Privacy
Act Statement:
5
U.S.C. 552a(e)(3)
The Consumer Financial Protection Bureau (Bureau) uses an outside firm to obtain the names and addresses of a national list of consumers to contact you for the purpose of participating in this survey. The information you provide through your responses will assist the Bureau in understanding people’s experiences when money gets tight.
The Bureau will only receive de-identified information. Only your de-identified information will be combined with other data that the Bureau has collected in a way that you cannot be identified.
Information collected on behalf of the Bureau will be treated in accordance with the System of Records Notice (“SORN”), CFPB.022, Market and Consumer Research Records, https://www.federalregister.gov/articles/2012/11/14/2012-27582/privacy-act-of-1974-asamended. Although the Bureau does not anticipate further disclosing the information provided, it may be disclosed as indicated in the Routine Uses described in the SORN. Direct identifying information will be kept private except as required by law. The Bureau may make an anonymous version of the survey data publicly available.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and 1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this study is voluntary. You may withdraw participation at any time.
Paperwork
Reduction Act Statement:
According
to the Paperwork Reduction Act of 1995, an agency may not conduct or
sponsor, and a person is not required to respond to a collection of
information unless it displays a valid OMB control number. The OMB
control number for this collection is 3170-0080. It expires on
11/30/2026. Comments regarding this collection of information,
including the estimated response time, suggestions for improving the
usefulness of the information, or suggestions for reducing the
burden to respond to this collection should be submitted to the
Consumer Financial Protection Bureau at CFPB_PRA@cfpb.gov.
Note: This list includes 154 questions, any or all of which could be part of the final instrument for either the follow up survey or the main survey. Ten of these questions are unlikely to be included and are separate from the remaining questions.
We may remove several of the questions for the version that we send to respondents to fit space constraints on the paper version of the survey and to ensure a readable and inviting layout. We may also move some questions from this instrument on to the follow-up survey that is part of this collection, and vice versa. Any changes of this nature that we make will not increase the burden hours associated with this collection.
Because we expect to remove and/or reorder questions, all references to particular questions or sections within the instrument (such as those in instructions to skip specific questions) are shown with placeholders.
How well do these statements describe you or your situation?
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This statement describes my situation … |
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Completely |
Very well |
Somewhat |
Very little |
Not at all |
I know how to make complex financial decisions |
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□ |
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I am comfortable using English to perform financial transactions |
□ |
□ |
□ |
□ |
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I am just getting by financially |
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□ |
□ |
□ |
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I am concerned that the money I have or will save won’t last |
□ |
□ |
□ |
□ |
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Because of my money situation, I feel like I will never have the things I want in life |
□ |
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How often do these statements apply to you?
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This statement applies to me … |
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Always |
Often |
Sometimes |
Rarely |
Never |
I have money left over at the end of the month |
□ |
□ |
□ |
□ |
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My finances control my life |
□ |
□ |
□ |
□ |
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What is your current work status? Please mark all that apply including for your spouse or partner if you have one.
|
You |
Spouse/Partner |
Self-employed |
□ |
□ |
Work full time |
□ |
□ |
Work part time |
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□ |
Retired |
□ |
□ |
Temporarily laid off or on leave |
□ |
□ |
Unemployed |
□ |
□ |
Not working for pay (homemaker, student, disabled, etc.) |
□ |
□ |
In the past 12 months, how often did you typically work from home?
Never in the past 12 months
Occasionally
1-2 days per week
3-4 days per week
5 or more days per week
Do you own your own business?
Yes
No (Skip to Question XX)
Is this business your primary income source?
Yes
No
Do you have a separate line of credit or credit card for the business?
Yes
No
Do you have a spouse or partner whom you share finances with?
Do you have any children, parents, relatives, or other dependents whom you share your finances with or who are financially dependent on you?
Yes
No
The next questions are about your household. By household, we mean you and anyone whom you share your finances with.
If you answered Yes to Question XX, Question XX, or both, answer the following questions for both you and the people you share your finances with.
