires on 10/31/2020. We are required to display this number to conduct this survey. By proceeding, you give your consent to participate in this study.

Your privacy is protected by the Privacy Act. The information provided may be shared with other Census Bureau staff for the work-related purposes identified in this statement. For more information on this collection, see SORN “COMMERCE/CENSUS-4, Economic Survey Collection” by visiting our website at census.gov and clicking on "Data Protection and Privacy Policy" at the bottom of the home page.

Small Business Pulse Survey

The U.S. Census Bureau is requesting your assistance in understanding the effect of changing business conditions due to the Coronavirus pandemic on your business. Your response is especially important right now as it helps policy makers, government officials, and businesses like yours understand these effects. Please complete this short 20 question survey; it will take approximately 5 minutes.

This survey asks about the experience of your business over the last week, but also about the experience of your business since the start of the Coronavirus pandemic. The White House declared a national emergency because of the Coronavirus pandemic on March 13, 2020.

1. Overall, how has this business been affected by the Coronavirus pandemic?

Select only one:

• Large negative effect

• Moderate negative effect

• Little or no effect

• Moderate positive effect

• Large positive effect

2. In the last week, did this business experience a change in operating revenues/sales/receipts, not including any financial assistance or loans?

Select only one:

• Yes, increased

• Yes, decreased

• No change

3. In the last month, what were the total operating revenues/sales/receipts for this business, not including any financial assistance or loans?

Select only one:

• $0 - $500

• $501 - $2,500

• $2,501 - $5,000

• $5,001 - $15,000

• $15,001 - $50,000

• $50,001 - $125,000

• $125,001 - $200,000

• $200,001 - $500,000

• $500,001 or more

• Don’t know

4. In the last week, did this business have a change in operating status?

Select only one:

• Yes, opened previously closed location

• Yes, temporarily closed location

• Yes, permanently closed location

• No change

5. In the last week, did this business have a change in the number of paid employees?

Select only one:

• Yes, increased

• Yes, decreased

• No change

6. In the last week, did this business bring back any paid employees who had been furloughed or laid off after March 13, 2020?

Select only one:

• Yes

• No

7. In the last week, did this business have a change in the total number of hours worked by paid employees?

Select only one:

• Yes, increased

• Yes, decreased

• No change

8. In the last week, did this business have a change in the total number of hours paid employees worked from home (telework)?

Select only one:

• Yes, increased

• Yes, decreased

• No change

9. In the last week, did this business experience any of the following?

Select all that apply:

• Production delays at this business

• Domestic supplier production or shipping delays

• Foreign supplier production or shipping delays

• Difficulty locating alternate domestic suppliers

• Difficulty locating alternate foreign suppliers

• Delays in transit to customers

• None of the above

10. In the last week, have any of the following affected this business’s ability to provide goods or services?

Select all that apply:

• Ability to re-hire furloughed or laid off employees and/or hire new employees

• Availability of employees to work

• Ability of employees to work from home (telework)

• Physical distancing of employees

• Physical distancing of customers and/or limits on the number of concurrent customers

• Availability of Personal Protective Equipment (PPE) and/or related equipment or supplies

• Availability of other supplies or inputs used to provide good or services

• None of the above

11. Relative to one year ago, at what level did this business operate in the last week?

Select only one:

• 0 - 20% of level of operations one year ago

• 21 - 40% of level of operations one year ago

• 41- 60% of level of operations one year ago

• 61 - 80% of level of operations one year ago

• 81 - 100% of level of operations one year ago

• More than 100% of level of operations one year ago

12. Since March 13, 2020, has there been an increase in this business’s ability to offer goods or services using online platforms?

Select only one:

• Yes

• No

13. How would you describe the current availability of cash on hand for this business, including any financial assistance or loans? Currently, cash on hand will cover:

Select only one:

• 1-7 days of business operations

• 1-2 weeks of business operations

• 3-4 weeks of business operations

• 1-2 months of business operations

• 3 or more months of business operations

• No cash available for business operations

• Don’t know

14. Since March 13, 2020, has this business missed any loan payments? Loan payments that have been forgiven or postponed should not be considered to be missed.

Select only one:

• Yes

• No

15. Since March 13, 2020, has this business missed any other scheduled payments, not including loans? Examples of other scheduled payments include rent, utilities, and payroll. Scheduled payments that have been forgiven or postponed should not be considered to be missed.

Select only one:

• Yes

• No

16. Since March 13, 2020, has this business requested financial assistance from any of the following sources?

Select all that apply:

• Paycheck Protection Program (PPP)

• Economic Injury Disaster Loans (EIDL)

• Small Business Administration (SBA) Loan Forgiveness

• Main Street Lending Program

• Deferral of Federal Employment Tax Deposits and Payments

• Federal Sick and Family Leave Tax Credits

• Federal Employee Retention Tax Credit

• Other Federal programs

• State or local government programs

• Banks

• Self

• Family or friends

• Other sources

• This business has not requested financial assistance from any source since March 13, 2020.

17. Since March 13, 2020, has this business received financial assistance from any of these programs from the Federal government?

Select all that apply:

• Paycheck Protection Program (PPP)

• Economic Injury Disaster Loans (EIDL)

• SBA Loan Forgiveness

• Main Street Lending Program

• Deferral of Federal Employment Tax Deposits and Payments

• Federal Sick and Family Leave Tax Credits

• Federal Employee Retention Tax Credit

• Other Federal programs

• This business has not received financial assistance from any Federal program since March 13, 2020.

18. In the next 6 months, do you think this business will need to do any of the following?

Select all that apply:

• Obtain financial assistance or additional capital

• Identify new supply chain options

• Develop online sales or websites

• Increase marketing or sales

• Learn how to better provide for the safety of customers and employees

• Identify and hire new employees

• Permanently close this business

• None of the above

19. In your opinion, how much time do you think will pass before this business returns to its normal level of operations relative to one year ago?

Select only one:

• 1 month or less
• 2-3 months
• 4-6 months
• 7-12 months

• More than 12 months
• I do not believe this business will return to its normal level of operations.
• There has been little or no effect on this business's normal level of operations.
• This business has returned to its normal level of operations.
• This business has permanently closed.