What was your household’s annual gross income (before taxes) in 2023 from all sources (wages, tips, child support, alimony, investment or rental income, retirement, Social Security, unemployment insurance and government benefits such as rental assistance)?
$20,000 or less
$20,001 to $35,000
$35,001 to $50,000
$50,001 to $65,000
$65,001 to $80,000
$80,001 to $100,000
$100,001 to $125,000
$125,001 to $175,000
$175,001 to $250,000
$250,001 or more
Which best describes your household’s income from month to month?
Income is about the same each month
Income varies somewhat from month to month
Income varies a lot from month to month
In the last 12 months, has the amount of money your household has in checking and savings gone up, stayed about the same, or gone down?
Gone up
About the same
Gone down
In the last 12 months, how have your normal household expenses like food, clothing, rent, or other bills that you pay regularly changed?
Gone up
About the same
Gone down
In the past 12 months, how often has your household received financial assistance from family or friends who are not in your household?
Never
Once
2-4 times
5 or more times
In the past 12 months, how often has your household provided financial assistance to family or friends who are not in your household?
Never
Once
2-4 times
5 or more times
In the past year, did your household receive benefits from any of the following government programs?
|
Yes |
No |
Temporary Assistance for Needy Families (TANF) |
□ |
□ |
Supplemental Nutrition Assistance Program (SNAP, food stamps, or WIC) |
□ |
□ |
Earned Income Tax Credit (EITC) |
□ |
□ |
Housing or rental assistance (such as Section 8 housing vouchers or public housing placement) |
□ |
□ |
Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) |
□ |
□ |
Medicaid |
□ |
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Low-Income Home Energy Assistance Program (LIHEAP) |
□ |
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Other (Specify) |
□ |
□ |
Do you or anyone in your household currently have a checking or savings account? Please include any accounts you can access to pay for things, such as money market or prepaid accounts.
Yes
No (Skip to Question XX)
Altogether, about how much money does your household have right now in all of its checking and savings accounts?
$0
Less than $100
$101 to $500
$501 to $1,000
$1,001 to $5,000
$5,001 to $10,000
$10,001 to $20,000
$20,001 or more
In the past 12 months, did you open a new checking or savings account?
Yes, a new checking account
Yes, a new savings account
Yes, both a new savings and a new checking account
No (Skip to Question XX)
Did you open a new account for any of the following reasons?
|
Yes |
No |
I did not have any bank accounts before, and felt that I wanted or needed one |
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□ |
I did not have enough money to need a bank account before, but now I do |
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The new account had a better interest rate |
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There were fewer fees associated with the new account |
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For budgeting, to track spending, or for another family member |
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□ |
There was an offer or bonus for opening a new account |
□ |
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My financial institution closed my previous account |
□ |
□ |
Some other reason (Specify) |
□ |
□ |
Is your new account at an online-only bank?
Yes
No
If your household lost its main source of income, about how long could you cover expenses by, for example, borrowing, using savings, selling assets, or seeking help from family or friends?
Less than two weeks
About one month
About two months
Three to six months
More than six months
In the past 12 months, have you or anyone in your household used any of the following payment or money transfer methods, even once?
|
Yes |
No |
Checks |
□ |
□ |
Prepaid cards |
□ |
□ |
Remittances (international money transfer) |
□ |
□ |
Peer-to-peer payment apps (such as Venmo, Zelle, or CashApp) |
□ |
□ |
Virtual currencies (such as bitcoin or Ethereum) |
□ |
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Check cashing services |
□ |
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Does anyone in your household have any stocks, bonds, or mutual funds outside of retirement accounts?
Yes
No
Whether or not your household is currently saving for retirement, does anyone in your household have an IRA, 401(k) account, pension plan, or other retirement account?
Yes
No
Thinking about your non-retirement accounts and any cash savings, about how much money does your household currently have that could be used for unexpected expenses or emergencies?
$___________.00
Did you consider flood or fire risk when you last decided where to live?
Yes
No
Do you or anyone in your household rent out a property you own for income?
Yes
No
Do you or someone in your household own your current residence?
Yes
No
If you or someone in your household owns your current residence, respond to Questions XX-XX, and Questions XX-XX if applicable.
About how much does your household spend on your mortgage (including property taxes and homeowners insurance) each month?
$___________.00
Has your household had a homeowners insurance policy cancelled in the past 12 months?
Yes, the insurance company cancelled it
Yes, we cancelled it ourselves
No
Does your household currently have homeowners insurance?
Yes
No (Skip to Question XX)
If nobody in your household owns your
current residence, respond to Questions XX-XX,
and Questions XX-XX if applicable.
In
the past year, have you . . .
|
Yes |
No |
Been threatened with eviction? |
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Been given an eviction notice? |
□ |
□ |
Moved because of rent increases? |
□ |
□ |
Moved because your lease was not renewed? |
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Experienced a rent increase that strained your budget? |
□ |
□ |
Do you rent your current residence?
Yes
No (Skip to Question XX)
About how much does your household
spend on rent each month?
$___________.00
In the past year, how often did you not pay or were late with the rent payment?
Never (Skip to Question XX)
1 time
2-3 times
More than 3 times
Are you current on your rent payments?
Yes
No
In the past 12 months, has your household experienced a significant unexpected expense from any of the following?
|
No |
Yes |
If yes, about how much was the cost? |
A major out-of-pocket medical or dental expense |
□ |
□ |
$______________________.00 |
An unplanned gift or loan to a family member or friend outside your household |
□ |
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$______________________.00 |
A major vehicle repair or replacement |
□ |
□ |
$______________________.00 |
A major house or appliance repair |
□ |
□ |
$______________________.00 |
A computer or mobile phone repair or replacement |
□ |
□ |
$______________________.00 |
Legal expenses, taxes, or fines |
□ |
□ |
$______________________.00 |
Increase in childcare or dependent care expenses |
□ |
□ |
$______________________.00 |
Moving costs |
□ |
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$______________________.00 |
Some other major unexpected expense |
□ |
□ |
$______________________.00 |
In the past 12 months, has your household experienced a significant drop in income from any of the following?
|
No |
Yes |
If yes, about how much income did you lose because of this circumstance over the past 12 months? |
Period of unemployment or furlough |
□ |
□ |
$___________________.00 |
Reduction in work hours |
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□ |
$___________________.00 |
Reduction in wages at your job |
□ |
□ |
$___________________.00 |
Changed to a lower-paying job |
□ |
□ |
$___________________.00 |
Loss of government benefits |
□ |
□ |
$___________________.00 |
Worked less because of illness or injury |
□ |
□ |
$___________________.00 |
Worked less to care for others who were sick or injured |
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□ |
$___________________.00 |
Worked less or stopped working to take care of children |
□ |
□ |
$___________________.00 |
Lost rental income from a property you own |
□ |
□ |
$___________________.00 |
Loss of revenue from a business you own |
□ |
□ |
$___________________.00 |
Loss of income due to a natural disaster |
□ |
□ |
$___________________.00 |
Other significant drop in income |
□ |
□ |
$___________________.00 |
In the past 12 months, have any of the following happened to your household?
|
Yes |
No |
Someone in your household got married |
□ |
□ |
Someone in your household divorced or separated |
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Someone in your household had a major illness or injury |
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Someone in your household died |
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Someone was born, adopted, or moved into your household |
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Someone left your household |
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Someone in your household retired |
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Natural disaster affected your home, employer, or business |
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You moved to a new residence |
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A car was repossessed |
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Someone in your household was arrested, charged with a crime, or held in jail or prison |
□ |
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You started a new business |
□ |
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You closed a business you owned |
□ |
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Do you expect to have difficulty paying for a bill or expense in the next 12 months?
Yes
No
In the past year, were you late on a loan payment of any kind? Include payments for things like credit cards, buy-now-pay-later purchases, student loan payments, mortgage payments, and any other form of credit.
Yes
No
At any time in the past 12 months have you or your household had difficulty paying for a bill or expense?
Yes
No (Skip to question XX)
How often did you have trouble in the last 12 months?
Only once in the last 12 months
2 times
3 or 4 times
5 to 12 times
More than 12 times
When was the most recent time that you or your household had difficulty paying a bill or expense?
In the last month
1-3 months ago
4-6 months ago
7-12 months ago
Thinking back to the most recent time you had difficulty, was there an event or expense that caused this difficulty?
Yes
No
What was that event or expense? Select all that apply.
Medical expenses or fees
Loss of income from illness
Loss of job
Other loss of income
Home repair
Auto repair
Taxes or fees
Legal bills
Death or funeral costs
Helping children, parents, or other family members
Student loan, school, or tuition costs
Moving costs
Fraud or theft
Gambling losses
Other (specify)
Thinking back to the most recent time you had difficulty, which of the following did you have difficulty paying for? Paying for one major expense may make it harder to pay other bills or expenses, so please mark yes for everything you had difficulty paying for.
|
Yes |
No |
A medical expense |
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□ |
A car or vehicle repair |
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A home repair |
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Food |
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□ |
Mortgage or rent |
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Utilities |
□ |
□ |
Taxes, fees, or legal bills |
□ |
□ |
Death or funeral costs |
□ |
□ |
Student loan, school, or tuition costs |
□ |
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Childcare |
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Other regular household expenses |
□ |
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Some other expense |
□ |
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Which of the following did you do when you had difficulty paying the most recent bill or expense? Select all that apply.
Did not pay for all of this expense
Negotiated a lower or delayed payment for this expense
Used non-retirement savings or investments
Used retirement savings
Sold or pawned something
Cut back on other expenses
Paid another bill late or skipped a payment
Increased income, for example, by working overtime or taking an extra job
Donated plasma or blood for money
Used a credit card and paid it off over time
Borrowed money from friends or family
Took out or used a home equity line of credit
Took out a loan from a bank, credit union, or other financial institution
Took out a cash advance from your employer
Took out a payday or auto title loan
Other
Thinking back to the most recent time you had difficulty, did you miss a payment for any of the following? Select all that apply.
Mortgage
Credit card bill
Student loan
Auto loan
Payday loan
Auto title loan
Personal loan from a bank or other financial services provider
Loan from a family member, friend, or acquaintance
Buy-now-pay-later payments
Cash advance from your employer
Rent
Other (Specify)
Getting enough food can also be a problem for some people. In the last 7 days, which of these statements best describes the food eaten in your household?
Enough of the kinds of food (I/we) wanted to eat
Enough, but not always the kinds of food (I/we) wanted to eat
Sometimes not enough to eat
Often not enough to eat
In the last 7 days, how difficult has it been for your household to pay for usual household expenses, including but not limited to food, rent or mortgage, car payments, medical expenses, student loans, and so on?
Not at all difficult
A little difficult
Somewhat difficult
Very difficult
Which one of the following statements best describes your access to transportation in the past 30 days?
Enough transportation to meet your needs
Enough transportation, but not always the kinds you want to use
Sometimes not enough transportation to meet your needs
Often not enough transportation to meet your needs
Always not enough transportation to meet your needs
Have you placed a bet on a sporting event or outcome in the last year?
Yes
No (Skip to Question XX)
Did you use a mobile phone to place a bet?
Yes
No
How frequently did you take part in sports betting in the past year?
Once
A few times
Monthly
Weekly
A few times a week
Daily
In the past year, how much money did you wager for a typical bet?
Less than $10
Between $11 and $20
Between $21 and $50
Between $51 and $100
Between $101 to $250
More than $250
In the past year, what was your largest loss in a single day?
Less than $10
Between $11 and $50
Between $51 and $100
Between $101 and $250
Between $251 and $500
More than $500
Did you gamble at a casino in the last year?
Yes
No
Did you gamble online or on your phone on something other than a sporting event in the last year?
Yes
No
Do you have health insurance (through an employer, purchased independently, or from a government program like Medicare or Medicaid)?
Yes
No
Are you currently covered by any of the following types of health insurance or health coverage plans?
|
Yes |
No |
Insurance through a current or former employer or union (through yourself or another family member) |
□ |
□ |
Insurance purchased directly from an insurance company, including marketplace coverage (through yourself or another family member) |
□ |
□ |
Medicare, for people 65 and older, or people with certain disabilities |
□ |
□ |
Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability |
□ |
□ |
TRICARE or other military health care |
□ |
□ |
VA (including those who have ever used or enrolled for VA health care) |
□ |
□ |
Indian Health Service |
□ |
□ |
Other (Specify) |
□ |
□ |
Does everyone else in your household have health insurance?
Yes
No
Do you or your household have any medical or dental bills that are past due or that you are unable to pay?
Yes
No
Do you or your household have any medical or dental bills that you are paying off over time directly to the provider?
Yes
No
Do you or your household owe money because you took out a loan or used a credit card to pay medical or dental bills?
Yes
No
Do you have a credit card that only lets you pay for medical or dental expenses with it? Please do not include debit cards for prepaid accounts like a Health Savings Account (HSA) or Flexible Spending Account (FSA).
Yes
No
In the past year, have you been contacted by someone other than your medical or dental provider to collect a past-due medical or dental bill?
Yes
No (Skip to Question XX)
In the past year, how many different bills has someone other than your medical or dental provider tried to collect from you?
1 bill
2-4 bills
5 or more bills
In the past year, how often has someone other than your medical or dental provider tried to collect a past-due medical or dental bill from you?
More than once per week
Weekly
A few times per month
Monthly
Once every few months
Only once
in the past month, about how much in past-due medical or dental bills has someone other than your medical or dental provider tried to collect from you?
$_____________.00
When were you most recently contacted by someone other than your medical or dental provider to collect a past-due medical or dental bill?
Less than a month ago
1 to 3 months ago
4 to 6 months ago
7 to 12 months ago
The most recent time you were contacted, about how much was the bill?
$_____________.00
The most recent time you were contacted, did you dispute the bill?
Yes
No
Without looking it up, what is your approximate credit score? It is okay if you have to guess.
My credit score is (enter a number ranging from 300 to 850): [Enter number]
When was the last time you checked your credit score or credit report?
Never
At least one year ago
Within the last year
How do you think your credit score has changed over the last year?
Gone up
Stayed about the same
Gone down
What sources of information do you use to make decisions about borrowing, credit, savings, or investments? Select all that apply
Family or friends
Financial planner, advisor, or broker
Internet, web service or application
Banker, lawyer or accountant
Book/magazine/newspaper/mail
Podcasts, radio, or television
Conferences, workshops, or other events
Social media (TikTok, YouTube, Reddit, etc)
Which social media sites did you use to find information to make decisions about borrowing, credit, savings, or investments? Select all that apply
TikTok
Twitter/X
YouTube
Snapchat
Discord
Other (Specify)
Have you applied for any type of credit or loan in the past year?
Yes
No (Skip to Question XX)
In the past year, were you turned down for a loan or not given as much credit as you applied for?
Yes
No (Skip to Question XX)
Did you then apply somewhere else?
Yes
No
Thinking back to the most recent credit or loan you applied for, what factors did you consider when choosing what to apply for?
Fees
Interest rates
Rewards (such as cash back, bonus points, or miles)
Monthly payment
Likelihood of qualifying
Reputation
Recommendation from family or friends
Other (Specify)
In the past year, did you think of applying for credit or a loan but changed your mind because you thought you might be turned down?
Yes
No
In the past year, did you think of applying for credit or a loan but changed your mind for any of the following reasons?
|
Yes |
No |
Interest rates were too high |
|
|
I decided that I was able to afford what I wanted without credit |
|
|
I decided that I didn’t want to go into debt |
|
|
I did not trust any of the lenders I found |
|
|
I did not understand the details of the credit or loans I was considering |
|
|
Some other reason (Specify) |
|
|
Did you refinance any loans in the past year?
Yes
No
Have you taken out a pawn shop loan in the past 12 months?
Yes
No
Have you taken out an auto title loan in the past 12 months? An auto title loan uses the car’s value to borrow money for a short period of time.
Yes
No
Have you used earned wage access in the past 12 months? Earned wage access allows workers access to a portion of their paycheck before payday. It is also called on-demand pay, instant pay, or a paycheck advance.
Yes, through a service or app connected to my employer
Yes, through an app not connected to my employer
No (Skip to Question XX)
If yes, did you pay a fee or tip to access the money?
Yes
No (Skip to Question XX)
Did you pay the fee or tip so that you could access the money quickly?
Yes
No
Have you taken out a payday loan in the past 12 months or continued to owe money on a previous payday loan? A payday loan is a loan that you must repay, make a payment on, or rollover on your next payday.
Yes
No (Skip to Question XX)
Have you rolled over a payday loan in the last 12 months?
Yes
No
In the past year, how many times have you purchased something using a “buy now, pay later” option, in which you did not pay for the full price at the time of purchase, but rather paid in four or fewer interest-free installments? Some retailers offer these payment plans through companies such as Affirm, Afterpay, and Klarna.
Never in the past year
1-2 times
3-6 times
More than 6 times
Do you have an auto loan?
Yes
No (Skip to Question XX)
Did you get the auto loan through the dealer or by going to a lender yourself?
Through the dealer
By going to a lender myself
Don’t know
In the past year, did a credit card company unexpectedly cancel your credit card or reduce your credit card limit?
Yes
No
Do you currently have a credit card?
Yes
No (Skip to Question XX)
In the past 12 months, have you incurred a late fee on any of your credit cards?
Yes
No
Did you have an unpaid balance on any of your cards after making your last payment?
Yes
No (Skip to Question XX)
Do you think you will pay the full balance in the next year?
Yes
No
Do you have autopay set up for the credit card you use most regularly? Autopay has an amount automatically deducted from your bank account to pay your credit card bill.
Yes
No (Skip to Question XX)
How is your autopay set up?
To pay the minimum payment
To pay the full statement balance
To pay some other amount
In the past 12 months, how many overdraft fees have you or others in your household been charged? An overdraft fee occurs when your account balance is less than a payment, but your bank covers the transaction and charges you a fee.
Not in the past 12 months
1-3 fees
4-10 fees
More than 10 fees
In the past 12 months, how many insufficient funds fees have you or others in your household been charged? An insufficient funds fee occurs when your account balance is less than a payment, and your bank denies the payment and charges you a fee.
Not in the past 12 months
1-3 fees
More than 4 fees
Do you currently have any student loans? Include any loans that you took out for someone else’s education in addition to any loans you have taken out for your own education.
Yes
No à Skip to Question XX
About how much are you paying on all of your student loans each month?
$_____________.00
What type of student loans do you have?
Private student loans only
Federal student loans only
Both private and federal student loans
Have you started making payments on your federal student loans after the pandemic pause for federal student loan repayment?
Yes, before October 2023
Yes, in October 2023
Yes, in November or December 2023
Yes, in January 2024 or later
I haven’t started making payments yet
Has anyone else ever made payments on the student loans you took out (for your own or someone else’s education)?
No, I have made all the payments
Yes, but I’ve made more than half of the payments
Yes, but I’ve made about half of the payments
Yes, but I’ve made less than half of the payments
Yes, and I have not made any payments
Not applicable, I have never had a student loan
Have you ever helped repay a student loan someone else took out for their education? Select all that apply.
Yes, for a spouse or partner
Yes, for a childe or grandchild
Yes, for someone else not listed above
No
In the past year, have you paid a company or service to try to help repair your credit or improve your credit score?
Yes
No (Skip to Question XX)
Was there a specific reason you wanted to improve your credit or credit score?
Yes
No (Skip to Question XX)
What was the reason for trying to improve your credit or credit score? Select all that apply
Qualify for a mortgage
Qualify for a credit card
Qualify for an auto loan
Rent an apartment
For a job
Get better terms on a loan or credit card
Refinance existing loans
Access credit for my business
General credit health
Other specify:
Who did you pay to help repair your credit? Select all that apply
Credit repair services, where you pay a company that provides dispute templates or promises to fix your credit or improve your credit score by disputing items on your credit report
Credit counseling, where a nonprofit or professional advises you on managing your money and debts
Debt consolidation loans, where you pay a company to combine your debts into one loan that you pay off in installments
Debt relief or settlement companies, that say they can renegotiate, settle, or in some way change the terms of a person's debt to a creditor or debt collector.
Other specify:
In your experience paying for a credit repair service, approximately how much did you spend in total trying to fix your credit?
Less than $250
$251 to $500
$501 to $750
$751 to $1,000
More than $1,000
In your experience paying for a credit repair service, were you required to make any payments before you saw results?
Yes
No
How successful was the company or service you paid in improving your credit?
Very successful
Somewhat successful
Not successful at all
I’m still in the process (i.e., no results yet)
I don't know
In the past year, have you disputed an item on your credit report by contacting a credit bureau?
Yes
No (Skip to Question XX)
If yes, was it removed?
Yes
No
In the past year, have you lost money to any of the following type(s) of fraud or scams? Include any instances where the money or property was eventually recovered or refunded.
|
Yes |
No |
Theft, misuse, or financial exploitation by a known or trusted person |
|
|
Credit or debit card fraud or unauthorized use |
|
|
Imposter scams (where scammers impersonate tech support, government, businesses, charities, or family members) |
|
|
Phishing scams (where scammers steal your password or other personal information) |
|
|
Investment scams (including fake cryptocurrency investments) |
|
|
Prize, sweepstakes, or lottery scams |
|
|
Fake business or job opportunity |
|
|
Online shopping scams |
|
|
Identity theft |
|
|
Social media scams |
|
|
Some other type of fraud or scam (please specify): |
|
|
In the past year, how many times have you lost money to a fraud or scam?
Never (Skip to Question XX)
One time
Two or three times
More than three times
For the most recent fraud or scam, did you ultimately lose any money?
__________
For the most recent fraud or scam you lost money to, what service or product was involved?
Did you report the fraud or scam that you lost money to most recently to any of the following? Select all that apply
Your bank or financial institution
One or more credit bureau (Equifax, Experian, TransUnion)
Local law enforcement (such as a police department or sheriff’s office)
A federal agency, such as the Federal Trade Commission (FTC), the Consumer Financial Protection Bureau (CFPB), or the Federal Bureau of Investigations (FBI)
Better Business Bureau
Some other entity (please specify):
I did not report the fraud or scam
Did anyone help you resolve your problem? Select all that apply.
I did not receive help
A financial professional or lawyer that you hired
Family
Law enforcement
Bank or financial institution
Community organization
Other state or local agency
A federal agency
Other, please specify:
Would you say your health in general is …?
Excellent
Very Good
Good
Fair
Poor
What is your current marital status?
Married
Never married, living with a partner
Never married, not living with a partner
Separated
Divorced
Widowed
Besides you and your spouse/partner, how many other adults over 18 live in your household?
No others
1 other
2 or more
How many children live in your household?
No children
1
2 or more
Are these children currently covered by Medicaid, the Children’s Health Insurance Program (CHIP), or any kind of government health insurance plan for those with low incomes or a disability?
Yes
No
What is your race and/or ethnicity? Select all that apply. Note, you may report more than one group.
American Indian or Alaska Native
Asian
Hispanic or Latino
Black or African American
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White
Were you born in the United States?
Yes
No
What is your highest level of education?
Less than a high school degree
High school degree
Technical or vocational degree
Some college, but no degree
Two-year college degree
Four-year college degree
Postgraduate degree (for example, MA, PhD, JD, MBA, MD)
Are you currently attending school?
Yes, full time
Yes, part time
No
Did either of your parents complete a four-year college degree?
Yes
No
What is your current military status?
|
You |
Spouse/ partner |
No military service |
□ |
□ |
On active duty |
□ |
□ |
Reserve or National Guard |
□ |
□ |
Veteran or retired |
□ |
□ |
What is your gender? Please mark all that apply.
Male
Female
Non-binary
Prefer not to answer
Do you consider yourself to be?
Straight or heterosexual
Gay, lesbian, or homosexual
Bisexual
Other or don’t know
Prefer not to answer
Suppose you won a prize and could decide when you would get the amount. Would you rather get:
$1000 in one month or
$1050 in six months
Suppose you won a prize and could decide when you would get the amount. Would you rather get:
$1000 in one month or
$1100 in six months
Suppose you won a prize and could decide when you would get the amount. Would you rather get:
$1000 in one month or
$1150 in six months
In some of the following questions, we will ask you to think about the percent chance of something happening in the future. Your answers can range from 0 to 100, where 0 means there is absolutely no chance, and 100 means that it is absolutely certain.
For example, numbers like:
2 and 5 percent may indicate "almost no chance"
18 percent or so may mean "not much chance"
47 or 52 percent chance may be a "pretty even chance"
83 percent or so may mean a "very good chance"
95 or 98 percent chance may be "almost certain"
How likely is it that...
You move to a new residence in the next year |
____% |
Your credit score will go down by more than 20 points in the next year? |
____% |
Your household will experience a significant income drop from a period of unemployment or furlough in the next year? |
____% |
You will experience a major out-of-pocket medical or dental expense in the next year? |
____% |
You will experience a major vehicle repair or replacement expense in the next year? |
____% |
How likely is it that you will experience an unexpected major house or appliance repair or replacement in the next year? |
____% |
We have provided the space below if you wish to share additional comments or further explain any of your responses. Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name, address, phone number, email address, Social Security number, etc.
In the past year, were you late on a loan payment of any kind? Include payments for things like credit cards, buy-now-pay-later purchases, student loan payments, mortgage payments, and any other form of credit.
Yes
No (Skip to Question XX)
Were you late on any of the following? Select all that apply.
Mortgage
Credit card bill
Student loan
Auto loan
Payday loan
Auto title loan
Personal loan from a bank or other financial services provider
Loan from a family member, friend, or acquaintance
Buy-now-pay-later payments
Cash advance from your employer
Rent
Other (Specify)
Thinking about the most recent time you were late on a loan, was there an event or expense that caused you to be late?
Yes
No
What was that event or expense? Select all that apply.
Medical expenses or fees
Loss of income from illness
Loss of job
Other loss of income
Home repair
Auto repair
Taxes or fees
Legal bills
Death or funeral costs
Helping children, parents, or other family members
Student loan, school, or tuition costs
Moving costs
Fraud or theft
Gambling losses
Other (specify)
About how large was the bill, expense, or loss of income from this event?
__________________
Was this event expected or unexpected?
Expected
Unexpected
What did you do when you were late on your payment? Select all that apply.
Made the payment in full as soon as I realized I was late
Took money from savings, investment, or a retirement account
Negotiated a lower or delayed payment
Reduced total spending in order to make payments
Spent less on necessities in order to make payments
Paid another bill late or skipped a payment for a different loan
Increased income, for example, by working overtime or taking an extra job
Worked with a professional financial coach or counselor
Sold something
Borrowed money from a different source
Other (specify)
If you borrowed money, which of the following did you do? (Select all that apply)
Pawned something
Borrowed from an IRA, 401k, or retirement account
Used a credit card
Took out or used a home equity line of credit
Took out a loan from a bank, credit union, or other financial institution
Borrowed from friends or family
Took out a payday loan
Took out an auto-title loan
Borrowed from an unlicensed lender who charges interest
Other (please specify)
If you sold something, what did you sell?
Valuables, such as jewelry or collectibles
Large possessions, such as furniture
A car or other motor vehicle you use for transport
Investment assets, such as stocks or bonds
The property where you resided
Another property you owned
Other (specify)
Thinking back to when you first took out this loan, do any of the following apply to your situation?
|
Yes |
No |
I would have been able to make the payments at the time, but something unforeseen occurred that made it difficult |
□ |
□ |
I anticipated that something would happen that would allow me to make the payments, but that didn’t happen |
□ |
□ |
In retrospect, I should have anticipated that I would not be able to make the payments |
□ |
□ |
I didn’t consider my future ability to make payments when choosing this loan |
□ |
□ |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Wilson, Eric (CFPB) |
File Modified | 0000-00-00 |
File Created | 2024-10-29 |